Violence-related mortality and morbidity of humanitarian workers

Elizabeth A. Rowley, MIA, MHS, Byron L. Crape, PhD, Gilbert M. Burnham, MD, PhD


Objectives: (1) To determine the rate of violencerelated deaths, medical evacuations, and hospitalizations occurring to national and expatriate staff of participating humanitarian organizations; (2) to describe the distribution of all-cause and causespecific mortality and morbidity of humanitarian workers with regard to possible risk factors.
Design: Surveillance study of field-based humanitarian workers; data were regularly collected from headquarters of participating organizations via e-mail and telephone between September 2002 and December 2005.
Participants: Eighteen humanitarian organizations reported on any death, medical evacuation, or hospitalization of any national or expatriate staff, for any cause, in any field location during the study period.
Interventions: None.
Main Outcome Measures: Risk of violencerelated events was calculated as the number of deaths, medical evacuations, and hospitalizations during the study period divided by the total number of field staff for organizations that had staff in those countries where events occurred to the staff of any participating organization. Distribution descriptions are presented as simple proportions.
Results: Risk of violence-related deaths, medical evacuations, and hospitalizations was six per 10,000 aid worker person-years.Fifty percent of intentional violence cases were lethal. Intentional violence accounted for 55 percent of all deaths reported, followed by coincidental illness (27 percent) and accidents (15 percent).
Conclusions: Aid worker deaths in this group were more frequently caused by intentional violence than either accidents or coincidental illness.The rate of six intentional violence events per 10,000 person-years can be used as a baseline by which to track changes in risk over time.


conflict, humanitarian, international, security, staff, violence

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