Title: Medical neutrality in context
Funder: Economic and Social Research Council

Abstract: Health workers today face more pressure than ever before in a number of complex conflicts, for instance in Syria and Ukraine. The population in these conflicts is unable to access healthcare, as clinics are shelled, physicians are arrested or forced to flee, medication is unavailable or unaffordable, and sometimes the trip to the doctor is simply too dangerous. Under such circumstances, a case of pneumonia is a deadly illness. Conflict zones become hotbeds of disease as cholera, polio, and other illnesses resurface that were previously eradicated from the region. The relentless refugee streams further export these healthcare risks. The breakdown of healthcare moreover has repercussions for the population long after the conflict has officially finished. It takes years to rebuild infrastructure, and train staff. Moreover, the population's health has suffered in the meantime. When they need to be at their most resilient to rebuild their country, their physical and mental health is at its weakest due to years of neglect. This research seeks to draw attention to local health workers, who bear the brunt of attacks. They are the last ones standing, when MSF and others are forced to leave. However, they are rarely topic of research. My research focuses specifically on the challenges they face in different conflict contexts. It is an interdisciplinary, comparative study focusing on the importance of the conflict context they are active in for threats on health workers and medical infrastructure. This has been singled out as an urgent research gap in our knowledge on medical neutrality, the protection of the medical sector in conflict. Taking the conflicts in Ukraine, Syria, and Egypt as the main case studies, I will answer the following questions: What strategic roles do local health workers occupy in different conflict contexts, and how does the realisation of these roles affect adherence to immunity by external actors and impartiality among health workers themselves? Under what circumstances are attacks more likely to occur, and how can threats be mitigated? This project uses a new interdisciplinary approach, drawing on social movement theory. Through this, previously unexplored activities and characteristics of local medical networks can be researched, such as their alliance-building strategies and recruitment activities. Moreover, the research project provides a more structured, in-depth study of the case studies than in previous studies on the question. In doing so, it provides some much needed answers that can inform policy making and research agendas, directly improving support for local health workers, and indirectly for the embattled local population. The project seeks to strengthen collaborative relations among policy makers and scholars, and incorporate local health networks into this fold. In doing so, it contributes to the creation of a collaborative network for knowledge exchange focused on local health workers and their patients. This will ensure the relevance of the research, and strengthen policy making with recommendations that are tailor-made for their situation. A specialized conference /workshop and at least four publications in academic journals are planned, in addition to publications specifically aimed at local health workers containing best practices. The project has furthermore a clear goal of informing the broader public of this phenomenon, in the shape of specifically targeted publications and a website. In addition, the project allows me to build crucial research skills and knowledge exchange skills. During the project, I will take courses on some of the research methods and technologies that are of increasing importance in my field, such as sophisticated data gathering systems, big data, and quantitative analysis. I will also take courses that will teach me how to better communicate interdisciplinary research projects and its outcomes to an academic audience.


Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: GENERIC HEALTH RELEVANCE