Global & Disaster Medicine

Archive for the ‘Conflict’ Category


For Immediate Release ***To view report: ***Link to live press conference March 6, 2017, 10:00am EST: TARGETED ATTACKS ON MEDICAL FACILITIES AND STAFF IN AFGHANISTAN LEAD TO DEATH AND DISEASE AMONG CHILDREN

New Report Calls for Afghan Government Forces to be Cited as Responsible for Attacks for First Time

NEW YORK, March 6, 2017 – Afghan government forces, the Taliban and other parties to the country’s conflict have repeatedly targeted medical facilities and staff, negatively impacting children’s health, Watchlist on Children and Armed Conflict said in a new report today. For the first time, Watchlist called on the UN Secretary General to list the Afghan National Defense and Security Forces (ANDSF) as one of the parties responsible for these attacks. Watchlist’s 27-page report, which focuses on 2015 and 2016, details how parties to the conflict, through more than 240 attacks, have temporarily or permanently closed medical facilities throughout Afghanistan, damaged or destroyed facilities, looted medical supplies, stolen ambulances, and threatened, intimidated, extorted, detained and killed medical personnel. They have restricted and sometimes blocked access to health care and used medical facilities for military purposes, which is in violation of international humanitarian law. While the Taliban and other anti-government groups were responsible for the majority of attacks, the ANDSF carried out at least 35 attacks on medical facilities and personnel between 2015 and 2016. “Targeted attacks on medical facilities have decimated Afghanistan’s fragile health system, preventing many civilians from accessing lifesaving care,” said Christine Monaghan, research officer at Watchlist who traveled to Afghanistan in November 2016 and wrote the report. “Children suffer as a result — we are seeing more deaths, injuries and the spread of disease.”

Attacks on hospitals have compounded challenges to children’s health, already exacerbated by two years of escalating armed conflict, according to the report. In Afghanistan, 4.6 million people, including more than 2.3 million children, are in critical need of health care, according to the World Health Organization (WHO). More than 1 million children suffer from acute malnutrition, an increase of more than 40 percent since the beginning of the reporting period in January 2015, according to WHO. Communicable diseases are also up; WHO reported 169 measles outbreaks in 2015, an increase of 141 percent from 2014. The United Nations Assistance Mission in Afghanistan (UNAMA) furthermore reported that child casualties increased by 24 percent from 2015 to 2016.

Watchlist’s report includes stories from individuals impacted by the damaged health care system. One father discussed how his 15-year-old son lost both feet after stepping on a mine. He could not get proper care in Kunduz City, where the only trauma center had been bombed and many medical professionals had been killed or had fled. He eventually took a taxi to Kabul, more than 200 miles away, where he was told his son needed to get treatment earlier. “Now, both of his legs must get cut off from just below the waist, because the bones are ruined and he has a serious infection,” the father told Watchlist. “For a week he was OK, but then from the infection he went into a coma. Ten days later, he died in the hospital.”

The report calls on all parties to immediately stop attacks on medical facilities and personnel, which are protected during times of conflict under international humanitarian and human rights laws. It calls on the UN Secretary-General to list the ANDSF in its 2017 annual report on children and armed conflict, which is expected to come out before the summer. While previous UN reports included incidents by Afghan forces, the SecretaryGeneral only listed the Taliban in his annual report as responsible for attacks on hospitals. Watchlist also recommends the Afghan government establish an independent and permanent body to investigate these attacks.

About the report “Every Clinic is Now on the Frontline” The Impact on Children of Attacks on Health Care in Afghanistan Watchlist conducted a research trip in Afghanistan in November and December 2016 and interviewed more than 80 people, including humanitarian actors, health workers, health “shura” members, and patients.

Watchlist visited five hospitals and focused its research on four provinces: Helmand, Kunduz, Nangarhar and Maidan Wardak. To read the report: About Watchlist on Children and Armed Conflict Watchlist on Children and Armed Conflict is a New York-based global coalition that serves to end violations against children in armed conflict and to guarantee their rights.

For more information: Press Contacts: Vesna Jaksic Lowe + 1 917.374.2273 Bonnie Berry +1 212.972.0695

Chemical warfare in Syria? Conclusive evidence that Syrian forces had dropped toxic industrial chemicals, including chlorine on opposition communities throughout the last year;

The Guardian


Chemical weapons? Since 1 March, 12 patients including women and children with respiratory symptoms and blistering have been received for treatment by a referral hospital in Erbil, Iraq.


WHO responds to reported use of chemical weapons agents in East Mosul, Iraq

3 March 2017 – Following the reported use of chemical weapons agents in East Mosul, Iraq, WHO, partners and local health authorities have activated an emergency response plan to safely treat men, women and children who may be exposed to the highly toxic chemical.

