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	Make no mistake: we will relentlessly denounce attacks on healthcare by Dr. Joanne Liu President, Médecins Sans Frontières/Doctors Without Borders (MSF)   May 2016   MSF International President Dr. Joanne Liu, at UN Security Council session. 3 May 2016   Last Wednesday, airstrikes obliterated Al Quds Hospital in Aleppo. They blew apart at least 50 men, women and children. It killed one of the last remaining paediatricians in the city. A murderous airstrike.   There were almost 300 airstrikes in Aleppo over the last 10 days. Civilians, often in crowds, were repeatedly struck.   What are individuals in wars today? Expendable commodities, dead or alive. Patients and doctors are legitimate targets. Women, children, the sick, the wounded and their caregivers, are condemned to death. Stop these attacks.   I went to Kunduz, Afghanistan following the U.S. attack on our trauma centre on 3 October 2015.   One of the survivors, an MSF nurse whose left arm was blown off during the relentless airstrike, told me something that haunts me daily.   He said that when fighting erupted in Kunduz, MSF told its staff that its trauma centre was a safe place.   “We believed you,” he said. “Did you know that we would be bombed?”   I told him that until 3 October, I truly believed that the hospital was a safe place.   I cannot say that any more about any medical facilities on the frontlines today.   In Afghanistan, the Central African Republic, South Sudan, Sudan, Syria, Ukraine and Yemen, hospitals are routinely bombed, raided, looted or burned to the ground.   Medical personnel are threatened. Patients are shot in their beds.   Broad attacks on communities and precise attacks on health facilities are described as mistakes, are denied outright, or are simply met with silence.   In reality, they amount to massive, indiscriminate and disproportionate civilian targeting in urban settings, and, in the worst cases, to acts of terror.   The effects of the attacks against health facilities emanate far beyond those immediately killed and injured.   They demolish routine and lifesaving healthcare for all. They make life impossible. Full stop.   On 26 October 2015, a Saudi-led coalition airstrike hit an MSF hospital in Haydan, in the north of Yemen, leaving at least 200,000 people without lifesaving care.   It was the first of three MSF facilities partially or completely destroyed in Yemen over a period of three months.   Attacks on MSF facilities provide only a glimpse into the brutality of war.   Attacks on other hospitals and clinics – and schools, markets, houses of worship – are routine. Local health workers bear the brunt of these abuses.   We are at a deadly impasse. We can no longer assume that fully functioning hospitals – in which patients are fighting for their lives – are out of bounds. Hospitals and patients have been dragged onto the battlefield.   In Jasim, a town in southern Syria, citizens have protested in front of a hospital to prevent its re-opening. They know what happens to functioning hospitals.   We are facing an epidemic of attacks on health facilities, impeding our ability to do our core work. And to date, our calls for independent investigations have gone unheeded.   Accountability begins with independent and impartial fact finding. Perpetrators cannot be investigators, judges and juries.   Make no mistake: we will relentlessly denounce attacks on healthcare. We will speak out loudly and with force about what we witness in the field.   Medicine must not be a deadly occupation. Patients must not be attacked or slaughtered in their beds.   We physicians take an oath when we join the medical profession. We treat every individual, regardless of who they are, regardless of their religion, their race, or on which side they may fight. Even if they are wounded combatants, or if they are labelled as criminals or terrorists.   Hospitals must not be attacked or forcibly entered by armed personnel, including to search for and capture patients.   To turn our back on these basic principles is to turn our back on the foundation of medical ethics.   Medical ethics cannot be buried by war. The neutrality of war-time medical care cannot be stamped out by state sovereignty or domestic law. Especially in an age of counter-terrorism and counter insurgency – characterized by shifting alliances and murky rules of engagement.   While the nature of warfare may have changed, the rules of war have not.   You are charged with protecting peace and security. Yet four of the five permanent members of this council have, to varying degrees, been associated with coalitions responsible for attacks on health structures over the last year.   These include the NATO-led coalition in Afghanistan, the Saudi-led coalition in Yemen, the Russia-backed Syrian-led coalition.   You therefore must live up to your extraordinary responsibilities, and set an example for all states. I repeat: Stop these attacks.   