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Hospitals, health workers increasingly targeted as conventions break down

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A wave of deadly attacks on hospitals and health workers in Middle East conflicts has fuelled fears that basic conventions against targeting medical and humanitarian services in war zones are breaking down.

United Nations Secretary General Ban Ki-moon has denounced what calls “the brazen and brutal erosion of respect for international humanitarian law.”

“These violations have become so routine there is a risk people will think that the deliberate bombing of civilians, the targeting of humanitarian and health care workers, and attacks on schools, hospitals and places of worship are an inevitable result of conflict,” he said.

Mr Bann called for action to be taken against those responsible.

“International humanitarian law is being flouted on a global scale,” Ban said. “The international community is failing to hold perpetrators to account.”

A senior Medical charity Medicins Sans Frontieres (MSF) official has warned that the concept of international humanitarian law may be “dead” after a hospital operated by the organisation was destroyed in a bombing attack by Saudi-led forces operating in Yemen – the second such attack in less than a month.

MSF said that on 26 October its hospital in Haydan was destroyed by air strikes carried out by the Saudi Arabia-led coalition fighting against Houthi forces in the war-torn Middle East country. Multiple casualties were only avoided by the rapid evacuation of patients and medical staff.

The attack came just weeks after United States forces bombed an MSF hospital in north-east Afghanistan, killing 22 people including 12 medical staff.

And the charity has reported that at least 35 patients and medical workers have been killed, and 72 wounded, following an escalation of air bombing raids in northern Syria.

It said 12 hospitals have been hit in the Idlib, Aleppo and Hama governorates in the past month, causing six to close and destroying four ambulances.

Head of MSF operations in Syria, Sylvain Groulx, said calls for an immediate halt to such attacks had so far fallen on deaf ears.

“After more than four years of war, I remain flabbergasted at how international humanitarian law can be so easily flouted by all parties to this conflict,” Mr Groulx said. “We can only wonder whether this concept is dead.”

Pressure is mounting on the United States Government to agree to an independent inquiry into its attack on the MSF hospital in the Afghan city of Kunduz.

The International Humanitarian Fact-Finding Commission (IHFFC), established under the Geneva Conventions, has written to both the US and Afghanistan governments to offer its services for an independent inquiry following a complaint from MSF.

US President Barack Obama has issued a public apology for the bombing, and his Government has initiated its own inquiry. But Mr Obama has been steadfast in resisting calls for arms-length investigation, and is considered unlikely to accept the Commission’s offer.

Neither the US nor Afghanistan are member states of the Commission, which has no power to compel their participation.

“It is for the concerned Governments to decide whether they wish to rely on the IHFFC,” the Commission said. “The IHFFC can only act based on the consent of the concerned State or States”.

President Obama has assured that his Government would conduct a “transparent, thorough and objective” inquiry into the tragedy.

But MSF claims the attack could amount to a war crime and must be investigated independently.

“We have received apologies and condolences, but this is not enough. We are still in the dark about why a well-known hospital full of patients and medical staff was repeatedly bombarded for more than an hour,” said Dr Joanne Liu, MSF International President. “We need to understand what happened and why.”

Dr Liu said her organisation was determined to uncover how the attack had occurred, and to hold those responsible to account.

“If we let this go, as if it was a non-event, we are basically giving a blank cheque to any countries who are at war,” Dr Liu said. “If we don’t safeguard that medical space for us to do our activities, then it is impossible to work in other contexts like Syria, South Sudan, like Yemen.

Saudi authorities have denied responsibility for the Yemen hospital attack, though it has been reported that Saudi Arabia’s ambassador to the UN has blamed MSF for providing incorrect GPS coordinates to the Saudi-led coalition – a claim the charity denies.

MSF said it provided Saudi-led armed forces with details of the hospital’s location on multiple occasions, including just two days before the strike that destroyed the facility.

President Obama called Dr Liu to apologise for the attack after the US military admitted responsibility.

The Kunduz hospital attack occurred despite the fact that MSF had given all warring parties the GPS coordinates of the hospital.

Outrage over the attack was heightened when the US initially appeared to claim it was a necessary and legitimate use of force, before later characterising it as a mistake.

MSF said that “any statement implying that Afghan and US forces knowingly targeted a fully functioning hospital – with more than 180 staff and patients inside – razing it to the ground, would be tantamount to an admission of a war crime,” MSF Australia President Dr Stewart Condon and Executive Director Paul McPhun said. “There can be no justification for this abhorrent attack.”

“Medecins Sans Frontieres reiterates its demand for a full, transparent and independent international investigation to provide answers and accountability to those impacted by this tragic event.”

Adrian Rollins