Secretary-General Decries ‘Affront to Shared Humanity’, as Security Council Considers Military Targeting of Hospitals in Conflict Zones
Permanent Council Members Linked to Attacks against Facilities in Syria, Yemen
Ending attacks on medical workers, facilities and transports in conflict hotspots — including by several of its own permanent members — must remain an urgent priority for the Security Council, speakers emphasized today as the body convened to consider hospital bombings in embattled Aleppo, Syria’s largest city.
Briefing the 15-member Council, representatives of humanitarian organizations described the daily struggles faced by medical workers who risked their lives to keep patients alive amid conflicts in Syria and elsewhere in the Middle East and other regions. The Council also considered a number of recommendations outlined by the Secretary-General in an August letter (document S/2016/722), and intended to protect medical personnel, as well as the sick and wounded.
Opening the meeting, United Nations Secretary-General Ban Ki-moon said the international community’s failure to act against such crimes would constitute an “affront to our shared humanity” and undermine the legal obligations of States and the multilateral system as a whole. While the Council’s adoption of resolution 2286 (2016) in May, condemning attacks on medical personnel in conflict situations, there had since been a surge in horrific attacks against hospitals, clinics and medical professionals, he noted. “International law is clear: medical workers, facilities and transports must be protected,” he said, emphasizing that the sick and wounded must be spared.
Describing deliberate attacks on hospitals as war crimes, he said that denying people access to essential health care constituted a violation of international humanitarian law. The carnage continued in Syria, in particular, where no one was spared. Noting that Aleppo had recently faced the most sustained and intense bombardment since the beginning of the conflict, he said that an estimated 95 per cent of the city’s medical personnel had fled, been detained or killed. Resolution 2286 (2016) urged parties to armed conflict, as well as Member States, to take concrete action, he said, adding that his own recommendations provided detailed steps in that regard.
Joanne Liu, International President of Médecins sans frontières/Doctors without Borders, said “the conduct of war today knows no limits”, and resolution 2286 (2016) had done little to change the situation on the ground. “This failure reflects a lack of political will among Member States fighting in coalitions and those who enable them,” she said. Describing a number of attacks against her organization in recent months, she said that, in both Syria and Yemen, four of the five permanent members of the Council had been implicated in attacks against medical facilities. Médecins sans frontières was still awaiting an independent investigation into the deaths of 42 patients and medical workers in Kunduz, Afghanistan, a year ago, she said, urgently requesting that the Secretary‑General appoint a special representative mandated to document and report attacks on medical facilities, health personnel and patients.
Peter Maurer, President of the International Committee of the Red Cross, (ICRC) said that, while resolution 2286 (2016) provided a solid foundation on which to make progress, more must be done. He recommended strengthening national legislation to improve access to health care, emphasizing the critical importance of Member States establishing national data-collection systems to gather information about patients and health facilities. Regarding accountability, he called upon Member States to ensure that those responsible for attacks and access restrictions on medical care were brought to justice. In that regard, resources must be allocated for capacity-building and effective investigations, he said, stressing also that it was essential for Member States to develop contingency plans in accordance with international standards.
Following those briefings, many Council members voiced support for resolution 2286 (2016) while several others expressed frustration over the lack of action to implement the resolution, citing a lack of political will. Still others underlined the need for swift, independent investigation of all allegations of attacks against medical facilities, and called for the urgent deployment of fact-finding missions in that regard.
Malaysia’s representative said today’s briefings had provided a harrowing glimpse into the struggles of health-care workers in armed conflict situations. Evidence of attacks against the sick and wounded, as well as medical personnel and facilities, underscored the grim reality that international humanitarian law had been flagrantly violated by a number of belligerent armed parties. Calling attention to such attacks in Syria and Yemen, he called on the Council to take urgent action beyond mere condemnation.
The representative of the United States warned that medical facilities in Aleppo were running out of medicines, baby milk and respirators, even as people died in the streets. The Council could not allow the systemic targeting of such facilities by the Bashar al-Assad regime, she said, adding that the actions of the regime and the Russian Federation ran contravened resolution 2286 (2016). She recalled that in July, President Barack Obama had issued an Executive Order — the first of its kind — on pre- and post-strike measures to address civilian casualties involving the use of force.
