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A high-level panel discussion on the sidelines of the United Nations General Assembly in New York on 25 September will focus on concrete measures that governments can take to ensure the safe delivery of impartial health care.
"During my visits this year to Gaza, Syria, South Sudan and other conflict-stricken countries, I saw once again how the disruption of health services can affect an entire population," said ICRC President Peter Maurer, who will chair the panel along with WHO Director-General Dr Margaret Chan.
"While many countries have taken steps to tackle obstacles to the delivery of health care, more has to be done," added Mr Maurer. "We need to see good practice shared, and international cooperation and assistance strengthened, so that the wounded and the sick may continue to receive care, and health-care workers may continue to provide it."
In 2012 the ICRC launched the Health Care in Danger project, a four-year effort to secure better protection for health services in conflict and emergencies. The goal is to develop practical recommendations – for instance, guidelines for armed forces staffing checkpoints so ambulances carrying wounded patients can pass quickly.
The role of States in protecting health care needs to be reinforced. States should ensure that their domestic laws meet international legal standards for the protection of patients and health workers, collect data on violence against patients and health workers and investigate its causes, and cooperate in developing worldwide systems for understanding and tackling the problem.
“Hospitals and medical personnel, the providers of primary medical care to the civilian population, are explicitly protected. Yet attacks are not just continuing, they are increasing,” said Dr Chan. “Health workers themselves have an obligation to treat the sick and injured without discrimination. States must respect that obligation, and not punish health workers for performing their duty.”
WHO has a specific mandate to protect the right to health, especially for people affected by humanitarian emergencies. The organization documents attacks on patients, health staff and facilities, and leads the Safe Hospitals Initiative, which aims to ensure healthcare is available in all settings, including emergencies.
Better statistics would help end chronic under-reporting of attacks on health services. ICRC research monitored more than 2,300 incidents involving serious acts or threats of violence in 23 countries between January 2012 and July 2014. But many incidents go unrecorded and the statistics do not reflect the indirect and multiplier effects on community health from attacks on medical staff or denial of access to hospitals and clinics.
Source : ICRC Resource center
…Humanitarian work is by definition dependent on those who do it. No workers? No aid. The equation is simple. But that simplicity conceals the most complex and difficult task today facing humanitarian organizations working in violence-prone environments. That task is to reach the people in need while guaranteeing the safety of their personnel. No effective action is possible without allowing humanitarian personnel to go about their work and actively ensuring their safety. This is an absolute sine qua non for aiding and protecting people affected by armed conflict. The ability of aid workers operating in armed conflicts and other situations of violence to protect and assist people in need depends on the degree to which they themselves are safe…
…Working in armed-conflict environments has always been dangerous and always will be. Today though, some of the inherent dangers are being exacerbated by the sheer number of high-risk combat zones and strife-torn situations in which organizations like ours are active. There have been dramatic changes such as the security constraints under which Red Cross / Red Crescent staff and volunteers, and humanitarian workers generally, have to operate in the midst of armed conflict. While conflicts may not necessarily be more violent than in the past, workers are more exposed. The fragmentation of armed groups (many of which have unclear command structures), the easy availability of small arms, the intertwining of varied motives, the out-sourcing of security tasks to private military/security companies: all these realities have changed the environment in which we operate. The resurgence of religious fundamentalism and the spreading of terror and violence, fuelled or aided by new and far-reaching social media, have brought new figures to the fore. And they are re-drafting the rules to fit their shifting agendas.
As a result of such changes, what we euphemistically call “security incidents” have been multiplying. Ultimately, this leads to the withdrawal of humanitarian personnel. Because of the risks involved, the number of organizations able, allowed or willing to work in conflict environments has shrunk dramatically over the last decade. This means that the calls for humanitarian action are ever less likely to be answered, the dire needs of so many unmet.
The negative perception that some individuals and groups have of humanitarian action – and the deliberate attacks against humanitarian workers that result – is a problem that the international community must address head on. Solutions do indeed exist…
Let me now mention a few of the elementary points that must be accepted and acted on if humanitarian workers are to carry out their duties effectively and in safety.
First and foremost, it is important to remind ourselves that protecting humanitarian workers in armed-conflict environments is an obligation under international humanitarian law. States and non-State actors must respect and protect humanitarian personnel, as well as objects used exclusively for humanitarian operations. This obligation, applicable in both international and non-international armed conflict, is absolute. Not only is this the unavoidable duty of the actual parties to the conflict, but all States have a collective responsibility to uphold that rule, as they do to ensure respect for humanitarian law as a whole.
