On April 29th an air-strike on the Al-Quds hospital in Aleppo, Syria killed at least 60 people – including 27 patients and healthcare workers.
The attack was one of the latest iterations of violent attacks on medical facilities happening at an increasing rate in conflict zones all over the world.
Al-Quds hospital was supported by the international medical relief organization Medicins Sans Frontiers (MSF). MSF reports that over the past few years’ attacks on their facilities have been increasing at a disturbing rate. Since the beginning of 2015, over 115 aerial bombing and shelling attacks have struck 82 of their facilities in Syria, Yemen, Ukraine, Afghanistan and Sudan.
Those figures, while staggering by themselves, represent only a snapshot of an insidious crisis facing healthcare in conflict.
Currently there is no international body charged with tracking instances of attacks on medical facilities in conflict zones. The World Health Organization (WHO) says that “data on attacks against health workers has been piecemeal and there has been no standard way of reporting them.”
Non-Governmental Organizations (NGOs) that specialize in medical relief, such as MSF, have been saddled with both providing aid in warzones, while also advocating for their own protection, and reporting on attacks when they do occur.
And for medical facilities not affiliated with an international NGO, an inconsistent and at times unreliable media means there is no guarantee an attack on a medical facility will receive coverage.
Healthcare in conflict is facing a serious emergency, yet it is a crisis that is not fully understood as data has not been collected or attacks tracked. Human Rights Watch estimates that “violence and threats against health workers and facilities, along with interference with access to health care, impedes the ability of millions of people around the world from receiving the health services they need.”
The WHO did respond in late 2015 by announcing plans to begin testing a mechanism that will track attacks on medical facilities in four conflict zones. The WHO hopes this will allow them to “identify patterns and find ways to avoid attacks or mitigate their consequences.”
While the new mechanism may begin to fill some gaps in the collection of data, the current reality facing healthcare workers operating in warzones remains grim.
On May 3rd, the UN Security Council adopted resolution 2286 that strongly condemns attacks against medical facilities (and) personnel in conflict situations.
The strongly worded resolution received widespread international support, being adopted unanimously by all Security Council members and receiving co-sponsorship by 84 other UN member states. However, despite the widespread support for the resolution, four of the five permanent members of the Security Council have been associated with military coalitions responsible for attacks on health structures in the last year. And at least one of the 84 co-sponsors, Saudi Arabia, has admitted to targeting health facilities during their military operations.
Medical professionals operating in conflict are relying on an international system for protection that claims healthcare is unassailable, yet continues to target medical facilities, healthcare workers and patients.
With no international body advocating for the protection of healthcare on an international scale, medical facilities, professionals and their patients will remain extremely vulnerable to attacks in conflict zones.
While MSF’s efforts to advocate for the protection of healthcare has garnered considerable attention and even action from the international community, an NGO cannot act as a substitute for an international institution. States need to be directly involved in the advocacy and protection of healthcare if the proper incentives and deterrents are to emerge and the rules of war are to be respected.
The WHO’s decision to begin tracking attacks on facilities may signal the organization’s intention to play a larger role in ensuring healthcare is protected in conflict. The WHO is a widely regarded international institution – with 194 member states – and has played a crucial role in managing other healthcare crises, like the Ebola and Zika outbreaks.
If this proves to be true it could mark a positive development in the way the international community treats attacks on medical facilities. Unfortunately however, instances of attacks continue to rise and any meaningful change in the international system will take time – there is little hope of short-term relief for the countless medical professional and their patients who are voiceless and vulnerable in the face of worsening conflict all over the world.
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