“It is because of the love for the job that we are still here”: Mental health and psychosocial support among health care workers affected by attacks in the Northwest and Southwest regions of Cameroon

Chandini, Moustapha Aliyou; Van den Bergh, Rafael; Agbor Junior, Agbor Ayuk; Willliam, Farnyu; Obi, Agnes Mbiaya Mbeng; Ngeha, Ngu Claudia; Karimu, Ismaila; Douba, Emmanuel Christian Epee; Kim, Hyo-Jeong; Tendongfor, Nicholas

doi:10.1371/journal.pgph.0002422

Cited by 2 publications

(1 citation statement)

References 24 publications

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“…Evidence from other settings confronted with attacks on health care suggests the considerable mental health burden resulting from such violence [ 27 – 32 ]. The burden of high-impact attacks documented here and elsewhere [ 18 ], combined with the occurrence of particularly traumatising events such as so-called “double tap” attacks [ 33 ], is likely to have contributed considerably to the high rates of absenteeism and health workforce turnover identified in different areas of Ukraine throughout the conflict [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Typology and implications of verified attacks on health care in Ukraine in the first 18 months of war

Kim,

Bruni,

Gorodetska

et al. 2024

PLOS Glob Public Health

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Attacks on health care are part of the spectrum of threats that health care endures during conflict. Protecting health care services against attacks depends on understanding the nature and types of attacks that occur during conflict. The World Health Organisation has implemented the Surveillance System for Attacks on Health Care (SSA) in Ukraine since 2020, and the system has continued to monitor and report on attacks on health care during the war in Ukraine. This study aims to analyse the data reported through the SSA for the first 18 months of the war. This paper involves a retrospective, descriptive study based on the analysis of publicly available SSA data of all incidents of attacks on health care in Ukraine reported through the SSA between February 24th 2022 and August 24th 2023. Out of the 1503 verified attacks, 37% occurred in the initial six weeks of the war. Attacks involving violence with heavy weapons were among the most common incidents reported (83%). The reported attacks were associated with a total of 113 deaths and 211 injuries among health care workers and patients: 32 (2%) attacks were associated with a death of a health care worker or patient, and 63 (4%) were associated with an injury. Health transports facing attacks had a higher probability of experiencing casualties than other health resources (p<0.0001, RR 3.1, 95%CI 1.9–4.9). In conclusion, the burden of attacks on health care in Ukraine was high and sustained over the course of the first 18 months of the war. Reported casualties were not homogenously distributed among attack incidents, but occurred in a set of high-casualty incidents. Health transports were found to be particularly vulnerable. In addition to continued calls for a cessation of hostilities, prevention, protection, mitigation, and reconstruction strategies are urgently required.

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Section: Discussionmentioning

confidence: 99%

Typology and implications of verified attacks on health care in Ukraine in the first 18 months of war

Kim,

Bruni,

Gorodetska

et al. 2024

PLOS Glob Public Health

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“It's normal to be afraid”: attacks on healthcare in Ouaka, Haute-Kotto, and Vakaga prefectures of the Central African Republic, 2016–2020

Kostandova,

OKeeffe,

Ali

et al. 2024

Confl Health

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Introduction Attacks on healthcare have further weakened the already fragile health system in the Central African Republic. We investigated attacks on healthcare in three conflict-affected prefectures—Ouaka, Haute-Kotto, and Vakaga—from 2016 to 2020. The study aim was to gain an in-depth understanding of the immediate and long-term effects of attacks on healthcare workers, facilities, supply chain, quality of care, and other components of the health system. We provide a qualitative description of the incidents, assess their impacts, identify mitigation efforts, and discuss challenges to recovery. Methods We used purposive and snowball sampling to identify participants in the study. Semi-structured key informant interviews were conducted with administrative and health authorities, front-line personnel, and staff of non-governmental organizations. Interviews were done in Sango, French, or English. Recorded interviews were transcribed and notes taken for non-recorded interviews. Transcripts and notes were analyzed using inductive coding, allowing participant responses to guide findings. Results Of 126 attacks identified over the study period, 36 key informants discussed 39 attacks. Attacks included killings, physical and sexual assault, abductions, arson, shelling with grenades, pillage, occupations, and verbal threats. The violence led to extended closures and debilitating shortages in healthcare services, disproportionately affecting vulnerable populations, such as children under five, or people who are elderly, chronically ill, or displaced. Healthcare workers faced psychological trauma and moral injury from repeated attacks and the inability to provide adequate care. Personnel and communities made enormous efforts to mitigate impacts, and advocate for assistance. They were limited by failed reporting mechanisms, ongoing insecurity, persistent lack of resources and external support. Conclusion Effective strategies to safeguard healthcare from violence exist but better support for communities and health workers is essential, including measures to assess needs, enhance security, and facilitate recovery by quickly rebuilding, resupplying, and re-staffing facilities. CAR’s government, international organizations, and donors should make concerted efforts to improve reporting mechanisms and end impunity for perpetrators. Their investment in community organizations and long-term health system support, especially for health worker training, salaries, and psychosocial care, are vital steps towards building resilience against and mitigating the impacts of attacks on healthcare.

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“It is because of the love for the job that we are still here”: Mental health and psychosocial support among health care workers affected by attacks in the Northwest and Southwest regions of Cameroon

Cited by 2 publications

References 24 publications

Typology and implications of verified attacks on health care in Ukraine in the first 18 months of war

Typology and implications of verified attacks on health care in Ukraine in the first 18 months of war

“It's normal to be afraid”: attacks on healthcare in Ouaka, Haute-Kotto, and Vakaga prefectures of the Central African Republic, 2016–2020

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