Meanwhile, the Russian Federation’s representative expressed support for resolution 2286 (2016), but nevertheless emphasized the responsibility of the conflict parties to uphold the safety of medical personnel. It was unfortunate that some States blamed Moscow and Damascus after every attack when, in fact, such incidents, as well as the destabilization in the region, were the result of the careless policies pursued by the United States and its allies.
Venezuela’s representative said it was inconceivable that the “mistake” of bombing medical facilities could be made at a time when high-tech precision weapons were available. Joining other speakers in endorsing the Secretary-General’s recommendations, he called upon countries with influence to compel parties to conflict to end attacks against medical facilities. Venezuela, for its own part, had never participated in any military coalition implicated in such attacks, he said, stressing that it endorsed no double standard on the matter.
Also speaking were representatives of Spain, Senegal, Uruguay, France, Egypt, China, Angola, Japan, Ukraine, United Kingdom and New Zealand.
The meeting began at 10:05 a.m. and ended at 12:04 p.m.
Opening Remarks
BAN KI-MOON, Secretary-General of the United Nations, said that the International Committee of the Red Cross (ICRC) and Médecins sans frontières played a critical role in providing health care in the most difficult and dangerous circumstances. Since the Council’s adoption of resolution 2286 (2016), there had been a surge in horrific attacks against hospitals, clinics and medical professionals. “International law is clear: medical workers, facilities and transports must be protected,” he said, emphasizing that the sick and wounded must be spared. Describing deliberate attacks on hospitals as war crimes, he said that denying people access to essential health care violated international humanitarian law.
“Since May, there has been no let-up,” he said, noting that civilians had been killed in attacks on hospitals from Yemen to Pakistan. In Syria, the carnage continued and no one was spared. In fact, Aleppo had faced the most sustained and intense bombardment since the start of the conflict. According to Physicians for Human Rights, 95 per cent of medical personnel in the city had fled, been detained or killed. Recalling that the World Humanitarian Summit and the Agenda for Humanity reaffirmed that safeguarding humanity in armed conflict must be a priority, he said the Security Council had a unique responsibility and wielded influence in that area. Resolution 2286 (2016) urged parties to armed conflict and Member States to take concrete action, he pointed out, adding that his own recommendations provided concrete and detailed steps on improving protection for medical staff and facilities, as well as the sick and wounded.
Stressing the importance of prevention efforts, he said Member States must do their utmost to promote respect for medical care and align national legislation with international humanitarian law. It was essential to establish dialogue among medical personnel, civil society organizations and the authorities. At the same time, it was critical to ensure that foreign policy decisions respected the provision of medical care in conflict. Moreover, Member States and parties to conflict must take precautions to safeguard medical facilities and personnel when they planned and conducted military operations, he said, noting that his recommendations covered military orders, the location of targets, visible military presence in and around medical facilities, and the issuance of advance warnings and evacuations.
He went on to underline that those responsible for violations must be prosecuted and punished, adding that Member States must conduct systematic and impartial investigations into specific incidents, and analyse better and more extensive data. In that context, he urged the Security Council to overcome its divisions and meet its responsibilities to prevent and reduce conflict, while building peace and stability. “Failure to act is an affront to our shared humanity,” he said. “It undermines States’ legal obligations and the multilateral system as a whole.”
JOANNE LIU, International President of Médecins sans frontières/Doctors without Borders, recalled last week’s savage attack on a United Nations and Syrian Red Crescent humanitarian convoy and on a hospital near Aleppo, saying “the conduct of war today knows no limits”. It was a race to the bottom, she said, noting that the unrelenting assault on Aleppo by Russian and Syrian forces in recent days was evidence of that fact. In adopting resolution 2286 (2016) last May, the Council had pledged to protect civilians and the medical services they needed to survive; five months later, however, the resolution had failed to change anything on the ground. “This failure reflects a lack of political will among Member States fighting in coalitions and those who enable them,” she said, urging the Council to make its pledges operational.
Describing a number of horrific attacks against Médecins sans frontières in recent months, including one that had killed 19 people — health workers and patients among them — at a hospital in Abs, Yemen, she said that as a result of four such attacks, the organization had been forced to withdraw from the north of the country, leaving scores of people behind with reduced medical care. The area then had been hit by Saudi carpet bombing, she said, underlining the negligence of the coalition led by Saudi Arabia, as well as that of its opponents. Many attacks had been brushed off as mistakes, she said, rejecting the use of that term.
