Source: https://ihl-databases.icrc.org/customary-ihl/eng/docs/v2_cha_chapter7_rule25_sectiona
Timestamp: 2019-04-25 16:46:47
Document Index: 611328524

Matched Legal Cases: ['§ 3', '§ 6', '§ 7', '§ 12', '§ 74', '§ 14', '§ 14', '§ 4', '§ 7', '§ 9', '§ 9', '§ 9', '§ 4', '§ 5', '§ 159', '§ 2', '§ 9', '§ 3', '§ 4', '§ 5', '§ 1', '§ 4', '§ 133', '§ 73', '§ 14', '§ 1', '§ 16', '§ 4666', '§ 64', '§ 474', '§ 2', '§ 5']

Customary IHL - Practice Relating to Rule 25. Medical Personnel
Convention for the Amelioration of the Condition of the Wounded and Sick in Armies in the Field, Geneva, 6 July 1906, Article 10.
Article 9 of the 1929 Geneva Convention provides:
The personnel engaged exclusively in the collection, transport and treatment of the wounded and sick, and in the administration of medical formations and establishments, … shall be respected and protected under all circumstances. If they fall into the hands of the enemy they shall not be treated as prisoners of war. Soldiers specially trained to be employed, in case of necessity, as auxiliary nurses or stretcher-bearers for the collection, transport and treatment of the wounded and sick, and furnished with a proof of identity, shall enjoy the same treatment as the permanent medical personnel if they are taken prisoners while carrying out these functions.
Article 10 of the 1929 Geneva Convention provides:
The personnel of Voluntary Aid Societies, duly recognized and authorized by their Government, who may be employed on the same duties as those of the personnel mentioned in the first paragraph of Article 9, are placed on the same footing as the personnel contemplated in that paragraph, provided that the personnel of such societies are subject to military law and regulations. Each High Contracting Party shall notify to the other, either in time of peace or at the commencement of or during the course of hostilities, but in every case before actually employing them, the names of the societies which it has authorized, under its responsibility, to render assistance to the regular medical service of its armed forces.
Convention for the Amelioration of the Condition of the Wounded and Sick in Armies in the Field, Geneva, 27 July 1929, Article 10.
Article 25 of the 1949 Geneva Convention I provides:
Convention (I) for the Amelioration of the Condition of the Wounded and Sick in Armed Forces in the Field, Geneva, 12 August 1949, Article 25.
Article 26 of the 1949 Geneva Convention I provides:
Each High Contracting Party shall notify to the other, either in time of peace or at the commencement of or during the course of hostilities, but in any case before actually employing them, the names of the societies which it has authorized, under its responsibility, to render assistance to the regular medical service of its armed forces.
Convention (I) for the Amelioration of the Condition of the Wounded and Sick in Armed Forces in the Field, Geneva, 12 August 1949, Article 26.
Article 36 of the 1949 Geneva Convention II provides that “medical and hospital personnel of hospital ships and their crews shall be respected and protected”.
Article 20, first paragraph, of the 1949 Geneva Convention IV provides:
Convention (IV) relative to the Protection of Civilian Persons in Time of War, Geneva, 12 August 1949, Article 20.
Article 8(c) of the 1977 Additional Protocol I defines medical personnel as “those persons assigned, by a Party to the conflict, exclusively to … medical purposes … or to the administration of medical units or to the operation or administration of medical transports”. It adds that “[s]uch assignments may be either permanent or temporary”. The definition covers both military and civilian medical personnel. Article 8(c)(ii) requires that personnel of aid societies be duly recognized and authorized by a party to the conflict.
Protocol Additional to the Geneva Conventions of 12 August 1949, and relating to the Protection of Victims of International Armed Conflicts (Protocol I), Geneva, 8 June 1977, Article 8(c). Article 8 was adopted by consensus. CDDH, Official Records, Vol. VI, CDDH/SR.37, 24 May 1977, p. 68.
Article 15(1) of the 1977 Additional Protocol I provides: “Civilian medical personnel shall be respected and protected.”
Protocol Additional to the Geneva Conventions of 12 August 1949, and relating to the Protection of Victims of International Armed Conflicts (Protocol I), Geneva, 8 June 1977, Article 15(1). Article 15 was adopted by consensus. CDDH, Official Records, Vol. VI, CDDH/SR.37, 24 May 1977, p. 70.
Article 9(1) of the 1977 Additional Protocol II provides: “Medical … personnel shall be respected and protected and shall be granted all available help for the performance of their duties.”
Article 11(f) of the draft Additional Protocol II submitted by the ICRC to the CDDH provided:
“medical personnel” means: (i) the medical personnel of the parties to the conflict, whether military or civilian, permanent or temporary, exclusively engaged in the operation or administration of medical units and means of medical transport, including their crews, and assigned inter alia to the search for, removal, treatment or transport of the wounded and sick;
(ii) the civil defence medical personnel referred to in Article 30 and the medical personnel of the National Red Cross (Red Crescent, Red Lion and Sun) Societies referred to in Article 35.
CDDH, Official Records, Vol. I, Part Three, Draft Additional Protocols, June 1973, p. 37.
