نقش سلامتی در ایجاد صلح در مراحل مخاصمه مسلحانه با اشاره به عملکرد سازمان جهانی بهداشت

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانش‌آموخته کارشناسی ارشد حقوق بین‌الملل، دانشکده حقوق و علوم سیاسی، دانشگاه شیراز، شیراز، ایران

2 استادیار حقوق بین الملل. بخش حقوق عمومی و بین الملل، دانشکده حقوق و علوم سیاسی. دانشگاه شیراز، شیراز، ایران

10.22099/jls.2025.46564.4892

چکیده

مقدمه: عوامل مختلفی می‌توانند نقض حق بر سلامتی، تضعیف و حتی فروپاشی نظام سلامتی یک کشور را به دنبال داشته باشند که در این میان، بروز مخاصمه مسلحانه مهم‌ترین عامل محسوب می‌شود. تشدید بیماری‌ها، سوءتغذیه، تخریب زیرساخت‌ها و ساختارهای نظام سلامت و افزایش بیماری‌های روانی از مهم‌ترین آثار مخاصمات هستند. میان سلامتی و صلح به‌عنوان دو حق بنیادین بشر، رابطه‌‌ای متقابل وجود دارد. سلامتی می‌تواند نقش تأثیرگذاری در صلح‌سازی در مراحل سه‌گانه پیش، حین و پس از مخاصمه مسلحانه ایفا کند. در این میان، سازمان جهانی بهداشت ضمن درک اهمیت صلح پایدار، بر نقش ویژه پزشکان و کارکنان سلامت در ایجاد صلح، حفظ و ارتقا آن به‌عنوان مهم‌ترین عامل دستیابی به سلامت برای همه تأکید دارد. تردیدی نیست که ایجاد و حفظ صلح از راه سلامتی نیازمند رویکردی چندجانبه است که بدون مشارکت متخصصان بهداشت محقق نمی‌شود. نظام سلامت به‌عنوان پرچم‌دار درمانِ قبل از آغاز مخاصمه، حین و پس ‌از آن، تکالیفی دارد که آن‌ها را از طریق کارکنان خود به انجام می‌رساند.در رأس این نظام، سازمان جهانی بهداشت قرار دارد. سازمان جهانی بهداشت ضمن 
درک اهمیت صلح پایدار، بر نقش ویژه پزشکان و کارکنان سلامت در ایجاد صلح، حفظ و ارتقا آن به‌عنوان مهم‌ترین عامل دستیابی به سلامت برای همه تأکید دارد. این مقاله مبتنی بر یک روش توصیفی - تحلیلی به این پرسش پاسخ می‌دهد که سلامتی چه نقشی در ایجاد صلح در مراحل مخاصمه دارد و در این خصوص، سازمان جهانی بهداشت چه عملکردی داشته است؟
روش: این مقاله با روش توصیفی- تحلیلی به بررسی موضوع می‌پردازد. مطالب این مقاله با مراجعه به کتب و مقالات فارسی و انگلیسی گردآوری شده است. اسناد و گزارش‌های بین‌المللی و همچنین وب‌سایت‌ها نیز بررسی شده و مطالبی از آن‌ها استخراج شده است.
