Taking Medical Personnel from Starlight Hospital

21 All medical personnel in the Starlight Hospital were followers of the Starlight Path. WOL
leaders had requested Starlight Hospital not to receive wounded or sick Fodavan soldiers.
Some doctors from the Starlight Hospital had publicly declared chewing Arbola Roots a health
hazard. In fact, many doctors and nurses in Starlight Hospital had been reluctant to treat
people of Ipso Faith and often refused to do so.
22 On the morning of 24 September, the Fodavan military forces conducted an evacuation in
the Starlight Hospital. 70 out of 100 doctors and nurses were brought to Fodava military bases,
those left behind were mostly young and inexperienced. Colonel Tomass claimed that the
Fodavan forces did not have enough medical personnel to attend to their wounded and sick
soldiers in the battlefield. He urged Starlight Path doctors and nurses to treat everyone equally.
23 Because of the lack of power and medical staff in the Starlight Hospital, the emergency
service of the hospital was shut down. The local population was in effect left without medical
services, as very few could travel to or be transported and admitted at the city center hospitals.
Furthermore, if they did they risked being arrested as WOL supporters or fighters. Many civilians
and WOL fighters died of war injuries and lack of medical attention.
24 As the battle in suburban Osso died down, all 70 Starlight Hospital personnel returned home
unharmed on 25 October 2012. Colonel Thomass told the press: We thank the doctors and
nurses for their invaluable services. They saved many lives. We should work together, people of
all religions, for humanity.

Medical personnel - Those persons assigned, by a party to an armed conflict,

exclusively to provide medical care, or to the administration of medical units or to
the operation or administration of medical transports. Such assignments may be
either permanent or temporary.14 Unassigned persons do not qualify as medical
personnel; they may qualify for other protections (such as those pertaining to
civilians).

Protections for the wounded would be largely meaningless

without access to medical personnel and supplies. So IHL also
shields those engaged in medical care and the means they need
to do so. Where assigned by a party to the conflict exclusively to
provide such care, medical personnel, transports, and units
benefit from a special status (beyond that conferred on
combatants, civilians, and civilian objects) under IHL. ( 5. For more on
the technical scope of the protections outlined in this paragraph, see infra Section 4:
Corollary Protections for Medical Caregivers, Transports, Units, and Supplies Respect and
protection of medical personnel, units, and transports: prohibition on knowingly attacking,

firing upon, or unnecessarily preventing them from discharging their proper functions and
id. at Capture, detention, and retention.) They

may not be knowingly

attacked, fired upon, or unnecessarily prevented from discharging
their proper functions. That protection may not cease unless
those personnel commit or those transports or units are used to
commitoutside their humanitarian functionacts harmful to the
enemy. Even then, that special protection for units and transports
may cease only after a warning has been given, setting,
whenever appropriate, a reasonable time limit, and where that
warning has gone unheeded. Moreover, at least in conflicts
between states, certain medical personnel may not be detained
but rather only retainedand then only if the condition and
numbers of prisoners of war merit it. Nor may medical personnel
be punished for having provided medical care, even to the enemy
wounded.

First, counterterrorism policies recast medical care as a form of

illegitimate support to the enemy. In comparison, according to the
International Committee of the Red Cross (ICRC), the dominant
idea behind the First Geneva Convention of 1949 is that medical
treatment, even where given to enemies, is always legitimate,
and does not constitute a hostile act. Medical personnel are
placed above the conflict.7
Second, counterterrorism policies reject the corollary proposition
that a terrorist organization may assign a medical corps to work
under its authority. Thus, domestic anti-terrorism legislations
often prohibit medical caregivers from acting under the direction
and control of terrorist groups. In comparison, the IHL system of
protection of medical care hinges partly on mutual trust between
the warring parties.
6. For more on the technical scope of the protections outlined in this paragraph, see infra
Section 4: Corollary Protections for Medical Caregivers, Transports, Units, and Supplies.
7. ICRC, Commentary on GC I, p. 192 [italics added].

