Protection of Civilians
Expected Council Action
In late September, the Council will hold a briefing, followed by consultations, on the Secretary-General’s recommendations regarding measures to prevent attacks on health care in armed conflict, as requested by resolution 2286 of 3 May. Briefers may include the Secretary-General and representatives of civil society, although this had yet to be confirmed at press time.
Press elements—or a press statement—could be a possible outcome of the meeting.
Key Recent Developments
In recent years, attacks on health care workers and medical facilities have been a disturbing feature of armed conflicts in numerous conflict zones. In addition to the harm caused to health care workers and facilities, such attacks have a devastating impact on people in need, whose access to health care and humanitarian assistance is curtailed. On 3 May, the Council adopted resolution 2286 on the protection of health care in armed conflict—including medical workers, transport, equipment and facilities—and strongly condemned any attacks against medical personnel.
Since the adoption of this resolution, attacks in Syria, Yemen and Pakistan have highlighted the gravity of the problem. On 31 May, a bomb struck the Al-Ihsan hospital in Aleppo, Syria, wounding 45 people, while at least 10 people died when the Bayan hospital, also in Aleppo, was hit during an aerial bombardment on 8 June. According to the World Health Organization (WHO), there have been 71 attacks on health facilities this year in Syria. In Yemen, a 15 August airstrike, reportedly by the Saudi-led coalition, hit the Abs Hospital in Hajjah, Yemen, killing 19 people and wounding 24. WHO has reported that more than 100 health facilities have been damaged in Yemen since the fighting there escalated in March 2015. According to MSF which supported the Abs Hospital—which was “partially destroyed” in the bombing—it was “the main medical facility…in the western part of Hajjah governate”. Following this attack, MSF withdrew its staff from hospitals in northern Yemen’s Sadda and Hajjah governates because of security concerns. In Pakistan, a suicide attack at the entrance to a hospital in Quetta on 9 August claimed the lives of more than 70 people; those targeted appeared to be lawyers mourning the death of a colleague, whose body was in the emergency room of the hospital. A Pakistani branch of the Taliban and the Islamic State of Iraq and the Levant took responsibility for the attack.
Resolution 2286 was designed to convey a strong political signal about the unacceptability of violations of international humanitarian law arising from attacks against medical and humanitarian workers exclusively engaged in medical duties in conflict situations. Among other things, the resolution:
- strongly condemned attacks against medical and humanitarian personnel and impunity for such attacks; and strongly urged states and all parties to armed conflict to develop effective measures to prevent and address attacks on health care in armed conflict;
- underlined the role of education and training in international humanitarian law as a means to support efforts to halt and prevent such attacks;
- requested the Secretary-General to promptly provide the Council with recommendations regarding measures to prevent attacks on health care workers and facilities in armed conflict; and
- requested the Secretary-General to brief annually on the implementation of the resolution.
Immediately following the adoption of the resolution, the Council received a briefing on health care in armed conflict. The briefers included UN Secretary-General Ban Ki-moon; Peter Maurer, the president of the ICRC; and Joanne Liu, the president of MSF. All of them underscored the devastating human impact of attacks on medical personnel and facilities in Syria, Yemen, Afghanistan and elsewhere. Ban said that “intentional and direct attacks on hospitals are war crimes” and that “denying people access to essential health care is a serious violation of international humanitarian law”. Maurer noted that “entire systems unravel under the attacks on health facilities and personnel”. Liu said that although the Council is responsible for protecting peace and security, “four of the five permanent members…have, in varying degrees, been associated with coalitions responsible for attacks on health-care structures”, including in Afghanistan, Yemen and Syria. She exhorted the Council to “stop those attacks”.
The Council held an open debate on 10 June on the protection of civilians in the context of peacekeeping operations. Jean-Marc Ayrault, France’s minister of foreign affairs and international development, presided. Ban and President Faustin-Archange Touadéra of the Central African Republic addressed the Council. Maurer briefed by video teleconference.
On 18 August, the Secretary-General submitted his recommendations for the protection of health care in armed conflict to the Security Council, as requested by resolution 2286. Among other things, the Secretary-General called for:
- adherence to international treaties;
- reinforcement of national legislation related to the protection of medical care in armed conflict;
- guarantees that medical personnel engaged solely in medical duties can act in accordance with medical ethics without being punished for doing so;
- adoption, review, revision and implementation of operational precautionary measures, including recording and mapping the location of medical personnel, facilities and equipment; and
- improvement in data collection, analysis and reporting.
Key Issues
The key issue for the Council is whether it can play an effective role in implementing the Secretary-General’s recommendations on the protection of health care in armed conflict and, as a result, have a concrete impact on country-specific situations in which medical workers and facilities are targeted. One complicating factor, as Liu noted in the 3 May briefing, is that several permanent members of the Council have been affiliated, to different extents, with coalitions involved in attacks on health care. A related question is how the Council can continue to maintain attention on this issue and ensure that its decisions appropriately reflect the imperatives of medical neutrality under international humanitarian law.
Options
The Council could consider issuing a statement that:
- welcomes the Secretary-General’s recommendations and urges that they be implemented by all relevant actors;
- urges states to refrain from exporting weapons that might be used in ways that violate international law, including in attacks on health care;
- calls on the UN system to develop a mechanism to collect data on attacks on medical workers and facilities across conflicts in a standardised way; and
- emphasises the importance of medical neutrality in relevant Council country-specific decisions.
Council and Wider Dynamics
The protection of health care in armed conflict is an issue of growing concern to several Council members and the wider UN membership. This is largely because of the high number of aid workers who are subjected to violence, the damage to medical facilities in numerous conflict settings and the negative implications of these attacks on the lives of civilians in need of medical care and humanitarian assistance. Furthermore, there seems to be a rising perception that parties to conflict in many contexts show little respect for international humanitarian law, which includes protections for aid workers.
Leadership on this issue has been taken by five elected members—Egypt, Japan, New Zealand, Spain and Uruguay—that served as penholders on resolution 2286, a resolution that was sponsored by 85 member states.
| Security Council Resolutions | |
| 3 May 2016 S/RES/2286 | This condemned attacks on health care workers and facilities in armed conflict. |
| Secretary-General’s Reports | |
| 13 May 2016 S/2016/447 | This was the 12th report on the protection of civilians. |
| Security Council Meeting Records | |
| 10 June 2016 S/PV.7711 | This was a ministerial-level open debate on the protection of civilians in the context of peacekeeping operations. |
| 3 May 2016 S/PV.7685 | This was a briefing on the protection of health care in armed conflict. |
| Security Council Letters | |
| 18 August 2016 S/2016/722 | This letter transmitted the Secretary-General’s recommendations on the protection of health care in armed conflict. |
