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Report of the Secretary-General on the protection of civilians in armed conflict
by António Guterres
United Nations
22 May 2018
With more than 128 million people worldwide requiring immediate humanitarian aid, mostly due to war and violence, the United Nations Secretary-General has urged the international community to do more to protect civilians caught in conflict.
António Guterres made the appeal during a UN Security Council meeting, where he presented a report outlining ways governments can step up action.
He noted that last year, hundreds of thousands of civilians were killed or injured in countries affected by conflict: Afghanistan, the Central African Republic, the Democratic Republic of the Congo, Iraq, Syria, Somalia, and Yemen.
“The most effective way to protect civilians is to prevent conflicts and to end them,” Mr. Guterres told the Council. “This is why conflict prevention, resolution and peacebuilding are, and will remain, the highest priorities for the whole United Nations system.”
Also briefing the Council, Yves Daccord, Director-General of the International Committee of the Red Cross (ICRC), echoed another concern expressed by the UN chief: attacks against medical facilities and personnel.
He said that in the two years since the Council adopted a resolution on this subject, the ICRC has recorded more than 1,200 incidents in 16 countries, with health workers killed, hospitals bombed or looted, and medical supplies destroyed or prevented from crossing front lines.
“The gap between words and actions is rather dramatic,” he charged. “And it is imperative that all states, not only parties to conflicts, uphold international commitments and make the protection of healthcare a national priority.”
António Guterres: In my previous report, I underlined that the most effective way to protect civilians is to prevent the outbreak, escalation, continuation and recurrence of armed conflict. This remains my overarching priority.
In this regard, dialogue and inclusive peace processes that address the parties’ grievances and lead to sustainable solutions, coupled with a long-term holistic approach that addresses the root causes and prevents the escalation or recurrence of conflict, promotes human rights and the rule of law and strengthens governance and institutions, are essential.
In my report on peacebuilding and sustaining peace, issued in January 2018, I sought to forge a common vision, systems and capacities across the United Nations to support Member States in sustaining peace and building resilient and prosperous nations in line with their commitment to leave no one behind.
Where we cannot prevent or resolve conflict, we must strengthen the protection of civilians. In doing so, we also contribute to the foundations for future peace.
In my previous report, I identified three protection priorities: enhance respect for international humanitarian and human rights law and promote good practice by parties to conflict; protect the humanitarian and medical mission and accord priority to the protection of civilians in United Nations peace operations; and prevent forced displacement and pursue durable solutions for refugees and internally displaced persons. In the present report, I review progress made in relation to those priorities, with a focus on enhancing respect for international law and promoting good practice.
Section II contains a review of the global state of the protection of civilians in armed conflict during the period from 1 January to 31 December 2017. It reveals a state of unrelenting horror and suffering affecting millions of women, children and men across all conflicts.
Civilians are routinely killed or maimed, and civilian objects damaged or destroyed, in targeted or indiscriminate attacks that frequently involve the widespread use of explosive weapons.
Civilians are forced from their homes to meet a perilous fate, while countless others are missing. Humanitarian and medical personnel are frequently targeted and killed or prevented from responding to those in need.
Meanwhile, conflict-driven food insecurity and the potential for famine leave millions of lives in the balance. All this, and the decimation of entire towns and cities and the once-vibrant communities and societies that were their lifeblood, undermine the prospects for peace and stability and the restoration of hope and opportunity for the future.
The state of the protection of civilians is bleak, and the need for action to address it is urgent.
As conflict becomes increasingly urbanized, with the potential to affect tens of millions of people, ensuring the effective implementation of international humanitarian and human rights law is of paramount importance.
The targeting of or failure to protect civilians cannot go unchallenged. The Security Council and Member States can ill afford to abdicate their responsibilities in the face of widespread violations and allow political differences to prevent or undermine concerted action to address and prevent violations. The stakes for civilians — and for international peace and security — are simply too high.
Member States have an instrumental role to advance respect for international humanitarian and human rights law, to end and prevent the spillover and recurrence of armed conflict, and to counter terrorism and prevent violent extremism. There are practical steps that can be taken by parties to conflict and Member States to respect and ensure respect for the law and enhance the protection of civilians.
I recommend that Member States develop national policy frameworks that establish clear institutional authorities and responsibilities for the protection of civilians; and that they support and facilitate expanded efforts to engage non-State armed groups to enter into action plans and develop codes of conduct, operational policy and other tools to ensure effective protection and accountability.
Such actions would constitute an advance towards effective implementation of the law and protection of civilians. At the same time, I recognize the continuing need for heightened advocacy and a concerted effort to ensure accountability for serious violations.