This proposal was amended and adopted by consensus in Committee II of the CDDH. The adopted text provided:
“Medical personnel” means those persons assigned exclusively to the medical purposes enumerated in sub-paragraph (c) [the search for, collection, transportation, diagnosis or treatment – including first aid treatment – of the wounded, sick and shipwrecked, and for the prevention of disease] and also those persons assigned exclusively to the administration of medical units or to the operation or administration of medical transports. Such assignments may be either permanent or temporary. The term shall include:
(ii) medical personnel of Red Cross (Red Crescent, Red Lion and Sun) organizations recognized and authorized by a Party to the conflict;
(iii) medical personnel of other aid societies recognized and authorized by a Party to the conflict and located within the territory of the High Contracting Party in whose territory an armed conflict is taking place.
CDDH, Official Records, Vol. XIII, CDDH/406/Rev.1, 17 March-10 June 1977, pp. 241 and 242.
Eventually, however, Article 11(f) of the draft Additional Protocol II was deleted by consensus in the plenary.
Article 13 of the 1880 Oxford Manual provides:
Persons employed in hospitals and ambulances – including the staff for superintendence, medical service, administration and transport of wounded, as well as … the members and agents of relief associations which are duly authorized to assist the regular sanitary staff – are considered as neutral while so employed, and so long as there remain any wounded to bring in or to succour.
In the 1991 Hague Statement on Respect for Humanitarian Principles, the Presidents of the six republics of the former Yugoslavia reminded all the parties to the conflicts in Bosnia and Herzegovina and in Croatia that: “All Red Cross personnel and medical personnel assisting civilian populations and persons hors de combat must be granted the necessary freedom of movement to achieve their tasks.”
Section 9.4 of the 1999 UN Secretary-General’s Bulletin provides: “The United Nations force shall in all circumstances respect and protect medical personnel exclusively engaged in the search for, transport or treatment of the wounded or sick.”
Benin’s Military Manual (1995) lists military and civilian medical personnel as specially protected persons.
Benin, Le Droit de la Guerre, III fascicules, Forces Armées du Bénin, Ministère de la Défense nationale, 1995, Fascicule II, p. 16.
Bosnia and Herzegovina’s Military Instructions (1992) provides: “It is prohibited to intentionally attack military medical personnel.”
Bosnia and Herzegovina, Instructions on the Implementation of the International Law of War in the Armed Forces of the Republic of Bosnia and Herzegovina, Official Gazette of ABiH, No. 2/92, 5 December 1992, Item 15, § 3.
Burkina Faso’s Disciplinary Regulations (1994) provides that, under the laws and customs of war, soldiers in combat must respect medical personnel.
Congo’s Disciplinary Regulations (1986) provides that medical personnel must be respected.
Croatia’s Commanders’ Manual (1992) states: “Specifically protected persons may not participate directly in hostilities and may not be attacked. They shall be allowed to perform their tasks, when the tactical situation permits.” Such persons include military and civilian medical personnel.
Croatia’s Soldiers’ Manual (1992) instructs soldiers to respect medical personnel.
Croatia, Rules of Conduct for Soldiers, Republic of Croatia, Ministry of Defence, 1992, pp. 2 and 3
The Dominican Republic’s Military Manual (1980) instructs soldiers not to attack medical personnel, but to protect them.
Ecuador’s Naval Manual (1989) states that “medical personnel, including medical and dental officers, technicians and corpsmen, nurses, and medical service personnel, have special protected status when engaged exclusively in medical duties and may not be attacked”.
El Salvador’s Soldiers’ Manual provides:
Doctors, nurses and other medical … personnel who serve in hospitals or work for the Red Cross … shall be specially protected because they relieve, aid and comfort all victims without distinction between friend and foe.
The Hellenic Territorial Army’s Internal Service Code (1984), as amended, provides that members of the armed forces should respect the personnel of hospitals and places where wounded and sick are gathered.
Hungary’s Military Manual (1992) instructs soldiers to respect and protect permanent medical personnel.
Indonesia’s Field Manual (1979) restates the rules on medical personnel found in Articles 24–26 of the 1949 Geneva Convention I.
Indonesia, Field Manual concerning the Treatment of Prisoners of War, Department of Defence, 1979, §§ 6–8.
Indonesia’s Air Force Manual (1990) provides: “A non-combatant is not a lawful military target in warfare. They consist of: a. members of the armed forces with special status such as … medical personnel.”
Italy’s LOAC Elementary Rules Manual (1991) states: “Specifically protected persons may not participate directly in hostilities and may not be attacked.” Such persons include military and civilian medical personnel.
Medical personnel are those exclusively assigned to medical units and engaged in the search for, or the collection, transport or treatment of the wounded and sick, or in the prevention of disease. They are to be respected, protected and not attacked. Military medical personnel who are captured during an international armed conflict are not prisoners of war. They may be “retained” for the sole purpose of providing medical care for POWs [prisoners of war] of their own forces … Military medical personnel who may have medical duties to perform on a temporary basis, e.g. stretcher bearers, may not be attacked while performing medical duties. On capture, they become POWs but are to be employed on medical duties if the need arises.
Lebanon’s Teaching Manual (1997) provides for respect for medical personnel, without distinguishing between military and civilian personnel.
Madagascar’s Military Manual (1994) defines medical personnel as “those exclusively assigned to medical units and medical transports” whether military or civilian. Their tasks consist in “the search for, collection, transportation, diagnosis or treatment of the wounded, sick, and shipwrecked, or the prevention of disease”.
Madagascar, Le Droit des Conflits Armés, Ministère des Forces Armées, August 1994, Fiche No. 3-SO, §§ B and C.
