Health: the latest WMD in Syria
The continued destruction of a once proud and beautiful country enters its sixth year and the challenges the healthcare profession has had to endure in this unique warzone have been profound. There are many aspects that influence healthcare policy and provision in times of war; from the socioeconomic to the political, however what has been seen increasingly in the case of Syria is the undermining of medical neutrality and the consistent ‘weaponisation’ of health.
Not long after the last hospital in Eastern Aleppo had been razed to the ground, the city fell to regime forces and it is in depriving people of their basic access to healthcare that health has been weaponised against those who direly require it1. Destroying hospitals and killing health workers both native and otherwise not only denies access to civilians who need medical attention but also discourages doctors from abroad from coming to help serve a community under attack. When no place is sacred and even doctors, patients and hospitals are legitimate targets in war, we see a breakdown in human decency unlike any other; nearly 800 healthcare workers have been killed (documented) on the job between 2011-162. The Fourth Geneva Convention affords protection to all civilian populations in times of war, in particular health and humanitarian workers tending to both combatants and civilians alike thereby recognising the importance of respecting and protecting the work of the medical profession3.
‘Syria has become the most dangerous place on earth for health-care providers’, says the Lancet in a preliminary inquiry for The Lancet–American University of Beirut Commission on Syria2. The Syrian Regime and its allies have consistently and brazenly disregarded the Geneva Conventions with widespread aerial bombardment of civilian areas with an alleged emphasis on targeting hospitals and vital healthcare infrastructure. Without vital healthcare institutions life becomes untenable in these areas forcing civilians to choose between migration and surrender or certain death from communicable illness, starvation and injury. Despite these tactics and patterns of attacks by pro-governmental forces identified early on in the Syrian conflict, the situation has since escalated causing a mass exodus of doctors and medical professionals leaving a deficit with even more deficient resources to treat the ever increasing numbers of casualties2.
The impact of weaponising healthcare is complex to categorise as its effects and implications are so far reaching. Some aspects to consider are, firstly, the immediate lack of access to medical assistance by those acutely unwell and injured collaterally in airstrikes or warzones. After this, the targeting and marginalization of doctors leads to underground hospitals and secret treatment out of fear for both the patient and the healthcare provider’s lives. Indeed in 2011 an execution of a doctor by pro governmental forces became the first of many such documented incidents4. Indeed this systematic targeting of medics in Syria by the Syrian regime culminated in legislation passed in 2012 that criminalised medical aid provision for opposition forces and those deemed to be in opposition to the regime, not dissimilar to Serbian legislation passed during the war in Kosovo5.
To be cont…
- Health workers and the weaponisation of health care in Syria: a preliminary inquiry for The Lancet–American University of Beirut Commission on Syria. Fouad M Fouad, Annie Sparrow, Ahmad Tarakji, Mohamad Alameddine, Fadi El-Jardali, Adam P Coutts, Nour El Arnaout, Lama Bou Karroum, Mohammed Jawad, Sophie Roborgh, Aula Abbara, Fadi Alhalabi, Ibrahim AlMasri, Samer Jabbour
- al-Khalidi S. Syrian forces shoot protesters, kill 6 in mosque. May 23, 2011. http://www.reuters.com/article/us-syria-gunfireidUSTRE72M04T20110323 (accessed March 7, 2017).
- United Nations Human Rights Council. Assault on medical care in Syria 2013. http://www.ohchr.org/EN/HRBodies/HRC/ RegularSessions/Session24/Documents/A-HRC-24-CRP-2.doc (accessed March 7, 2017).