Attacks on Medical Workers in War Zones under Fire

The growing number of indiscriminate bombings in three of the most devastating military conflicts currently underway -- in Syria, Afghanistan and Yemen - are taking a heavy toll on medical personnel serving with humanitarian organizations -- along with thousands of civilians caught in the crossfire between government forces and rebel groups.

The U.S. bombing of a hospital run by Doctors Without Borders in Kunduz, Afghanistan last October, and the Syrian government's attacks on doctors and medical facilities, have been singled out as just two examples of the dangerous environments under which health care workers operate.

The attacks have also prevented medical care being provided to populations in need--and largely under siege.

When medical staff are killed in these attacks, the many lives that could be saved are also jeopardized, according to experts from Physicians for Human Rights (PHR), Doctors Without Borders, and the Open Society Foundation.

Speaking at a panel discussion this week, some of the experts said when combatants destroy a hospital, thousands of people who are sick and wounded, are left with nowhere to go.

Asked if these attacks are by design or by accident, Elise Baker, program associate at Physicians for Human Rights, told IPS the five-year-old conflict in Syria has been marked by government forces orchestrating a deliberate campaign to destroy the health care infrastructure and attack medical personnel in opposition-controlled areas.

"This is just one element of a campaign against civilians which is in direct violation of the key principle of distinction in the laws of war which makes it unlawful to ever target civilians or civilian objects such as hospitals and schools".

She said additional evidence of attacks on health care facilities as being part of a campaign is that humanitarian aid, including medical supplies and medicines, have largely been distributed through Damascus.

Government forces have obstructed the delivery of these and other life-saving supplies to opposition-held areas or only let convoys through after stripping out medical supplies.

Baker said PHR's map documenting the attacks on hospitals does not include strikes "that we believe were accidental or - to use the parlance of humanitarian law, a result of collateral damage."

"PHR is deeply concerned about the reports of attacks on hospitals in Yemen."

However, she said, it is unclear at this point whether the Saudi-led coalition is targeting hospitals or if hospitals are being hit as the coalition members carpet bomb areas in an indiscriminate manner, and in turn, hospitals, like civilians and civilian objects, are paying the price.

According to PHR's data, 2015 marked the worst year on record for attacks on medical facilities in Syria, with government forces responsible for most of the more than 100 attacks.

Between March 2011 and November 2015, there were 336 attacks on 240 medical facilities in Syria, 90 percent of them committed by Syria and its allied forces.

In the same time period, 697 medical personnel were killed, with Syria and its allies responsible for 95 percent of the deaths.

PHR tracks these findings in an interactive map, which includes photographic and video documentation of these crimes. In November, PHR released a report detailing the Syrian government's attacks on health care, "Aleppo Abandoned: A Case Study on Health Care in Syria."

Asked about a letter from the Saudi government urging UN and international aid agencies to leave areas controlled by the Houthi rebel forces in Yemen to facilitate bombings, UN spokesperson Stephane Dujarric confirmed receipt of the letter.

"Yes, there's been an exchange of letters between the Permanent Mission of Saudi Arabia and our colleagues at the Office of Humanitarian Affairs," he said.

"What I can tell you is that the United Nations continues to call on all parties to allow access for humanitarian workers wherever they are needed to be, that access needs to be free and unfettered for humanitarian workers and, obviously, humanitarian goods."

"And it is also important to note that all the parties involved in this conflict and any conflict need to make sure they do their utmost to protect those humanitarian workers," Dujarric told reporters Thursday.

Asked whether the clearance sought was only around military installations, Dujarric said: "I think the only premise that we accept is that humanitarian workers need to have free and unfettered access to all the areas where they need to be, and it is incumbent on all the parties to ensure that they protect those humanitarian workers."

Baker told IPS it is unlawful for warring parties to use indiscriminate weapons in civilian areas.

It violates the other key principle of the laws of war which is that any attacks must be proportionate, and to the extent that there are concerns about harm to civilians, the military benefit must outweigh the potential harm to civilians.

"Clearly, this principle is not being applied in Yemen," she said.

Asked what action the UN should take, Baker told IPS: First, the UN Security Council should condemn all these violations in the strongest possible terms. Allowing them to continue undermines decades of work establishing these norms that were aimed at making war a little less hellish for civilians.

Second, the UN Security Council has the power to refer situations in which these crimes are occurring to the International Criminal Court - but as we have seen, the five permanent members of the UN Security Council effectively are content to live with a stalemate.

In the case of Syria, she pointed out, Russia and China are refusing to allow stronger action, and in the case of Yemen, the US, UK and France support the Saudi-led coalition.

"As a result, the UN Security Council, which is charged with maintaining international peace and security, has failed miserably, and it is civilians in Syria and Yemen and elsewhere who are paying the price - often with their lives", Baker added.

She said PHR has documented numerous incidents where Syrian government forces have attacked the same hospital repeatedly in a short period of time or have attacked numerous hospitals in a small geographic area within a short period of time.

These attacks clearly indicate the Syrian government's intent to destroy health care systems inside opposition-controlled Syria. Two particularly compelling examples are included below.

PHR has documented seven attacks on M10 hospital, Aleppo city's main trauma hospital. Four of these attacked happened within the 10-day period between June 23 and July 3, 2014.

The two most recent attacks occurred on April 28 and April 29, 2015. This hospital was established before the conflict started. It is not in a hidden location, she noted.

On August 7, 2015, between 10am and 1pm, Syrian government forces bombed five hospitals in Idlib governorate. The following day, they hit another hospital in Idlib.

Two days later on August 10, government forces hit three more hospitals in Idlib. All nine hospitals attacked in that four-day period were within 30 miles of each other.

All were at least six miles from the nearest frontline, and none were near military locations. All were attacked with discriminate weaponry. Five of the nine hospitals had been attacked previously by Syrian government forces.