The manual states: “Specifically protected persons may not participate directly in hostilities and may not be attacked. They shall be allowed to perform their tasks, when the tactical situation permits.” Such persons include military and civilian medical personnel.
Madagascar, Le Droit des Conflits Armés, Ministère des Forces Armées, August 1994, Fiche No. 2-O, § 7 and Fiche No. 3-O, § 12.
Mali’s Army Regulations (1979) provides that, according to the laws and customs of war, soldiers in combat must respect medical personnel.
Mexico’s Army and Air Force Manual (2009), in a section on the 1949 Geneva Conventions, states: “Medical personnel engaged in searching for, collecting, transporting and caring for the sick and wounded, preventing illness and disease and managing health facilities and institutions … must be respected and protected in all circumstances.”
Mexico, Manual de Derecho Internacional Humanitario para el Ejército y la Fuerza Área Mexicanos, Ministry of National Defence, June 2009, § 74.
Mexico’s IHL Guidelines (2009), in a section entitled “Basic rules of conduct in armed conflict”, states: “Do not attack medical … personnel. Ensure their protection.”
Mexico, Cartilla de Derecho Internacional Humanitario, Ministry of National Defence, 2009, § 14(i); see also § 14(f).
Morocco’s Disciplinary Regulations (1974) provides that, according to the laws and customs of war, soldiers in combat must respect medical personnel.
Nigeria’s Operational Code of Conduct (1967) states: “Hospital staff and patients should not be tampered with or molested.”
Nigeria, Operational Code of Conduct for Nigerian Armed Forces, Federal Military Government of Nigeria, July 1967, § 4(d).
Medical personnel engaged exclusively in the search and collection of the wounded and sick and the prevention of disease, the staff engaged in the administration of hospitals and medical units … are also entitled to protection.
Nigeria’s Soldiers’ Code of Conduct states: “Medical personnel must be respected.”
Nigeria, Code of Conduct for Combatants, “The Soldier’s Rules”, Nigerian Army, undated, § 7.
The Republic of Korea’s Operational Law Manual (1996) states that military medical personnel must be protected.
Romania’s Soldiers’ Manual (1991) provides for respect for medical personnel.
Senegal’s Disciplinary Regulations (1990) provides that soldiers in combat must respect and protect medical personnel.
Sierra Leone’s Instructor Manual (2007) lists “civilian and military medical personnel and facilities” among “persons under special protection”.
Sierra Leone, The Law of Armed Conflict. Instructor Manual for the Republic of Sierra Leone Armed Forces (RSLAF), Armed Forces Education Centre, September 2007, p. 29.
The manual further states: “All medical personnel are protected from attack while carrying out their medical duties and they should not participate in combat activity. If they do, they will lose their protection.”
Sierra Leone, The Law of Armed Conflict. Instructor Manual for the Republic of Sierra Leone Armed Forces (RSLAF), Armed Forces Education Centre, September 2007, p. 56.
Spain’s LOAC Manual (1996) defines medical personnel with reference to Article 8 of the 1977 Additional Protocol I.
Spain, Orientaciones. El Derecho de los Conflictos Armados, Publicación OR7-004, 2 Tomos, aprobado por el Estado Mayor del Ejército, División de Operaciones, 18 March 1996, Vol. I, § 9.2.a.(1).
The manual states, with reference to the relevant provisions of the Geneva Conventions and both Additional Protocols, that “respect and protection” of medical personnel include the duty not to attack medical personnel, and the duty to defend, assist and support such personnel when needed. The manual further explains:
It must be underlined that the protection of medical personnel is not a personal privilege but rather a corollary of the respect and protection due to the wounded and sick, who must be treated humanely in all circumstances. This means that the protection of medical personnel is not permanent but is only granted when such personnel are carrying out their humanitarian tasks. Medical personnel lose the special protection to which they are entitled if they commit acts of hostility. Such behaviour might even constitute perfidy if in so doing they take advantage of their medical position and the distinctive emblems.
Spain, Orientaciones. El Derecho de los Conflictos Armados, Publicación OR7-004, 2 Tomos, aprobado por el Estado Mayor del Ejército, División de Operaciones, 18 March 1996, Vol. I, § 9.2.a.(2).
Spain’s LOAC Manual (2007) defines medical personnel with reference to Article 8 of the 1977 Additional Protocol I.
Spain, Orientaciones. El Derecho de los Conflictos Armados, Tomo 1, Publicación OR7–004, (Edición Segunda), Mando de Adiestramiento y Doctrina, Dirección de Doctrina, Orgánica y Materiales, 2 November 2007, § 9.2.a.(1).
The manual also states that medical personnel of the armed forces and civilian medical personnel are protected persons and cannot therefore be attacked.
Spain, Orientaciones. El Derecho de los Conflictos Armados, Tomo 1, Publicación OR7–004, (Edición Segunda), Mando de Adiestramiento y Doctrina, Dirección de Doctrina, Orgánica y Materiales, 2 November 2007, § 4.5.b.(1).(b); see also §§ 5.2.a.(2).(c), 7.3.a.(10) and 9.2.a.2.(c).
It should be emphasized that the protection to which medical personnel are entitled is not an individual privilege granted to them, but rather a natural corollary to the obligations to respect and protect the wounded and sick, who must be treated humanely in all circumstances.
This means that such protection is not permanent; it is granted when and for as long as medical personnel are performing humanitarian duties. If medical personnel commit acts of hostility, they lose this special protection, and their conduct could be considered an act of perfidy if they take advantage of their medical status or the protective emblems to commit such acts.