In Syria, the attacks had never stopped, she continued. Doctors in Aleppo pulled their weakest patients off ventilators “so someone else gets a chance”. Just this morning, two more hospitals in the east of that city had been struck, leading to their temporary closure. In both Syria and Yemen, four of the five permanent members of the Council had been implicated in such attacks, she said, calling on those nations to revoke the “licence to kill” they had issued. Military action and humanitarian needs must be balanced, and attacking hospitals and medical workers was a non-negotiable red line.
Emphasizing the need for accountability and credible investigations, she said Médecins sans frontières was awaiting an independent investigation into the deaths of 42 patients and medical workers in Kunduz, Afghanistan, a year ago. She urgently requested that the Secretary-General appoint a special representative mandated to document and report attacks on medical facilities, health personnel and patients.
PETER MAURER, President of the International Committee of the Red Cross, said that attacks and access restrictions on medical care undermined international law. In Syria, civilians and medical staff were under attack, many hospitals were not functioning, and electricity and water resources had been disrupted. While expressing concern about the deteriorating situation, he commended the Council’s leadership. “We must remain confident in our actions and make a difference on the ground,” he said.
Drawing attention to Council resolution 2286 (2016), he said that, while the international community had a solid foundation on which to make progress, more must be done. He recommended strengthening national legislation to improve access to health care, emphasizing also the critical importance of Member States establishing national data-collection systems to gather information about patients and health facilities, and convening multistakeholder meetings.
Regarding accountability, he called upon Member States to ensure that those responsible for attacks and access restrictions on medical care were brought to justice. In that regard, resources must be allocated for capacity-building and effective investigations, he said, emphasizing that it was also essential that Member States develop contingency plans in accordance with international standards.
Statements
ROMÁN OYARZUN MARCHESI (Spain), recalling that his delegation had co-sponsored resolution 2286 (2016), expressed his full support for the Secretary‑General’s recommendations, citing in particular to reform of the rules of conduct and the prohibition against storing weapons near hospitals and clinics. Calling urgently upon all States to put those measures into practice and adopt new technology to prevent attacks against health-care facilities, he said, that while no single resolution could end such attacks, resolution 2286 (2016) could serve as a basis for changing the culture within the Council. Spain sought to leave behind a guide of good practice for other Council members, and had joined the Group of Friends of Resolution 2286 (2016), which should meet at least once a year. The Council must recognize that it was failing doctors and patients, and that it owed them a response, he said, adding that, while it had the necessary tools, it lacked the political will to take action. Expressing support for proposals to impose sanctions in response to serious attacks against medical facilities, or to refer such cases to the International Criminal Court, he said Spain was prepared to contribute to rapid, impartial investigations against suspected perpetrators.
ABDOULAYE BARRO (Senegal) said today’s briefings demonstrated once again the need for the Council to take up the issue of protecting medical personnel, facilities and equipment in conflict zones. Welcoming the Secretary-General’s recommendations for ending attacks against such persons and facilities, as well as opening investigations and prosecuting perpetrators, he said the role of United Nations peacekeeping missions should also be strengthened, emphasizing that the Council must ensure that resources were adapted to their mandates. Urging the lifting of all barriers to health care in conflict areas, he called for increased support for local health facilities and for the provision of proper training for military personnel in order to reduce the disruption of health care to a minimum. In addition, he expressed support for more Council briefings on attacks against health-care workers and facilities.
ELBIO ROSSELLI (Uruguay), noting that there appeared to be no end in sight to such tragic attacks, said resolution 2286 (2016) had not been worded strongly enough to protect patients and medical staff against the cowardly attacks they faced. Expressing support for the Secretary-General’s recommendations, as well as for the proposal to establish the post of special representative to investigate such attacks, he endorsed the statement by Spain’s representative and underscored the importance of the commitment to investigate and punish the perpetrators of such horrendous acts. “War crimes must be prosecuted to the fullest extent of the law,” he stressed.
FRANÇOIS DELATTRE (France), while expressing concern about attacks against medical facilities and staff in Syria, South Sudan, Yemen, Iraq and Afghanistan, stressed that resolution 2286 (2016) had laid the groundwork for addressing that problem effectively. Drawing attention to the recent air strikes on hospitals, he said “if these are not war crimes, I don’t know what else is”. In that regard, he called on those who had not done so to ratify the Additional Protocol to the Geneva Conventions. Among other efforts, it was essential to conduct impartial investigations to bring perpetrators to justice, he said.
