Humanitarian medicine and Hybrid warfare: how emerging technologies are (re)shaping the capacity of healthcare professionals to deliver effective care in conflict and low-resource settings

Healthcare services around the world are undergoing a rapid process of digitalisation that presents novel threats to healthcare workers and patients across humanitarian settings. This review evaluates the key mechanisms by which emerging digital technologies are reshaping humanitarian practice and posing new challenges to patients, practitioners and policy-makers in low-resource environments. First, we examine emergent physical and psychological harms stemming from digital technologies at the individual patient level, summarising the latest evidence on injuries from drone-induced trauma, multi-robotic systems (MRS) and electromagnetic (EM) weapons. Second, we discuss population-level risks in global health settings, detailing the clinical harms associated with hospital cyberattacks in hybrid warfare and the novel challenges of AI-enhanced technologies for non-profit agencies attempting to deliver care (e.g., misinformation and “Deepfakes”). Further, we illustrate the new vulnerabilities that emerge as humanitarian agencies transition to electronic and biometric databases, highlighting the associated privacy risks for asylum seekers and refugees. Drawing together the latest insights from frontline practitioners, the World Health Organisation (WHO) and the United Nations (UN), we showcase specific technological threats affecting vulnerable patient groups, such as the deployment of GPS trackers and implants by sex trafficking groups, and the use of social media by modern slavery networks. This article introduces global health and humanitarian practitioners to essential digital concepts that are increasingly relevant to their work in the field, including Swarm Intelligence technologies, UAVs (Unmanned Aerial Vehicles), Large Language Models (LLMs), Cyberwar, Netwar and electromagnetic (EM) warfare. Framed through the lens of clinical care, we shine a light on the neglected intersection of humanitarian practice and digital technology, demonstrating that patients who are marginalised globally are often at greatest risk from technological harm.