Maternity and mortality

This post was written by an anonymous Missing in the Mission blogger on July 30, 2016. The views expressed are those of the author and not of any aid organizations.
Kunduz intensive care unit

“August 2013: Files lie on a desk at the ICU of Kunduz Trauma Center. Photo: Mikhail Galustov” Source: What Was Lost in the Kunduz Hospital Attack by MSF-USA on Medium.com.

A maternity hospital we are supporting in Northwest Syria was bombed last Friday. I found out in a series of emails from colleagues Saturday morning, with links to gut wrenching news coverage. My Syrian colleagues confirmed the events with cell phone photos and videos sent through WhatsApp and Skype.

Health facilities being targeted in war zones with air strikes isn’t front-page news anymore. While I was supporting the Syrian team in Turkey last month, we had a team meeting on the 28th of June. The security update announced that in the month of June there had been 27 attacks on health centers in Syria so far—one a day. Attacks on health facilities are also not unique to the hell that is the war in Syria right now. Conservative reporting by the WHO found 57 attacks on health care in 17 countries during the 3 months between January 1 and March 31, 2016. Nor are the perpetrators of these health care attacks unique to ISIS or Islamic terrorist groups. The US Air Force attacked an MSF-supported trauma center in Kunduz, northern Afghanistan, killing 42 medical providers, patients, and their caregivers. The US and UK governments supply weapons and military support to Saudi Arabia, knowing full well that these weapons are used in airstrikes targeting health facilities in Yemen—well over 100 facilities have been hit by Saudi-led airstrikes in the past 16 months, killing an unknown number of health care-seeking civilians. In my own country, a self-professed evangelical Christian opened gunfire in the parking lot of a Planned Parenthood health care facility in Colorado Springs just last year.

These are the types of headlines that scroll across my phone on a daily basis and stir up the pit in my stomach, forcing me to come to terms with my own role on a humanitarian health team. We invest in large campaigns encouraging mothers to bring their children to the health centers on a regular basis for vaccination and nutrition screening, interventions that have been proven to save lives in the long term. Lately I wonder if we’re just putting the lives of these mothers and children in immediate danger inside health facilities that have become bulls-eyes for barrel bombs. Are our rehearsed, and too often repeated, words expressing outrage and strongly condemning these types of attacks really all that we can do as an organization? As a voting, tax-paying citizen of a country supplying weapons used for these attacks in one area, directly attacking a hospital with minimal repercussions in another area, and doing little more than wagging a finger as the entire health care system comes under attack in a third area, what is my role?

I believe the cynicism that begins to spew out of seasoned humanitarians is warranted when it results in this line of questioning. We are undoubtedly in positions of power working in a multi-billion dollar industry that actively seeks to target the world’s most vulnerable. Ethically, we should be routinely questioning our roles as individuals and as organizations and evaluating our actions against our precious humanitarian principles of humanity, neutrality, impartiality, and independence.  But when these questions regarding our role continue to go unanswered, and when donors with political agendas blur the industry’s principles, and when we start to tire of constantly cleaning up the mess of global politics, that’s when we humanitarians burn out. And right now, I’m doing all that I can in order not to burn out.

My friends back home working on the Black Lives Matter movement have been discussing how the increasing numbers of publicly blasted videos of black people being killed is not serving its purpose of holding our society accountable, rather it’s desensitizing all of us to the grave injustice of innocent life lost. I’ve seen the same happen with the coverage of international crises – one toddler washed up on a Turkish beach is compelling, a continuous flood of similar images for years is overwhelming. After supporting a humanitarian response in Yemen for a few months last year, I had to take the advice of more experienced humanitarians and do a news-sabbatical for weeks after my return to actually get the rest I needed. A friend from college recently wrote a piece for the New Yorker titled, “Racism, Stress, and Black Death” in which he writes, “For many, refusing to watch viral videos of black death is not an act of apathy. Turning off the news is not an act of indifference. Sometimes, these are acts of self-preservation.” Self-preservation is so important to all those fighting grave injustice worldwide and requires immeasurable strength to stay woke while avoiding desensitization.  Right now, I’m exerting a great deal of energy trying not to let these interminable attacks on health care become just numbers in headlines scrolling across my phone.

Perhaps this is why I welcomed the wave of emotions that crashed that morning while reading the news of the maternity hospital being attacked. The casualty numbers are low (2) and the hospital is still semi-functional as it was only the front that was hit. However, I cannot think of a more defenseless civilian target than a hospital full of women with their legs spread in the middle of labor and premature newborns learning how to breathe while lying in incubators! The perpetrators of the attack are unknown at this point** but I find it difficult to direct my anger at anyone other than the global network of politicians, journalists, militaries, etc that have allowed these attacks to continue to happen. Perhaps this anger is misdirected, but I am not a part of Assad’s regime. I am not a part of the Russian military. I am not a part of a despicable terrorist group. I will never be able to understand or manipulate their horrific actions. I am, however, a part of the global community. I am a humanitarian working in the health sector with a responsibility to reduce excess mortality and morbidity in the world’s most vulnerable communities.  I’m not ready to burn out. I’m not ready to become desensitized. So what do I do? I asked a Syrian colleague working out of Antakya, Turkey that question over Skype that next morning. He said, “We get to work, it’s not so bad. If we work hard we can keep this maternity hospital functioning.” But for how long?

**It has since been confirmed that the hospital was targeted with air strikes by the Syrian government.

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