Second, the blurring of what should be a sharp line between military, political and humanitarian activities poses a real threat to humanitarian action and humanitarian workers. With their determination to work in close proximity to the people they are striving to help and to keep tabs on their needs day after day, humanitarian workers depend on being – and on being perceived to be – neutral and impartial. But their reputation is challenged by the blurring of political, peace-keeping, development and humanitarian mandates that we have seen in recent decades. Any attempt to exploit humanitarian aid or mix together humanitarian goals and political agendas automatically increases the risk of the humanitarian work being perceived with hostility and creating dangers for humanitarian personnel on the ground.
Looking at the majority of crises today, what is missing is a strong political will to protect humanitarian workers and respect the principles according to which they operate, thus ensuring a separate scope for humanitarian action. This is imperative, whatever parallel efforts are under way to find political solutions to a conflict. Humanitarian action must not serve as a fig leaf for political inaction. Only political leadership and political solutions can end protracted crises and bring sustainable peace and security to countries affected by war. This is a burden that humanitarian workers cannot be expected to shoulder.
The Security Council has an extremely important responsibility and role to play in this regard. The Council in our view must safeguard the scope for humanitarian action while abstaining from regulating that scope. The Security Council should not be – and should not be expected to behave as if it were – a humanitarian actor, for that risks blurring further the distinction between political and humanitarian functions. I do understand that the Council on certain occasions wishes to support and encourage humanitarian aid as a first confidence-building step in a broader political process. However, the consequence is that, too often, humanitarian action becomes a hostage, as it were, to lack of political progress.
My third point is that security is intimately linked to acceptance. Without these two things, humanitarian workers find it extremely difficult to safely reach people in need and provide impartial aid and protection. Acceptance depends on the ability of humanitarian organizations to engage with local communities and others. This means speaking with armed non-State actors about humanitarian law and principles and obtaining unambiguous and adequate security guarantees. Through extensive networking at the local and international levels and through constant dialogue with all parties concerned, the ICRC aims to ensure a safer working environment for its staff. This is our main strategy. We call it a threat-reduction strategy and we implement it by dealing with local contacts who control the level of threat to which our operations are exposed.
Our security therefore depends on our being accepted and trusted by the parties to the conflict who are in de facto control of the areas in which we operate. These entities must understand our objectives, and the exclusively humanitarian purpose of our actions. Recent experience has shown very clearly that we cannot work in insecure areas or in politically difficult environments without having direct and indirect contact with everyone capable of endangering our staff, or potentially capable of influencing those people. This dialogue is necessary in all our operations, from Syria to Ukraine, from the Central African Republic to South Sudan and Somalia, and from Afghanistan to Colombia.
At a more basic level, it is important to mention that security management requires humanitarian organizations to adopt professional standards and training in this area. The Red Cross and Red Crescent Movement, the United Nations and many NGOs face the challenge of acquiring the security-management expertise they need and to coordinate among themselves. Different organizations use different models: some – such as the UN system – adopt a centralized approach, in which headquarters plays a significant role. Others, such as the ICRC, follow a more decentralized approach in which decision-making is mainly delegated to the field. No matter the model applied, what counts is a willingness to seek the best combination for improving the safety of humanitarian workers. This increasingly requires professional standards in risk assessment and analysis, community-based information gathering, devising new protection and crisis-management tools, mitigation measures, proper training, and a system to ensure accountability for actions taken…
…I would like to mention here the Health Care in Danger initiative led by the ICRC over the past two and a half years. It has generated compelling information on the threats facing health-care workers, many of whom are humanitarian volunteers and staff. After studying some of the riskiest situations such as crossing checkpoints, medical evacuations, and deploying troops next to health facilities, we have made recommendations to armed entities, lawmakers, health authorities, ambulance providers and many more. We have striven to explain some of the key ethical dilemmas for health-care workers – as regards duty of care, medical confidentiality, accountability, etc. – and we are now working on practical means for humanitarian workers to address these dilemmas. This initiative involves participation by NGOs, religious leaders, the World Medical Association, the International Council of Nurses, the International Committee on Military Medicine, the International Hospital Federation and many more. Their conclusions will be carried forward by a multiplicity of interested parties, the goal being to go far beyond professional circles…
…The ICRC and the World Health Organization will co-organize an event on health care and violence during the General Assembly this fall, and we hope that many States, including the members of the Security Council, will be present to discuss this important subject.
