Healthcare always spared in wars, not in Syria
Date: 2016-08-01 09:00
Throughout the history of modern conflicts, combatants have generally recognized medical personnel and facilities as non-combatants and spared them from attack. The Geneva Convention explicitly states that both military and civilian medical personnel exclusively assigned to medical duties must be respected and protected in all circumstances. Consequently, intentionally directing attacks against identifiable medical personnel and facilities constitutes a war crime, Steven Phillips writes in The Washington Institute.
The Geneva Convention Rules were followed even in intense modern warfare scenarios. However, the Syrian conflict stands in sharp contrast to this model of healthcare during modern warfare. The Syrian healthcare system, public health infrastructure, and health information resources have been devastated by the ongoing conflict, especially in opposition-held areas. Health care personnel, health care facilities, ambulances, manufacturers and suppliers of medical equipment and pharmaceuticals, including NGOs such as Doctors Without Borders, have been purposely and aggressively targeted on multiple fronts, primarily by the Assad regime.
The Assad regime, which controls the skies, is responsible for 88 percent of recorded hospital attacks and 97 percent of medical personnel killed, with 139 deaths directly attributed to torture or execution. In total, there have been 233 deliberate or indiscriminate attacks on 183 medical facilities.
Russia’s entrance into the air campaign has dramatically increased hospital and clinic bombings. In October 2015, the first full month of Russian involvement, twelve medical facilities were purposely targeted and bombed. Early in 2016, Russian bombs targeted three hospitals, killing many and depriving thousands of Syrians access to care.
The effects of these bombings have accumulated into a national health crisis. According to the World Health Organization, approximately two-thirds of Syrian hospitals and clinics have been rendered useless or destroyed by the conflict. Remaining medical facilities are understaffed, poorly equipped, under-supplied, and overwhelmed with trauma care. Restrictions on travel and sanctions have resulted in drug, medical supplies, and equipment shortages.
With a shattered infrastructure, both doctors and patients have suffered tremendously. Nearly 700 healthcare workers have been killed or injured, and a full half of the country’s physicians have been forced to flee the country. More than one million Syrians have been wounded or killed, leaving hundreds of thousands with poorly managed chronic disabilities and a tragic lack of access to basic medical services. Deaths from treatable diseases and wounds have skyrocketed. Aside from combat-related challenges, treatments for chronic cardiovascular and renal diseases, cancer, diabetes, and non-urgent routine medical interventions are severely interrupted. “Elective” follow-up care for wounds, amputee prosthetics, infections, and other conditions can no longer be a priority and rarely receive attention.
The large-scale displacement of the Syrian population, unsanitary conditions, and contaminated water supply is fueling a resurgence of once-extinct communicable diseases: polio, cholera, typhoid, hepatitis, and parasitic infections. The mental trauma inflicted by this nearly six-year long conflict on the civilian population is incalculable.
The Syrian American Medical Society has been actively facilitating the rotation health care volunteers in Syria, but its doctors—Dr. Samer Atar among them—are chronicling the horrors of the field and the severe inadequacies of the medical situation that has led to the loss of many savable lives.
Healthcare professionals are in many ways at a loss as to how the situation can be alleviated. Leonard Rubinstein, Director at the Bloomberg Center for Public Health and Human Rights at Johns Hopkins University, noted that the situation in Syria “is the worst concerted attack on healthcare in living memory… in places like Bosnia, Chechnya, Afghanistan, and the Gaza Strip, there has been nothing like what has happened in Syria.”
Throughout the history of warfare, the medical respondents, both military and civilian, have intentionally been spared from attack. Even during the intense combat of World War I and World War II, periodic truces had been called to allow medical teams to evacuate and treat the injured; not so in Syria. The Assad regime has purposefully and intentionally targeted their own medical infrastructure including humanitarian volunteer teams. This violation of the Geneva Convention has resulted in the nearly complete destruction of a pre-conflict, modern Syrian health care system. The rebuilding of their devastated health structure will require a herculean effort by the international community, which should commit itself to decades of work.