Ethan Rhodes
During Syria's civil war, there have been numerous reports of hospitals being bombed. While there is evidence of Russian and Syrian forces deliberately targeting medical facilities, there is also an account of a hospital being bombed by the US military. In October 2015, a US military plane bombed a hospital in Kunduz, Afghanistan, resulting in the death of three people and the injury of several others. The US military claimed the attack was accidental and that they had received reports of the hospital building being occupied by active Taliban militia. However, MSF staff reported no armed combatants or fighting in the compound prior to the airstrike. This incident raises questions about the protection of medical facilities in conflict zones and the accountability of those who violate international humanitarian law.
| Characteristics | Values |
|---|---|
| Who is responsible for the bombings? | Syrian government forces, Russian aerospace forces, and Russian warplanes. |
| Who are the victims? | Medical workers, civilians, and humanitarian organizations. |
| What is the extent of the damage? | At least 24 health facilities and 35 schools were hit, with over half of the country's health facilities damaged or destroyed. |
| When did the bombings occur? | Between late April and June 2019, with reports of bombings as early as 2012. |
| Where did the bombings take place? | Idlib province, Aleppo, and the Idlib region. |
| Why are hospitals being targeted? | To eliminate a vital lifeline for civilians and pave the way for ground forces to advance, which amounts to war crimes. |
| How are hospitals being protected? | Through registration on a "no-strike list" with the UN, sharing of GPS coordinates, and international humanitarian law. |
| Are there any disputes or alternative explanations? | Yes, Russia and Syria deny the bombings and claim that the US orchestrates misinformation campaigns. |
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What You'll Learn
- The US military claimed the 2015 Kunduz hospital bombing was accidental
- The Syrian government denies conducting chemical attacks on hospitals
- The UN says Syrian and Russian warplanes target medical facilities
- Hospitals can register their GPS coordinates on a no-strike list
- The US ended direct contact with Russians in 2016 over a campaign against ISIL
The US military claimed the 2015 Kunduz hospital bombing was accidental
During the Syrian Civil War, human rights groups and UN monitors documented a pattern of Syrian government air strikes on health care facilities in opposition-controlled areas. The UN operates a mechanism for humanitarian deconfliction in Syria, under which hospitals can voluntarily register their GPS coordinates on a "no-strike list". However, there have been reports of air strikes hitting even the "deconflicted" clinics. The Syrian and Russian governments have denied these allegations.
In 2015, the Kunduz Trauma Centre operated by Médecins Sans Frontières (MSF) in Afghanistan was attacked. The attack was carried out by a United States Air Force AC-130U gunship, killing 42 people and injuring over 30. The US military initially claimed that the airstrike was carried out to defend US forces on the ground and that it was requested by Afghan forces. However, they later stated that the airstrike was a US decision and not requested by Afghan forces. The US military claimed that they had received reports that the hospital building was holding active Taliban militia. MSF, on the other hand, reported no armed combatants or fighting in the compound prior to the airstrike. They also stated that all warring parties had been notified about the hospital and its operations well in advance.
Following the attack, there were calls for an independent investigation. The US military publicly released their own investigation into the attack but did not consent to an independent investigation by the IHFFC. The investigation found a series of failures that resulted in the attack, and 16 American military personnel were punished. The attack was condemned by MSF as a deliberate breach of international humanitarian law and a war crime.
The legal precedent for prosecuting war crimes includes acts that were committed with recklessness or negligence. Former International Criminal Tribunal prosecutor M. Cherif Bassiouni suggested that even if the hospital had lost its right to protection due to Taliban infiltration, the US military would have to prove it was a military necessity to strike or risk prosecution for negligence.
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The Syrian government denies conducting chemical attacks on hospitals
During the Syrian Civil War, the Syrian government has repeatedly denied using chemical weapons or conducting attacks on hospitals and medical facilities. In 2017, the Syrian government denied a UN report accusing it of a sarin attack that killed over 80 civilians in Khan Sheikhoun, a rebel-held area. The Syrian government asserted that it does not possess or use chemical weapons against its citizens.
