Hostname: page-component-8448b6f56d-c4f8m Total loading time: 0 Render date: 2024-04-17T11:02:41.784Z Has data issue: false hasContentIssue false
  • English
  • Français

Health Care Providers in War and Armed Conflict: Operational and Educational Challenges in International Humanitarian Law and the Geneva Conventions, Part I. Historical Perspective

Published online by Cambridge University Press:  30 April 2018

Frederick M. Burkle Jr ,
Adam L. Kushner ,
Christos Giannou ,
Mary A. Paterson ,
Sherry M. Wren  and
Gilbert Burnham
Frederick M. Burkle Jr*
Affiliation:
Harvard Humanitarian Initiative, Harvard University and Harvard T.C. Chan School of Public Health, Cambridge, Massachusetts Woodrow Wilson International Center for Scholars, Washington, District of Columbia
Adam L. Kushner
Affiliation:
Woodrow Wilson International Center for Scholars, Washington, District of Columbia Department of International Health, Center for Humanitarian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
Christos Giannou
Affiliation:
International Committee of the Red Cross, Geneva, Switzerland Blizard Institute, University of London, United Kingdom
Mary A. Paterson
Affiliation:
School of Nursing, The Catholic University of America, Washington, District of Columbia
Sherry M. Wren
Affiliation:
Center for Innovation in Global Health, Stanford University School of Medicine, Stanford, California Palo Alto Veterans Health Care System, Palo Alto, California
Gilbert Burnham
Affiliation:
Department of International Health, Center for Global Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
*
Correspondence and reprint requests to Frederick M. Burkle, Jr, Harvard Humanitarian Initiative, c/o 452 Iana Street, Kailua, HI 96734 (e-mail: fburkle@hsph.harvard.edu).
Get access Rights & Permissions [Opens in a new window]

Abstract

Since 1945, the reason for humanitarian crises and the way in which the world responds to them has dramatically changed every 10 to 15 years or less. Planning, response, and recovery for these tragic events have often been ad hoc, inconsistent, and insufficient, largely because of the complexity of global humanitarian demands and their corresponding response system capabilities. This historical perspective chronicles the transformation of war and armed conflicts from the Cold War to today, emphasizing the impact these events have had on humanitarian professionals and their struggle to adapt to increasing humanitarian, operational, and political challenges. An unprecedented independent United Nations–World Health Organization decision in the Battle for Mosul in Iraq to deploy to combat zones emergency medical teams unprepared in the skills of decades-tested war and armed conflict preparation and response afforded to health care providers and dictated by International Humanitarian Law and Geneva Convention protections has abruptly challenged future decision-making and deployments. (Disaster Med Public Health Preparedness. 2019;13:109–115)

