A moral duty to protect frontline health worker wellbeing

In humanitarian crises, local and international teams of health workers are lifelines for communities under threat. But they face real risks themselves, and ensuring their safety and wellbeing goes beyond policy—it is an ethical obligation.

Investing in comprehensive occupational health programmes for health workers on the frontline is more than just a bureaucratic requirement; it is a moral obligation. Photo: Gani Nurhakim

Health workers are often the backbone of humanitarian responses to crises. From conflict zones to areas affected by natural disasters, and supported by non-medical operational teams, we are the frontline workers—and, frequently, the unsung heroes.

The physical toll and danger we face can be intense and overwhelming. Understanding these risks and taking steps to mitigate them—not only as individuals but also through the duty of care of the organisations we work for—are essential for our own wellbeing and the continued resilience of the critical services we provide.

Constant exposure to risks

Imagine working in a mobile clinic in a rural area with limited supplies, or in a hospital crowded with patients, with more people in need than available beds during an outbreak, or facing repeated mass casualties. In these situations, health workers face constant exposure to risks such as conflict and violence, and infectious diseases like malaria, cholera, TB, and Ebola.

While vaccines and protective gear offer some defence, shortages, logistical constraints, and surges in patient numbers can make even the most experienced staff vulnerable. The Ebola outbreak of 2014–2016 in Guinea, Liberia and Sierra Leone, where hundreds of health workers in fell ill and many died, is a strong reminder of how quickly situations can become dangerous.

Beyond diseases, the physical demands of the job are relentless. Defined working hours often exist only on paper; in reality, long shifts, often lasting days without breaks, can push bodies and minds to their limits. Fatigue and muscle strain become constant companions. Coupled with the pressure we place on ourselves and the trauma and suffering we witness, exhaustion can accumulate unnoticed, sometimes to a critical point.

The environment itself adds another layer of risk. Uneven terrain, damaged buildings, overcrowded clinics, and inadequate sanitation can lead to slips, falls, or accidents. In conflict zones or regions experiencing civil unrest, these risks escalate: health workers may face direct threats from violence or be caught in dangerous situations beyond their control. Natural hazards like floods, landslides, and extreme heat pose real dangers when staff are on the move carrying patients or working in makeshift facilities.

Improving health worker safety on the frontlines

Despite these challenges, there are ways to reduce risk and protect health workers. Simple measures like proper personal protective equipment (PPE), strict hygiene practices, vaccinations, and training in infection prevention can significantly reduce threats. Repeated training of these measures helps them become automatic. Workload management—rotating shifts according to ILO labour law standards, mandatory rest periods, and safe sleeping quarters—helps prevent exhaustion and physical strain. Ergonomic support and proper equipment can reduce back injuries and other musculoskeletal problems, and while not always possible, should be prioritised whenever feasible.

Environmental safety planning is just as crucial. At the start of a humanitarian response, organisations assess hazards, including structural instability, chemical exposure, and security threats, and put in place measures to minimise them. Safe housing, reliable transportation, emergency and medical evacuation plans, and clear communication channels ensure that staff can respond effectively and stay safe, even when the situation on the ground is unpredictable. It is of utmost importance that management and leadership check in on staff wellbeing. Asking ‘How are you?’ and seeking an honest answer beyond ‘I’m fine’ can make a real difference.

Gaps remain, but significant progress has been made in recent years to improve safety mechanisms and routines. Yet working in humanitarian responses as a health worker has never been more dangerous. Active attacks on health facilities and workers, shortages of supplies, underfunded programmes, and the unpredictability of emergencies mean that health workers sometimes operate without full protection. In some cases, a lack of adequate safety measures may even require suspending operations.

Comprehensive occupational health programmes are essential

Investing in comprehensive occupational health programmes for health workers on the frontline is more than just a bureaucratic requirement; it is a moral obligation. These include routine health screenings, mental health support, vaccination programmes, training in safety protocols, and ensuring that staff have adequate rest, food, and hydration. A culture of safety, where health workers can report hazards without fear of reprisal, is essential.

International standards, such as those set by the World Health Organization (WHO) and the International Labour Organization (ILO), provide benchmarks for protection. Adherence to these guidelines, reinforced by robust funding and management support, ensures that no health worker is left exposed due to oversight or resource gaps.

We are more than just providers of care—we are lifelines for communities in crisis. The physical and emotional risks we face daily are real and significant, yet often invisible. Strong safeguards, proper equipment, sufficient rest, adequate training, and risk planning do more than reduce illness and injury—they empower health workers to continue their life-saving work with confidence and resilience.

Because those who protect life deserve to be protected, too.

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The opinions expressed are those of the author and do not necessarily reflect the position of Re:solve Global Health or the International Federation of Red Cross and Red Crescent Societies (IFRC).

Ines Hake is a German nurse who began her humanitarian career in 2007 with a deployment to Iraq with MSF. After multiple missions, she joined the International Federation of Red Cross and Red Crescent Societies (IFRC) in 2020, where she is now manager of the occupational health, safety and wellbeing unit, supporting the physical and mental health of staff working in challenging environments.