The manual further states that “medical personnel … who take a direct part in hostilities” are military objectives and can therefore be attacked.
Sweden’s IHL Manual (1991) considers that Article 15 of the 1977 Additional Protocol I on the protection of medical personnel has the status of customary law.
Switzerland’s Basic Military Manual (1987) states: “Medical … personnel must be respected and protected in all circumstances. They may not be attacked or prevented from carrying out their duties.” It defines medical personnel as including persons specially and exclusively assigned to the care of the wounded and sick, such as doctors, nurses and stretcher-bearers; administrative staff of medical units and establishments such as hospital administrators, drivers and cooks; chaplains and temporary medical personnel.
Switzerland, Lois et coutumes de la guerre (Extrait et commentaire), Règlement 51.7/II f, Armée Suisse, 1987, Article 78(1) and commentary.
- Personnel, installations, material and means of transport of the medical services as well as carriers
of signs or objects marked with distinctive signs must be respected and spared;
177 The red cross and the red crescent on a white ground represent a distinctive emblem. Civilian and military medical personnel must be enabled to carry out their duties at all times. Civilian and military medical personnel who do not participate in hostilities must be protected at all times, even when wearing no distinctive emblem or no distinctive emblem that has been officially recognized by the Conventions.
178 For their own protection, medical personnel may be armed with a personal weapon (e.g. assault rifle, submachine gun, pistol). Explosive weapons and collective weapons are prohibited. Medical personnel do not participate in hostilities, except for their own protection or for the protection of the patients in their care. Nor must they be engaged in other harmful acts (e.g. intelligence services).
179 Enemy medical personnel may be retained for as long as they are needed for the care of patients. Superiors make the necessary arrangements.
Switzerland, Bases légales du comportement à l’engagement (BCE), Règlement 51.007/IVf, Swiss Army, issued based on Article 10 of the Ordinance on the Organization of the Federal Department for Defence, Civil Protection and Sports of 7 March 2003, entry into force on 1 July 2005, §§ 159(3), 176–179, 225 and 237.
Zimbabwe’s Code of Conduct for Combatants (1993) states: “Respect medical personnel”.
Zimbabwe, Code of Conduct for Combatants, Joint publication of the Zimbabwe Defence Forces and the International Committee of the Red Cross Regional Delegation in Harare, 1993, p. 5.
The Code of Conduct adds: “Special protection is to be given to medical personnel”.
Under the Federation of Bosnia and Herzegovina’s Criminal Code (1998), “murder, torture [or] inhuman treatment” of medical personnel is considered to be a war crime.
Bosnia and Herzegovina, Federation, Criminal Code, 1998, Article 155.
Bosnia and Herzegovina, Republika Srpska, Criminal Code, 2000, Article 434.
Whoever, in violation of the rules of international law in time of war or armed conflict, orders or perpetrates in regard to … medical personnel … any of the following acts:
Under Croatia’s Criminal Code (1997), “the killing, torture or inhuman treatment” of medical personnel is a war crime.
Under El Salvador’s Code of Military Justice (1934), medical personnel must be respected.
El Salvador, Code of Military Justice, 1934, Article 69.
Under Estonia’s Penal Code (2001), “a person who kills, tortures, causes health damage to or takes hostage a member of a medical unit properly identified, or any other person attending to the sick or wounded persons” commits a war crime.
Ethiopia, Criminal Code , 2004, Article 271(1)(a).
Georgia’s Criminal Code (1999) provides for the punishment of “wilful breaches of norms of international humanitarian law committed in an international or internal armed conflict … against medical … personnel”.
Italy’s Law of War Decree (1938), as amended in 1992, states that military medical personnel must be respected and protected “provided they are not committing acts of hostility”.
Lithuania’s Criminal Code (1961), as amended in 1998, prohibits attacks against medical and civilian defence personnel, military or civilian hospitals, health centres, vehicles transporting the wounded and sick, and personnel of the ICRC or National Red Cross and Red Crescent Societies if protected by the distinctive emblems.
Poland’s Penal Code (1997) provides for the protection of medical personnel, including the medical personnel of authorized aid societies.
Poland, Penal Code, 1997, Article 123(1)(2).
Romania’s Penal Code (1968) provides for the punishment of anyone who “subjects to inhuman treatment … members of civil medical personnel … or subjects such persons to medical or scientific experiments”.
Serbia’s Criminal Code (2005) states that, in time of war, armed conflict or occupation, ordering or committing an attack “against … medical staff” constitutes a war crime.
Under Slovenia’s Penal Code (1994), “slaughter, torture [or] inhuman treatment” of medical personnel is a war crime.
Spain’s Military Criminal Code (1985) provides for the punishment of any soldier who “exercises violence against the personnel of medical … services, be they enemy or neutral, members of aid organizations and personnel affected to the services of [medical establishments]”, provided that the protection due is not misused for hostile purposes.
Spain’s Penal Code (1995) provides for the punishment of “anyone who should … exercise violence on health … personnel, or members of medical missions or rescue teams”.
2. Exercising violence against medical … personnel or against a member of medical missions.
(c) personnel of the medical … service of the enemy, unless they turn into combatants.