The discussion here today cannot amount to empty rhetoric. This resolution cannot end up like so many others, including those passed on Syria over the past five years: routinely violated with impunity.   In Syria, where healthcare is systematically targeted, and besieged areas are cynically denied medical care – uphold your obligations.   Ensure the protection of the impartial provision of healthcare in conflict.   Also support the obligations of health workers to treat all sick and wounded without discrimination.   Dr. Maaz, the paediatrician murdered in Aleppo last week, was killed for saving lives.   Today, we remember his humanity and bravery, shared by so many patients, nurses, doctors, communities and MSF staff caught up in areas of conflict.   For their sake: translate this resolution into action. Re-commit – unambiguously – to the norms that govern the conduct of war.   This resolution must lead to all states and non-state actors stopping the carnage.   You must also pressure your allies to end attacks on healthcare and populations in conflict areas. We will not leave patients behind. And we will not be silent. Seeking or providing healthcare must not be a death sentence.   You will be judged not on your words today, but on your actions. Your work has only begun. Make this resolution save lives.   http://www.msf.org/en/article/msf-president-un-security-council-stop-these-attacks   28 April 2016   Airstrike destroys Red Cross, MSF-supported hospital in Aleppo.   The bombing of the MSF-supported hospital in the northern Syrian city of Aleppo on Wednesday night has killed at least 14 people, and three doctors.   According to hospital staff on the ground, the hospital was destroyed by at least one airstrike which directly hit the building, reducing it to rubble. Other airstrikes in the neighbourhood also hit areas close to the hospital.   “MSF categorically condemns this outrageous targeting of yet another medical facility in Syria” said Muskilda Zancada, MSF head of mission, Syria. “This devastating attack has destroyed a vital hospital in Aleppo, and the main referral centre for paediatric care in the area. Where is the outrage among those with the power and obligation to stop this carnage?”   MSF, along with the International Committee of the Red Cross (ICRC), which also supported the Al Quds hospital, both expressed outrage over what appeared to be deliberate targeting of the life-saving facility.   "The recent attack on the ICRC-supported Quds hospital is unacceptable and sadly this is not the first time the lifesaving medical services have been hit," said Marianne Gasser, head of the ICRC mission in Syria, in a press statement.   "We urge all the parties to spare the civilians. Don''t attack hospitals, don''t use weapons that cause widespread damage. Otherwise, Aleppo will be pushed further to the brink of humanitarian disaster."   Over the last week, several other medical structures have been attacked and destroyed in Aleppo, and five rescue workers from the Syrian Civil Defence organisation have been killed.   “Compounding this tragedy is that the dedication and commitment of the staff of Al Quds, working under unimaginable conditions, has been unwavering throughout this bloody conflict,” said Zancada.   The 34-bed hospital offered services including an emergency room, obstetric care, an outpatients department, an inpatients department, an intensive care unit and an operating theatre. Eight doctors and 28 nurses worked full time in the hospital, which was the main referral centre for paediatrics in Aleppo.   Health Care in Danger - Stop the Violence. Protect Health Care (Federation of Red Cross, Red Crescent Societies)   In the last few months, a number of attacks against health-care workers, medical transports and facilities have taken place in several countries, like Afghanistan, Syria and Yemen to mention a few.   These incidents are taking place in countries with fragile health-care systems that are already struggling to treat the numbers of people affected by the ongoing conflicts there. In some cases, the situation is made yet worse by the restrictions placed on aid workers, preventing them from getting to the people who need them.   Both the attacks themselves and their consequences are of serious concern. These were attacks on medical personnel and facilities protected under international humanitarian law, leaving death and destruction in their wake and disrupting vital health-care services. All those involved with the Health Care in Danger initiative are alarmed by the long-term impact these attacks may have on people’s health.   These are not isolated incidents. The International Committee of the Red Cross, through the Health Care in Danger project, has been gathering data in 11 countries since January 2012. By December 2014, 2,398 attacks against health-care personnel, facilities and vehicles had been recorded. This alarming situation highlights the urgent need for measures to prevent future violence.   