Interstate armed conflict, characterised by violent confrontations between states, has far-reaching consequences that extend beyond the immediate battlefield. Among the most profoundly affected sectors is the patient care industry, which encompasses hospitals, clinics, and other healthcare facilities. The intersection of warfare and healthcare presents unique challenges that require an in-depth understanding of the issues at hand. This article explores the impact of interstate armed conflict on the patient care industry, detailing the challenges faced by healthcare providers, the strategies employed to mitigate these challenges, and the role of international organisations in supporting healthcare systems during times of conflict.

Disruption of healthcare services

Infrastructure Damage

One of the most immediate and visible impacts of interstate armed conflict on the patient care industry is the damage to healthcare infrastructure. Hospitals, clinics, and other medical facilities often become collateral damage during conflicts. The destruction of buildings and medical equipment severely limits the capacity of healthcare providers to deliver essential services.

For instance, the Syrian Civil War, which began in 2011, has resulted in the extensive destruction of the country’s healthcare infrastructure. According to the World Health Organization (WHO), more than half of Syria’s public hospitals were either partially functioning or completely out of service as of 2017. This has left millions without access to adequate healthcare, exacerbating the humanitarian crisis.

Workforce shortages

Interstate armed conflicts frequently lead to a significant reduction in the healthcare workforce. Medical professionals may be displaced, injured, or killed, and many flee conflict zones to seek safety. This exodus of healthcare workers creates severe shortages in areas where they are most needed.

During the conflict in Yemen, which escalated in 2015, thousands of healthcare workers were forced to flee their posts. The resulting shortage has made it exceedingly difficult to provide care to the population, particularly as the conflict has led to widespread outbreaks of diseases such as cholera and diphtheria.

Supply chain disruptions

Medical Supplies and Equipment

The patient care industry relies heavily on a steady supply of medical equipment and pharmaceuticals. Interstate armed conflicts disrupt these supply chains, making it challenging to procure necessary supplies. Ports, roads, and airports may be damaged or blocked, and international sanctions can further complicate the importation of medical goods.

For example, during the Iraq War (2003-2011), sanctions and ongoing conflict led to severe shortages of essential medical supplies. Hospitals struggled to obtain basic items such as bandages, syringes, and antibiotics, severely hampering their ability to treat patients effectively.

Humanitarian Aid Obstacles

Humanitarian aid is crucial for maintaining healthcare services in conflict zones, but delivering this aid is fraught with challenges. Armed conflict can make it dangerous or impossible for aid organisations to reach affected areas. Additionally, warring parties may restrict or manipulate the distribution of aid for strategic purposes.

In the ongoing conflict in South Sudan, humanitarian organisations have faced significant obstacles in delivering medical aid. Both government forces and rebel groups have blocked access to certain areas, and aid workers have been targeted in attacks, making it perilous to provide the necessary support to healthcare facilities.

Health impacts on the population

Physical Injuries and Trauma

Interstate armed conflicts lead to an increase in physical injuries and trauma, putting immense pressure on the patient care industry. Injuries from gunfire, explosions, and other combat-related incidents require immediate and often complex medical attention. Hospitals in conflict zones must rapidly adapt to the influx of trauma patients, which can overwhelm their capacity.

The conflict in Ukraine, which began in 2014, has resulted in thousands of casualties requiring medical treatment for injuries sustained in fighting. Ukrainian hospitals, particularly those near conflict zones, have had to develop specialised trauma care units to manage the high volume of patients.

Mental Health Issues

The psychological toll of armed conflict on populations is profound. Civilians and combatants alike experience high levels of stress, anxiety, and post-traumatic stress disorder (PTSD). The patient care industry must address these mental health issues, which are often exacerbated by the lack of resources and infrastructure.

In Afghanistan, decades of conflict have led to a mental health crisis. The WHO has reported that up to two-thirds of the Afghan population suffer from mental health problems, yet the country has very few mental health professionals and limited facilities to provide care.

Adaptation and resilience strategies

Mobile Clinics and Field Hospitals

In response to the destruction of fixed healthcare facilities, mobile clinics and field hospitals have become vital in providing medical care during armed conflicts. These units can be rapidly deployed and set up in areas where traditional healthcare infrastructure has been destroyed or is inaccessible.

During the conflict in the Democratic Republic of the Congo, mobile clinics have been essential in delivering healthcare to remote and conflict-affected regions. These clinics provide a range of services, including primary care, maternal and child health services, and emergency care, helping to mitigate the impact of the conflict on the civilian population.

Training and Support for Local Healthcare Workers

Building the capacity of local healthcare workers is crucial for sustaining healthcare services during and after conflicts. International organisations and non-governmental organisations (NGOs) often provide training and support to local medical staff to enhance their skills and ensure continuity of care.

For example, the International Committee of the Red Cross (ICRC) has implemented training programmes for healthcare workers in conflict zones around the world. These programmes focus on emergency medical care, trauma surgery, and the management of mass casualties, equipping local staff with the skills needed to handle the challenges of conflict situations.

Role of international organisations

World Health Organization (WHO)

The WHO plays a critical role in coordinating international health responses to armed conflicts. It provides technical assistance, supplies, and funding to support healthcare systems in conflict-affected areas. The WHO also works to monitor and address public health threats that arise during conflicts, such as disease outbreaks.

In Yemen, the WHO has been instrumental in responding to the cholera outbreak that has plagued the country since 2016. The organisation has provided medical supplies, established treatment centres, and supported vaccination campaigns to control the spread of the disease.

Médecins Sans Frontières (MSF)

Médecins Sans Frontières, also known as Doctors Without Borders, is renowned for its work in conflict zones. MSF provides emergency medical care, runs hospitals and clinics, and offers mental health support in some of the most dangerous and difficult-to-reach areas of the world.

In Syria, MSF has operated numerous medical facilities and mobile clinics, providing critical care to those affected by the conflict. Despite the risks, MSF teams continue to deliver healthcare services, demonstrating the organisation’s commitment to helping those in need during times of war.


Interstate armed conflicts pose significant challenges to the patient care industry, affecting everything from infrastructure and supply chains to workforce availability and population health. The destruction of healthcare facilities, shortages of medical supplies, and displacement of healthcare workers severely hinder the ability to provide adequate care. Additionally, the physical and mental health impacts on the population create a substantial burden on the healthcare system.

However, through adaptation and resilience strategies, such as the deployment of mobile clinics and the training of local healthcare workers, the patient care industry can continue to function, even under the most challenging circumstances. International organisations like the WHO and MSF play a crucial role in supporting healthcare systems during conflicts, providing the necessary resources and expertise to maintain essential services.

As the nature of armed conflict evolves, it is imperative that the patient care industry remains adaptable and resilient. By learning from past conflicts and continuing to innovate in the face of adversity, healthcare providers can better prepare for and respond to the challenges posed by interstate armed conflict, ensuring that even in times of war, the health and well-being of populations are prioritised.