Red Cross study reveals there have been more than 650 attacks on medical staff and patients in 16 conflicts since 2008
LONDON (AlertNet) - From hospitals in Somalia being shelled to ambulances being shot at in Libya and doctors kidnapped in Iraq, health workers and medical facilities are increasingly becoming targets in war zones.
A Red Cross study reveals there have been more than 650 attacks on medical staff and patients in 16 conflicts since 2008 – all in blatant contravention of international laws.
The need to protect health workers during hostilities is obvious, but get a group of doctors together to discuss the subject and it quickly becomes clear it’s a far thornier problem than first appears.
One controversial idea comes from Professor David Southall, a paediatrician who helped found the International Health Protection Initiative (IHPI). He suggests setting up a special protection force to safeguard healthcare in war zones. Southall would also like to see perpetrators of attacks on health workers brought before the International Criminal Court (ICC).
His proposals were highlighted during a recent debate, by senior doctors in London, which showed just how complex an issue health protection is.
Rhona MacDonald, co-founder of IHPI, said she would be uncomfortable with mandating a protection force that could potentially become embroiled in violence and end up killing people, some of whom might be child soldiers.
“As a doctor … you’re about protecting lives, you’re not about killing people, you’re about saving them,” said MacDonald, who has worked for charities Oxfam and Medecins Sans Frontieres.
Iraqi doctor Salam Ismael knows the risks faced by medics on the frontline only too well. In Fallujah, he saw one of his best friends shot dead as he helped a patient.
“This issue (of protection) is crucial because anyone who is a humanitarian worker in the field has to be able to do their job without fear that a sniper can put a bullet in their head. And that has happened in every single place I’ve worked,” he said.
Ismael, who has also done stints in Somalia, Syria and Niger, said it was vital to protect health workers in such places because their skills were often irreplaceable.
“In Somalia for example, we have only 11 surgeons in the whole capital … if anyone was killed, there would be no one to replace them,” he added.
He pointed out that if nothing is done to protect health workers in war zones it will become increasingly impossible to recruit people because they will be too afraid of getting killed – a problem he has witnessed in Iraq.
Some 18,000 of war-torn Iraq’s 34,000 doctors fled the country between 2003 and 2006, according to the country’s health ministry. Iraq’s health system is now collapsing said Ismael, who founded the medical, non-governmental organisation Doctors for Iraq.
LIVE BLOG
Health workers are protected under the Geneva Conventions provided they remain neutral. But the conventions have been violated in almost every single recent conflict.
Psychiatrist Lynne Jones, who has worked in many conflict areas including Bosnia and Kosovo, said she did not see how health workers could be neutral as they had to be on the side of the victims they were treating.
The debate coincided with the launch of a live blog on the IHPI website where witnesses to attacks on health facilities can post reports and video footage.
Paediatrician Mathew Ellis said the blog would help empower health workers and could provide a channel for the collection of evidence for prosecutions.
He added it was important to remember it was usually local rather than international health workers who were targeted in violence – something he had seen himself in Ethiopia when his local colleagues were interned by Tigrayan Government Forces and at least two were killed.
Other doctors also welcomed the blog initiative but stressed that health workers could risk being killed in many places if they were caught filming.
“If I carried a camera inside the clinic in Fallujah and one of the militias saw me he would think I was filming it for the Americans and I would be shot,” Ismael said.
CONTROVERSY
Hugh Davies, a human rights lawyer, said attacks on health workers during hostilities were undoubtedly war crimes, but he doubted the ICC could handle the resulting caseload if it started prosecuting the perpetrators.
“It would run into thousands, they can barely cope with the leading figures,” he added.
Davies also argued that putting people on trial could be difficult because many civil wars ended with negotiations that included some form of amnesty against prosecution.
On Southall’s proposal for a specialised protection force, the lawyer wondered if there was a risk that hospitals receiving third-party protection might become de facto fortifications and end up at increased risk of attack.
Southall, a controversial figure in Britain for his involvement in a high-profile court case and for some of his medical research methods, emphasised he was not just concerned with protecting health workers, but healthcare in general – including ensuring food security and preventing sexual abuse.
The type of force he envisaged would be well-equipped, properly mandated – possibly by the ICC – and comprise ethical soldiers who would not abuse women and children as has happened with some U.N. peacekeepers.
Southall would like to see a pilot trialled in a very clear-cut and contained conflict such as Northern Uganda where the Lord’s Resistance Army has slaughtered villagers and enslaved children.
If an international protection force was mandated to capture anyone carrying out war crimes it could act as a powerful deterrent to other organisations committing atrocities elsewhere in the world, he argued.
Southall said the main role of the ICC would be to support a protection system. He drew a parallel with the child protection system in Britain where a paediatrician treating a child abuse victim might call in help from the courts, which could invoke emergency protection orders, possibly involving the police.
Other proposals during the debate proved less contentious. The doctors agreed that one way to protect healthcare in poor countries in the long term was to tackle the manufacture and trade in small arms and light weapons which are the main cause of civilian deaths in conflicts.
They called on health professionals to support the work of the United Nations and the Control Arms coalition to draw up an Arms Trade Treaty.
Our Standards: The Thomson Reuters Trust Principles.