MICHELE SISON (United States) said two hospitals had been hit by air strikes in eastern Aleppo, which had killed and injured patients, as well as medical staff. “Hospitals have no room to receive patients,” she said, noting that facilities were running out of medicine, baby milk and respirators. Unable to find help, people were dying in the streets. The Council could not allow the systematic use of the same tactics by the Bashar al-Assad regime, she said, noting that more than 300 attacks had been documented since 2011. “Actions taken by the Russian Federation and the Assad regime are contrary to the demands of resolution 2286 (2016),” she added. Turning to Yemen, she expressed regret over incidents involving humanitarian workers, medical staff and facilities, saying the Council must use its influence to convince the parties to stop the violence. In July, the President of the United States had issued an Executive Order on pre- and post-strike measures to address civilian casualties involving the use of force, she recalled. As the first policy of its kind, it aimed to reduce civilian casualties in partnership with relevant stakeholders.
AMR ABDELLATIF ABOULATTA (Egypt) expressed regret that some parties to conflict continued to obstruct the delivery of humanitarian assistance. Recalling the principle of protecting civilians in armed conflict, he said further measures must be taken to meet the needs of the sick and wounded. Given the situation on the ground, it was critical that parties avoid taking any divisive action. Expressing support for the Secretary-General’s recommendations, he said Member States must do all in their power to promote respect for medical care in armed conflict, and ensure that those responsible for violations were prosecuted and punished.
RAFAEL DARÍO RAMÍREZ CARREÑO (Venezuela) echoed calls for all parties to conflict to stop bombing hospitals, health workers and patients, which could not be justified under any circumstances. Now was the time to comply with resolution 2286 (2016). At a time when high-tech precision weapons were available, it was inconceivable that such “mistakes” could be made. Condemning attacks against medical facilities in Palestine, Yemen and Syria, he said it was unacceptable that such entities as ICRC had become military targets. He endorsed the Secretary-General’s recommendations and called upon all Member States to adhere to relevant international treaties. Emphasizing that peacekeeping and special political missions should play a more active role in creating an environment conducive to the protection of health workers and patients, he also called upon countries with influence to compel parties to conflict to end attacks against medical facilities. For its own part, Venezuela had never participated in any military coalition implicated in such attacks, he said, stressing that it endorsed no double standard on the matter.
WU HAITAO (China) said resolution 2286 (2016) underscored the importance of ending attacks against medical facilities, health workers and patients. Political efforts were needed to end conflicts in hotspots around the world, he said, urging the Council to promote dialogue and negotiation, and the international community to take a fair and objective view. It was incumbent upon Governments and parties to conflict to protect medical personnel and facilities, he said, noting that the former bore primary responsibility for protecting civilians within their borders. For their part, humanitarian agencies must win the trust of the parties concerned and adhere to the United Nations Charter, including the principle of sovereignty, and avoid becoming involved in conflict. Among other things, he called on the United Nations to establish an effective mechanism for communicating with humanitarian agencies, taking into account the views of the countries concerned.
RAMLAN BIN IBRAHIM (Malaysia) said today’s briefings had provided a harrowing glimpse into the struggles of health-care workers in armed conflict situations. Evidence of attacks against the sick and wounded, as well as medical personnel and facilities, underscored the grim reality that international humanitarian law had been flagrantly violated by a number of belligerent armed parties. Resolution 2286 (2016) had failed to change anything on the ground, which meant that the Council now faced the urgent task of implementing the Secretary-General’s recommendations. He noted that medical facilities in Syria continued to be targeted despite the recent agreement between the Russian Federation and the United States. The conflict in Yemen had seen similar attacks as recently as mid-August, he said, calling on the Council to take urgent action beyond mere condemnation. Going forward, the Secretary-General’s recommendations should act as a guiding framework, and the Council should work to ensure that attacks against medical facilities were swiftly investigated. He called for the establishment of fact-finding missions, stressing that all perpetrators must be held accountable.
ISMAEL ABRAÃO GASPAR MARTINS (Angola) condemned attacks and access restrictions on medical care, which had devastating impacts on civilians and medical staff. The deliberate obstruction of humanitarian assistance had undermined Council efforts mandated by the United Nations Charter. Calling attention to recent trends, he pointed out that vital medical supplies continued to be damaged and destroyed in South Sudan, Afghanistan, Yemen and Syria, prolonging people’s suffering. Meeting the basic needs of citizens was the main responsibility of Governments, he said, urging Member States to comply fully with international law.