یافته‌ها: این مقاله استدلال می‌کند که به دو دلیل کلی، سلامت باید به‌عنوان محوری برای ایجاد صلح در نظر گرفته شود. نخست، خدمات اولیه بهداشتی و کیفیت اولیه بهداشت یک حق بشری است. در این مفهوم، بهبود سلامت یک هدف است. به‌ویژه برای جوامعی که توسط جنگ ویران ‌شده‌اند، ارائه خدمات پزشکی و بهداشت عمومی بهبودیافته بسیار موردنیاز و مطلوب است؛ دوم، بهبود سلامت، جزئی جدایی‌ناپذیر از دیگر عناصر ایجاد و تثبیت صلح یعنی توسعه اقتصادی، مشارکت سیاسی و پایداری جامعه است. عملاً نظام سلامت می‌تواند از رهگذر دیپلماسی سلامت و مراقبت‌های بهداشتی، نقش کلیدی در حمایت از رشته‌های بهداشت، صلح و توسعه و همچنین در تبدیل فرهنگ خشونت به فرهنگ صلح ایفا کند. حین مخاصمه نیز نقش پزشکان، پرستاران و کارکنان حوزه سلامت در کاهش یا رفع مخاصمه و نهایتاً ایجاد و تثبیت بسیار مهم است. احیا یا تقویت اعتماد ازدست‌رفته جامعه به‌ویژه از طریق عادلانه کردن روند توزیع خدمات بهداشتی و درمانی راهکار مهمی است که می‌تواند در این مرحله از مخاصمه مفید باشد. در این خصوص نظام سلامت می‌تواند با حمایت از ارسال کمک‌های بشردوستانه و مشارکت در فرایند گفتگو میان طرفین از رهگذر دیپلماسی سلامت تأثیرگذار باشد و به کاهش یا رفع مخاصمه کمک کند.
این مقاله همچنین نتیجه می‌گیرد که نظام سلامت می‌تواند ازجمله به‌وسیله ارزیابی شاخص‌های سلامت عمومی و کمک به ارائه خدمات بهداشتی به پیشگیری از مخاصمه کمک کند. اعتمادسازی میان طبقات اجتماعی، تسهیل همکاری‌های بهداشتی، بهبود برابری سلامت از طریق گفتگو بین نهادهای دولتی، بهداشتی و بشردوستانه، ترویج همکاری متقابل و کمک به بازسازی زیرساخت‌های سلامتی، اقدام‌های مهمی هستند که می‌تواند به صلح‌سازی در حین و پس از مخاصمه کمک کنند. سازمان جهانی بهداشت نیز سال‌هاست که تلاش دارد از طریق اجرای دو برنامه «سلامتی به‌عنوان پلی برای صلح» و «واکنش بشردوستانه» در مسیر دستیابی به صلح از طریق سلامتی نقش‌آفرین باشد که البته نتایج آن‌ها علی‌رغم اثربخش بودن، متغیر بوده است.
نتیجه‌گیری: به‌طورکلی، موفقیت و اثربخشی سیستم‌های بهداشتی در ایجاد صلح متغیر است. در واقع نمی‌توان در مورد میزان تأثیرگذاری برنامه‌های بهداشتی در برقراری صلح نظر قطعی داد، اگرچه شواهد حاکی از اثربخشی متغیر آن‌هاست. واقعیت این است که نگاهی به شرایط کشورهای درگیر مخاصمه نشان می‌دهد که با توجه به موقعیت‌های متفاوت آن‌ها از نظر شرایط زمان مناقشه و همچنین توانایی‌ها، ظرفیت‌ها، امکانات بهداشتی، آموزشی و مالی، اثربخشی و موفقیت برنامه‌های بهداشتی در برقراری و حفظ صلح پایدار در این سرزمین‌ها قطعاً متفاوت است.