Switzerland’s Ordinance on the Red Cross Service (2006) states:
Article 1 Object and scope of application
1 The present ordinance regulates:
a. the attribution of the members of the Red Cross Service (RCS) to the army;
c. the rights and duties of the RCS that depart from military law;
2 For the rest, the members of the RCS have the same rights and the same duties as the military.
Article 2 Attribution and tasks
1 Members of the RCS are assigned to the army as specialists. They carry out their tasks within the framework of the army’s medical service.
2 Within the framework of the instruction, peace support and assistance services and within the framework of the active service, they support:
a. the nursing services;
b. the medical, dental and pharmaceutical services;
c. the medico-technical and medico-therapeutic services.
3 They are responsible for promoting the fundamental rules of international humanitarian law and the principles of the Red Cross.
Switzerland, Ordinance on the Red Cross Service, 2006, Articles 1–2.
Tajikistan’s Criminal Code (1998), in the section on “Serious violations of international humanitarian law”, provides for the punishment of “wilful breaches of norms of international humanitarian law committed in an international or non-international armed conflict, against … medical … personnel”.
The Report on the Practice of Algeria notes that no instances of attacks against medical personnel or objects by the Armée de Libération Nationale (ALN) were reported during Algeria’s war of independence.
Report on the Practice of Algeria, 1997, Chapter 2.7.
According to the Report on the Practice of Chile, it is Chile’s opinio juris that the prohibition of attacks on medical personnel and objects is part of customary international law.
Report on the Practice of Chile, 1997, Chapter 2.7.
In 1972, in a statement before the General Conference of UNESCO concerning US attacks in Viet Nam, China criticized the United States because it allegedly had “wantonly bombarded Vietnamese cities and villages, seriously destroyed many schools and cultural and sanitary facilities [and] killed a large number of teachers, students, patients and medical personnel”.
China, Statement before the General Conference of UNESCO, 25 October 1972, Selected Documents of the Chinese Delegation to the United Nations, The People’s Press, Beijing, 1972, p. 239.
According to the Report on the Practice of China, it is China’s opinio juris that medical personnel shall be respected and protected.
In 2010, in the History and Geography Textbook for 8th Grade, Djibouti’s Ministry of National Education and Higher Education, under the heading “Basic rules of IHL” and in a section on “Specific protection”, stated: “Medical … personnel … shall be respected and protected.ˮ
The Report on the Practice of Iraq refers to the protection afforded to medical personnel by the 1949 Geneva Conventions.
On the basis of the reply by Iraq’s Ministry of Defence to a questionnaire, the report also states that the protection of relief personnel is “an absolute principle, without any restriction”.
Report on the Practice of Iraq, 1998, Chapter 4.2.
According to the Report on the Practice of the Islamic Republic of Iran, the Islamic Republic of Iran accused Iraq on several occasions of attacking Iranian Red Crescent personnel during the Iran–Iraq war. Islamic Republic of Iran claimed that Iraq had violated IHL by committing these acts.
During the Iraqi occupation of Kuwait in 1990, Kuwait stated in a letter to the UN Secretary-General: “On the pretext that the staff had been lax in attending to the injured Iraqis, a number of the hospital staff were arrested, tortured and then executed.” These acts were described as violations of “the most basic of human rights” and of the 1949 Geneva Convention IV.
Kuwait, Letter dated 16 September 1990 to the UN Secretary-General, UN Doc. S/21777, 17 September 1990, p. 1.
At the International Conference for the Protection of War Victims in 1993, Kuwait stated: “Persons committing acts against [medical personnel] must be considered as war criminals.”
Kuwait, Statement at the International Conference for the Protection of War Victims, Geneva, 30 August–1 September 1993.
According to the Report on the Practice of Kuwait, attacks against medical personnel are an offence under Kuwaiti law.
Report on the Practice of Kuwait, 1997, Chapter 2.7.
According to the Report on the Practice of Nigeria, it is Nigeria’s opinio juris that the prohibition of attacks on medical personnel and objects is part of customary international law.
Report on the Practice of Nigeria, 1997, Chapter 2.7.
On the basis of replies by army officers to a questionnaire, the Report on the Practice of Rwanda states: “Military medical personnel must be protected.”
Medical personnel of aid societies were not specifically mentioned, but in reply to the question regarding the improper use of uniforms, an officer stated that the use of the “uniforms” of humanitarian organizations was prohibited since it endangered their staff.
The medical and religious personnel who administer to prisoners must not be considered prisoners of war, although they have the right to the same treatment.
Switzerland, Federal Department of Foreign Affairs, ABC of International Humanitarian Law, 2009, pp. 18 and 34–35.
The current situation in Gaza cries out to us the importance of the issue we are discussing today. …
… Switzerland also wishes to recall that all the parties to the conflict are under the obligation to protect medical personnel, hospitals and other sanitary facilities.
One of the primary concerns of humanitarian law and policy is to guarantee access to victims and to provide assistance to them. However, it frequently occurs … that it is impossible to ensure the security of humanitarian actors. This was once more clearly evident in the Gaza Strip at the end of 2008 and at the beginning of 2009. Switzerland called upon all the parties to the conflict … to protect medical personnel, hospitals and other medical units.
In 2011, in a statement before the UN Security Council during an open debate on children and armed conflict, made on behalf of the Group of Friends of Children and Armed Conflict, including Switzerland, the deputy permanent representative of Canada stated:
Order No. 579 issued in 1991 by the Chief of Staff of the Yugoslav People’s Army (YPA) instructs YPA units to “apply all means to prevent any attempt of … mistreatment of … religious and medical personnel”.
