An introductory Q&A with the Healthcare in Conflict network
Q. How did the Healthcare in Conflict network come about?
As spaces – both in the literal and the figurative sense – of exception, conflict zones tend to create vulnerable settings, particularly for healthcare and medicine. Conflict in the 21st century increasingly focuses on the purposeful destruction and destabilisation of civil society, making non-combatants a main target. It is characterised by disregard for the rules of war, international humanitarian law and human rights. Thus, conflicts have a tremendous impact on healthcare provision and access to healthcare. Medical issues in conflict zones range from non-communicable diseases, communicable diseases, traumatic injuries, and mental health issues to issues related to maternal, women’s, and child health. The specific dynamics of each of the issues and the countless conditions they cover can be vastly different. However, the effect that humanitarian emergencies have on these medical issues is similar and the main mechanisms through which humanitarian emergencies have these detrimental effects are the same. One of the key problems that humanitarian emergencies pose is the destruction of health infrastructure, coupled with a lack of healthcare workers (HCWs) and the potential for increased physical danger to HCWs, as well as limited access to essential medicines. Some issues are further exacerbated. Humanitarian emergencies can directly cause both physical and mental injury, such as blast injuries, injuries linked to debris or inadequate shelter, gunshot wounds and post-traumatic stress disorder. Additionally, humanitarian emergencies can trigger risk factors and risk factor cascades that significantly increase the risk of communicable disease outbreaks.
To give a glimpse of the vast implications of conflict and crises resulting from conflict on health and healthcare it is worth revisiting the Rwanda crisis of 1994, which remains one of the most pivotal humanitarian crises of the last 50 years. Not only was the underlying conflict of a devastating nature but the initial response and lack of coordination also led to additional preventable deaths and in turn to an overhaul of the humanitarian system. Refugees fleeing from violence in Rwanda towards Zaire – now the Democratic Republic of the Congo – experienced extreme rates of mortality during the summer and autumn of 1994. In early July, a cholera outbreak swept through the refugee population and before the end of this outbreak a shigella dysentery outbreak compounded the situation. Estimates of mortality vary widely, but it is estimated that at the height of the crisis, between 58,000 and 80,000 persons died within the span of one month in a situation of uncoordinated humanitarian response and extremely limited healthcare access.
The result of the 1994 Rwanda (reponse) crisis has been the development of the Sphere standards and humanitarian charter, and the United Nations Cluster response system, all of which acknowledge the interdisciplinary, multi-sectoral nature of response. Similarly, threads towards healthcare in conflict are varied and response, prevention and preparedness in the context of healthcare in conflict cannot be limited to traditional epidemiological and medical concepts but have to be seen as more holistic and transdisciplinary activities that promote conditions that are less advantageous to health risks. They have to draw on disciplines as varied as medicine, epidemiology, sociology, international relations, law and others while also involving practitioners and stakeholders from all of these disciplines, civil society, military, media, healthcare and other stakeholders. Equally, the study of healthcare in conflict has to be and is interdisciplinary in nature. While this can be seen as a strength and even a necessity, this interdisciplinarity also comes with risks, especially in a setting such as Cambridge. An interdisciplinary network, open to all faculties and departments, allows us to break down barriers and explore the wide landscape of individuals and groups working on issues related to healthcare in conflict across and beyond the Cambridge ecosystem, building synergies and learning from each other to ultimately deliver both better and more integrated research as well as response.
Q. By definition, a CRASSH Research Network has an interdisciplinary question at its core. What is yours?
At the core of our network lies the question “What impact does conflict have on health and healthcare?”. This is a massive question that can be approached from almost any subject imaginable and we welcome contributions of any and all perspectives, from the arts and humanities to medicine and the natural sciences and from academics to practitioners to activists.
Q. Could you tell us a bit more about this year’s convenors, speakers and attendees and the perspectives they bring to the discussion?
The convenors of Healthcare in Conflict are both firmly rooted in academia and humanitarian practice. Their research addresses issues such as attacks on healthcare and outbreak risks in conflict settings. With backgrounds in social sciences, epidemiology and clinical medicine, we are drawing on a wide array of approaches ourselves.
Our speakers will be a mix of individuals from across Cambridge and from further afield. We are inviting both academics and practitioners, particularly those who have a foot in both worlds. If you have a suggestion for an internal (Cambridge) or external speaker, please do get in touch.
We are welcoming both casual and repeat attendees. Opening the sessions widely by adopting a hybrid format, we hope that not only regular attendees who we expect to primarily be colleagues from across Cambridge will be able to participate but also those with a specific interest in a single conflict or subject matter will be able to benefit from the sessions.
Q. What can we expect from Healthcare in Conflict in 2023-24?
We have an exciting programme planned for the upcoming academic year. Initially, we will prioritise sessions with speakers from within Cambridge to allow the formation of a true network of all researchers involved in research on healthcare in conflict across disciplines. Up to one session per term will include a guest speaker from further afield to talk on one specific aspect of healthcare in conflict. Topics will cover both different conflict settings (either a wider geographic region such as the Middle Eastern region or more narrowly, such as single country/conflict) and different aspects of healthcare in conflict (e.g. impacts of the destruction of healthcare, legal aspects of attacks against healthcare, infectious diseases in conflict sessions, search and rescue operations, methods of data collection, ideas on safeguarding healthcare measures). For Michaelmas Term, we have planned session thematic sessions on infectious disease outbreaks in conflict zones, international law and attacks against healthcare and bridging academia and practice through surge capacity building. We will kick off the network with a landscape mapping session to get a better understanding of the wide range of people in the Cambridge ecosystem working on and interested in this field.
Q. How can people learn more about your Network?
We welcome anyone and everyone to come join our network. We are an interdisciplinary group and our door is open to any members from any faculty and those outside of the university. You can find out more about us on our network page on the CRASSH website. We would love it if you considered following us on Twitter and joining our mailing list. Also, feel free to get in touch directly with either of us via email if you have questions or suggestions or would like to come to our events.