Another ICRC initiative I would like to mention is what we call the Safer Access Framework. This framework involved broad consultations with over 50 National Red Cross and Red Crescent Societies on how best to identify and meet the challenges they face in ensuring operational access and acceptance at all times. The aim of this initiative is to increase the ability of National Societies to deliver assistance while at the same time reducing the risks facing staff and volunteers…
…Recent attacks on humanitarian organizations by both non-State entities and government forces demonstrate that aid organizations are not always targeted because of faulty perception of their roles and responsibilities. Sometimes such targeting is part of a carefully plotted political and military strategy. These attacks are deliberate and the perpetrators will not be deterred by well-crafted explanations of humanitarian mandates or by security procedures. The fact is that such acts issue from a shrewd calculation of the symbolic importance of humanitarian organizations and the political and economic benefit likely to be derived from attacking them. For an organization like the ICRC, finding a way to respond to such manifestations of hostility can be an insuperable challenge, for they threaten its very operational model and its ability to reach affected communities. The States and other parties to conflict must rally in great numbers to put an end to these practices.
The current political environment has sore need of impartial humanitarian organizations that conduct strictly humanitarian activities. The members of the International Red Cross and Red Crescent Movement are committed to standing by people in need during armed conflict and other situations of violence. We are determined to live up to the following principle: the only side taken by the Red Cross and Red Crescent is the side of the victims. Protecting the life of humanitarian workers is not the responsibility of any specific country. It is the responsibility of all nations and communities, stemming from a truly universal value.
Source : World humanitarian day – ICRC Resource centre
L’inflation dans l’utilisation de la tactique de « combat » des boucliers humains est le résultat de la structure asymétrique des conflits contemporains dans lesquels un belligérant (le plus souvent étatique et occidental) dispose d’une supériorité militaire et technologique écrasante sur le belligérant adverse (en général non étatique). Ce dernier répond par une asymétrie juridique pouvant prendre la forme du bouclier humain. L’idée est de dissuader l’adversaire d’attaquer sous peine d’être accusé de violer le droit (en lançant une attaque indiscriminée ou disproportionnée) et de subir l’opprobre de l’opinion publique (en apparaissant dans les médias comme une puissance immorale s’en prenant à la population civile).
Le Secrétaire général des Nations Unies avait parfaitement résumé cette logique dans un rapport sur la protection des civils en période de conflit armé en 2010 : « Les groupes armés cherchent fréquemment à compenser leur infériorité militaire par des stratégies qui violent de façon flagrante le droit international, qu’il s’agisse d’attaques délibérées contre des civils, y compris les violences sexuelles, d’attaques contre des biens à caractère civil tels que des écoles, de l’enlèvement et de l’incorporation forcée de civils ou de l’utilisation de civils comme boucliers pour protéger les objectifs militaires ».
Source : dommages civils.
Il s’agit d’une intervention militaire qui est au droit international car elle répond à une invitation des autorités irakiennes au pouvoir et respecte, dans les conditions actuelles, les termes de cette invitation.
L’intervention sur invitation d’un État est en effet liée à deux conditions : qui appelle au secours ? dans quel cadre se déroule l’intervention ? L’autorité qui sollicite un État tiers doit d’abord être l’autorité effective de l’État en difficulté, c’est-à-dire celle qui contrôle l’ensemble du territoire – pas forcément sa totalité. Le droit international est plus flou quant au cadre d’intervention. Un État tiers ne peut pas intervenir dans une guerre civile mais son intervention est recevable dans la lutte contre le terrorisme ou la criminalité organisée.
La dernière exigence est le respect du droit international humanitaire (protection des populations civiles, proportionnalité des attaques, etc.) et de toutes les autres règles internationales applicables.
Il existe deux possibilités qui permettent à un État d’intervenir militairement sur un territoire souverain sans le consentement de son gouvernement. La première est l’existence d’une résolution du Conseil de sécurité des Nations unies, sous le chapitre 7 (qui autorise l’usage de la force), qui permet à un État ou à une communauté d’États d’intervenir pour maintenir la paix et la sécurité internationale. La deuxième possibilité est le cas de légitime défense. Les États-Unis ont pu, par exemple, exercer ce droit contre l’Afghanistan des Talibans à la suite des attentats du 11 septembre 2001.
Un État ne peut pas intervenir sans résolution du Conseil de sécurité pour des motifs humanitaires. Il n’est pas permis de se passer d’une résolution du Conseil de sécurité à titre humanitaire. Le principe de responsabilité de protéger rappelle aux États leurs obligations de prévenir et réprimer génocide, crimes contre l’humanité, nettoyage ethnique et crimes de guerre contre leurs populations. Mais ce principe ne peut pas être utilisé comme un titre juridique, permettant à un État tiers d’intervenir unilatéralement au secours des populations en danger. C’est d’abord un mécanisme pour inciter au dialogue, à la prévention. Seule une résolution des Nations unies peut décider d’une intervention au nom de la responsabilité de protéger.