Another Independent Report – ICRC Health Care Situation and Conditions in Bahrain

ICRC: Health care in danger: making the case
10 Aug 2011 – BCHR

The International Committee of the Red Cross (ICRC) said on Wednesday it was “extremely concerned” about events in Bahrain and mentioned the country in a report on attacks against health care workers and hospitals.

“We are extremely concerned about what is going on in Bahrain. We are doing our utmost to ensure we have access not only to hospitals but to detention centres,” ICRC director-general Yves Daccord told a news briefing in Geneva on Wednesday.

The report, which surveyed 16 countries and took more than two years to research, warned that the very foundations of the Geneva Conventions – the right of those wounded in war to receive medical attention, and the right of those treating them to work unimpeded – are under threat.

The report cited several examples as evidence that attacks on health care workers are increasing, from the murder of medical students in Somalia, to the invasion of an Afghan hospital by militia groups, to the shelling of hospitals in Sri Lanka. All of these incidents took place in 2009.

One year later the picture was, if anything, even bleaker, with doctors in Libya attacked, and ambulances fired upon. In Bahrain, patients were reportedly snatched from their beds, and hospital staff intimidated.

The ICRC said the violence is driving thousands of medical professionals from their jobs, and putting millions of lives at risk.
Extracts from the report regarding Bahrain

VIOLENCE AGAINST HEALTH-CARE FACILITIES

Attacks on health-care facilities during armed violence and internal disturbances tend to fall into four main categories.
[..]
The second category of attack is also deliberate, but this time for political, religious or ethnic reasons rather than for military advantage per se. Such assaults against health-care facilities include [..]; the cordoning off and military takeover of Salmaniya referral hospital in Bahrain in early 2011 after it was perceived to support the cause of anti-government protesters;

What the law says:

• Health-care facilities shall be respected and protected at all times and shall not be the object of attack.
• Protective emblems such as the red cross, red crescent and red crystal identifying medical units shall be respected in all circumstances.
• Small arms are permitted in health-care facilities for the purpose of self-defence or defence of the wounded and the sick (against bandits, for example). The presence of all other weapons
compromises the neutral status of a facility.
• Health-care facilities lose their protection if they are used to commit “acts harmful to the enemy.”
• “Acts harmful to the enemy” include the use of health-care facilities to shelter able-bodied combatants, to store arms or ammunition, as military observation posts or as a shield for military action.

VIOLENCE AGAINST THE WOUNDED AND THE SICK

In some contexts, the wounded and the sick face discrimination in access to, and quality of, health care. Although prohibited by international humanitarian law and human rights law, as well as contrary to medical ethics, health-care personnel have refused to treat, or given inferior treatment to patients on the basis of their ethnicity, religion or political affiliation. [..] In recent unrest in Bahrain, Syria and Yemen, protesters have been too afraid to use medical facilities for fear that their wounds will identify them and provoke harsh reprisals.

What the law says:
The four Geneva Conventions of 1949 and their Additional rotocols of 1977 contain the following rules:
• The wounded and the sick, as well as the infirm, and expectant mothers, shall be the object of particular protection and respect.
• The wounded and the sick must be protected against ill-treatment and pillage.
• No one may be left wilfully without medical assistance and care.
• Whenever circumstances permit, and particularly after fighting, each party
to a conflict must, without delay, take all possible measures to search for, collect and evacuate the wounded and the sick without adverse distinction between them.
• The special role of the ICRC is recognized in facilitating the establishment of neutralized zones to protect the wounded, the sick and civilians from the effects of war.
• Parties to a conflict have the first obligation to care for the wounded and the sick. Any care provided by the local population, humanitarian organizations or other third parties does not relieve the parties of their obligations.

VIOLENCE AGAINST HEALTH-CARE PERSONNEL

Health-care personnel face many challenges working in situations of armed conflict and other violence, having to adapt standards of care to the resources available and dealing with large influxes of patients requiring immediate life-saving attention. Beyond these professional challenges often lie grave dangers associated with the nature of their work.
[..]
On occasion, health-care personnel have also been arrested for carrying out their professional responsibilities to treat all in need regardless of who they are and what they have done.
In Bahrain, 47 doctors and nurses who treated protesters have been detained in sweeping arrests of health workers that followed the crackdown on protesters and face trial in a military court on a range of other accusations.

What the Law says:
• Health-care personnel, whether military or civilian, may not be attacked or harmed.
• Health-care personnel shall not be hindered in the performance of their exclusively medical tasks.
• Parties to a conflict shall not harass or punish health-care personnel for performing activities compatible with medical ethics, nor shall they compel them to perform activities contrary to medical ethics or to refrain from performing acts required by medical ethics.
• Medical personnel may not be required to give priority to any person except on medical grounds. Medical personnel decide, in accordance with medical ethics, which patient receives priority.
• The protection of medical personnel ceases when they commit, outside their humanitarian function, acts harmful to the enemy. …source