May 26, 2018 Volume 391 Number 10135 p2079-2184 e20
Health care in conflict: war still has rules
Denouncing attacks on health-care facilities and personnel in conflict situations, the UN Security Council unanimously adopted resolution 2286 in May, 2016. Addressing the Council, then UN Secretary-General Ban Ki-moon, condemned military actions leading to destruction of health-care facilities as war crimes, and called on Member States to honour their obligations to protect health-care workers and patients in conflict saying “even war has rules”.
But 2 years later, on May 21, a new report from the Safeguarding Health in Conflict Coalition, Violence on the front line: attacks on healthcare in 2017, shows a grim reality of continued attacks on health infrastructures coming from all sides, and which persist with impunity.
In 2017, at least 188 hospitals and clinics were damaged or destroyed, 50 ambulances attacked or stolen, and there were 57 reports of armed groups violently assaulting staff and patients in hospitals—101 health-care workers were killed and 64 kidnapped, 203 patients were killed, and 141 injured. Denial or obstruction of access to health-care facilities was reported 74 times. 57 of these events were in the occupied Palestinian territory. In Turkey, a physician was arrested for providing impartial medical care, and in Afghanistan, female health workers have been threatened for actions deemed inappropriate for a woman. Health facilities in Afghanistan, Burkina Faso, the Central African Republic, Egypt, and Turkey have been forced to close.
When resolution 2286 was adopted, Peter Maurer, President of the International Committee of the Red Cross, urged Member States that “after outrage must come action, not complacency”. But the sheer number of attacks in 2017 demonstrates the international community’s catastrophic failure to uphold its commitment to the resolution. The Coalition makes specific recommendations to the UN High Commission for Human Rights, Security Council, and Secretary-General to ensure that the lives and rights of health-care workers and patients are protected in conflict areas. António Guterres, UN Secretary-General, must continue to condemn these attacks, work proactively to stop them, and hold the perpetrators accountable for their war crimes.