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Hospitals, doctors in gun sights

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The AMA has joined international calls for combatants to respect the neutrality of health workers and medical facilities amid widespread outrage at an attack on a Syrian hospital that has reportedly left at least 55 dead and 60 injured.

AMA Vice President Dr Stephen Parnis said it was “unacceptable” that health professionals and facilities were being targeted in armed conflicts in many parts of the world, most recently in Syria.

“It is unacceptable that health personnel and facilities are ever regarded as legitimate targets,” Dr Parnis said. “It is the duty of the international health community to speak out and protect the non-discriminatory provision of health care to all those in need.”

The AMA Vice President was commenting following a recent spate of deadly attacks on hospitals and clinics in strife-torn parts of the world, including Syria and Afghanistan, in which hundreds of patients, doctors, nurses and other health workers have been killed and injured.

In one of the most recent incidents, Syrian Government forces were blamed for killing at least 55 people and injuring 60 late last month after launching an air strike on the al-Quds Hospital in Aleppo.

Several doctors and nurses were among those killed in the attack on the hospital, including one of the city’s few remaining paediatricians, Dr Mohammed Wassim Maaz.

A spokeswoman for Medicins Sans Frontieres (MSF) which, along with the International Committee of the Red Cross (ICRC), has been supporting the hospital, told The Guardian that 95 per cent of doctors from opposition-held parts of Aleppo had fled or been killed, leaving fewer than 80 doctors to care for around 250,000 still living in the war-torn city.

The al-Quds Hospital is the latest in a string of attacks on medical facilities. According to media reports at least seven MSF-supported hospitals and clinics have been bombed since the beginning of the year, and the US Government has punished 16 military officers over a deadly airstrike on a MSF hospital in the Afghan city of Kunduz last year in which 42 people, including 13 doctors, nurses and other health workers, were killed.

In a report on the incident released late last month, the Pentagon blamed a chain of human errors and failures of procedures and equipment for the attack, but rejected accusations from MSF that it amounted to a war crime.

MSF is furious that the hospital was bombed despite the fact all combatants had been notified of its location, and that the attack continued despite repeated calls from the medical charity to the US military alerting it to the fact it was bombing a medical facility.

The military personnel involved, including a general, will not face criminal charges and will instead receive a range of “administrative actions” including suspension, letters of reprimand and removal from command.

The ICRC, the World Health Organisation and the World Medical Association have in recent years been sounding increasingly loud warnings about the incidence of attacks on health workers and medical facilities.

Late last year they issued a joint call for governments and non-state combatants to adhere to international laws regarding the neutrality of medical staff and health facilities, and ensuring this commitment is reflected in armed forces training and rules of engagement.

The ICRC, through its Health Care in Danger project, recorded 2398 attacks on health workers, facilities and ambulances in just 11 countries between January 2012 and the end of 2014.

Disturbingly, while many incidents involved health workers and facilities caught in cross-fire or being hit in indiscriminate attacks, the ICRC has also identified numerous incidents where they have been deliberately targeted.

Governments attending the 32nd International Conference of the Red Cross and Red Crescent last December reaffirmed their commitment to international humanitarian law and a prohibition on attacks on the wounded and sick as well as health care workers, hospitals and ambulances, and the ICRC is also working with non-state combatant groups to raise awareness of laws and conventions around the protection of patients, health workers and medical facilities.

Adrian Rollins