The worst year. Despite a new UN resolution strongly condemning attack against medical units and personnel, deliberated attacks against hospitals, doctors, and patients in Syria have reached an unprecedented level in 2016. Breaches of International Humanitarian Law have become commonplace, and impunity the norm.


Between January and September 2016, 126 attacks on healthcare facilities in Syria have been verified by WHO and partners. Reported attacks during October-December are currently under documentation and verification process. Undoubtedly, the number of verified attacks in 2016 will tragically increase. In November, repeated attacks on medical units, notably in Idlib and Aleppo, reached a peak. Due to attacks, no functional hospital were left in east Aleppo earlier this month.

Over half of the medical facilities in Syria are either closed or partly functioning. The targeting of hospitals and health centres do not only risk the lives of health workers and their patients, but also disrupt the provision of critically needed services. It destroys life.

Six medical units supported by Médecins du Monde have been attacked in Syria this year. 15 health workers and 53 patients lost their lives during these attacks.

In February, one hospital in Idlib Governorate was damaged in an air strike. As a result, patients had to seek care in another hospital 10 km away. The hospital has since then been rehabilitated.

– In April, one hospital in east Aleppo where trauma services and primary health services were provided was damaged in an air strike. The same day, still in east Aleppo, another attack hit a primary health care centre. Both structures were rehabilitated.

– In June, another hospital in east Aleppo where trauma services and primary health services were provided was attacked. A warehouse where drugs were stocked was attacked three times in several days, seriously affecting the delivery of medicines to health centres.

– In July, a hospital in Dera’a Governorate providing primary and secondary care – including maternal and childcare – was destroyed. Patients, including pregnant women, had to seek care in another hospital located 10 km away from the destroyed facility. The hospital has been rebuilt in another location but is not yet fully operational.


On 3 May 2016, the United Nations Security Council adopted the resolution 2286. The resolution reaffirms the need for the parties to armed conflict to abide by their obligations under International Human Rights Law and International Humanitarian Law (IHL) and calls for further measures to enhance the protection of, prevent attacks against medical units and personnel, and to better ensure accountability for such acts.

In a letter to the President of the Security Council dated 18 August 2016, UN Secretary General Ban Ki-Moon, recommended that “States should use tools and means of leverage at their disposal, such as diplomatic, political and economic means, to ensure that parties to armed conflict respect their obligations under international law in relation to the protection of medical care in armed conflict”.

However, nothing has changed on the ground and medical units and personnel continue to be targeted.

 “It is a disgusting and blatant disregard for the special protected status of health-care facilities under international humanitarian law; a clear ‘spit in the face’ defiance of your resolution [2286]” Under-Secretary-General For Humanitarian Affairs and Emergency Relief Coordinator, Stephen O’Brien, Statement to the Security Council on Syria, 21 November 2016


Under customary IHL, States have the duty to investigate war crimes allegedly committed by their nationals or armed forces, or on their territory, and if appropriate, prosecute the suspects. Attacks against medical units are war crimes. Such a duty to investigate and hold to account is applicable to non-state actors. When they fail to do so, UN Secretary General recommended in its 18th August letter that “the Security Council should consider establishing international fact-finding missions or commissions of inquiry […] to investigate allegations of serious violations of international law relating to the protection of medical care in armed conflict”.

It is time to act.

Since we do have a difference of opinion between the Minister Mouallem [Government of Syria Foreign Affairs Minister] saying that there is total denial of any aerial bombing of hospitals in eastern Aleppo and our point of view that indicates that there has been tragic bombing of hospital in eastern Aleppo and elsewhere frankly, then perhaps we should be allowed to send a verification team on the UN side and made by the UN and other partners to verify the damage of the hospitals in both east and west Aleppo.”  UN Special envoy for Syria, Staffan de Mistura, Press Conference, 20 November 2016


To UN Security Council members:

  • UNSC members should take immediate steps to hold accountable all parties to the conflict for breaches of international law:
  1. UNSC members should establish an International Fact-Finding Mission/Commission of Enquiry on violations of international law relating to the protection of medical care in armed conflict.
  2. UNSC members should refer the situation to justice, to the International Criminal Court or an ad hoc tribunal.
  • UNSC members should ensure the full implementation of the UNSCR 2286.

To the parties to the conflict:

  • Parties to the conflict should abide by the norms that safeguard health care facilities, workers and patients, including international humanitarian law, human rights law, the Humanitarian Charter, humanitarian principles, medical ethics and duty of care and immediately cease attacks on health facilities, medical personnel and patients.