Doctors are dying in Syria

Last week, yet another Doctors Without Borders clinic was bombed — this time in Aleppo, Syria. The bombing followed a week of increasing violence, just as U.N. peace talks stall. The most recent destruction of medical facilities started with a series of Russian airstrikes last year on a hospital in Idlib and the bombing of a hospital close to the Turkish border, allegedly by Syrian military forces.

{mosads}Since 2011, 358 strikes against medical facilities in Syria have resulted in the deaths of 726 medical personnel. The latest incident resulted in the death of the last pediatrician in Aleppo. With a near constant barrage of such reports, the legality of these bombings comes into question once again. One thing is certain — there is an urgent need to protect health workers in conflict settings.

Every 25 minutes, a Syrian is killed, intensifying the need for healthcare workers and hospitals. With the increase of violence directed toward health facilities, any piece of legislation that does not support the full protection of aid workers must be examined.

Existing U.S. legislation — namely the Patriot Act — is at odds with the medical neutrality protections in the Geneva Conventions. The legislation implemented following 9/11 provides limited medical neutrality and its application is left to interpretation by each presidential administration. Due to vague wording, humanitarian staff could be accused of providing material support to terrorism merely by providing healthcare.

The provision of lodging, expert advice or assistance, and training may all be construed as material support for terrorism. Even though the provision of medicine is allowed, counseling on how to take that same medicine is considered a “gray area.”

Worse still, the exclusion of medical staff from such legal protections has grave consequences for aid workers. Last month, Hassan Al-Araj, the last cardiologist working in the Hama district in Syria, was allegedly targeted and killed by the Assad regime.

“The systematic targeting of healthcare professionals just because they are performing their humanitarian duty, should not become the new normal,” notes Dr. Zaher Sahloul, chairman of the Syrian American Medical Society.

There is growing concern, given the recent finding that the U.S. bombing of an Afghan Doctors Without Borders hospital was deemed an accident — not a war crime. Salhoul noted that Syrian doctors have been targeted and killed by their own government using air to surface missiles while performing their professional duties in war-torn Syria. Such attacks are happening in spite of the Geneva Conventions, the international protections for medical facilities, equipment and staff.

The U.S. even has draft legislation — the Medical Neutrality Act — that has provisions protecting health facilities, staff and supplies, unhindered access to nondiscriminatory medical care, and limitation of government interference in any of these areas. The Medical Neutrality Act perfectly complements the Geneva Convention and fills the gap in the Patriot Act. However, two failed attempts to pass the Medical Neutrality Act of 2011 and Medical Neutrality Protection Act of 2013 show the lack of traction in Congress to address existing shortcomings.

Aid workers place themselves in harm’s way in order to fulfill their professional duties. The deliberate targeting of the health sector in conflict settings increases that risk. Legislation needs to be implemented here in the United States in order to project military and civilian Americans working abroad. Yet, for now, the Medical Neutrality Act is stuck in subcommittee.

In a post-9/11 world, anti-terrorism laws are a set of crucial tools to prevent violence toward Americans, but these important laws must be written with precision to limit unintended consequences. Legislation and political cooperation are the major ways to protect those of us working in war zones.

The U.N. Security Council unanimously adopted a resolution condemning attacks on health facilities and health workers; it is time that the United States acts to close loopholes in our own legislation. “Passing legislation in the US will have symbolic power and gives some hope to the colleagues and families of 730 healthcare victims in Syria,” notes Salhoul.

Evans is an assistant professor of global health and director of the Emory University Center for Humanitarian Emergencies. Martin is programs manager at the Emory University Center for Humanitarian Emergencies.