These International Laws Are Also Clearly Referenced in the Hague Statement on Respect

DECLARATION Given the current humanitarian crisis in Syria where patients, healthcare workers, and hospitals are under attack, we the undersigned, without presumption of authority or judgment, stand in solidarity with our healthcare colleagues and their right to international health neutrality. For many decades, we have provided global health care professionals with education and training in humanitarian assistance in sudden onset disasters and conflicts worldwide. In this training and education, each and every health care provider, both civilian and military, is made aware of the inherent protections provided to them under international humanitarian law (IHL), including the four Geneva Conventions (GCs) of 1949, as well as the principles and rules of IHL applicable to the conduct of hostilities, including the targeting of hospitals and medical facilities. These must be upheld. These international laws are also clearly referenced in the Hague Statement on Respect for Humanitarian Principles (1991), UN Security Council Resolution 2286 on attacks against medical workers (2016) and military manuals of many States. As an example, the Russian Federation’s Military Manual (1990) states that attacks against medical personnel constitute a prohibited method of warfare. The Russian Federation’s Regulations on the Application of IHL (2001) states: “Persons protected by international humanitarian law include medical and religious personnel. Attacks against such persons are prohibited.” As of June 2016, 757 healthcare personnel have been killed and 382 attacks have occurred on 269 separate medical facilities across Syria. One-hundred and twenty-two hospitals have been hit multiple times. All healthcare providers, both civilian and military, of the Assad Government and the Russian Federation must recognize that whereas under IHL, their own medical military personnel, activities, units, transports, and objects (including hospitals), enjoy protection against direct attack themselves (see rules 25 to 30 of the ICRC’s customary IHL study, as well as protections in the Geneva Conventions and, where applicable, their Additional Protocols). IHL requires Parties to both respect and to ensure respect for IHL, including under common Article 1 to the four Geneva Conventions. Failure to do so leads to risks of moral, ethical and legal consequences and penalties of their actions and inactions. We join our healthcare professionals worldwide in condemning absolutely these deplorable actions in Syria, Yemen as well as in many other countries around the world, and demand their immediate cessation. We further advocate for the following remedies: 1. The establishment of healthcare safe zones in conflict regions to ensure the integrity of hospitals, clinics, and health centers. 2. Allow safe and unfettered passage of medical supplies, equipment, and personnel. 3. Cessation of all attacks on patients, pre-hospital personnel, and hospital medical staff. 4. Recognition by all parties of the neutrality of health care workers and their rights and responsibilities to care for any sick and injured patient, regardless of their nationality, race, religion, or political point of view.

Public Policy Scholar Chief, Division of Medical Toxicology Frederick M. Burkle, Jr., MD, MPH Department of Emergency Medicine, Professor, Senior Fellow & Scientist Brigham and Women’s Hospital Harvard Humanitarian Initiative Timothy B. Erickson, MD, FACEP Harvard Humanitarian Initiative Woodrow Wilson Senior International Professor and Chairman Brigham and Women's Hospital Michael J. VanRooyen, MD, MPH Department of Emergency Medicine, Director: Harvard Humanitarian Initiative

Miriam T. Aschkenasy, MD, MPH Samer Attar, MD Neil G. Boothby, Ed.D Deputy Director Department of Surgery Director Global Disaster Response Northwestern University Program on Forced Migration and Health Massachusetts General Hospital Chicago, IL Columbia University David A. Bradt, MD, MPH Colin M. Bucks, MD Gilbert Burnham, MD Sr. Associate, Department of International Health Medical Director for Disaster Preparedness International Health, Center for Global Health School of Public Health Department of Emergency Medicine Center for Refugee and Disaster Response Johns Hopkins University, Baltimore Stanford University Johns Hopkins University, Baltimore

Brendan Cahill Kevin M. Cahill, MD Melani Cammett Executive Director Professor Professor Institute, International Humanitarian Affairs Institute, International Humanitarian Affairs Department of Government Fordham University Fordham University Harvard University

Emily Y Chan MD, SMPIH, DFPH Jennifer Chan, MD, MPH Nieves Amat Camacho, BSc, RN Director, Collaborating Centre at Oxford University Director Global Emergency Medicine Global Health Centre Chinese University of Hong Kong Disaster and Department of Emergency Medicine Research in Healthcare in Disasters Medical Humanitarian Response Northwestern University Karolinska Institutet, Sweden

Nicholas Comninellis, MD MPH Hilarie H. Cranmer, MD, MPH Francesco Della Corte, MD President & CEO Director, Global Disaster Response CRIMEDIM Research Center Institute of International Medicine MGH Global Health Emergency and Disaster Medicine Kansas City, MO Massachusetts General Hospital Università del Piemonte Orientale, Novara Italy

Christina M. Drummond, MBBS M. James Eliades, MD, MPH Dabney Evans, MD, MPH Disaster Medical Coordination Population and Family Health Program Director Burnet Center Forced Migration and Health Center for Humanitarian Emergencies Prahran, Victoria, Australia School of Public Health, Columbia University Emory University, Atlanta

Paul Farrell CD, MB, BCh Alba Ripoll Gallardo, MD P. Gregg Greenough, MD, MPH President CRIMEDIM- Research Center Harvard Humanitarian Initiative The World Association for Disaster and Emergency and Disaster Medicine Harvard University Emergency Medicine Università del Piemonte Orientale, Italy T.C. Chan School of Public Health

Pier Luigi Ingrassia, MD, PhD M. Ihsan Kaadan, MD, MS Stephanie Kayden, MD, MPH CRIMEDIM- Research Center Clinical Research Coordinator Chief, International Emergency Medicine Emergency and Disaster Medicine Corrigan Minehan Heart Center Humanitarian Programs; Brigham and Università del Piemonte Orientale, Italy Massachusetts General Hospital Women’s Hospital, Harvard Medical School Jennifer Leaning, MD, SMH Kirsten Johnson, MD, MPH Robert Murphy, MD Professor, Practice of Health and Human Rights Humanitarian U Studies Initiative Professor Medicine and Biomedical Engineering Director, FXB Center for Health and Human Rights McGill University Director, Center for Global Health Harvard T.H. Chan School of Public Health Montreal, Canada Northwestern University

Adam C. Levine, MD, MPH, FACEP Rachel T. Moresky, MD, MPH Hani Mowafi, MD, MPH Department of Emergency Medicine Director Director, International Emergency Medicine Chief, Global Health Director GHIEM Fellowship Global Emergency Medicine Fellowship Program on Forced Migration and Health Department of Emergency Medicine Director, Humanitarian Innovation, Brown University School of Public Health Columbia University Yale University School of Medicine

Ronak B. Patel, MD MPH Luca Ragazzoni, MD, PhD Anthony D. Redmond, MD Department of Emergency Medicine CRIMEDIM Research Center Professor, International Emergency Medicine Director, Urbanization & Crisis Program Emergency and Disaster Medicine Head WHO Collaborating Centre EMed Teams Stanford University Universita del Piemonte Orientale, Italy Director, Humanitarian and Conflict Response University of Manchester, UK

Leslie Roberts, MSPH, PhD Paul Spiegel, MD, MPH Johan Von Schreeh, MD, PhD Professor, Program on Forced Migration & Health Professor Health Systems International Health Surgery and Disaster Medicine Department of Population and Family Health Director, Center Refugee & Disaster Response Global Health Policy, Dept of Public Health Mailman School of Public Health, Columbia University Bloomberg School of Public Health Karolinska Institute, Stockholm, Sweden Johns Hopkins University