However, there is significant evidence to the contrary. Human Rights Watch documented 16 Syrian government attacks with chlorine-filled munitions between April 2014 and late 2016. Additionally, UN investigators found that Syrian forces had used chemical weapons more than two dozen times during the conflict. In 2013, hundreds of civilians died in a sarin gas attack in the suburbs of Damascus, which Western states blamed on the Assad government. While the Syrian government denied responsibility and blamed rebels, it subsequently joined the international Chemical Weapons Convention and surrendered its declared chemical weapons stocks for destruction.
Despite these denials and international agreements, attacks on hospitals and medical facilities in Syria have continued. In April 2018, chemical weapons were used in an attack on a hospital in Douma supported by the Syrian American Medical Society. Non-Russian and non-Syrian sources claimed that the attack was carried out by Syrian forces, which the Syrian and Russian governments denied. Between late April and June 2019, a total of 24 health facilities and 35 schools in the Idlib region were hit by Syrian and Russian air raids and rocket fire.
The targeting of hospitals and medical facilities has been a persistent issue throughout the Syrian Civil War. Since 2014, the UN has maintained a "no-strike list" of hospitals that voluntarily register their GPS coordinates. However, there have been reports of hospitals on this list being targeted, raising concerns that the information is being used to deliberately target medical facilities. Rights groups and UN officials have documented a pattern of Syrian government airstrikes on healthcare facilities in opposition-controlled areas. Physicians for Human Rights estimates that medical facilities were attacked over 300 times between March 2011 and August 2015, with 90% of the attacks conducted by Syrian government forces.
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The UN says Syrian and Russian warplanes target medical facilities
During the Syrian Civil War, the Syrian and Russian governments have been accused of targeting medical facilities in areas not under their control. In 2012, before Russia actively joined the war, Syrian government forces attacked the Dar al-Shifa Hospital in Aleppo twice. United Nations investigators called these attacks systematic.
Since then, the UN has documented a pattern of Syrian government airstrikes on healthcare facilities in opposition-controlled areas. In 2015, the United States Department of State Spokesman John Kirby stated that hospitals in Syria were attacked by Russian forces. In February 2016, U.S. Air Force Lieutenant General Charles Q. Brown Jr. affirmed that Russia was responsible for attacking hospitals in Syria. Later that year, United Nations Secretary-General Ban Ki-moon stated that attacks on hospitals in Aleppo constituted war crimes, and the UN repeatedly accused Syria and Russia of conducting a deadly campaign that appeared to target medical facilities.
In 2018, Physicians for Human Rights (PHR) documented 307 attacks on medical facilities and the deaths of 670 medical personnel in Syria since the start of the conflict in March 2011 through the end of August 2015. They confirmed that Russian airstrikes damaged three medical facilities in Syria in two days. PHR's director of programs, Widney Brown, stated, "Bashar al-Assad’s forces have been relentlessly attacking Syria’s health care system for the past four years and the Russian government is now following in their footsteps."
In 2019, the UN reported that 25 health facilities in the Idlib province had been hit since April, despite a deal between Russia and Turkey to avert a massive Syrian government offensive there. Rescue workers and local NGOs reported that Syrian and Russian government warplanes targeted and damaged three health facilities across rebel-held areas in Syria. An attack on the national hospital in the town of Jisr al-Shughour killed five people and injured 21 civilians, including two children.
In October 2019, The New York Times published a story proving that Russian forces deliberately bombed four hospitals in opposition-held Idlib province in May 2019. Dr. Amani Ballour, a Syrian pediatrician, reported that a secret underground hospital in East Ghouta, known as the Cave, was bombed by Russian warplanes in 2015, killing three male nurses and injuring two female nurses. In February 2020, Russian warplanes hit two hospitals in the northern town of Darat Izza near the Turkish border, wounding civilians and forcing the medical facilities to close.
