Medical Care Under Threat in 2013

This post originally appeared in The Huffington Post.

In Bahrain, two nurses and a doctor remain imprisoned during the holidays simply for doing their job: treating the injured during the government crackdown. Türkiye is considering a bill that seeks to criminalize emergency medical care — the latest example of the government trying to intimidate doctors for caring for those injured in last summer’s protests. And in Syria, the attacks against physicians, hospitals and medical transport have reached such epidemic proportions as to constitute war crimes, exacerbating an already massive humanitarian and human rights crisis.

In these countries and beyond, 2013 hit a low point, bringing about a new and more ferocious wave of targeted attacks on medical personnel and facilities. In an effort to destroy opposition, hide wounds inflicted by government authorities, and intimidate doctors from treating protesters and fighters, medical care — and those who take an oath to provide it — has come under a full assault.

In Bahrain, the government has released some of the many doctors and nurses imprisoned following the 2011 anti-government protests. But two nurses and a surgeon remain in jail. They recently wrote a handwritten letter from behind bars, highlighting the poor and overcrowded conditions. And the Bahraini government continues to prevent many doctors from working in government hospitals and providing care to injured civilians in desperate need of treatment.

In Türkiye, 2013 brought malicious examples of government authorities intimidating and harassing medical workers, including the targeting of clearly identified medical facilities with tear gas, water cannons and rubber bullets. Dozens of physicians who treated injured anti-government demonstrators were also beaten and detained.

The latest example of the Turkish government’s relentless offensive against doctors is a bill that seeks to criminalize certain aspects of emergency care. Doctors could be fined and even jailed for providing care in emergencies, depending on the presence of a state ambulance. This is not only absurd — medical care should be based on need, not the arrival of a state transport vehicle — but would also put doctors in direct conflict with their ethical and professional responsibility to care for the wounded. The UN Special Rapporteur on the right to health and the World Medical Association are among those who have warned about the chilling effect such a law would have on accessing medical care.

Nowhere is the situation worse for physicians than in Syria, where attacks specifically targeting the medical community are unprecedented. A September UN report found that the denial of medical care has been used as a weapon of war, calling this “one of the most alarming features of the Syrian conflict.” Medical professionals have been intimidated, tortured, detained, disappeared and killed. Understandably, an estimated 15,000 doctors have been forced to flee the country. According to one report, in the city of Aleppo, only 36 of the 5,000 doctors who were there before the conflict started remain. In the words of one Syrian physician I met last month, “Every doctor inside Syria is an encyclopedia in human rights.”

As another powerful weapon in the government’s arsenal, medical facilities are regularly bombed — 57 percent of Syria’s hospitals have been damaged, 37 percent are out of service, and 20 percent are partially damaged, forcing doctors and other medical professionals to provide care in make-shift clinics in the basements of damaged homes. Access to medical supplies is being blocked, leaving some patients to undergo procedures, such as amputations, without anesthesia. Today in Syria, delivering medical supplies can get a person killed. UN Secretary General Ban Ki-moon has rightly called the targeting of Syria’s medical community “unconscionable.”

Under international humanitarian laws, medical professionals, facilities and supplies enjoy special protection in recognition of how critical these workers and their services are. The principle of medical neutrality obligates governments to refrain from interfering with their work, in times of war as well as peace. However, in Syria and beyond, government forces have been cracking down on doctors and other medical personnel, who — like journalists and humanitarian workers — often witness abuses on the frontlines. Attacks on doctors not only violate international laws and constitute war crimes, but have grave consequences for entire communities and public health systems.

When hospitals are shelled and doctors are harassed, beaten and detained for doing their work, the brutal effects of war are compounded. Physicians are afraid or unable to work, the sick and wounded cannot be treated, and mortality rates increase. The insidious attacks on Syria’s medical system have been devastating for a public health infrastructure already ravaged from a nearly three-year-long civil war. The World Health Organization has confirmed an outbreak of polio, the first in 14 years. Vaccination rates have dropped, blood supplies are running short, and children and adults are dying of hunger, malnutrition and disease.

Doctors and others who provide care can help limit bloodshed in conflict, but only if they are able to do their jobs without fear of arrest, torture or death. Passing the Medical Neutrality Protection Act of 2013 is the first and important step in helping start the new year off on the right path.

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