Yugoslavia, Chief of General Staff of the Yugoslav People’s Army, Political Department, Order No. 579, 14 October 1991, § 2.
The Report on the Practice of Zimbabwe states that the rule on the protection of medical personnel from attack is part of customary international law. In particular, it points out the customary status of Articles 15 and 16 of the 1977 Additional Protocol I.
In a resolution adopted in 1984 on the situation of human rights in El Salvador, the UN General Assembly urged the government and the insurgent forces “to agree as early as possible to respect the medical personnel … as required by the Geneva Conventions”.
UN General Assembly, Res. 39/119, 14 December 1984, § 9, voting record: 93-11-40-15.
In a resolution adopted in 1985 on the situation of human rights and fundamental freedoms in El Salvador, the UN General Assembly:
Expresses … its deep concern at the fact that serious and numerous violations of human rights continue to take place in El Salvador owing above all to non-fulfilment of the humanitarian rules of war and therefore … recommends that the UN Special Representative [for El Salvador] should, for the duration of the armed conflict, continue to observe and to inform the General Assembly and the Commission on Human Rights of the extent to which the contending parties are respecting those rules, particularly as regards humanitarian treatment and respect for … health personnel … of either party.
UN General Assembly, Res. 40/139, 13 December 1985, § 3, voting record: 100-2-42-15.
This recommendation was reiterated in a subsequent resolution adopted in 1986.
UN General Assembly, Res. 41/157, 4 December 1986, § 4, voting record: 110-0-40-9.
In a resolution adopted in 1987 on the situation of human rights in El Salvador, the UN Commission on Human Rights requested that the UN Special Representative for El Salvador “continue to observe and inform the General Assembly and the Commission of the extent to which the contending parties are respecting the humanitarian rules of war, particularly as regards respect for … health personnel”.
UN Commission on Human Rights, Res. 1987/51, 11 March 1987, § 5, voting record: 36-0-7.
In a resolution adopted in 2006 on the question of human rights violations emanating from Israeli military incursions in the Occupied Palestinian Territory, the UN Human Rights Council:
1. Condemns the Israeli killing of Palestinian civilians, including women and children, as well as of medics in Beit Hanoun and other Palestinian towns and villages, and calls for bringing the perpetrators thereof to justice.
UN Human Rights Council, Res. S-3/1, 15 November 2006, preamble and § 1, voting record: 32-8-6.
In a resolution adopted in 1985 on the situation in El Salvador, the UN Sub-Commission on Human Rights:
Recommends that the UN Special Representative for El Salvador inform the Commission on whether both parties accept their obligation to respect the Geneva Conventions and to what extent they are truly observing them, specially in those aspects which refer to the protection of … the medical personnel of both parties.
UN Sub-Commission on Human Rights, Res. 1985/18, 29 August 1985, § 4.
In 1994, in its final report on grave breaches of the Geneva Conventions and other violations of IHL committed in the former Yugoslavia, the UN Commission of Experts Established pursuant to Security Council Resolution 780 (1992) linked attacks on medical personnel to “ethnic cleansing”, regarding them as a coercive means to remove the population from certain areas.
UN Commission of Experts Established pursuant to Security Council Resolution 780 (1992), Final report, UN Doc. S/1994/674, 27 May 1994, §§ 133–134.
UN Commission of Experts Established pursuant to Security Council Resolution 935 (1994)
In 1994, in its final report on grave violations of IHL in Rwanda, the UN Commission of Experts Established pursuant to Security Council Resolution 935 (1994) treated the cases of attacks on medical personnel no differently from attacks on civilians. It mostly referred to common Article 3 of the 1949 Geneva Conventions (acknowledging its customary status) and of the 1977 Additional Protocol II.
UN Commission of Experts Established pursuant to Security Council Resolution 935 (1994), Final report, UN Doc. S/1994/1405, 9 December 1994, §§ 73–92.
In 1995, in a report on the conflict in Guatemala, the Director of MINUGUA recommended to the Unidad Revolucionaria Nacional Guatemalteca (URNG) that it “should issue precise instructions to its combatants to refrain from … endangering ambulances and duly identified health workers who assist such wounded persons”.
In its report in 1993, the UN Commission on the Truth for El Salvador held that the summary execution of a Spanish doctor who had entered El Salvador to work as a doctor for the Farabundo Martí para la Liberación Nacional (FMLN) was a flagrant violation of IHL and human rights law. No indication was given as to what were the doctor’s activities, and the Commission made no mention of the special protected status of medical personnel.
UN Commission on the Truth for El Salvador, Report, UN Doc. S/25500, 1 April 1993, Annex, pp. 89–92.
The Commission described the summary execution of a French nurse working in an FMLN hospital by a unit of the Salvadoran Air Force as a deliberate attack on medical personnel in violation of IHL.
UN Commission on the Truth for El Salvador, Report, UN Doc. S/25500, 1 April 1993, Annex, pp. 87–89.
In a resolution adopted in 1988 on the protection of humanitarian medical missions, the Council of Europe Parliamentary Assembly called on all States to respect “the right of medical personnel to be protected during their missions”. It recalled that the 1977 Additional Protocols afforded protection to medical personnel intervening in conflicts of a non-international nature. The Parliamentary Assembly further emphasized that the protected status applied only to medical personnel working under the aegis of the ICRC or to personnel employed by a State and that the application of these texts did not always cover cases of internal conflicts not recognized by the legal government.
Council of Europe, Parliamentary Assembly, Res. 904 (1988), 30 June 1988, § 14 and Annex, § 1.
