In 2011, I negotiated in Afghanistan with the Taliban and the United States to establish a trauma hospital in the northern city of Kunduz that would care for the wounded and sick, regardless of who they were. Between 2012 and 2015, Médecins Sans Frontières treated thousands of patients – mostly civilians, but also Taliban and Afghan army patients. This we celebrated as a win for impartial humanitarian action.
But front lines changed, and during a fateful week in October 2015 when the Taliban took control of the town, US and Afghan counter-terrorism forces declared the entire area, and the people in it, as hostile territory. Arguing that Taliban fighters had “taken over” our hospital, the United States bombed it five times over the span of two hours, until it burned to the ground, with everyone in it. The only Taliban inside were patients – hors combat. I would return to Afghanistan shortly after to mourn the lives of 48 staff and patients who died that day, some scorched to death in their hospital beds.
The bombing of our hospital in Kunduz was condemned around the world, and the United States ultimately financially compensated the families of the victims. But an independent investigation to determine why the hospital was bombed was denied. It is an extreme example of what can go wrong when the impartiality of humanitarian action is not respected.
A new bill before the Dutch government threatens to make the same mistake. The law proposes to criminalize citizens’ travel – without Dutch government permission – to areas it designates as controlled by ‘terrorist’ organizations. The criteria upon which such permission will be granted are not clear. Aimed originally at preventing Dutch citizens from joining the so-called Islamic State, this broad new law has serious inadvertent effects on me and many others in many other places around the world.
As a Dutch aid worker regularly travelling to such areas to deliver lifesaving medical assistance, this new law, if adopted, essentially obliges me to prove I have no terrorist intentions prior to saving lives. This remarkable reversal of the burden of proof not only restricts and endangers my own profession, but violates the humanitarian principle of impartiality that populations trapped in conflict rely on. This principle guarantees that their needs, not which side of the front line they find themselves, determines their access to assistance.
Impartiality is the core tenet of humanitarianism relief. For a medical organization such as ours, the consequences of such legislation are even more dire. Under international law, both civilians and combatants have a right to medical care. This was one of the main purposes of the Geneva Conventions, which allow special protection under IHL for an impartial humanitarian body that collects the wounded and sick. Combatants receiving medical care are considered hors combat and have the same status as civilians. This means MSF has the legal right – and responsibility – to treat everyone, even ‘terrorists’ and even in ‘designated areas’.
Saving lives is not a crime. Under international law, preventing me from doing so is.
[Excerpts of article by Michiel Hofman, Senior humanitarian specialist with Médecins Sans Frontières]