The Health Care in Danger initiative, with the support of experts and professionals from different backgrounds, international professional associations and health-care services, as well as the International Red Cross and Red Crescent Movement, has formulated a substantive body of recommendations and identified practical measures that, if implemented by all those concerned, would increase the protection of health-care services in armed conflict or other emergencies.   As members and partners of the Health Care in Danger initiative, we call on States, weapon bearers, international and national humanitarian agencies and health organizations to give urgent attention to the recommendations resulting from the Health Care in Danger initiative.   In particular, we urge States to make every effort to investigate and condemn attacks against health-care personnel, facilities and medical transports that violate international law, including international humanitarian law.   To revise their domestic legislation and its implementation to ensure that it is in line with their obligations under international law, including international humanitarian law.   To ensure that the military are properly trained to know, abide by and respect the applicable legal framework for the protection of health care as well as ethical duties of health-care personnel.   To cooperate with health and humanitarian organizations to ensure that health personnel are specially trained to know, apply and uphold their legal and ethical duties.   To actively seek to raise awareness of the proper use of the red cross/red crescent/red crystal emblems by armed forces and by the population at large.   To take the opportunity of the forthcoming International Conference of the Red Cross and Red Crescent to further their commitment to implementing recommendations and measures on protecting health care in armed conflict and other emergencies and to consider submitting specific voluntary pledges on this issue.   We urge State armed forces to respect in all circumstances, in particular in situations of armed conflict or other emergencies, health care workers, facilities and medical transports and to allow patients to receive adequate care, regardless of their affiliation.   To revise military rules of engagement and operational practice and procedures to ensure that recommendations and measures for the protection of the delivery of health care are included therein and that military personnel are adequately trained in them.   We call on all non-state actors to respect in all circumstances, in particular in situations of armed conflict or other emergencies, health care workers, facilities and medical transports and to allow patients to receive adequate care, regardless of their affiliation.   We encourage international and national humanitarian and health organizations to continue to advocate for the preservation of principled humanitarian action, the respect of the "Ethical Principles of Health Care in Times of Armed Conflict and Other Emergencies “endorsed by civilian and military health-care organizations in June 2015.   And the protection of patients, health-care personnel, facilities and medical transport in armed conflict or other emergencies and to join ongoing efforts or to start their own initiatives to those ends.   To ensure that health facilities they govern are taking necessary actions to reduce the risk of violence within the facilities premises.   * Health Care in Danger is an initiative of the International Red Cross and Red Crescent Movement to make access to, and delivery of, health care safer in armed conflict or other emergencies. The initiative is supported by a number of partners and organisations, members of the Health Care in Danger Community of Concern.   http://healthcareindanger.org/ http://healthcareindanger.org/the-issue/ http://www.ifrc.org/en/news-and-media/opinions-and-positions/opinion-pieces/2015/stop-the-violence-protect-health-care/ http://www.icrc.org/en/document/hcid-statement http://www.safeguardinghealth.org/sites/shcc/files/SHCC2016final.pdf (60pp) http://bit.ly/2a2tNak http://www.emro.who.int/eha/news/protecthealthworkers-stop-the-attacks-on-health-care-in-syria.html http://www.emro.who.int/eha/countries-in-crisis/index.html http://www.msf.org/en/article/20160808-syria-msf-supported-hospital-idlib-bombed-ground-amid-increased-intensity-attacks http://bit.ly/2aLCxjr http://bit.ly/2b8ij3I http://www.msf.org/en/news http://bit.ly/2bsS8qJ http://bit.ly/2bNEc7x http://bit.ly/2aQefF2 http://ab.co/29VrkZX   * UN Security Council Resolution 2286 adopted in May condemning attacks on health care workers and facilities in armed conflict: http://bit.ly/2beluch Visit the related web page