Following the killing of six ICRC medical aid workers in Chechnya in December 1996, the OSCE Chairman stated that he was “horrified to learn of the atrocious crime which claimed the lives of six International Red Cross aid workers as they were sleeping” and strongly condemned “this act of violence … and terrorism”.
OSCE, Chairman in Office, Press Release 86/96, 17 December 1996.
At the CDDH, the Working Group on the Protection of Medical Personnel considered in its report that the term “medical personnel” as used in the 1977 Additional Protocol II should include all the categories of personnel listed in Article 8(c) of the 1977 Additional Protocol I.
CDDH, Official Records, Vol. XIII, CDDH/II/269, 3 February–18 April 1975, p. 217.
However, the definition developed for the 1977 Additional Protocol II by Committee II, which took into account the specific aspects of non-international armed conflicts, provided that medical personnel included, inter alia, “medical personnel of other aid societies [other than Red Cross or Red Crescent organizations] recognised and authorised by a Party to the conflict and located within the territory of the High Contracting Party in whose territory an armed conflict is taking place”.
CDDH, Official Records, Vol. XIII, CDDH/235/Rev.1, Report of Committee II, 21 April–11 June 1976, p. 304.
In this respect, the Drafting Committee stated:
It had been necessary to specify that aid societies other than Red Cross organizations must be located within the territory of the High Contracting Party in whose territory the armed conflict was taking place in order to avoid the situation of an obscure private group from outside the country establishing itself as an aid society within the territory and being recognized by the rebels.
CDDH, Official Records, Vol. XII, CDDH/II/SR.80, 4 June 1976, p. 270, § 16.
The Final Declaration adopted by the International Conference for the Protection of War Victims in 1993 urged all States to “make every effort” to protect medical personnel.
Conference of African Ministers of Health
In a resolution on health and war adopted in 1995, the Conference of African Ministers of Health invited OAU Member States “to do everything possible to protect medical personnel against pressure, threats and attempts on their lives”.
The ICRC Commentary on the Additional Protocols, in the light of the fact that the 1977 Additional Protocol II provides no definition of medical personnel, states: “We should therefore refer, both for medical personnel and for religious personnel, to the definitions of these terms given in Article 8 (Terminology) of Protocol I.”
The Commentary further specifies that:
4666. The term “Red Cross organizations” was used in order to cover not only the assistance available on the government side, but also groups or sections of the Red Cross on the other side which already existed, and even improvised organizations which might be set up during the conflict.
4667. Such was the intention of the negotiators, and this interpretation remains in the absence of definitions in the Protocol. It is supported not only by the above-mentioned work of the Conference, but also by Article 18 (Relief societies and relief actions), paragraph 1, which uses the term “Red Cross organizations” in this sense. As regards relief societies, it was considered necessary to specify that relief societies other than Red Cross organizations should be located within the territory of the Contracting Party where the armed conflict was taking place, to avoid private groups from outside the country establishing themselves by claiming the status of a relief society and then being recognized by the insurgents.
4668. In the absence of a precise definition, the term “medical personnel” covers both permanent and temporary categories. The term “permanent medical personnel” means medical personnel exclusively assigned to medical purposes for an unspecified length of time, while “temporary medical personnel” are personnel exclusively assigned to medical purposes for limited periods.
4669. In both cases such assignment must be exclusive. It should be noted that such status is based on the functions carried out, and not on qualifications.
Yves Sandoz et al. (eds.), Commentary on the Additional Protocols, ICRC, Geneva, 1987, §§ 4666–4669.
64. “Medical personnel” means personnel assigned exclusively to medical activities, to the administration of medical establishments and to medical transportation.
78. The law of war grants the same status to civilian and military medical services … The provisions governing military medical personnel … apply equally to the corresponding categories of the civilian medical service.
Frédéric de Mulinen, Handbook on the Law of War for Armed Forces, ICRC, Geneva, 1987, §§ 64 and 78.
Frédéric de Mulinen, Handbook on the Law of War for Armed Forces, ICRC, Geneva, 1987, §§ 474–475.
In a press release issued in 1978, the ICRC urgently appealed to the belligerents in Lebanon “to take measures immediately to ensure that hospitals and medical personnel may continue their work unimpeded and in safety”.
In a press release issued in 1991 in the context of the Gulf War, the ICRC reminded the parties to respect and protect medical personnel at all times.
ICRC, Press Release No. 1658, Gulf War: ICRC reminds States of their obligations, 17 January 1991.
In 1991, the Croatian Red Cross denounced attacks against medical personnel by the Yugoslav army.
Croatian Red Cross, Protest against repeated violations of the Geneva Conventions and Humanitarian Law in Vukovar, 22 November 1991.
In a press release issued in 1992, the ICRC urged the parties to the conflict in Nagorno-Karabakh to ensure that medical personnel were respected and protected.
ICRC, Press Release No. 1670, Nagorno-Karabakh: ICRC calls for respect for humanitarian law, 12 March 1992.
In a press release issued in 1992, the ICRC enjoined the parties to the conflict in Afghanistan “to respect medical personnel”.
ICRC, Press Release No. 1712, Afghanistan: ICRC appeals for compliance with humanitarian rules, 5 May 1992; see also Press Release No. 1726, Afghanistan: New ICRC appeal for compliance with humanitarian rules, 14 August 1992 and Press Release No. 1764, Afghanistan: ICRC calls for respect for the civilian population, 8 February 1994.
