Since the onset of hostilities on 7 October 2023, a staggering 47% of the recorded attacks on health care in Lebanon – amounting to 65 incidents out of 137 – have resulted in the tragic loss of at least one health worker or patient, with the figures being updated as of 21 November 2024.
This alarming percentage eclipses those of any current conflict zones worldwide, highlighting that nearly half of all assaults on health care provide fatal outcomes for medical personnel and their patients.
To put this into perspective, the global average stands at a mere 13.3%, drawn from data across 13 countries or territories reporting such violence from 7 October 2023 – 18 November 2024, including regions like Ukraine, Sudan, and the occupied Palestinian territory (oPt). Notably, in the case of oPt, 9.6% of all reported incidents have culminated in fatalities involving at least one medical professional or patient.
Between the dates of 7 October 2023 and 18 November 2024, a total of 226 health professionals and patients lost their lives in Lebanon, while 199 more sustained injuries, adding to the grim toll of these violent encounters.
A staggering total of 1401 attacks on health were recorded in the oPt, Lebanon, and Israel during the same timeframe, comprising 1196 in oPt, 137 in Lebanon, and 68 in Israel.
Civilian health care has special protection
“These figures illustrate a deeply troubling trend. It is abundantly clear – obstructing civilians from accessing critical care and targeting health professionals constitutes a flagrant violation of international humanitarian law. Such laws prohibit the militarization of health facilities; even if health infrastructures are misused for military objectives, stringent protocols must be followed, which include a mandatory warning and a waiting period post-warning,” stated WHO Representative in Lebanon, Dr. Abdinasir Abubakar.
International humanitarian law unequivocally stipulates that health workers and facilities are to be safeguarded during armed conflicts, ensuring they are never subjected to attacks. Furthermore, health facilities are expressly forbidden from being utilized for military purposes, underscoring the need for accountability regarding any misuse of these essential resources.
“It is imperative to enact consequences for violations of international law; adherence to the principles of caution, distinction, and proportionality is essential. It has been reiterated that indiscriminate assaults on health care represent a violation of human rights and international law that cannot be normalized—whether in Gaza, Lebanon, or elsewhere,” emphasized WHO Regional Director for the Eastern Mediterranean, Dr. Hanan Balkhy.
The majority of incidents in Lebanon impact health workers
The overwhelming majority (68%) of incidents reported in Lebanon by the SSA have adversely affected health personnel, a distressing pattern that has persisted over recent years, similar to the situation experienced in Gaza last year. In Lebanon, approximately 63% of these incidents impacted health transport, while 26% targeted health facilities.
Attacks on health care inflict damage in two profound ways. First, there is the immediate tragedy when health workers lose their lives or when a health center is decimated. The second wave of impact ripples through the subsequent weeks and months, as the injured remain untreated, those needing regular care are deprived of it, and children miss critical immunizations.
“The casualty figures among health workers of this magnitude would incapacitate any nation, not solely Lebanon. However, the numbers alone fail to convey the long-term ramifications of these attacks: the missed treatments for various health conditions, women and girls being denied access to maternal, sexual, and reproductive health services, unrecognized treatable diseases, and, ultimately, the lives lost due to the lack of health care availability. That is the profound impact that remains challenging to quantify,” expressed Dr. Abubakar.
1 in 10 hospitals in Lebanon directly impacted
The greater the toll taken on the health workforce, the weaker a nation’s ability to rebound from a crisis and provide health care in a post-conflict landscape.
Lebanon, classified as a lower middle-income country, has an advanced health system that faces severe strain from multiple crises over recent years. Following the escalation of hostilities in September 2024, the increased frequency of attacks on health care has further destabilized an already overwhelmed system.
Currently, the health system in Lebanon is under intense pressure, with 15 out of 153 hospitals either completely closed or only partially operational. In Nabatieh, one of Lebanon’s eight governorates, a shocking 40% of the hospital bed capacity has been rendered unavailable.
“The magnitude of these attacks on health care cripples a health system when those who rely on it most urgently need its services. Beyond the immediate loss of life, the fatalities among health workers signify a loss of precious investment in human resources essential for the sustainability of a fragile nation moving forward,” Dr. Balkhy concluded.
To date, between 1 January 2024 and 18 November 2024, a total of 1246 attacks on health care have been recorded globally across 13 countries or territories, resulting in the deaths of 730 health workers and patients and injuring 1255.
Note to editors
The Surveillance System for Attacks on Health Care (SSA) was established by the World Health Organization in 2017 as an independent global monitoring mechanism with the objective of gathering reliable data on attacks against health care. This initiative aims to identify patterns of violence that can inform risk reduction and enhance resilience measures, ensuring healthcare is safeguarded. The SSA also serves as a vital source of evidence for advocacy against such attacks on health care.
What measures can be taken to improve the safety of health workers in Lebanon amidst ongoing conflict and increasing violence against healthcare facilities?
**Interview with Dr. Abdinasir Abubakar, WHO Representative in Lebanon**
**Interviewer:** Dr. Abubakar, thank you for speaking with us today. The statistics regarding attacks on health care in Lebanon since October 7, 2023, are quite alarming. Can you elaborate on the specific challenges health workers are facing in these violent encounters?
**Dr. Abubakar:** Thank you for having me. Indeed, the data we’ve observed highlights an extraordinarily troubling trend. Since the onset of hostilities, we see that 47% of attacks on health care have resulted in fatalities among health workers or patients. This figure is significantly higher than the global average of 13.3%. The overwhelming majority of these attacks, specifically 68%, have adversely affected health personnel, and critically, 63% targeted health transport. These trends not only endanger lives but fundamentally undermine the health system’s ability to provide care when it is needed most.
**Interviewer:** That’s devastating. Could you explain why the attacks on health care are treated with such urgency under international law?
**Dr. Abubakar:** International humanitarian law is clear: health workers and facilities must be protected during armed conflicts. Attacking health care is not merely a breach of ethical standards; it constitutes a violation of international law. This includes the necessity to warn before military actions that might affect health facilities, along with a waiting period. Such protocols are in place to bolster the sanctity of health care, which must remain impartial and accessible to all civilians.
**Interviewer:** The impact of these attacks seems to be far-reaching. What are some of the long-term consequences for public health in Lebanon?
**Dr. Abubakar:** The immediate loss of life is only one aspect. Beyond that, we face severe long-term repercussions. Patients with chronic conditions miss their treatments, maternal health services are compromised, and critical immunizations for children are delayed. This cascade effect creates a public health crisis that can lead to preventable diseases and deaths, further destabilizing an already fragile health care system. It’s essential we recognize that these numbers represent human lives—lives that cannot be accounted for easily but are forever impacted by this violence.
**Interviewer:** Given the scale of violence, what can be done to safeguard health workers and infrastructure moving forward?
**Dr. Abubakar:** Implementing and enforcing international humanitarian standards is critical. We must see accountability for those who violate these laws. Furthermore, the global community needs to raise its voice against these violations consistently. We must advocate for immediate action to protect health workers and to restore the vital functions of health care systems affected by conflict. The commitment must be to uphold the principles of caution and proportionality regarding civilian health care, not only in Lebanon but everywhere conflicts are affecting access to care.
**Interviewer:** Thank you, Dr. Abubakar, for sharing these insights. It’s crucial to continue emphasizing the importance of protecting health care in conflict zones.
**Dr. Abubakar:** Thank you for highlighting this urgent issue. Awareness and advocacy are fundamental to driving the necessary changes we need to protect lives and uphold health care standards under any circumstances.