MEDICAL FACILITIES UNDER FIRE SYSTEMATIC ATTACKS DURING APRIL 2017 ON IDLIB HOSPITALS SERVING MORE THAN ONE MILLION IN SYRIA CONTENT 04 Introduction 08 Data ethics HUMAN VIOLATIONS RIGHTS 09 Methodology 15 Specific attacks against hospitals and field clinics 18 Incident 1: The national hospital of Marret Numan 29 Incident 2: The medical point of Khan Shaykhoun 50 Incident 3: The health center in the town of Heish 55 Incident 4: The hospital in Shanan 65 Incident 5: The hospital in Abadeen (The cave hospital) 81 Incident 6: Kafar Takharim Hospital (Wassim Hasseino) 90 Incident 7: The university hospital in Deir Sharqi 100 Incident 8: The Shamna medical point in Mar Zita 109 Further research PUBLISHED DATE: JULY 2017 110 Errors, corrections and feedback COVER PHOTO BY: MUZAFFAR SALMAN (2013) OF DOCUMENTATION PRESERVING 111 References 4 Medical Facilities Under Fire April 2017 April 2017 Medical Facilities Under Fire 5 In April 2017 25 hospitals or medical facilities in Syria were attacked: an average of one attack every 29 hours.8 91% have been inde- pendently found to be carried out by Syrian government or Russian organisations to report violations targeting medical facilities in Idlib in April 2017. forces.9 Many of those targeted were located in Idlib, the largest re- Those efforts include: maining opposition controlled city after 2016’s siege in Aleppo left - Syria Campaign (May 2017): “Saving Lives Underground” 11 thousands displaced - the majority went to Idlib or to the Aleppo - Medecins Sans Frontieres (Feb. 2017): “At Least 25 Killed in Attack on MSF-Support- countryside.10 ed Hospital in Northern Syria (Updated)” 12 - Human Rights Watch (May. 2017):“Hospitals, Health Workers Under Attack”13 Information published in this joint report suggests that in April 2017 - Organisation for the Prevention of Chemical Weapons (June 2017): “OPCW Fact-Find- Syrian and Russian armed forces were responsible for the eight at- ing Mission Confirms Use of Chemical Weapons in Khan Shaykhun on 4 April 2017”14 tacks on Syrian hospitals and healthcare centers - facilities serving The added value of this report to the efforts mentioned above includes damage iden- a combined 1.3 million people (a beneficiary group larger than the tification, as well as cross referencing and contextualising visual content (75 verified population of Brussels), as reported in witness statements as well as videos) with witness statements (14 people) and with flight observation data (6343 by the managers of those medical facilities. observations) provided by a spotter organisation of aircraft in the immediate vicinity INTRODUCTION of hospitals at the time of attacks. Geolocation of visual content was done in collabo- The Syrian Archive and its partners (Syrians for Truth and Justice, Jus- ration with the Bellingcat Investigation Team. tice for Life) analysed and verified this pattern of attacks by cross referencing a combination of open-source visual content, flight ob- Prior to publication, consent was acquired with those interviewed (e.g. medical work- servation data, and witness statements. Findings regarding these at- ers, facility managers, and Civil Defense volunteers) regarding the public sharing of tacks were characterized by repeated bombardments, lack of warn- information regarding attacks. ings, and an absence of active military hostilities in the vicinity of the attack. Through collecting, verifying and reporting investigative This report is broken into the following sections: Ethics; Methodology; Specific attacks findings from these incidents, the authors hopes to preserve critical against hospitals and field clinics; Further research; Errors, corrections and feedback. information that may be used for advocacy purposes or as evidence in future proceedings seeking legal accountability. This report complements and supports recent efforts by human rights syrianarchive.org syrianarchive.org 6 Medical Facilities Under Fire April 2017 April 2017 Medical Facilities Under Fire 7 forces. For example, in 2013 the United Nations Inde- ed, sick and shipwrecked, and the prevention of disease, have been committed by all parties to the conflict; the BACKGROUND pendent Commission of Inquiry, the group responsible to the administration of medical units or to the operation identification of perpetrators to end the cycle of impu- ospitals have been forced into the frontlines of the for investigating alleged war crimes in Syria, found that or administration of medical transports.”20 Moreover, nity; and the development of a process of justice and HSyrian conflict since it began six years ago. On 22 attacks on hospitals are used systemically as a weapon persons performing medical duties who do not fall with- reconciliation. Through collecting, verifying, curating