Since 1 March, 12 patients including women and children with respiratory symptoms and blistering have been received for treatment by a referral hospital in Erbil according to local health authorities. Of these, 4 patients are showing severe signs associated with exposure to a blister agent. WHO and partners are working with health authorities in Erbil to provide support in managing these patients.

Since the beginning of the Mosul crisis, WHO has been taking concrete steps to ensure preparedness for the potential use of chemical weapons, together with local health authorities.

As part of a chemical weapons contingency plan, WHO experts have trained more than 120 clinicians and provided them with equipment to safely decontaminate and stabilise patients before they are referred to pre-identified hospitals for further care. Field decontamination and contaminated patients stabilization are built into all field hospitals, and referral systems to pre-identified hospitals are in place. 

WHO is extremely alarmed by the use of chemical weapons in Mosul, where innocent civilians are already facing unimaginable suffering as a result of the ongoing conflict.

The use of chemical weapons is a war crime and is prohibited in a series of international treaties. These include the Hague Declaration concerning Asphyxiating Gases, the 1925 Geneva Protocol, the Chemical Weapons Convention and the Statute of the International Criminal Court (ICC).

Related links

Declaration (IV,2) concerning Asphyxiating Gases. The Hague, 29 July 1899

1925 Geneva Protocol

Chemical Weapons Convention

Statute of the International Criminal Court

Report of the Independent International Commission of Inquiry on the Syrian Arab Republic

Report of the Independent International Commission of Inquiry on the Syrian Arab Republic

The Independent International Commission of Inquiry on the Syrian Arab Republic was established on 22 August 2011 by the Human Rights Council through resolution S-17/1 adopted at its 17th special session with a mandate to investigate all alleged violations of international human rights law since March 2011 in the Syrian Arab Republic.

The Commission was also tasked to establish the facts and circumstances that may amount to such violations and of the crimes perpetrated and, where possible, to identify those responsible with a view of ensuring that perpetrators of violations, including those that may constitute crimes against humanity, are held accountable.


Aleppo aerial campaign deliberately targeted hospitals and humanitarian convoy amounting to war crimes, while armed groups’ indiscriminate shelling terrorised civilians – UN Commission

Independent International Commission of Inquiry on the Syrian Arab Republic


GENEVA (1 March 2017) – The brutal tactics used by the parties to the conflict in Syria as they engaged in the decisive battle for Aleppo city between July and December 2016 resulted in unparalleled suffering for  Syrian men, women and children and amount to war crimes, according to a UN report released today.

In their report based on 291 interviews, including with residents of Aleppo city, and the review of satellite imagery, photographs, videos and medical records, the Independent International Commission of Inquiry on the Syrian Arab Republic documents daily Syrian and Russian airstrikes against eastern Aleppo over several months which steadily destroyed vital civilian infrastructure resulting in disastrous consequences for the civilian population.

By using brutal siege tactics reminiscent of medieval warfare to force surrender, Government forces and their allies prevented the civilian population of eastern Aleppo city from accessing food and basic supplies while relentless airstrikes pounded the city for months, deliberately targeting hospitals and clinics, killing and maiming civilians, and reducing eastern Aleppo to rubble, the report states.

By late November 2016 when pro-Government forces on the ground took control over eastern Aleppo, no functioning hospitals or other medical facilities remained. The intentional targeting of these medical facilities amounts to war crimes, the Commission concludes.

In the report, mandated by the Human Rights Council at its 25th special session in October 2016, the three-person Commission also notes how armed groups indiscriminately shelled civilian-inhabited areas of western Aleppo city with improvised weapons, causing many civilian casualties. A number of these attacks were carried out without a clear military target and had no other purpose than to terrorise the civilian population.

“The violence in Aleppo documented in our report should focus the international community on the continued, cynical disregard for the laws of war by the warring parties in Syria. The deliberate targeting of civilians has resulted in the immense loss of human life, including hundreds of children”, said Commission Chair Paulo Pinheiro.

In one of the most horrific attacks investigated by the Commission, Syrian Air Force deliberately targeted a United Nations/Syrian Arab Red Crescent humanitarian convoy in Orum al-Kubra, Aleppo countryside. The attack killed 14 aid workers, destroyed 17 trucks carrying aid supplies, and led to the suspension of all humanitarian aid in the Syrian Arab Republic, further aggravating the unspeakable suffering of Syrian civilians.

“Under no circumstances can humanitarian aid workers be targeted. A deliberate attack against them such as the one that took place in Orum al-Kubra amounts to war crimes and those responsible must be held accountable for their actions”, said Commissioner Carla del Ponte.

The repeated bombardments, which also destroyed schools, orphanages, markets, and residential homes, effectively made civilian life impossible and precipitated surrender. The report further stresses that Syrian aircraft used chlorine – a chemical agent prohibited under international law – against the civilian population of eastern Aleppo, causing significant physical and psychological harm to hundreds of civilians.

