A/68/297
35. Due to the depletion of resources, exodus of doctors and health-care personnel
and attacks on health-care workers, 40 countries and areas in post-conflict situations
may be dependent on international donors and initiatives by non-governmental and
intergovernmental organizations for the reconstruction of their health systems. Such
health initiatives can be used as a tool for peacebuilding. 41 International aid
agencies have used such strategies to break through ethnic divides, thereby
increasing the availability and accessibility of health facilities, goods and services
and reducing discrimination. 42 To ensure acceptability and accessibility of health
services, international aid providers should also be cognizant of the culture of
countries and communities. For example, in some countries, provision of health
services to pregnant women by male doctors may not be culturally acceptable and
may thus impede accessibility. 43
36. Sustainability of donor-aided policies and initiatives is essential for ensuring
long-term availability and accessibility of quality health facilities, goods and
services in countries recovering from conflict. Ensuring participation and ownership
in all phases of decision-making processes by the affected population is essential for
the success and sustainability of donor-aided reconstruction of the health system. 44
Such health initiatives could be successful through continuous collaboration and
cooperation with the local population, and by sharing technical know-how with
them. An understanding of political realities, especially in areas of protracted
conflict and transitioning societies is equally important to ensure sustainability of
donor-aided initiatives. 45
IV. Vulnerable groups
37. States should give particular attention to persons rendered vulnerable by
conflict, such as women, children, older persons, people with disabilities and
displaced communities. This requires States to address marginalization arising from
social, political and economic exclusion; discrimination against persons belonging
to or perceived to belong to a specific community; vulnerability due to ill-health;
and conflict strategies that deliberately render certain communities vulnerable.
These factors, individually or in combination, may expose certain groups to multiple
vulnerabilities and an increased risk of violation of their right to health.
Recognizing the diverse vulnerabilities in different communities and empowering
them to participate in all decision-making processes that affect their health enable
States to fulfil their obligation under the right to health during conflict and also
promotes a sustainable recovery from conflict.
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41
42
43
44
45
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ICRC, “Health care in danger: making the case” (Geneva, 2012), p. 6.
MacQueen and Santa-Barbara, “Peace building through health initiatives”, p. 293.
WHO Regional Office for Europe/Department for International Development (United Kingdom),
“WHO/DFID peace through health programme: a case study prepared by the WHO field team in
Bosnia and Herzegovina”, document EUR/ICP/CORD 03 05 01 (Copenhagen, September 1998).
Rita Giacaman, Hanan F. Abdul-Rahim and Laura Wick, “Health sector reform in the Occupied
Palestinian Territories: targeting the forest or the trees?” Health Policy Plan, vol. 18, No. 1
(March 2003), p. 59.
Nelson Martins and others, “Reconstructing tuberculosis services after major conflict:
experiences and lessons learned in East Timor”, PLOS Medicine, vol. 3, No. 10 (October 2006),
pp. 1765-1775.
Ibid.; Giacaman, Abdul-Rahim and Wick, “Health sector reform in the Occupied Palestinian
Territories”, p. 10.
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