ISLAMABAD: A new report published by the Safeguarding Health in Conflict Coalition (SHCC) says incidents of violence against or obstruction of healthcare in Pakistan more than doubled in 2022 as compared to 2021, likely reflecting the broader increase in insecurity in the country.

The US-based SHCC report released on Thursday identified 16 incidents of violence against or obstruction of healthcare in Pakistan in 2022, an increase from seven in 2021.

The report says nearly 90 per cent of these incidents involved threats and violence against polio vaccination workers, undermining healthcare providers’ ability to meet vaccination targets.

Most incidents affected local healthcare providers, with one reported as directly affecting the UN-funded INGO vaccination programme. With one exception, all the incidents were reported after polio cases were detected in April, it says.

Nearly 90pc of such incidents involved threats against polio workers

Nearly two-thirds of all incidents took place in the border areas of Khyber-Pakhtunkhwa’s southern districts. Attacks on and obstructions of healthcare were also reported in Balochistan and Sindh, but less frequently. The majority of incidents involved threats or violence against polio workers during vaccination drives or at these workers’ homes. In contrast, two incidents took place in health and dental clinics in Sindh.

Security guards or police escorts often accompany vaccination campaign staff for protection. In 2022, eight such guards were killed, 15 injured, and two kidnapped, causing panic and distress among vaccinators and patients who witnessed the attacks, ultimately disrupting the vaccination efforts.

The report, however, pointed out that the number of recorded incidents is likely lower than the actual number that occurred.

There are indications that health workers participating in vaccination campaigns often experience violence and threats every day while carrying out their work, although these incidents are usually not reported.

Vaccine hesitancy due to misinformation and disinformation in conservative rural areas, coupled with direct violence against these programmes, has caused significant setbacks in campaigns to eradicate polio. Balochistan and Khyber-Pakhtunkhwa provinces — areas that have a high level of distrust about vaccination campaigns and are considered high-priority areas during vaccination drives — are often hit by violence.

Increased violence and insecurity along the Afghan-Pakistan border regions and the resurgence of Tehreek-i-Taliban Pakistan (TTP) attacks impacted polio vaccination campaigns in 2022.

In April, after a 15-month period of no reported polio outbreaks, a new case was detected in the violence-hit North Waziristan district on the Afghan border, a high-priority vaccination campaign area.

By the end of 2022, the highly infectious wild poliovirus had paralysed 20 children, leading to an increase in vaccination drives and a subsequent uptick in violence against these programmes.

Health services were impacted by catastrophic floods and landslides during the June-October monsoon period. These natural disasters damaged health facilities, displaced staff, and disrupted a nationwide polio vaccination campaign organised in August.

The report says 2022 marked the most violent year against health workers and facilities in conflicts in the last decade, documenting 1,989 attacks and threats against healthcare facilities and personnel across 32 countries and territories in armed conflict and situations of political violence.

The report figure represents the most severe year of attacks against healthcare in the last decade globally.

Over half of all the attacks were reported in just two countries, Ukraine and Myanmar. The report claims that more than 750 attacks were perpetrated by Russia on healthcare in Ukraine alone — the most committed in a single year in one country.

According to the report, incidents increased by 45 per cent in 2022 compared to 2021 and marked the highest annual number of incidents that the SHCC has recorded since it began tracking such violence.

Vaccination campaigns frequently came under attacks in Afghanistan and Pakistan, but were also subjected to violence in Mali, Nigeria, South Sudan, and Sudan.

In 2022, at least 704 incidents were reported of health facilities being damaged or destroyed in 25 countries and territories, including 468 in Ukraine, 45 in Myanmar, 29 in Congo, 12 each in Yemen and Syria, and 11 in Sudan. The looting of health facilities, medicines, supplies, and ambulances was common in conflicts throughout the world and was reported in 17 countries, including 104 in Ukraine, 33 in Congo, 30 in Myanmar, and 15 in Burkina Faso.

Published in Dawn, June 3rd, 2023