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

The Role of Health in Peacebuilding in the Phases of Armed Conflict with Reference to the Performance of the World Health Organization

نویسندگان [English]

  • Elmira Rahmani 1
  • Aghil Mohammadi 2
1 M.A in International Law, School of Law and Political Science, Shiraz University, Shiraz, Iran
2 Assistant Professor of International Law, Department of Public and International Law, School of Law and Political Science, Shiraz University, Shiraz, Iran
چکیده [English]

Introduction
Various factors can lead to the violation of the right to health, the weakening and even the collapse of a country's health system, among which the outbreak of armed conflict is considered the most important and devastating factor. The exacerbation of diseases, widespread malnutrition, the systematic destruction of health system infrastructure and structures, and the alarming increase in mental illnesses are among the most significant and long-lasting effects of violent conflicts. As two fundamental and interdependent human rights, health and peace maintain a complex and mutually reinforcing relationship. Health can play an influential and transformative role in peacebuilding across all three critical phases: before the outbreak, during, and after the cessation of armed conflict. There is no doubt that building and maintaining sustainable peace through health initiatives requires a comprehensive, multifaceted approach 
that cannot be successfully achieved without the active participation and commitment of health professionals at all levels. The health system, as the primary institution responsible for medical treatment before, during and after the outbreak of conflict, has specific tasks and responsibilities that it must carry out through its trained personnel and established networks. This global system is coordinated and led by the World Health Organization as the preeminent international health body. This organization, while fully understanding the fundamental importance of sustainable peace for global health, consistently emphasizes the special role of doctors, nurses and other health workers in building, maintaining and promoting peace as the most important factor in achieving the goal of universal health coverage. This article systematically answers two key questions: what concrete role does health play in peacebuilding throughout different conflict phases, and what specific measures has the World Health Organization implemented in this regard?
Method
This article thoroughly examines the issue based on a rigorous descriptive-analytical method that incorporates multiple research approaches. The comprehensive content of this article has been carefully collected through extensive reference to authoritative Persian and English academic books and peer-reviewed journal articles. Relevant international legal documents and official reports from international organizations, as well as reliable institutional websites, have also been critically reviewed and analyzed, with significant content being systematically extracted from these diverse sources to ensure a balanced perspective.
Results
This article presents a compelling argument that health should be considered central and indispensable to peacebuilding efforts for two fundamental and interrelated reasons. First, access to basic health services and ensuring a minimum quality of health standards constitute an inalienable human right that must be protected in all circumstances. In this fundamental sense, improving population health represents not just a means but an essential goal in itself. Especially for societies devastated and traumatized by prolonged war, the urgent provision of improved medical and public health services is both desperately needed and morally imperative. Second, improving health outcomes serves as an integral and necessary component of other critical elements of peacebuilding and consolidation, namely sustainable economic development, meaningful political participation, and long-term societal stability. In practical terms, the health system can play a key and multifaceted role in supporting the interconnected fields of health, peace, and development, as well as in transforming the prevailing culture of violence into a sustainable culture of peace, primarily through innovative health diplomacy and equitable healthcare delivery.
During active conflict situations, the role of doctors, nurses, and frontline health workers becomes particularly crucial and challenging in efforts to reduce tensions, mitigate conflict impacts, and ultimately create conditions for stability and reconciliation. Restoring or strengthening community trust that has been severely eroded by violence, particularly through ensuring fair and impartial distribution of scarce health services, represents an important peacebuilding strategy that can be highly effective at this critical stage of conflict. In this regard, the health system can be particularly impactful by actively supporting the efficient delivery of humanitarian medical aid and participating in mediated dialogue processes between conflicting parties through health-focused diplomacy, thereby helping to reduce hostilities and resolve underlying tensions.
This article also reaches the significant conclusion that building trust between divided social groups, facilitating collaborative health partnerships, improving health equity through structured dialogue between government agencies, health providers and humanitarian organizations, promoting mutual understanding and cooperation, and helping to reconstruct damaged health infrastructure constitute important and practical measures that can substantially contribute to peacebuilding both during ongoing conflicts and in post-conflict recovery phases. The World Health Organization has also been consistently trying for many years to play a constructive role in achieving sustainable peace through health interventions, primarily through two flagship programs: the innovative "Health as a Bridge to Peace" initiative and the comprehensive "Humanitarian Response" framework, although their concrete results have shown considerable variation across different contexts, despite demonstrating significant potential effectiveness in certain situations.
Conclusions
Overall, the success and measurable effectiveness of health systems in contributing to peacebuilding has varied considerably across different conflict settings and historical periods. In reality, it is not possible to formulate a definitive or universal assessment regarding the precise extent to which specific health programs have been successful in establishing lasting peace, although substantial evidence suggests their effectiveness has been highly context-dependent and variable. The complex reality is that a careful examination of conditions in countries affected by violent conflicts clearly shows that given their vastly different situations in terms of the specific conditions prevailing at the time of conflict, as well as their varying institutional abilities, technical capacities, health system resilience, educational resources, and financial facilities, the effectiveness and long-term success of health-focused programs in establishing and maintaining sustainable peace in these troubled territories has inevitably shown significant variation and requires case-by-case evaluation.

کلیدواژه‌ها [English]

  • Health as Bridge for Peace
  • Humanitarian Response Plan
  • Stages of armed conflicts
  • World Health Organization
  • Peacebuilding
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