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UNITED NATIONS (AP) — Attacks on hospitals, doctors, ambulances, the wounded and sick took place in at least 20 countries affected by conflict last year, U.N. Secretary-General Antonio Guterres said Thursday.
Guterres told a U.N. Security Council meeting on health care in conflict that in most of the countries "fragile medical systems were already at the breaking point" — and in most cases no one was held accountable.
"These attacks are evidence of a broader trend: parties to conflict are treating hospitals and health clinics as targets, rather than respecting them as sanctuaries," he said. "This goes against the spirit of the Geneva Conventions, the fundamental tenets of international humanitarian law, and our basic humanity."
In Syria, Guterres said, Physicians for Human Rights documented over 400 attacks since the conflict began in 2013, and more than 800 medical staff killed. More than half of all medical facilities are closed or only partially functioning and two-thirds of specialized medical personnel have fled the country, he said.
In Afghanistan, he said, reported attacks on health facilities and personnel almost doubled in 2016, compared with 2015. And in South Sudan, where medical facilities have suffered years of attacks, less than 50 percent are functioning in conflict areas, he said.
The secretary-general lamented that little has changed on the ground since the Security Council adopted a resolution a year ago demanding that all parties to conflicts protect staff and facilities treating the wounded and sick.
Among the attacks in at least 20 countries documented by the U.N. World Health Organization, Guterres said that just a few months after the resolution was adopted, a hospital in Yemen whose roof was clearly marked and coordinates known was hit in an airstrike, killing 15 people including three medical staff.
He said the resolution and former Secretary-General Ban Ki-moon's recommendations must be turned into reality. Switzerland and Canada have gathered an informal group of U.N. member states to support implementation of the resolution, which also urges all countries to bring those responsible for attacks on health facilities and personnel to justice, he said.
Guterres urged parties to conflict to respect international humanitarian and human rights law, and urged arms suppliers to consider the potential consequences of any sales. He also called for stepped up protection of humanitarian and medical missions and greater investments to tackle the roots of conflicts.
Human Rights Watch Deputy Executive Director Bruno Stagno Ugarte told the council a review of 25 attacks on health facilities in 10 countries between 2013 and 2016 that was published Wednesday found that "little has been done" to investigate or bring those responsible to justice. At least 232 people were reportedly killed including 41 health workers and more than 180 injured in those attacks, he said.
Stagno, who is in charge of advocacy, said Human Rights Watch believes 16 attacks "may have constituted war crimes," either because they intentionally targeted protected health facilities or there is evidence of "criminal recklessness."
He accused the Security Council of failing to take "early warning" actions to prevent conflicts and rights abuses. And he urged that all perpetrators of attacks on hospitals and medical personnel be put on a U.N. list. This requires them to enter into action plans with the U.N. to end their violations or be subject to possible sanctions, he said.
Christine Beerli, vice-president of the International Committee of the Red Cross, told the council that much more needs to be done to stop violence against health care facilities and staff, which is being carried out by governments and armed groups.
"We are not only seeing health workers killed or threatened, hospitals destroyed, and ambulances obstructed, but entire public health systems collapse," she said. "It happens in many places, but most recently in Yemen we have seen a deadly cholera outbreak which has taken the lives of hundreds of people just in the past few weeks."
Beerli said the ICRC is particularly concerned about the return of conflict to towns and cities in recent years. "Some 50 million people in urban areas now bear the brunt of conflict," she said.
Beerli expressed hope that when the council meets on the issue next year there will be fewer armed conflicts and improvements in reducing the humanitarian consequences of military operations and in protecting health care — especially in urban areas.
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