Keywords

International Humanitarian LawGeneva Conventioncomplex humanitarian emergenciesInternational Committee of the Red Crosswar and armed conflict
Type
Commentary
Information
Disaster Medicine and Public Health Preparedness , Volume 13 , Issue 2 , April 2019 , pp. 109 - 115
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Rule 47, attacks against persons hors de combat. Customary International Humanitarian Law. International Committee of the Red Cross website. https://ihl-databases.icrc.org/customary-ihl/eng/docs/v1_rul_rule47. Accessed September 4, 2017.Google Scholar
2. Burkle, F, Martone, G, Greenough, PG. The changing face of humanitarian assistance. Brown J World Aff. 2014 Spring/Summer XX(1):25-42.Google Scholar
3. Spiegel, PB. The humanitarian system is not just broke, but broken: recommendations for future humanitarian action. Lancet. 2017 Jun 7; pii: S0140-6736(17)31278-3.Google Scholar
4. Hawkins, V, Pérache, AH. Humanitarian medicine is more than a technical exercise. Lancet. 2017 Jun 7; pii: S0140-6736(17)31352-1.Google Scholar
5. Roser, M. War and Peace. https://ourworldindata.org/war-and-peace/. Accessed October 6, 2017.Google Scholar
6. Trei, L. In Post-Cold War era, civil wars’ causes misunderstood Post-colonial conflicts in small, weak states more to blame than ethnic, religious strife. Stanford Report, Set 25, 2002. Available at: https://news.stanford.edu/news/2002/september25/civilwar-925.html. Accessed 4 Nov, 2017.Google Scholar
7. Definitions: what’s the difference between intrastate, interstate & extrastate???. Miss World Security, 26 September 2012. file:///C:/Users/SKIP/Desktop/Definitions What’s the difference between Intrastate, Interstate & Extrastate. Miss World Security.htm. Accessed October 1, 2017.Google Scholar
8. Council on Foreign Relations. Global Conflict Tracker: Updated 10 November 2016. http://www.cfr.org/global/global-conflict-tracker/p32137?goal=0_aa18ea5b4e-ff3d9e77cf-#!/. Accessed November 10, 2017.Google Scholar
9. Hervey, A. The Decline of War. https://medium.com/@angushervey/the-decline-of-war-8760f9a5b5ce#.jagyj163g. Accessed June 1, 2016.Google Scholar
10. Dupuy, K, Gates, S, Nygard, HM, et al, Trends in armed conflict, 1946-2016. PRIO Conflict Trends 02/2017. https://www.prio.org/utility/DownloadFile.ashx?id=1373&type=publicationfile. Accessed October 2, 2017.Google Scholar
11. International Committee of the Red Cross. Geneva Convention Relative to the Protection of Civilians in Time of War. https://ihl-databases.icrc.org/ihl/385ec082b509e76c41256739003e636d/6756482d86146898c125641e004aa3c5. Accessed October 2, 2017.Google Scholar
12. Siegel, R. Powell’s cautions on Iraq. National Public Radio, April 20, 2004, 12:00 AM ET. https://www.npr.org/templates/story/story.php?storyId=1844476. Accessed October 3, 2017.Google Scholar
13. Salama, P, Spiegel, P, Talley, L, Waldman, R. Lessons learned from complex emergencies over past decade. Lancet. 2004 Nov 13-19;364(9447):1801-1813.Google Scholar
14. Abiew, FK, Keating, T. NGOs and UN peacekeeping operations: strange bedfellows. Int Peacekeeping. 1999 June; 6(2):89-111.Google Scholar
15. Brown, RE. Mission to Biafra (January 1969): a study and survey of a population under stress. Clin Pediatr (Phila). 1969 June;8;(6):313-321.Google Scholar
16. Enuka, C. Post-Cold War conflicts: imperative for armed intervention [version 1.0]. Glob J Hum Soc Sci Interdiscip. 2012;12(9):16-26.Google Scholar
17. Garfield, RM, Polonsky, J, Burkle, FM Jr. Changes in size of populations and level of conflict since World War II: implications for health and health services. Disaster Med Public Health Prep. 2012 Oct; 6(3):241-246.Google Scholar
18. Responsibility to protect. United Nations Office on Genocide Prevention and the Responsibility to Protect. http://www.un.org/en/genocideprevention/about-responsibility-to-protect.html. Accessed November 1, 2017.Google Scholar
19. Rana, R. Contemporary challenges in the civil-military relationship: complementarity or incompatibility? International Review of the Red Cross, No. 855, 30-09-2004 Article. https://www.icrc.org/eng/resources/documents/article/other/66ddf7.htm. Accessed September 5, 2017.Google Scholar
20. Burkle, F Jr, Garfield, R. Civilian mortality after the 2003 invasion of Iraq. Lancet. 2013 Mar 16;381(9870):877-879.Google Scholar
21. Armed Conflict Survey 2017: IISS. https://www.iiss.org/en/publications/acs/by%20year/armed-conflict-survey-. Accessed September 2, 2017.Google Scholar
22. Burkle, FM. Triage and the lost art of decoding vital signs: restoring physiologically based triage skills in complex humanitarian emergencies. Disaster Med Public Health Prep. 2017 Apr 21:1-10.Google Scholar
