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'Indiscriminate and widespread destruction': Ambulances repeatedly targeted in Syria

How the ‘weaponisation of healthcare’ is being used as a war tactic.

A Syrian man inspects the wreckage at a site after Syrian government airstrikes, which targeted the civilian hospital in Hass, rural Idlib, in September 2018.
A Syrian man inspects the wreckage at a site after Syrian government airstrikes, which targeted the civilian hospital in Hass, rural Idlib, in September 2018.
Image: Anas ALkharboutli/DPA/PA Images

AMBULANCES IN SYRIA are deliberately and repeatedly targeted as part of war tactics, researchers have said.

Half of the ambulances targeted in 2016 and 2017 sustained serious damage and/or had to be withdrawn from service, the findings of a recent report show.

Now in its eighth year, the Syrian conflict has taken a heavy toll on medical facilities and health professionals from airstrikes, bombings, shootings, kidnappings and lootings.

This is despite the fact that healthcare facilities and the ambulances servicing them are protected under International Humanitarian Law and the Geneva Conventions, and the UN resolution 2286, passed in 2016, condemning attacks on medical facilities and staff.

To try to quantify the extent of the damage inflicted on the country’s ambulance service, the researchers analysed data from individual reports submitted to the Syrian Network for Human Rights (SNHR) throughout 2016 and 2017 and reviewed published research on attacks on ambulances since the start of the war in 2011.

Analysis of the SNHR data, published in BMJ Global Health, showed there were 204 individual attacks involving 243 ambulances in 2016 and 2017. Half (52%) of the vehicles were deliberately targeted.

Most attacks occurred in areas with large factions of opposition forces: Aleppo, Idlib, and Damascus. Only 1-2% of the attacks occurred in pro-government areas.

syria Map of ambulance attacks 2016–2017 (n=204 incidents, Syrian Network for Human Rights data). Source: BMJ Global Health

Half of the vehicles (49%) were either heavily damaged or had to be withdrawn from service. Only 12% of vehicles sustained mild damage.

The principal perpetrators were the Syrian regime (123 incidents; 60%) and Russian armed forces (60; 29%), the research notes. Air-to-surface missiles and shelling were most often used in the attacks.

Cluster bombs, which scatter munitions over a wide area, leaving unexploded remnants in the ground, and barrel bombs-unguided drums filled with metal fragments and explosives with a massive blast radius-are frequently used by Syrian government and Russian armed forces, note the researchers.

‘Indiscriminate and widespread destruction’

Researchers said the “high degree of indiscriminate and widespread destruction caused by these bombs” will most likely have contributed to the large number of ambulances becoming collateral damage during attacks on medical facilities.

The use of cluster bombs was banned in 2008 by the Convention on Cluster Munitions, indicating an “intentional disregard for international treaties on medical neutrality by the [Syrian] government”, they point out.

damage Source: BMJ Global Health

The review of the published research (18 articles) included the impact of the attacks, such as care being delayed or prevented altogether; blocking and other forms of violence, such as looting; the withdrawal of humanitarian agencies to protect workers; and ‘double-tap’ attacks – where a location is bombed twice, several minutes apart, with the intention of targeting first responders, including paramedics.

“This ‘weaponisation of healthcare’ turns the essential need for healthcare into a war tactic that aims to destabilise, intimidate, and demoralise,” the researchers said.

The intentional, highly destructive and repetitive targeting of ambulances throughout the Syrian conflict has had an immeasurable and devastating impact on the people of Syria and the healthcare system.

“As the most dangerous place in the world to be a healthcare provider, no cadre of health worker or health facility is immune to the attacks.”

Collecting data on attacks on ambulances and pre-hospital providers is challenging, but is nevertheless essential for ensuring that these incidents don’t become “usual war-time tactics”, the researchers added. 

“The UN Security Council and global humanitarian community must do more to protect the sacred space of medical neutrality in conflict and bring harsher punishments to perpetrators of violence against healthcare in Syria,” they said.

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Órla Ryan

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