As part of their response to terrorist threats, some states attack

medical caregivers and some abuse, withhold, prevent, or punish

medical care. Attacks directed at health-care facilities in terroristcontrolled areas and the use of health-care professionals in the
abusive treatment of alleged terrorists have been widely
condemned.1(On attacks on health-care facilities, see, e.g., Ben Hubbard, ISISImposed Fuel Embargo Threatens Syrias Medical Centers, New York Times, June 18,
2015, available at http://www.nytimes.com/2015/06/19/world/middleeast/isis-imposed-fuelembargo-threatens-syrias-medical-centers.html [https://perma.cc/3BVK-VPEF] (reporting that
[i]nternational aid groups sounded the alarm on Thursday about Syrian government attacks
on medical facilities in opposition-controlled areas.); on the use of health-care professionals
in the abusive treatment of alleged terrorists, see, e.g., International Committee of the Red
Cross, Report on the Treatment of Fourteen High-Value Detainees in CIA Custody, February
2007, pp. 2123, available at http://assets.nybooks.com/media/doc/2010/04/22/icrcreport.pdf [http://perma.cc/G6MX-C7AQ]; U.N. Commission on Human Rights, Situation of
Detainees at Guantnamo Bay (Report of the Chairperson-Rapporteur of the Working Group
on Arbitrary Detention, Leila Zerrougui; the Special Rapporteur on the independence of
judges and lawyers, Leandro Despouy; the Special Rapporteur on torture and other cruel,
inhuman or degrading treatment or punishment, Manfred Nowak; the Special Rapporteur on
freedom of religion or belief, Asma Jahangir; and the Special Rapporteur on the right of
everyone to the enjoyment of the highest attainable standard of physical and mental health,
Paul Hunt), U.N. doc. E/CN.4/2006/120, February 27, 2006, paras. 6682, 9294. See also the
discussion and citations in Sigrid Mehring, First Do No Harm: Medical Ethics in International
Humanitarian Law 4967 (2015) [hereinafter Mehring, Medical Ethics in IHL].)

Across recent and current armed conflicts, state responses to

terrorism have cast a spotlight on the scope and implementation
of IHL protections for medical care:
During its internal armed conflict, Peru prosecuted physicians for
providing medical assistance to members of Sendero Luminoso (the
Shining Path);14
Colombia penalized a medical professional who managed the longerterm specialized care of members of the Fuerzas Armadas
Revolucionarias de Colombia (Revolutionary Armed Forces of Colombia,
or FARC);15
Syria detained physicians who gave medical care to wounded
opposition fighters designated as terrorists,16 and it attacked healthcare facilities in terrorist-controlled areas;17
14. De La Cruz-Flores v. Peru, Merits, Reparations, and Costs, Judgment, Inter-Am. Ct. H.R.
(ser. C) No. 115 (Nov. 18, 2004).
15. Court of Justice of Colombia, Criminal Cassation Chamber, Case No. 27227, May 21,
2009, p. 3.
16. U.N. Human Rights Council, Report of the independent international committee of inquiry
on the Syrian Arab Republic, U.N. doc. A/HRC/25/65, Feb. 12, 2014, para. 111 (Medical staf
suspected of treating or providing medical supplies to the opposition were detained and
tortured, as in the case of Dr. Abbas Khan, who died in government detention on 17
December.) and Annex VII, Assaults on Medical Care, para. 21 (concluding that [a]nti-

terrorism laws issued on 2 July 2012 efectively criminalised medical aid to the opposition.
Laws 19, 20 and 21 contravene the customary international humanitarian law rule that
under no circumstances shall any person be punished for carrying out medical activities
compatible with medical ethics, regardless of the person benefiting therefrom.); Aryn Baker,
Syrias Health Crisis Spirals As Doctors Flee, Time Blog, February 4, 2014, available at
https://time.com/3968/syrias-health-crisis-spirals-as-doctors-flee/
[https://perma.cc/D3JW98ZD] (reporting that, In July 2012, the Syrian government passed an anti-terrorism law
that efectively made it a crime to provide medical care to anyone suspected of supporting
the rebels. Ahmed was caught between the Hippocratic oatha doctors promise to treat
every patientand the growing pressure to take sides. The regime said Why are you
helping the Free Army? and the Free Army said Why are you helping the regime?).
17. Ben Hubbard, ISIS-Imposed Fuel Embargo Threatens Syrias Medical Centers, New York
Times, June 18, 2015, available at
http://www.nytimes.com/2015/06/19/world/middleeast/isis-imposed-fuel-embargo-threatenssyrias-medical-centers.html [https://perma.cc/3BVK-VPEF] (reporting that [i]nternational aid
groups sounded the alarm on Thursday about Syrian government attacks on medical
facilities in opposition-controlled areas.).