Attacks on hospitals: war zone medics push for consequences

Last Wednesday, beside a dirt road in the backwoods of the Central African Republic, Arsene Bassanganam was killed in cold blood. The driver of a “Doctors Without Borders” jeep carrying patients and medicine, he was shot dead after an ambush.

Less than a month earlier in the besieged Syrian city of Aleppo, Mohammed Wassim, the last pediatrician left in town, was killed by a government airstrike on his hospital. Fifty-five other medical workers and patients died with him.

“I have never seen a time when there have been so many and such intense attacks on hospitals and health workers in conflict zones,” says Susannah Sirkin, a 30-year veteran of Physicians for Human Rights, a New York based activist group.

From Afghanistan to Yemen, and from South Sudan to Syria, “medical facilities … have become death traps,” the newly formed Medics Under Fire said in a letter to British premier David Cameron earlier this month. “The protections envisioned and enshrined in the Geneva Conventions more than 150 years ago are in tatters today.”

The London-based organization is part of a developing international campaign to stem lethal attacks – both deliberate and indiscriminate – against doctors, nurses, hospitals, and ambulances in war zones.

Such assaults constitute war crimes under international law, and Medics Under Fire is working with lawyers to take cases to the International Criminal Court in The Hague, according to the group's founder, David Nott.

That was also the thrust of a UN Security Council resolution passed unanimously three weeks ago, aimed at protecting medical professionals and their patients in war zones. The resolution called on UN Secretary-General Ban Ki-Moon to come up with ways of ensuring that perpetrators are brought to justice, ending their current impunity. 

That is a “valuable rhetorical instrument,” says Ms. Sirkin.

But she points out that Security Council member Russia is helping the Syrian regime – one of the worst offenders – while the United States, Britain, and France back Saudi Arabia’s bombing campaign in Yemen, which has struck dozens of hospitals.

“It is about time all medics in the world stand up,” says Dr. Nott, a surgeon who has volunteered his services in many war zones, including Syria. “We are sick of this.”

Syria is a particularly grave case; human rights groups have documented 365 attacks on 259 different medical facilities there since 2011, and at least 738 medical professionals have been killed. Government forces and their Russian allies are said to be responsible for 90 percent of the incidents.

But Yemenis are suffering, too; bombing by the Saudi-led coalition has closed health facilities and forced their staff to flee, leaving more than 14 million people without healthcare, according to a report released this week by a coalition of nongovernmental organizations in the health field.

And in Afghanistan a US gunship shot up a hospital last November, killing 42 doctors, nurses, and patients in what the Pentagon later said was a mistake.

That hospital was run by “Doctors Without Borders,” known by its French acronym MSF. “Hospitals and patients have been dragged onto the battlefield,” MSF International President Joanne Liu told the UN Security Council earlier this month.

The rising number of humanitarian workers killed or injured in conflict zones is partly a simple reflection of the increase in the numbers of such people working in dangerous places, says Fabrice Weissman, who works for an MSF think tank.

His organization, for example, has tripled the number of its field workers since 1998. “We now have a level of exposure we never had in our history,” says Mr.Weissman.

If the casualty rate among humanitarians has not risen dramatically, except in some black spots such as Syria, it may be because they are more careful now.

“The number of claims we get from aid workers has not gone up,” says Smita Bhargava of Clements Worldwide, an insurance broker which works with UN agencies and NGOs sending employees to hotspots. “Humanitarian organizations are much more prepared than they were 10 years ago and they take a lot more precautions.”

They need to. This week’s report from the “Safeguarding Health in Conflict Coalition” of NGOs documents attacks on medical staff and facilities in 19 countries. They took place, says Sirkin, “in an atmosphere of complete impunity. There is no accountability for these war crimes.”

Neither governments nor rebel groups are keen to let independent investigators look into allegations of war crimes; a special International Humanitarian Fact Finding Commission set up under the Geneva Convention has not once been called on to do anything since it was created 25 years ago.

And governments protect their allies: an effort in 2014 to charge the Syrian government with war crimes at the International Criminal Court foundered on opposition from Russia and China.

Only “a huge international outcry by civil society” will give teeth to international humanitarian law, says Sirkin. Weissman agrees that “naming and shaming every time a crime happens” is the best way of bringing perpetrators to heel.

But he cautions that war zones are never safe for humanitarian workers and never have been. “It is not because a government or armed group subscribes to international law that it will be respected,” Weissman cautions.

“We know it’s a daily struggle to negotiate a space of peace and protection in the face of horror,” he says. “It’s a constant struggle to find the right way to be present in the face of war.”