Is it a War Crime to Attack a Hospital?
The intentional targeting of hospitals and healthcare facilities by warring parties is a long-standing concern. Over the years, conflicts around the world have claimed the lives of countless individuals seeking medical care, doctors, nurses, and support staff. The destruction of healthcare infrastructure has devastating effects on civilian populations, disrupting vital medical services and pushing affected communities to the brink of disaster.
Yes, it is a war crime to attack a hospital.
The deliberate destruction or attack on a hospital is considered a war crime under international humanitarian law (IHL). The core principles of IHL protect individuals and objects indispensable for the survival of the wounded, sick, and non-combatants. In light of this, healthcare facilities, including hospitals, must be respected and protected, as they are seen as sanctuaries providing humanitarian assistance.
Defining a Hospital
A hospital is considered a protected institution under IHL, defined as a facility providing medical and sanitary care to the sick, wounded, and infants (Protocol Additional to the Geneva Conventions of August 12, 1949, and relating to the Protection of Victims of Non-International Armed Conflicts, Article 1.3). This categorization extends to:
- Permanent and temporary hospitals, maternity wards, and hospitals of all kinds
- Any facility providing medical services, including mobile hospitals
- Health centers, maternity wards, and clinics, among others
When Does it Become a War Crime?
The intent or purpose behind the destruction of a hospital is pivotal in determining whether it amounts to a war crime. Intentionally targeting, bombing, shelling, or attacking a hospital:
• Directly harming: causing harm to those receiving medical care, or treating patients
• Disrupting medical services: disrupting or destroying medical supplies, equipment, or healthcare personnel
• Complying with orders or decisions: carrying out explicit instructions or decisions to harm hospitals or healthcare facilities
• Conducting excessive force: using means that exceed the necessary or expected measures to achieve military objectives
Consequences for Those Responsible
Warring parties found responsible for violating the protection of a hospital and its occupants, medical staff, and supplies are held accountable for serious breaches of international law. This can include:
• War crime prosecutions: individuals responsible may be tried and convicted by the International Criminal Court (ICC) or national jurisdictions
• Accountability through political and diplomatic processes: parties may face criticism and sanctions from the international community, including diplomatic consequences
• Repercussions for military personnel and civilian leaders: those in positions of authority may be removed or face disciplinary measures for ordering or condoning illegal attacks
Additional Prohibitions
It’s essential to note that certain acts are strictly prohibited during armed conflicts, as per IHL:
- Intentionally directed violence: targeting medical facilities, personnel, or those trying to provide medical aid is prohibited
- Medical neutrality: healthcare staff must not be forced into service as combatants
- Medical confidentiality: the secrecy of medical conditions, treatment, and consultations is essential
Tables: Examples of Hospital Attacks and Consequences
| Year | Location | Outcome | Responsible Party |
|---|---|---|---|
| 1994 | Rwanda | Death toll: 11 doctors, 50 injured; destruction of hospital buildings and equipment | Rwandan army and Interahamwe militia |
| 2015 | Yemen | Wounding of 1 doctor, 10 hospital employees; destruction of ICU equipment | Saudi-led coalition (UAE, Jordan, Bahrain) |
| 2019 | Syria | Bombing of hospital compound; death toll: 18 people, including a UN staff member | Regime forces (Syrian Government) |
Case Law and International Instruments
Significant case law has helped solidify the legality of protecting hospitals and medical infrastructure. Key examples:
• The Nuremberg Trials (1945-1949): The Nuremberg Code established the importance of respecting medical neutrality in conflict.
• Geneva Conventions (1949): The core treaty protecting civilians and cultural heritage in armed conflicts highlights the necessity of protecting medical personnel, facilities, and objects.
• ICC Judgment in the Lubanga case (2012): The International Criminal Court reaffirmed the importance of upholding international humanitarian law regarding hospital attacks.
Challenges and Future Directions
The ongoing struggle to respect hospital sanctuaries presents multiple challenges:
• Improving awareness and respect for IHL: heightened recognition and implementation of international humanitarian law
• Instituting accountability mechanisms: creating robust systems for prosecution, investigation, and addressing consequences for violators
• Enhancing education and training: educating troops and military leaders on IHL principles and the grave consequences of violating hospital protection
• Advocacy and monitoring: continuous attention from human rights organizations and UN agencies to monitor violations and advocate for change
In conclusion, the targeting or destruction of hospitals in conflict zones is a war crime. International humanitarian law recognizes healthcare facilities as protected and critical to the survival of civilian populations. Warring parties must respect and honor these principles to avoid accountable, reputational, and reputational damage. Strengthening awareness, prosecution mechanisms, and education will foster greater compliance and ensure respect for hospital sanctuaries during armed conflicts.
