title: Health care workers in danger zones: a special report on safety and security in a changing environment.
abstract: BACKGROUND
  Violence against humanitarian health care workers and facilities in situations of armed conflict is a serious humanitarian problem. Targeting health care workers and destroying or looting medical facilities directly or indirectly impacts the delivery of emergency and life-saving medical assistance, often at a time when it is most needed.
  
  
  OBJECTIVE
  Attacks may be intentional or unintentional and can take a range of forms from road blockades and check points which delay or block transport, to the direct targeting of hospitals, attacks against medical personnel, suppliers, patients, and armed entry into health facilities. Lack of access to vital health care services weakens the entire health system and exacerbates existing vulnerabilities, particularly among communities of women, children, the elderly, and the disabled, or anyone else in need of urgent or chronic care. Health care workers, especially local workers, are often the target.
  
  
  METHODS
  This report reviews the work being spearheaded by the Red Cross and Red Crescent Movement on the Health Care in Danger initiative, which aims to strengthen the protections for health care workers and facilities in armed conflicts and ensure safe access for patients. This includes a review of internal reports generated from the expert workshops on a number of topics as well as a number of public sources documenting innovative coping mechanisms adopted by National Red Cross and Red Crescent Societies. The work of other organizations is also briefly examined. This is followed by a review of security mechanisms within the humanitarian sector to ensure the safety and security of health care personnel operating in armed conflicts.
  
  
  RESULTS
  From the existing literature, a number of gaps have been identified with current security frameworks that need to be addressed to improve the safety of health care workers and ensure the protection and access of vulnerable populations requiring assistance. A way forward for policy, research, and practice is proposed for consideration.
  
  
  CONCLUSIONS
  While there is work being done to improve conditions for health care personnel and patients, there need to be concerted actions to stigmatize attacks against workers, facilities, and patients to protect the neutrality of the medical mission.
authors.affiliation: 1Department of Family Medicine,McMaster University,Hamilton,Ontario,Canada.
authors.forename: Lynda J
authors.initials: LJ
authors.lastname: Redwood-Campbell
authors.affiliation: 2Canadian Red Cross,Ottawa,Ontario,Canada.
authors.forename: Sharonya N
authors.initials: SN
authors.lastname: Sekhar
authors.affiliation: 2Canadian Red Cross,Ottawa,Ontario,Canada.
authors.forename: Christine R
authors.initials: CR
authors.lastname: Persaud
mesh_terms: D003695:Delivery of Health Care; D014943:Global Health; D006268:Health Facilities; D006282:Health Personnel; D006801:Humans; D060051:Occupational Injuries / Q000517:prevention & control*; D012011:Red Cross; D012449:Safety; D014857:Warfare