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Saving healthcare workers in warzone through spatial and blockchain technology

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And yet the helicopters come. The chop-chop of their blades causes panic every time. And the barrel bombs continue to rain down, on our homes, on our schools and our hospitals, often at a rate as high as 50 per day. Why do I stay? Because it would be strange not to: this is my city. People are being killed every day. It is my duty – Dr. Abdel, Aleppo

The last operating hospital in east Aleppo, Syria has been destroyed by airstrikes, leaving up to 250,000 residents without access to surgery or specialist care, and rebel-held districts at the point of collapse.

More than three-quarters of Syrian doctors have fled since 2011. Those that remain have chosen to stay to serve, believing it their duty to save lives, even though it means risking theirs as hospitals are targets of daily airstrikes. Many of those that remain do not have the training they need. Dentists are performing surgeries, vets are treating cases of malnutrition and young volunteers are trained as anaesthesiologists. In 2014 and 2015, the World Health Organisation (WHO) estimated there were 594 attacks in 19 countries, with 959 deaths and 1561 injuries. Whether in Syria, Afghanistan, South Sudan or Yemen, an attack on health facilities anywhere undermines the whole global community. Condemnation of such attacks has been widespread in humanitarian and health sectors, from Médecins Sans Frontières (MSF) through to the United Nations (UN).

On May 3, 2016, the UN Security Council passed Resolution 2286, strongly condemning attacks against medical facilities and medical personnel in conflict. This Resolution demanded an end to impunity for those responsible for attacks against hospitals and respect for international humanitarian and human rights law on the part of all warring parties. After the Resolution’s adoption, United Nations Secretary-General Ban Ki-moon said, “Even wars have rules.”

Since then, there have been over 73 attacks on hospitals in Syria.

The agony is – the contrast of condemning by means of laws and adhering to the laws has taken most of the precious lives. The bullet has no names – military or militant – the causalities are always common people.

A map of attacks on health care in Syria, produced by Physicians for Human Rights gives a detailed overview.

So what can be done, and could better use of technology play a greater role? What technologies could assist?

The most obvious are spatially technologies. In an epoch of smart phones, each of which can take a photo that can carry a precise geocode, there are surely no technical barriers to geocoding location of all health care facilities. This information could then be mapped, and made available either widely to the public, or to a restricted group. The bombing of targets in war relies on such precision, and can as easily be used to avoid particular targets. Mapping using GIS software is already an established tool in humanitarian needs assessment and emergency response.

If this is in place, accused side could not argue that such attacks were not deliberate when faced with evidence of such attacks. Currently, accused do argue that such attacks were ‘accidental’, unforeseeable or that some other party was responsible. That latter explanation would still be possible, but could be tested through data available from military and intelligence sources.

There may be a role for emerging technologies too. For example, the simple promise of new Blockchain technology is that it ‘allows people that don’t trust each other, to trust each other’. Blockchain technology is the innovation behind Bitcoin. It has the potential to disrupt many industries by making processes more democratic, secure, transparent and efficient, and is currently approaching the peak of its hype cycle.

The CRC for Spatial Information (CRCSI) hosted a Student Day Solvathon, which focused on Blockchains in spatial technology. 20 PhD students thought creatively about how Blockchain technology could be applied. One of the initiatives they created was Blockchain technology in health care:

A systematic solution to the problem of hospital attacks could be one which provides transparent, decentralized, immutable, publicly available records of humanitarian activity used to visualize the location of verified humanitarian facilities. The decentralised nature of a blockchain could allow untrusting involved parties to agree or trust the validity of information. Records can be immutable and transparent, so there would be traceability and increased accountability. If this platform was augmented with crowdsourced data, there could be continuous verification from multiple sources agreeing or converging on the location of a hospital. In essence, this would be decentralising and democratising humanitarian map data in conflict zones to support policy makers, governments, negotiators, experts in international relations and law (UN, WHO) and humanitarian organisations (MSF, Red Cross/Red Crescent).

The effects of the attacks against health facilities emanate far beyond those immediately killed and injured. They demolish routine and lifesaving healthcare for all. One doctor can save hundreds of  lives… Physicians take an oath when joining the medical profession – they treat every individual, regardless of who they are, regardless of their religion, their race, or on which side they may fight. Even if they are wounded combatants, or if they are labelled as criminals or terrorists.