As ambassadors, foreign ministers, and heads of state gather in New York this week for the opening of the United Nations General Assembly, hundreds of critical global issues and vital events vie for their attention. Terror and nuclear proliferation. Development goals and climate change. Reforming the UN itself, its meetings and its budgets. Refugees.
Across the Atlantic in Geneva, UN delegates have been convening at the 36th Human Rights Council for several weeks, and NGOs from every corner of the world have appealed for attention to the trauma and troubles they face: hunger and a collapsed economy in Venezuela; ethnic cleansing of the Rohingya in Myanmar; imprisonment of dissenters in China and Turkey; conflicts in Iraq, Syria, and Yemen.
Into the mix of crises demanding the world’s concern is the horrifying erosion of the longstanding norms protecting the delivery of medical care during times of peace and war alike. Physicians for Human Rights (PHR) has, since our earliest days in the 1980s, documented and advocated to stop attacks on health personnel and facilities both during civil unrest and in armed conflicts, and to protect the rights of the sick and wounded to medical care.
We’ve worked to provide rigorous documentation of the worst of these violations in today’s troubled world via our online map of attacks on health in Syria. Now, PHR and a coalition of human rights and humanitarian organizations are urging the nations of the world to reiterate their commitments to the laws that protect health and to promise to punish those who violate them. In the case of Syria, the deliberate targeting of health care by governments and their militaries is, grotesquely, an actual strategy of war. The Syrian government and their Russian allies consider those who provide medical care to “the enemy” as the enemy itself.
On Tuesday, as I prepared to speak at an event in Geneva, I learned of the killing of a beloved International Committee of the Red Cross (ICRC) physiotherapist in Afghanistan who worked with those who had lost limbs during the country’s years of conflict. A few months ago, I witnessed the trial of a doctor in the southeastern Turkish town of Şırnak, arrested and jailed for doing his duty: providing emergency medical care to sick and wounded patients. Four witnesses for the prosecution, also prisoners themselves, stated in court that they had been tortured to sign statements against this doctor. Nevertheless, our medical colleague was sent back to prison.
The abduction, arrest, and outright killing of thousands of health care workers, as well as the destruction of and damage to hospitals and clinics, have profound impacts on the health and well-being of populations for years and even decades to come.
Governments have said the right things and passed appropriate statements. UN Security Council Resolution 2286, passed in May 2016, is the first-ever Council resolution that specifically addresses attacks on health services in armed conflicts. The resolution urges member states and the UN Secretary General to take specific proactive steps to prevent attacks and hold perpetrators accountable. But more than one year since its passage by the Council, the laws protecting medical care continue to be routinely violated with utter impunity in dozens of countries. And the Security Council has done virtually nothing to implement its resolution.
In Geneva this week, the governments of Switzerland and Colombia sought to focus on this crisis from a human rights perspective. It is clearly a humanitarian emergency, and humanitarian organizations such as Doctors Without Borders (MSF) and the ICRC have put this crisis squarely on their agendas. Attacks on health also represent a public health crisis, so the World Health Organization (WHO) has launched a vital data gathering effort to help gauge and report the scale and scope of the problem.
But this crisis also belongs at the heart of the human rights agenda as health workers are arrested, tortured, and executed for treating patients or advocating for them; as facilities are invaded, shelled, or bombed; as militaries and armed groups turn hospitals into bases for military operations; as ambulances are fired on; as aid convoys are blocked; and as medicines are stripped out of supply lines in deliberate attempts to harm civilian populations.
The most fundamental rights to life and security of the person are under attack: the right not to be arbitrarily arrested, the right not to be tortured, the right to freedom of movement, and of course, the right to the highest attainable standard of health. These all are threatened by the continual erosion of the rules protecting health care. Indeed, UN Special Rapporteur on the Right to Health Dainius Parus this week called out the ongoing assault on health facilities and workers as an attack on the right to health.
So what can be done? The Safeguarding Health in Conflict Coalition, of which PHR is a member, believes it is critical for the office of the UN High Commissioner for Human Rights and the Human Rights Council to document assaults on health as part of their routine human rights assessments. The UN Special Rapporteur on the Right to Health has made a critical commitment to studying and reporting on laws that improperly criminalize the delivery of health in a range of countries and situations, such as the case I witnessed in Turkey.
We expect attacks on the medical mission to be incorporated into the next Human Rights Council resolution on the Right to Health, scheduled for June 2018. International Independent Commissions of Inquiry, such as one that must be established by the UN Security Council for Yemen, should pay special attention to the crimes of bombing and shelling hospitals, and of blocking medical supplies during armed conflicts. Critically, the UN’s human rights bodies should call out perpetrators and press for accountability.
Normalization of violence against health should shock the conscience of all states and all people. We look forward to deeper engagement of the UN Secretary General. The human rights and humanitarian responses of governments must be more robust. Working with NGOs and local health workers, we must tackle this crisis together. We have the laws, and we have the rhetoric. We now need action.