Health facilities and workers in conflict zones faced a record number of attacks last year – Mother Jones

The Israeli military has repeatedly attacked Al-Shifa Hospital, according to a report released today that highlights record attacks on healthcare workers and facilities in conflict zones in 2023.Omar Ishaq/dpa/ZUMA

As Leonard Rubenstein When he heard the news on Monday that the International Criminal Court prosecutor, Karim AA Khan, was applying for arrest warrants against Hamas and leading Israeli politicians for alleged war crimes, he was struck by what he saw as a glaring omission: the indictment included the well-documented, There is no mention of the Israeli military’s devastating attacks on Palestinian healthcare workers and facilities.

“The situation in Gaza was so devastating,” Rubenstein said Mother Jones“and it has never been the subject of any specific international prosecution.”

As founder of the Safeguarding Health in Conflict Coalition, Rubenstein has brought together more than 40 organizations to Awareness of attacks on healthcare in conflict zones and increase documentation and accountability of these attacks. According to a new report released by the coalition today, 761 incidents of violence against healthcare workers were reported in Gaza and the West Bank – the highest number of any conflict-affected country and territory covered by the group last year.

Nearly 500 of the reported violent incidents occurred in Gaza, where 143 health workers were killed – the highest number recorded in the year any conflict since 2016, the report said. In addition, health facilities were damaged or destroyed in more than 120 cases. According to the report, all but six of these incidents occurred after October 7, when Hamas launched a deadly attack on Israel that killed 1,200 Israelis and took more than 250 hostages, including some Americans. Nearly 200 other reported incidents of violence, including the killing of three health workers, occurred in the West Bank and East Jerusalem. According to the report, Israel reported 33 incidents of violence against health care last year, resulting in the deaths of nearly two dozen health workers in Israel.

These numbers are part of a broader – and worrying – global trend. According to the new report, more than 2,500 incidents of violence against health workers were reported in 30 countries and territories in 2023 – a 25 percent increase compared to 2022 and the highest number recorded by the coalition always reported since it began tracking these attacks 11 years ago.

With 418 incidents, Myanmar, where internal armed conflict has raged since the brutal military coup in February 2021, recorded the second-highest number of reported violent incidents last year, including the arrest of more than 100 health workers and the violent killing of 37. In addition, there were more than 180 incidents in which health facilities were damaged, destroyed or occupied.

The country with the third highest reported levels of violence is Ukraine, where the military has been battling Russian forces since the invasion in February 2022. There have been more than 390 violent incidents, including the killing of 109 health workers and more than 200 incidents in which health facilities were damaged, destroyed or occupied. Afghanistan, the Democratic Republic of Congo and Sudan also recorded particularly high rates of violence. State forces were blamed for almost half of the incidents listed in the report; other armed groups – such as Hamas – were responsible for the rest of the attacks, particularly in sub-Saharan Africa.

Rubenstein, a human rights lawyer currently working at the Johns Hopkins Bloomberg School of Public Health, is also the author of the 2021 book Dangerous Medicine: The Fight to Protect Healthcare from the Violence of War. He offers several explanations for the general increase in violence. One of them is the increasing use of explosive weapons and drones, some of which are used in combination, which, he says, “makes the disposal of weapons much easier for all types of groups.” Deconfliction, a practice that is supposed to involve forward planning by military personnel to protect humanitarian actors in conflict, has also largely failed. especially in Gaza, adds Rubenstein. But for him, the main culprit in the wave of violence simply boils down to: a lack of “political will” on the part of world leaders to take more decisive action to address the problem.

“At the moment we are in a situation where the problem is widely recognized and outrage is expressed when the health service is under attack, but there is no serious action to stop it,” he told me.

Zaher Sahloul, a Syrian doctor who has worked in conflict zones around the world, is the president of MedGlobal, an organization that sends health volunteers and supplies to conflict zones around the world. He was not involved in the preparation of the report, although MedGlobal is a member of the coalition. When I asked him to explain what he thought were the reasons for the escalation of violence, he answered me with just one word: “racism.”

“Most of the victims, frankly, come from countries in the global South,” he said. “When people who are not from the West are killed, it is not seen as very important.”

Historically there have been such some well-intentioned efforts to combat these attacks. Rubenstein points to a 2012 World Health Assembly resolution that requires the World Health Organization to collect and report information on attacks on health care. Four years later, the UN Security Council passed a resolution They call for “an end to impunity” for attacks on medical facilities and personnel. But critics – including Rubenstein and Sahloul – have criticized both resolutions, claiming their accountability mechanisms are inadequate.

Quantifying the number of these attacks is also a critical issue, but security concerns and communication blockages have made data collection difficult, the report said. Furthermore, “the gendered impact of violence against health workers remains largely unreported,” despite the majority of health workers worldwide being women. In Afghanistan, where the Taliban have imposed draconian restrictions on the lives of women and girls since taking power in August 2021, the report said: “Health workers have been arrested for failing to separate male and female patients, or , in the case of women, for traveling without madam (male guardian).”

So what can be done? Recommendations include calling on human rights groups to collect data on these attacks; creating a mechanism within the UN Security Council to refer allegations of these attacks to the International Criminal Court for prosecution; and Military personnel should adopt a no-gun policy at health care facilities and otherwise review their training to ensure they prioritize protecting health care facilities in combat. The report’s first recommendation brings us back to our starting point: The ICC “should prioritize the investigation and prosecution” of attacks on health workers and the patients they treat, particularly in Ukraine, Israel and the occupied Palestinian territories.

Whether they will do so remains unclear. A spokesman for the ICC prosecutor’s office said they could not comment. Mother Jones‘ Questions about why this week’s arrest warrants contained no reference to attacks on health care. The Israeli military often tries to justify its attacks on hospitals in Gaza by saying that Hamas uses them as shields to conceal or camouflage a network of tunnels where ammunition is stored and where combatants hide. Rubenstein, Sahloul and other critics claim the Israel Defense Forces have failed to substantiate these claims. Instead, they appear to have failed to take steps to minimize harm to patients in hospitals, as required by the Geneva Convention, and have carried out unfounded mass arrests of Palestinian health workers.

“Overall,” said Rubenstein, “I believe the impunity of the attacks has allowed them to continue without consequences for the perpetrators.”

Meanwhile, the situation in Gaza is dire. The U.N. relief agency for Palestinian refugees, known as UNRWA, said on Tuesday only seven of its two dozen health facilities in Rafah were operating and that medical supplies had not been able to be delivered for over a week due to Israeli seizures at border crossings.

Sahloul doesn’t expect the situation to improve anytime soon. “Attacks on health care lead to irreversible, worse access to health care,” he told me. The attacks on Al-Shifa Hospital in Gaza, for example, he said, “will be felt for generations to come, because it’s almost impossible to restore the expertise, the connections, the networks, the technology… even when the war ends.”

“If doctors flee for fear of their lives, they will not come back.”