and May 2011, two months after opposition protests against of war by the Assad regime.17 The Commission of In- in this legal definition but are attacked when providing investigating visual content, the Syrian Archive aims to President Bashar al-Assad began, government forces quiry additionally found that deliberate attacks against similar medical services enjoy the same protection under preserve data as a digital memory to establish a data- stormed the hospital in Dara’a, kicked out non-essential medical staff and ambulances amount to war crimes of International Humanitarian Law.21 base of human rights violations,and to act as a tool for medical staff, and placed snipers on the roof. The follow- intentionally attacking medical personnel and transport, legally implementing justice and accountability efforts as ing day snipers began firing on demonstrators, marking who are awarded special protection under International The principle of proportionality also prohibits parties concept and practice in Syria. the start of escalations that have continued to this day. 15 Humanitarian Law. to an armed conflict from launching attacks that might Since its founding in 2014, the Syrian Archive have col- incidentally harm medical personnel, creating excessive laborated with organisations including Human Rights In 2012, in a widely condemned move in violation of Medecins Sans Frontieres, an international humanitari- harm in relation to any concrete military advantages Watch (HRW), Amnesty International, Berkeley Universi- International Humanitarian Law, President Bashar al-As- an non-profit organisation that supports many facilities gained.22 Article 3 of the Geneva Conventions further ty and Essex University, Witness, Bellingcat and various sad introduced counter-terrorism legislation which de- in Syria, stopped sharing data on medical facilities with requires that the wounded and the sick be collected and agencies of the United Nations (UN), specifically the clared illegal any medical facilities operating without Russian and Syrian forces because they feared the data cared for during armed conflict. Independent International Commission of Inquiry on the government approval. Requests for government approval they shared, such as geocoordinates, that was intended “ABOUT THE AUTHORS” Syrian Arab Republic. to operate medical facilities in opposition held territory to protect civilians and humanitarian workers was being This report has been written jointly by the following or- SYRIANS FOR TRUTH AND JUSTICE 18 were ignored, effectively making illegal the operation of used to deliberately target them. ganisations: yrians for Truth and Justice 24 is an Syria-based in- any opposition held hospitals.16 The law also criminalised dependent, non-governmental organization whose SYRIAN ARCHIVE S failing to report “anti-government activity,” which -ac Under International Humanitarian Law, medical person- members include Syrian human rights defenders, ad- 23 cording to the UN, “effectively criminalized medical aid nel enjoy a protected status. As part of their protect- he Syrian Archive is a Syrian-led initiative striv- vocates and academics of different backgrounds and to the opposition.” ed status, they cannot be targeted by any party to the Ting to promote sustainable peace and respect for nationalities. The initiative strives for Syria, where all armed conflict.19 The law defines medical personnel as, human rights within Syrian society through facilitating Syrian citizens (males and females) have dignity, equality, Since then, hospitals and medical facilities have repeat- “Personnel assigned, by a party to the conflict, exclusive- justice and accountability efforts. This includes evidence justice and equal human rights. edly been bombed in attacks largely attributed by inter- ly to the search for, collection, transportation, diagnosis gathering and documentation of incidents; the acknowl- national human rights monitors to Syrian and Russian or treatment, including first-aid treatment, of the wound- edgment that war crimes and human rights violations syrianarchive.org syrianarchive.org 8 Medical Facilities Under Fire April 2017 April 2017 Medical Facilities Under Fire 9 JUSTICE FOR LIFE DATA ETHICS towards those working in such environments. along with the Justice for Life Organisation, established ustice for Life 25 is a Syria-based civil society and a For this reason, two versions of this report have been a field research team which was tasked with entering the he authors have strived to incorporate a “Do No non-governmental non-profit organization concerned written: a public version which provides summary find- city and inspecting the impact sites. These organisations J Harm” ethical framework into its processes. Due to with strengthening