YOSHIFUMI OKAMURA (Japan) said attacks on medical facilities for strategic purposes were “malicious beyond human decency and absolutely unacceptable”. Resolution 2286 (2016) demonstrated the Council’s strong commitment to ensure that such facilities were fully protected and secured, even during combat. A lack of accountability was a main factor behind the failure to prevent attacks on medical facilities. Facts were difficult to ascertain, different sides blamed each other and no thorough investigations were ever carried out. In that regard, the International Humanitarian Fact-Finding Commission had an important role to ensure the objective and fair application of international humanitarian law. The Council should play an active role in fact-finding and ensuring accountability, he said, adding that Japan would collaborate with the United Nations and other concerned parties on the issue.
EDUARD FESKO (Ukraine) said that, while international humanitarian and human rights law had sufficient provisions on legal protection for medical and humanitarian personnel and facilities, they were often violated by parties to armed conflict. He expressed support for the Secretary-General’s recommendations on enhancing the collection of data on attacks against medical care, conducting independent investigations into serious violations and ensuring accountability for those responsible. In cases where domestic accountability mechanisms were inadequate, Member States should cooperate fully with existing international criminal justice institutions in order to help combat impunity and ensure respect for international humanitarian law, he said.
EVGENY ZAGAYNOV (Russian Federation) acknowledged that medical staff and humanitarian personnel were risking their lives to address the needs of the sick and injured. Like the majority of States, the Russian Federation had supported resolution 2286 (2016), yet responsibility for upholding the safety of such personnel rested on the parties to the conflict. Turning to the Secretary-General’s report, he emphasized that the suffering of civilians in Syria must be verified. It was unfortunate that some States blamed the Russian Federation and Damascus after every attack, when, in fact, such incidents, as well as the destabilization in the region, were the result of the careless policies of the United States and its allies. Stressing the need for an effective solution, he said there was more than one way to end the conflict. Drawing attention to anti-Russian propaganda, he said it was intended to divert attention from failed policies. “Falsified information is being spread,” he said, calling for an end to provocative rhetoric.
PETER WILSON (United Kingdom), describing today’s briefings as a “wake-up call” for the Council, said that, sadly, five months after the adoption of resolution 2286 (2016), the overwhelming danger facing medical personnel and patients was still painfully apparent, adding that attacks were most starkly on display in Aleppo. “We cannot hide behind the passive voice,” he said. Syrian and Russian air forces were carrying out attacks against medical facilities in that city, whose name had become synonymous with suffering. While 400,000 people had lost their lives as a direct result of the conflict in Syria, the secondary death toll was likely to be much higher. Together with the forced removal of medical supplies from humanitarian convoys, attacks on medical facilities amounted to a calculated dismantling of Syria’s health-care system. Calling on all parties to improve the flow of humanitarian supplies to the 14 million people in Yemen who needed it, he urged thorough investigations into all allegations of international humanitarian law violations in that country. Groups such as Islamic State of Iraq and the Levant (ISIL/Da’esh) were no exception to the law, which was why the United Kingdom would propose a new plan to preserve and gather evidence of the group’s crimes in Iraq, he said.
GERARD VAN BOHEMEN (New Zealand), Council President for September, spoke in his national capacity, saying that the past few months had been “more than dispiriting” as attacks against medical workers, facilities and humanitarian convoys had increased. In Yemen, attacks had forced Médecins sans frontières to withdraw its support from six hospitals. In Syria, there had been a clear pattern of systematic targeting of medical workers and facilities, he said, citing reports that all hospitals in eastern Aleppo had been subjected to military attacks. The apparently deliberate attack on a humanitarian convoy last week had set a new low, demonstrating that some Member States were willing to show reckless disregard for international law in order to reach their military and political goals. States should do more to ensure their domestic regulatory frameworks protected medical care in armed conflict, he said, adding that they should also promote understanding of international humanitarian law among their armed forces. As for the Council, it must hold accountable those responsible for attacks on health-care providers and facilities.
Mr. ZAGAYNOV (Russian Federation) took the floor a second time to point out that the part of his statement saying, “suffering of civilians must be ended” had been interpreted incorrectly.