As it became clear that eastern Aleppo would be taken by pro-Government forces, all parties continued to commit brutal and widespread violations, the report states. In some districts, armed groups shot at civilians to prevent them from leaving, effectively using them as human shields. Pro-government forces on the ground, composed mostly of Syrian and foreign militias, executed hors de combat fighters and perceived opposition supporters, including family members of fighters. Others were arrested and their whereabouts remain unknown.

The report also notes that the eastern Aleppo evacuation agreement forced thousands of civilians – despite a lack of military necessity or deference to the choice of affected individuals – to move to Government-controlled western Aleppo whilst others were taken to Idlib where they are once more living under bombardments. In line with the precedents of Moadamyia and Darayya, this agreement confirms the regrettable trend whereby parties to the conflict in Syria use civilian populations as bargaining chips for political purposes.

“Some of these agreements amount to forced displacement. It is imperative that the parties refrain from similar future agreements and provide the conditions for the safe return of those who wish to go back to their homes in eastern Aleppo”, said Commissioner Karen AbuZayd.

The Independent International Commission of Inquiry on the Syrian Arab Republic, which comprises Mr. Paulo Sérgio Pinheiro (Chair), Ms. Carla Del Ponte, and Ms. Karen Koning AbuZayd has been mandated by the United Nations Human Rights Council to investigate and record all violations of international law since March 2011 in the Syrian Arab Republic.

The full report and supporting documentation can be found on the Human Rights Council web page dedicated to the Independent International Commission of Inquiry on the Syrian Arab Republic:

The report is scheduled to be presented on 14 March during an interactive dialogue at the 34th session of the Human Rights Council.

– See more at:


Alleged war crimes in Aleppo: A U.N. panel said the evacuation of eastern Aleppo was one of many war crimes committed by those fighting for control of the city.

SF Gate

  • Often difficult to know whether specific strikes were carried out by Russia or the Syrian government.
  • Syrian warplanes targeted hospitals on at least two occasions
  • A humanitarian aid convoy was attacked on Sept. 19.
  • Evidence was found  that the Syrian government had used prohibited cluster munitions.
  • Both sides carried out indiscriminate attacks in densely populated civilian areas
  • Rebels launched imprecise mortar attacks on government-held neighborhoods.
  • Some rebels shot civilians to prevent them from leaving and used them as human shields
  • Government forces forcibly conscripted 200 men
  • Syria’s air force used chemical weapons — chlorine gas — against residential areas.


Gaza: Gazans are rebuilding after living through wars, but after so many years of isolation, residents of Gaza find themselves ever further from Palestinians in the West Bank, their future clouded by rising doubts that they could ever unite and work toward a lasting peace.

NY Times

  • Two million tons of rubble have been cleared
  • Two-thirds of the 160,000 damaged homes have been rebuilt
  • Half of the 11,000 homes that were destroyed have been rebuilt
  • Roads are better, travel faster.
  • The first real mall, with a food court and 12 escalators
  • Unemployment is high, especially among the many young people graduating from college.
  • 50,000 people remain displaced.
  • Electricity and water supplies are still near crisis levels.
  • Tunnel building goes on

The UN mission in Afghanistan expresses particular concern about a 65 percent jump in the number of children killed or injured by explosive remnants as fighting has spread to heavily populated civilian areas.

NY Times

“…..In 2016, 3,498 civilians were killed and 7,920 others wounded — an increase of 3 percent over the previous year….”


Drones & ISIS: Could it happen here as a weapon of terror?

NY Times

“….In the past two months, the Islamic State has used more than 80 remotely piloted drones against Iraqi forces and their allies. About one-third of the aircraft, some as small as model airplanes, dropped bombs or were rigged with explosives to detonate on the ground……

War and economic crisis in Yemen has left an estimated 3.3 million people, including 2.2 million children, suffering from acute malnutrition and 460,000 under 5 have severe acute malnutrition.


Meritxell Relano, UNICEF representative in Yemen:

“Because of the crumbling health system, the conflict and economic crisis, we have gone back to 10 years ago. A decade has been lost in health gains,” she said, with 63 out of every 1,000 live births now dying before their fifth birthday, against 53 children in 2014.

Yemen has been divided by nearly two years of civil war that pits the Iran-allied Houthi group against a Sunni Arab coalition led by Saudi Arabia. At least 10,000 people have been killed in the fighting.

Releno later told a news briefing that the rate of severe acute malnutrition had “tripled” between 2014 and 2016 to 460,000 children…..”

A car bomb ripped through a busy commercial district in Azaz, Syria along the Turkish border Saturday, killing nearly 50 in a huge explosion


  • Rescuers and doctors said the explosion was so large there were nearly 100 wounded and burned.
  • Over 50 wounded were transported to the Turkish border town of Kilis for treatment, as local hospitals couldn’t cope.



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