During armed conflicts and other situations of violence, EMTs are deployed to respond to the needs of the affected population. It is when fighting breaks out that healthcare services are most needed, but it is also when they are most exposed to violence and insecurity. Current evidence indicates that health personnel, health infrastructure and patients have been the target of different types of attacks.

A new report published on 24 of May 2022 by the Safeguarding Health in Conflict Coalition identified there were 1,335 incidents of violence or obstruction against health care perpetrated in 2021: 161 health workers killed; 320 injured; 170 kidnapped; 713 arrested. Health facilities were destroyed or damaged in 188 incidents, 111 health transports destroyed or damaged and 64 health transports stolen or hijacked.

In a nutshell, health facilities and health workers were subjected to devastating and widespread violence and obstruction of care in 49 conflict-affected countries in 2021.

This presentation analyzes the current challenges, describes the method used consisting of a scoping review of the available evidence in addition to semi-structured feedback from key stakeholders working in unsecured environments, and supports the identification of skills and competencies that EMT members need before deployment. This presentation will also propose the definition of skills and competencies for EMT members needed before deployment to unsecured environments.

Recommendations for future action focus on International norms and standards, a competencies framework, evidence and data, and state-of-the-art competencies to address safety and security during deployment needed for a capability-building framework.

How to optimize EMTs' response in unsecured environments requires designing training and learning pathways that improve skills and knowledge on safety and security for EMT members before their deployment to prevent and mitigate violence against health care during deployment in unsecured environments.