Humanitarian Health Responses in Urban Conflict Zones

War has long tested the design, capacity, and protected status of health care personnel and systems. In recent years, however, urban conflict zones have come to exemplify many of the most intractable humanitarian dilemmas around the delivery of medical care. In this essay, I examine several recurring dilemmas concerning operational independence and physical safety, as encountered in Syria and Yemen. I argue that, as a generative force, war has the potential to make (and remake) social, economic, and political life in urban settings in ways that accentuate essential challenges facing the safe and principled delivery of health care. These far-reaching effects leave humanitarians and their supporters to adapt existing strategies, many developed in more rural contexts, to shifting urban environments. In such contexts, the establishment of "hospital" or "relief zones" may offer a pragmatic and principled strategy to mitigate many of the dilemmas surrounding the protection of medical facilities and personnel in urban conflict settings.