In a press release issued in 1992, the ICRC urged the parties to the conflict in Tajikistan “to make certain that medical personnel … are respected and protected”.
In a communication to the press issued in 1993, the ICRC appealed to the belligerents in the conflict in Georgia “to respect hospitals and medical personnel in all circumstances”.
ICRC, Communication to the Press No. 93/32, Conflict in Georgia: ICRC action, 22 September 1993.
In a declaration issued in 1994 in the context of the conflict between the Mexican Government and the Ejército Zapatista de Liberación Nacional (EZLN), the Mexican Red Cross stated:
Protection must be extended to health personnel in general and, in particular, to Mexican Red Cross personnel … Health personnel as well as Mexican Red Cross personnel must be deemed to be neutral and must therefore not be attacked.
Mexican Red Cross, Declaración de Cruz Roja Mexicana en torno a los acontecimientos que se han presentado en el Chiapas a partir del 1o. enero de 1994, 3 January 1994, § 2(C).
In a press release issued in 1994, the ICRC appealed to the parties to the internal armed conflict in Yemen to respect and facilitate the work of first-aiders from the Yemen Red Crescent Society and of ICRC delegates.
ICRC, Press Release No. 1773, Fighting in Yemen, 9 May 1994.
In 1994, in a Memorandum on Respect for International Humanitarian Law in Angola, the ICRC stated that medical personnel “shall be protected and respected”.
ICRC, Memorandum on Respect for International Humanitarian Law in Angola, 8 June 1994, § III, IRRC, No. 320, 1997, p. 504
In a press release issued in 1994, the ICRC urged the parties to the conflict in Chechnya “to ensure that medical personnel … are respected and protected”.
In a press release issued in 1995, the ICRC expressed concern about an attack on a hospital in Burundi, which it regarded as a grave breach of IHL, and reminded the belligerents that all medical personnel must be respected.
ICRC, Press Release No. 50, Burundi: Grenade lands in hospital room, 13 December 1995.
In a press release issued in 2000, following allegations that the Palestine Red Crescent Society had been targeted in shooting incidents, the ICRC stated: “Any attacks … on those medical personnel … indeed constitute a grave violation of International Humanitarian Law.”
ICRC, Press Release, Israel and the Occupied Territories: Respect for medical personnel, ICRC Tel Aviv, 1 November 2000.
Members of the medical services must be respected and protected. They must be allowed to circulate unharmed so that they can discharge their humanitarian duties. All those who take part in the confrontations must respect the medical services, whether deployed by the armed forces, civilian facilities, the Palestine Red Crescent Society or the Magen David Adom in Israel.
ICRC, Communication to the Press No. 00/42, ICRC appeal to all involved in the violence in the Near East, 21 November 2000.
In a communication to the press issued in 2001, the ICRC, deeply concerned by the situation in Afghanistan, urged the warring parties to “ensure the safety of medical personnel”.
ICRC, Communication to the Press No. 01/47, Afghanistan: ICRC calls on all parties to conflict to respect international humanitarian law, 24 October 2001.
In several reports on violations of the laws of war and on human rights in Nicaragua between 1985 and 1988, Americas Watch noted attacks against medical personnel by the armed opposition.
Americas Watch, Violations of the Laws of War by Both Sides in Nicaragua: 1981–1985 , New York, March 1985, pp. 81–83; Human Rights in Nicaragua: 1985–1986, New York, March 1986, p. 105; Human Rights in Nicaragua: August 1987–August 1988, New York, August 1988, pp. 94–95.
In one such report, it mentioned an incident in which civilian medical personnel were kidnapped by the contras. Two of them were taken over to Honduras and held and maltreated for several days. Miskito Indians were tried and convicted as accomplices in the kidnapping. They were later granted an amnesty. In the same report, Americas Watch also stated that doctors who worked in the countryside had been targeted for abduction and that several foreign physicians had been murdered.
Americas Watch, Violations of the Laws of War by Both Sides in Nicaragua: 1981–1985, New York, March 1985, pp. 74 and 80–82.
In 1988, in the context of the conflict in Angola, UNITA expressed concern about the premeditated targeting of medical personnel by government forces. It deplored the fact that the 1949 Geneva Conventions had no validity in guerrilla warfare.
“Comments of a UNITA official”, Allgemeine Zeitung, 21 March 1988.
In 1989, in a report on violations of the laws of war in Angola, Africa Watch stated that the targeting of medical personnel was unlawful.
Africa Watch, Angola: Violations of the Laws of War by Both Sides, New York, April 1989, pp. 147–148.
In a report in 1989, MAG, a Philippine NGO, reported threats, harassment and physical abuse of health workers.
Aurora A. Parong, Total War: A Threat to People’s Health and Lives, Medical Action Group (MAG), Philippines, 1989, p. 4, § 5.
The Turku Declaration of Minimum Humanitarian Standards, adopted by an expert meeting convened by the Institute for Human Rights of Åbo Akademi University in Turku/Åbo, Finland in 1990, states: “Medical … personnel shall be respected and protected and shall be granted all available help for the performance of their duties.”
The Rules of International Humanitarian Law Governing the Conduct of Hostilities in Non-international Armed Conflicts, adopted in 1990 by the Council of the International Institute of Humanitarian Law, provide: “The obligation to respect and protect medical … personnel … in the conduct of military operations is a general rule applicable in non-international armed conflicts.”