	Wars without limits are wars without end by Peter Maurer International Committee of the Red Cross, agencies   24 May 2016, Istanbul, Turkey   Speech given by Peter Maurer, President of the International Committee of the Red Cross, at the World Humanitarian Summit – High level Leaders’ Roundtable - Uphold the norms that safeguard humanity.   I speak to you today in the ICRC’s role as the Guardian of the Geneva Conventions – a set of universally ratified treaties, applicable to all parties in conflict. At the heart of all international humanitarian law (IHL) lies the protection of civilians, of detainees, of the wounded and sick, and of others not participating in hostilities. It is this shared humanity that gives IHL its relevance, its legitimacy, and its universal sense.   I speak to you also because millions of people who suffer in armed conflicts around the world have no voice. What will future historians remember from our present time? That millions of people were deliberately or carelessly targeted; that their homes, hospitals and schools were destroyed and entire cities bombed to rubble; that millions of men, women and children were forced into displacement? We still have a shot at making a different kind of history.   This is where international humanitarian law can guide us – and future generations – through the dark times of war, to make the right choices when confronted with violence and hatred, with radical ideologies of exclusion and destruction.   The dangerously large gap between discourse and practice around the law must be closed. The crumbling consensus of belligerents around the law must be halted. Respecting the law is the first step to turn the tide. It is simple, yet demanding: • Stop targeting civilians; • Do not rape, torture or summarily execute people; • Do not bomb or otherwise attack hospitals and schools; • Do not threaten, kidnap or kill those who help; • Do not abuse civilians as human shields; • Do not use illegal weapons and do not use weapons illegally; And if you see any of these happening: Do something against it, with all your authority and power.   Do not take the easy way out by declaring all civilian victims collateral damage. Instead, respect IHL: • Make every effort to protect civilians in your choice of weapons and military tactics; • Provide relief for those who suffer and allow access to those who help in a neutral, impartial and independent way; • Care for those who flee violence; • Treat detainees humanely.   IHL is principled but also pragmatic and practical: it does not rule out war, it sets limits to its conduct, thereby recognizing the very real dilemma of finding the balance between military necessity and humanitarian imperative. But law can only ever be a means to an end. Law is never an end in and of itself.   IHL can be a formidable instrument if it is applied in good faith, and continually interpreted and developed to match new challenges. It must not be abused as a political instrument against adversaries, exacerbating already tense situations. It must serve to build a space for dialogue among and between belligerents. It must be the basis of renewed dialogue on the challenges and dilemmas of preserving a minimum of humanity in war: getting food parcels and doctors into besieged areas, getting a team into a prison to reduce malnutrition and disease, getting engineers to rebuild sewage systems and the list goes on.   As difficult and senseless as war can be, we need unremitting investment, engagement and negotiation, to translate the spirit of the law into a reality for the people who need protection. IHL is no longer just the business of a few military and legal specialists; it is headline news and an integral part of the humanitarian landscape. It has value as a strong normative system, not least for all those who are suffering from war.   With our experience from the frontlines of armed conflict, we stand ready to engage with you, individually and collectively, publically or confidentially, as you deem fit, to move to the next level, to find pragmatic solutions to complex dilemmas, to understand the specificities of your respective environments, and to learn together from best practices.   I call on you to respect the law, to ensure respect for the law, to keep the balance in a world where many different powers pull in all different directions. If this Summit wants success, the outcome must focus on people, not on systems.   Commitments must be followed by concrete actions and a profound change of behaviour on all sides. The people suffering in wars deserve nothing less than actions that will protect their lives and dignity. I call upon you to grasp this Summit’s opportunity, to recommit to the global contract of humanity in IHL – in your own interest and, yes, in the interest of your adversaries, too. Use your power to ensure that war has limits – every day, in every armed conflict, and for everyone – because wars without limits are wars without end.   http://www.irinnews.org/interview/2016/05/27/qa-peter-maurer-respect-rules-war-or-pay-price http://blogs.icrc.org/law-and-policy/ http://bit.ly/2bDnLYk http://bit.ly/2c5R20E http://bit.ly/2bNDxW9 http://www.spherehandbook.org/ http://www.sphereproject.org/news/ Visit the related web page
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