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Hospitals can register their GPS coordinates on a no-strike list
Despite the strong protections enjoyed by medical facilities under international humanitarian law, hospitals on the no-strike list have still been attacked. UN officials, rights groups, and aid workers have documented numerous air strikes on clinics and hospitals in insurgent-controlled territory. This has led to concerns that the no-strike list is being used to locate and destroy medical facilities.
In response to these concerns, some have questioned the effectiveness of the no-strike list in protecting hospitals. For example, OCHA's Mark Lowcock noted that many non-hospital sites on the list had not been attacked, suggesting that health-related targets may be deliberately selected for destruction. Additionally, the Syrian Network for Human Rights reported that six out of twenty-four clinics attacked between April 26 and May 24, 2021, had been on the no-strike list, indicating that being on the list did not offer protection.
While the UN's no-strike list is intended to protect hospitals and medical facilities, the attacks on registered locations raise doubts about its effectiveness and suggest a possible misuse of the information.
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The US ended direct contact with Russians in 2016 over a campaign against ISIL
In 2012, the Syrian Civil War saw Syrian government forces attacking medical facilities in areas not under their control. In 2014, the UN set up a "no-strike list" to protect hospitals and other humanitarian sites in Syria. However, even after this, hospitals and other medical facilities continued to be targeted.
In 2015, Russia began to send warplanes, tanks, artillery, and combat troops to an airbase near Latakia in Syria. A treaty was signed between Russia and Syria, granting Russia's personnel jurisdictional immunity. In September 2015, a joint information centre was set up by Iran, Iraq, Russia, and Syria to coordinate their operations against ISIL.
In February 2016, Amnesty International reported that Russian warplanes deliberately targeted civilians and rescue workers during their bombing campaign. Human Rights Watch also reported the extensive use of cluster munitions by Syria and Russia, in violation of a United Nations resolution. The Syrian Network for Human Rights stated that from September 2015 until the end of February 2016, Russian airstrikes killed at least 2,000 civilians.
In October 2016, the United States ended direct contact with Russians involved in the campaign against ISIL, citing concerns over the targeting of medical facilities. Russia responded by suspending an agreement with the US regarding plutonium reduction. In November 2016, the US issued a warning to Syria and Russia regarding the repeated bombings of hospitals. Despite this, attacks on hospitals and medical facilities in Syria continued, with Russia denying its involvement and blocking attempts to hold the Syrian government accountable.
In April 2018, chemical weapons were used in an attack on a hospital in Douma, resulting in retaliatory strikes by Israeli, French, British, and American forces against targets in Syria. In 2019, The New York Times published a story proving that Russian forces deliberately bombed hospitals in the Idlib province. Russia denied the allegations and accused the US of orchestrating a misinformation campaign.
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Frequently asked questions
Yes. In October 2015, a US military plane bombed an MSF hospital in Kunduz, Afghanistan. The US military claimed it was an accident and that they had received reports that the hospital was holding active Taliban militia.
The hospital was left unusable after the bombing. All critical patients had to be referred elsewhere, and all MSF staff were evacuated from Kunduz.
The US military conducted an internal investigation and described the incident as "the direct result of avoidable human error, compounded by process and equipment failures". They disciplined 16 members of the military, but none were criminally charged.
MSF had provided the GPS coordinates of the trauma hospital to the US Department of Defense, the Afghan Ministry of Interior and Defense, and the US Army in Kabul. MSF also contacted the US military during the attack, but the message did not get through due to faulty electronics on the plane.
The UN has a mechanism for humanitarian deconfliction, where hospitals can voluntarily register their GPS coordinates on a "no-strike list". However, there have been reports that even hospitals on this list have been bombed, raising concerns about the effectiveness of this protection mechanism.