23. Burkle, FM Jr, Erickson, T, von Schreeb, J, et al. The solidarity and health neutrality of physicians in war & peace. PLoS Curr. 2017 Jan 20;9:699-700.Google Scholar
24. Medecins sans Frontieres President to UN Security Council. “Stop these attacks” Speech by Dr. Joanne Liu, 3 May 2016, New York. https://www.msf.org.uk/article/msf-president-un-security-council-stop-these-attacks. Accessed November 2, 2017.Google Scholar
25. Destroying the Last Havens of Humanity in War. Medecins sans Frontieres Activity Report. http://activityreport2016.msf.org/destroying-humanity-in-war/. Accessed September 27, 2017.Google Scholar
26. Security Council adopts Resolution 2286. 2016; strongly condemning attacks against medical facilities, personnel in conflict situations. United Nations Security Council 7685th Meeting, SC 12347; May 3, 2016; New York.Google Scholar
27. Davies, SE, Ruston, S. Protecting and prioritizing health care in conflict. International Peace Institute Global Observatory. 20 May 2016. https://theglobalobservatory.org/2016/05/medecins-sans-frontieres-syria-humanitarian-red-cross/. Accessed October 1, 2017.Google Scholar
28. Serle, J, Fleck, F. Keeping health workers and facilities safe in war. Bull World Health Organ. 2012 Jan 1;90(1):8-9.Google Scholar
29. Violence Against Health Care: Results From a Multi-Centre Study in Karachi. https://www.google.com/search?q=The+2015+ICRC+Violence+Against+Health+Care+report&ie=utf-8&oe=utf-8. Accessed October 1, 2017.Google Scholar
30. How is IHL relevant in modern humanitarian contexts? Paper presented at: International Committee of the Red Cross & Medecins sans Frontieres Symposium; October 14, 2015; Canberra, Australia.Google Scholar
31. Coupland, R. Security of health care and global health. N Engl J Med. 2013 March 21;368:1075-1076.Google Scholar
32. Coupland, R. Security, insecurity and health. Bull World Health Organ. 2007;85:181-184.Google Scholar
33. Ajello, P, Sultany, A. Iraq. WHO and health authorities deliver 24/7 health services for hundreds of people fleeing the crisis in Telafar, Iraq. WHO Press Releases, August 22, 2017. http://www.emro.who.int/irq/iraq-news/who-and-health-authorities-deliver-247-health-services-for-hundreds-of-people-fleeing-the-crisis-in-telafar-iraq.html. Accessed October 1, 2017.Google Scholar
34. Mosul Crisis, Iraq. World Health Organization Special Situation Report. Issue No. 26: 09 July to 23 July 2017. http://www.emro.who.int/images/stories/WHO_Special_Situation_Report_on_Mosul_Crisis_09_to_23_July_2017_Cleared.pdf?ua=1. Accessed October 12, 2017.Google Scholar
35. Childers, R, Parker, P. In a stable battlefield, avoid using austere surgical units to meet the golden hour of trauma time to care goal. Injury. 2017 Sep 1; pii: S0020-1383(17)30567-3.Google Scholar
36. World Health Organization, Health Cluster. Classification and Minimum Standards for National and International Medical Teams in Sudden Onset Disasters. 2013. http://www.who.int/hac/global_health_cluster/fmt_guidelines_september2013.pdf. Accessed October 12, 2017.Google Scholar
37. Health Cluster Guide. A Practical Guide for Country-Level Implementation of the Health Cluster. Geneva: World Health Organization; 2009:31-32. http://www.who.int/hac/network/global_health_cluster/chapter1.pdf. Accessed October 17, 2017.Google Scholar
38. Military Factory. https://www.militaryfactory.com/dictionary/military-terms-defined.asp?term_id=2165. Accessed October 10, 2017.Google Scholar
39. How does law protect in war? ICRC, IHL and the challenges of contemporary armed conflicts. Online Casebook. Conference of the Red Cross and Red Crescent, 2-9 December 2003. https://casebook.icrc.org. Accessed October 12, 2017.Google Scholar
40. Rule 14: proportionality in attack. Customary International Humanitarian Law. International Committee of the Red Cross. https://ihl-databases.icrc.org/customary-ihl/eng/docs/v1_cha_chapter4_rule14. Accessed October 13, 2017.Google Scholar
41. D’Ascanio, M. The Armed Conflict in Syria: “Death from the Skies, Deliberate and indiscriminate Air Strikes on Civilians “How Does Law Protect in War? https://casebook.icrc.org/case-study/armed-conflict-syria-0. Accessed October 13, 2017.Google Scholar
42. McKernan, B. As US-backed forces seize Raqqa’s Old City from Isis, UN condemns price of air strikes for civilians. Independent. 1 Sept 2017. http://www.independent.co.uk/news/world/middle-east/raqqa-old-city-isis-us-backed-forces-syria-islamic-state-defeat-a7924506.html. Accessed September 1, 2017.Google Scholar