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Ana Elisa Barbar

Adviser to Health Policy and Operations

International Committee of the Red Cross

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A “humanitarian” approach

  • Challenges to deliver (with quality!)
  • Challenges to ensure continuity
  • Challenges in the environment

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Bringing the context to the discussion

  • What is the physical condition of the place of care?
  • What is going on outside of the place of care?
  • Is it safe to come to the place of care?
  • Is it safe to remain at that site?
  • Is there a trustful relationship between health personnel and patients?

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Why discuss violence when talking about patient safety and preventing avoidable harm?

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Policies, capacity-building, procedures, systems

Implementation of better protocols, research

Culture of learning and respect, accountability

A harmful act on itself

and

a disruptive element to the whole cycle

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Layers of violence

  • Dissatisfaction, lack of trust (direct connection with quality and safety)
  • Cultural and communication gaps
  • Free circulation of weapons
  • Criminal acts
  • Intentional targeting

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  • Not the FULL responsibility of health systems, but it’s the health system who bears the burden!
  • Different strategies to prevent risks and mitigate consequences

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What can be done (few examples)

  • Work hard on quality of care, bringing it to the highest achievable standards
  • Include the communities and patients in decisions about pathways of care, placement of facilities, functioning of services, etc
  • Ensure compliance to medical ethics, and build capacity on communication and inter-cultural skills
  • Advocate widely and constantly against attacks and blockages: Health care should remain free from violence everywhere!
  • Encourage, steer and promote legislation and policy frameworks that are protective of healthcare
  • Reinforce structure of health facilities if/when needed

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Key messages

  • Not a conversation about fear or about making peace
    • Ethics, trust, satisfaction, wellbeing and respect, contingency measures, protective laws and frameworks
    • Healthcare should be free from violence, regardless of the context

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  • Missing element in health responses, and should be considered beyond humanitarian and emergency settings
    • Voice of patients and communities is essential

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  • Safety without security is still an incomplete puzzle!

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Thank you!���Visit the website www.healthcareindanger.org�

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