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Hospital Bombings Highlight Challenges Health Care Providers Face In War Zones


For more reaction, we reached Jonathan Whittall in Beirut. He's head of humanitarian analysis for Doctors Without Borders, also known by its French acronym, MSF. I asked him if there needs to be harsher punishment when hospitals are attacked.

JONATHAN WHITTALL: I think there needs to be clear accountability, yes. And what we've seen is responses, for example, in the case of Kunduz, the punishment that's dished out does not match the magnitude and the gravity of the situation. And what we've been asking for as Doctors Without Borders is also to have a kind of independent investigation or independent fact-finding capacity when these events happen. And we can't rely, even in the case of Afghanistan, on the perpetrators of these acts to investigate themselves. So that's something that's key for us as well - is to see some capacity for an independent investigation into these - into these attacks.

MCEVERS: The hospital in Kunduz is not an isolated incident. Just this week, a hospital in Aleppo, Syria, was hit by an airstrike, likely by the Syrian government or its ally, Russia, since they are the forces that are attacking that area. Jonathan Whittall says it's part of a terrible trend in Syria and elsewhere of medical facilities being targeted.

WHITTALL: In Syria last year alone, we had 63 MSF-supported facilities that were hit. This year, 11 facilities that we've been supporting have been hit. Estimates of around 23 medical staff have been killed in those various strikes. So we're dealing with a huge problem when it comes to protection of the medical mission - the ability to operate in these kinds of environments. But there's two things at stake here. One is in the case where medical facilities are being directly targeted. And in those incidents, what we're seeing is a kind of criminalization of the enemy, the enemy being regarded as terrorists or criminals and, by extension, the medical facilities at which they seek treatment are being targeted so they kind of - the doctor of your enemy is becoming the enemy as well. And that's a huge problem because, for medical workers, we don't distinguish who walked through our front gates, and neither should we. Our responsibility is to provide treatment to whoever needs it and whoever they are. And then, the second kind of issue that we're seeing is an indiscriminate total war, recklessness in the conduct of hostilities and a complete disregard for civilian life, where not only hospitals are being hit, but schools, bakeries, weddings, all sorts of civilian sites and structures. And this is a huge problem as well. And so the attacks on the medical facilities are indicative and representative of a much bigger disregard for civilian life.

MCEVERS: When do you decide that a location is just too risky for you to have people there?

WHITTALL: It's based on the agreements that we're able to reach with the parties to the conflict. So for example, now we're in a process in Afghanistan of re-evaluating our ability to operate. In Kunduz, for example, we haven't returned to reopen the hospital in Kunduz because we need to regain some kind of assurances that hospitals are protected sites, that doctors and nurses can't be punished for providing treatment to whoever walks through the door, whether they're a person who's suffered a car crash or whether it's an insurgent who's got a bullet hole in his leg. We can't operate in a hospital where we can expect special forces will storm through the doors and arrest our patients. And we can't operate when we see the kind of extreme recklessness as we did in the case of Kunduz recently. Next week, we will see a resolution being passed in the Security Council on the protection of hospitals. And this is a positive signal coming from the Security Council, but I'm talking to you from Beirut, which this region is the graveyard of failed UN resolutions. And we need to see words being put into action. And our patients are directly suffering the consequences of UN Security Council members and other state failures to put their words into action and to uphold their responsibilities.

MCEVERS: I was just going to say, you talk about getting reassurances, but it feels like, these days, reassurances don't mean much.

WHITTALL: Indeed. Reassurances are a starting point, but it's certainly not the end of the process. We need to see words put into action.

MCEVERS: Jonathan Whittall is the head of humanitarian analysis for Doctors Without Borders. He joined us from Beirut. Thank you very much.

WHITTALL: Thank you so much, Kelly. Transcript provided by NPR, Copyright NPR.