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Central African Republic: Days of violence and mass casualties in Bangui
by Medicins Sans Frontieres / Doctors Without Borders
17 May 2018
For over 18 months, Central African Republic (CAR) has yet again been subjected to extreme violence inflicted on a population left traumatised by the civil war in 2013 and 2014. Until recently, the capital city Bangui appeared to have been spared the attacks and fighting that have erupted in the provinces.
This is no longer the case. In just a few weeks, over 150 casualties have been treated in SICA hospital managed by Médecins Sans Frontières in Bangui. The teams have had to activate two mass casualty plans to respond to the emergency caused by a succession of particularly violent days in the capital.
On Sunday 8 April, national and international security forces mounted a joint operation against local armed groups in the city’s economic hub and mainly Muslim PK5 district. The operation led to clashes that left dozens of wounded among the armed forces as well as the population.
Two days later, the fighting flared up again and casualties arrived in huge numbers at the city’s medical facilities. Over the course of two days, the teams in SICA hospital treated 64 patients, principally for bullet wounds.
Violence erupted yet again on Tuesday, 1 May, with clashes and attacks targeting Fatima district, especially the church, as well as PK5 and the surrounding neighbourhoods. Armed groups, but also people who live in these neighbourhoods, clashed and heavy artillery resounded throughout the town.
This resurgence of violence, unprecedented since 2015, has rekindled divisions between Christian and Muslim communities and triggered a wave of reprisals across the city. It’s challenging for people, and therefore medical teams and ambulances, to move around, homes and places of worship have been torched and vandalised, and families have been forced to leave their homes. Over 70 casualties were treated in SICA hospital in just a few hours on 1 May, prompting MSF’s teams to activate the mass casualty plan for a second time.
The mass casualty plan is activated to respond to a mass influx of casualties during emergency situations. A triage zone is set up at the hospital entrance where medical personnel determine the severity of patients’ injuries and assign them a colour. “Green” patients are the least severely wounded. Once they’re examined, some are fitted with plaster casts and others have their wounds dressed or are referred for X-rays and told to come back for further treatment in a few days. “Yellow” patients require more complex care in the emergency room and “red” patients are often taken straight to the operating theatre. “Black” patients are in such critical condition that they are either deceased on arrival, die very soon after, or have very little chance of survival.
For the logistics teams, the challenge is to set up as soon as the plan is activated a system to admit and initiate care of wounded patients, while ensuring a minimum level of security.
“Our priority was organising a triage zone, positioning beds and stretchers and setting up an area in front of the hospital where the wounded could come in and out and the porters and medical staff could work without being hampered by the crowds of people,” explains Pierre, a logistician at SICA hospital. “The guards are really important. They talk to people, try and calm things down and explain what MSF does.”
On 1 May, the crowd set upon an ambulance they thought was transporting wounded Muslims to SICA hospital. It did eventually manage to get through. The casualties — men and women but also children — arrived in waves.
“The patients we treated on the days we activated the mass casualty plan had war wounds,” adds orthopaedic surgeon André Valembrun. “These cause significant damage to bones and tissue that often require long and complicated treatment.”
Pascale is a nurse. She’d gone to Bangui for an entirely different purpose: assisting with the long-term introduction of osteosynthesis in surgical care at SICA hospital. The emergency rapidly took priority over her work schedule as, during mass casualty plans, all available medical personnel are called in to help. Pascale looked after patients in the “green” zone. While undoubtedly less serious, “green” doesn’t mean patients’ injuries are trivial and Pascale saw people with fractures, open wounds or grenade shrapnel in their faces.
“One of the patients who affected me most was a woman who had no idea where she was. I later found out her child had been shot and taken to another of the city’s medical facilities,” Pascale said. “She jumped on a motorbike taxi to go to him but in the general panic, with crowds of people trying to flee the fighting, she had an accident. She was injured and brought to SICA hospital. She was completely out of it so I stayed with her until she gradually came round. Lots of the patients were in a state of shock. They hadn’t expected such a level of violence.”
After the shockwave, an uneasy calm has returned to Bangui. Like some of his Central African colleagues, Pierre wants to believe the worst-case scenario is still preventable.
“There’s an atmosphere stoking preparations for violence. There’s a lot of uncertainty and rumours are rife,” said Pierre “The accumulation of tensions could unleash a huge wave of violence. But people here are all too familiar with mindless violence and, although the fear is really palpable, there’s also a sense that the worst isn’t inevitable.”

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