How the UN failed to save Syria’s hospitals
Source: Aljumhuriya, 24th July, 2019
A Syrian doctor says the UN’s plan to stop attacks on hospitals in Syria has failed. If it can’t be fixed, it should be abandoned.
In northwest Syria, a colleague of mine named Morhaf works as a doctor in a health facility supported by our organization, the Syrian American Medical Society (SAMS), which provides medical care in some of the most dangerous regions of the Syrian conflict. In my capacity as head of advocacy in Turkey, I recently asked Dr. Morhaf to conduct an interview with a large human rights NGO to talk about the ongoing attacks on health centers in his area by the Syrian regime and its Russian ally. His response was highly telling. “What did the hundreds of interviews we gave about Aleppo with human rights NGOs and investigation bodies change? Did we stop attacks on health centers?” he asked me.
We did not, is the answer. Since the outbreak of the Syrian conflict in 2011, more than 570 attacks on health centers have been reported. Over 800 health workers have been killed in these attacks.
Moving underground
Forced to fend for themselves, local medical staff inside Syria have proven strikingly creative in finding alternative methods of protecting their facilities. They have built hospitals underground, or used basements or even caves as makeshift health centers. While these don’t always meet international standards for medical facilities, they’ve succeeded nonetheless in decreasing the risks of attack. So convinced were we, as the regional staff, of the benefits of these underground hospitals that we began trying to raise funds from donors for their construction. Though the local staff went along with this out of necessity, it was never their first choice; they were always clear that the goal ought to be protection and accountability.
Failed “deconfliction”
To that end, we began considering participation in a UN program intended to reduce risks to medical practitioners in war zones. Under this “humanitarian deconfliction mechanism,” as it’s known, the geographic coordinates of health centers (as well as other vital civilian infrastructure, such as schools) are shared with the UN, which in turn passes them on to the warring parties, in order that they—theoretically—avoid targeting the locations in question. Given the systematic bombing of health facilities in Syria, it was always going to be difficult to convince our colleagues on the ground that this mechanism might work, but we eventually reached the stage of having no alternative options.
Sure enough, in 2018, there were six attacks on “deconflicted” health facilities, while in 2019, fourteen of the thirty-eight attacks on medical centers between 26 April and 22 July alone struck deconflicted sites. There have been no consequences for the perpetrators, who are known to all parties, raising inevitable questions about the value of the mechanism.
No will, no way
What is the reason for so abject a failure? It’s certainly not a lack of information. There are at least two full pages on attacks on medical facilities in each one of the reports put out by the UN Independent International Commission of Inquiry on Syria, attributing responsibility for the majority of attacks to the Syrian regime. The World Health Organization’s website hosts a dedicated page documenting attacks, which demonstrates that they are far more systematic in Syria than in other conflict zones. Leading human rights NGOs such as Human Rights Watch, Physicians for Human Rights, and many others have similarly documented systematic attacks on health facilities in Syria.
There is more than enough information out there; the problem is there is still no will to stop the perpetrators. Instead, we see only cosmetic solutions providing ostensible success stories for state donors to convince their domestic parliaments they are doing good.
Are there alternatives?
In spite of all the above, I do believe that, even within the deeply flawed institutions of the international community, with all their bureaucracy, power imbalances, and political dynamics, there are still things that can be done for Syria. The UN could take several steps to stop these attacks. Its Commission of Inquiry (COI) should be much quicker in investigating attacks on health centers—to date, all its reports have come out months after the crimes have been committed, making them useless during the time periods that offensives are actually underway. UNOCHA should provide its “deconfliction” data to both the COI and the International Impartial and Independent Mechanism in Syria (IIIM). Similarly, both UNOCHA and the COI should be given access to the UN’s Operational Satellite Applications Programme (UNOSAT), in order to compare satellite images before and after reported attacks. The IIIM should immediately launch investigations into these attacks, and work with war crimes prosecutors around the world to hold perpetrators to account.
Dr. Mohamad Katoub is a doctor formerly based in Damascus’ Eastern Ghouta suburb. He is the head of advocacy in Turkey for the Syrian American Medical Society (SAMS). He tweets @MhdKatoub.