BRUSSELS—Doctors Without Borders/Médecins Sans Frontières (MSF) will suspend medical activities in the besieged Damascus suburbs of East Ghouta following recent violations of medical facilities by armed groups, the international medical humanitarian organization said Monday.
According to reports from MSF-supported doctors in the area, approximately 30 masked and armed men stormed the Hazzeh Hospital in the East Ghouta region on April 29, looking for specific wounded patients. They also stole the hospital’s ambulance. A few kilometers south, the Aftares medical point was struck by bullets. As fighting surrounded the medical point for two days, medics were trapped and unable to collect the wounded—even those lying within sight of the hospital—or to evacuate to a safer area. The attacks constitute grave violations of the protected status of hospitals and medical workers in war zones.
"On behalf of the doctors we support, MSF condemns in the strongest terms the armed incursion into a health facility by masked individuals, the intimidation of health workers, and the seizing of an ambulance," said Brice de le Vingne, MSF director of operations. "Also of grave concern is the sustained heavy shooting by two armed groups at and around a functional hospital. Speaking over the deafening sound of gunfire, the nurses running the small Aftares medical point told us that their facility had been hit by bullets and that they managed to treat a few wounded people, but that they could only perform minor surgery and dressings. They were unable to negotiate an evacuation of their patients to better-equipped facilities."
The suspension of activities is a decision made under extreme circumstances to underscore that such attacks on health care facilities and workers will not be tolerated by MSF or the medical staff it supports, MSF said. Medical support to the East Ghouta region will remain suspended until there are clear signs that fighting parties will respect the provision of health care.
"Medical spaces are protected under international law and must remain a place of humanity in war, in which everyone—civilian or not—is treated only on the basis of medical need," said de la Vingne. "We will speak out to defend the protected nature of medical spaces and to underscore the need to prioritize the protection of patients and medical staff. We have issued clear demands to the armed groups operating in the East Ghouta area, assuring them that MSF’s considerable medical support to the zone will be suspended until there are clear signs that belligerents will take precautions to ensure the respect of patients, medical facilities, and health care workers alike."
The East Ghouta zone near Damascus has been besieged by Syrian Government forces since early 2013. MSF has been providing remote support to the majority of health facilities in the area, and has built a strong relationship with local medics, helping them maintain their space for impartial medical care and providing them with technical and material support. Intense fighting between opposition armed groups erupted on April 28; no consideration for the special protected status of medical care has been displayed.
These incursions into health facilities and obstruction of health care come at a time when lifesaving medical care is needed most; a nearby MSF-supported field hospital that has so far been able to continue functioning received more than 100 wounded people during the two days of intense fighting on April 29 and 30 alone.
MSF calls on all armed groups in Syria, on whichever side they fight, to respect the protected nature of medical spaces and the protection of patients while under treatment. This means avoiding bombing or shelling of health structures and desisting from armed incursions, intimidation of medics, theft of ambulances and hospital supplies, and attempting to seize or kidnap patients under medical care.
The demands of MSF to the armed groups in the East Ghouta area are listed below:
- No weapons or people bearing arms to enter medical facilities;
- Patients must be considered outside of the conflict and due precautions must be taken by fighting parties to avoid direct action against health care, or striking health care in their crossfire, or any other military acts that may jeopardize patients’ medical care;
- The transport of wounded and other patients, regardless of their identity, as well as the unobstructed movement of ambulances, must be permitted and facilitated;
- Medical facilities, their goods and supplies, and ambulances must never be used for military purposes; and
- Unobstructed evacuation of patients and medics when they need to move to a safer area must be permitted.
MSF directly operates four health facilities in northern Syria and provides support to more than 150 health facilities countrywide. In East Ghouta, MSF supports 19 field hospitals, two maternity units, seven primary health care centers, and five small medical posts. Many of these are fully MSF-supported, and some are supported by a variety of aid organizations including MSF. Over just three months, from November 2016 to January 2017, these facilities performed 291,000 emergency room and outpatient consultations, 18,750 surgical operations, and 3,100 safe deliveries. MSF accepts no governmental funding for its work in Syria, in order to be demonstrably independent from political motives.