Armed Conflict and Health

Currently, several states in India are ridden with low-intensity conflicts. The state of Jammu and Kashmir, the states in the North East and recently Chhattisgarh have been witnessing an extremely complex insurgency as well as several years of civil strife. There is limited documentation or study of the effects on the health and the health system and the challenges of the health system in responding. Violence against women in such contexts is often not recognised but rather it is systematic used as tool by the state – police and army- as well as the militants or insurgents to silence and terrorize communities.

For the past four years, CEHAT has been engaging with various organizations as well as the State in an effort to address violence in conflict and facilitate an understanding and recognition of it as a public-health issue. The first consultation was held in Srinagar, in collaboration with the J&K State Commission for Women in September 2009, which threw up the need to conduct training programs with health care providers so that they may be able to recognize and respond to the effects of violence specifically against women. Subsequently, in December 2010 and April 2011 training initiatives were organized in Delhi and Mumbai with participants together from different states in the country, including Jammu and Kashmir, Manipur, Jharkhand, Chhattisgarh and Maharashtra to engage with the issue of violence in conflict situations. As part of future planning, the participants of these trainings identified a need to form a group of health professionals that will work towards addressing issues that emerged, such as initiating counseling services, training of health care providers on the issue of VAW and training for conducting autopsy and act as a lobby to provide protection to health professionals from external pressures/politics. They would form a critical mass for bringing about the required changes in the system for sensitising it and for raising the issue of right to health care in armed conflict.

CEHAT was also part of the symposium held by Women Against Sexual Violence and State Repression (WSS) which highlighted the need to develop protocols that would include sexual assault examinations as part of autopsies in areas of conflict, developing a protocol for investigating cases of custodial rape, training of health professionals as well as the police and judiciary to understand the limitations of medical evidence, evolving a way to enable unbiased investigation of cases of sexual assault specific problems related to chain of custody and neutrality of health professionals in situations of conflict.

Currently, CEHAT is in the process of conducting a study the public health profile in conflict regions of Chhattisgarh in collaboration with local health organizations. This study will look at status of the health system in these areas and the effect of violence on the system and document the experiences and difficulties faced by healthcare providers in working in these areas.

Period of Project January 2009 onwards

Supported by Ford Foundation, Tata Social Welfare Trust

Team Siddarth David, Sana Contractor, Padma Deosthali, Zamrooda Khanday, Yavnika Tanwar