Global Policy Forum

Iraqi troops, US-led coalition forces and insurgents are all guilty of breaking Geneva conventions that govern the neutrality of hospitals, say health specialists. The increasing risk of being shot or arrested in a hospital in Iraq is preventing ordinary citizens from seeking medical attention. "The Geneva convention states that a hospital is and should remain neutral and accessible to everybody, particularly civilians. Yet, when it's occupied by armed groups or official forces, people would not have this free and humanitarian access," said Cedric Turlan, information officer for the NGO Coordinating Committee in Iraq (NCCI).

Turlan said that hospitals are getting caught in the midst of violent clashes between insurgents and US or Iraqi troops, and between Sunni and Shia militias. In the course of these battles, ambulances are sometimes destroyed or confiscated and entire hospitals, particularly in the restive Anbar province, are taken over by a particular armed group - whether official or non-official. This is deterring patients from seeking medical help in hospitals and is making the provision of health care an almost impossible task, say specialists.

According to Turlan, the most recent example of a hospital occupation happened in December 2006, in Ramadi, some 115km west of the capital, Baghdad. The general hospital there is located in the highly tense district of Al-Sofiya. According to officials working at the hospital, 13 civilians were killed by snipers in the first week of November 2006 as they were entering the hospital to get treatment.

Snipers on the hospital roof

As such, less than 10 percent of the hospital's staff was still working there when US-led forces burst into the hospital many times during the day and night looking for snipers on the hospital's roof. "The multinational forces were outside, surrounding the hospital but they intruded into the hospital on a daily basis. Now, people rarely go to the hospital because they fear being shot or arrested. Ramadi hospital also functions as a registration centre for the new Iraqi police and army," Turlan said. For several months now, patients have refrained from using the hospital for fear of being shot by snipers or by US-led forces.

According to reports received by NCCI, Mosul Hospital is also occupied by military forces these days and ambulances have been attacked regularly by all forces fighting in Najaf, Fallujah and other parts of Anbar. A report released by the United Nations Assistance Mission in Iraq on 31 December 2006 said that its Human Rights Office had submitted an official memorandum in November to Major General Thomas Moore, chief-of-staff of the multinational forces in Iraq.

The memo requested more detailed information on a number of incidents involving coalition force activities in Ramadi and Fallujah and raised the issue of the military using facilities protected by the Geneva Conventions, such as hospitals and schools. To date, no response has yet been received. IRIN contacted the press office of the multinational forces in Baghdad but received no response.

Doctors threatened to treat insurgents

In addition to the official military and armed groups' occupying hospitals, insurgents have been forcing doctors to treat their injured but not to register their names in the hospital records. "Every day they are asking for assistance in our hospital. And when they feel it looks dangerous for them to come, the insurgents capture a doctor, sometimes with a nurse, and take them to a place where their fighter, who needs medical care, is. We have no choice. If we don't accept, they will kill us within at most 24 hours as happened to two friends of mine," said a doctor working at Yarmouk Hospital, the main emergency centre in the capital, who spoke on condition of anonymity.

"Every human being should have access to free and good medical care but they should be treated like any other Iraqi. Forcing doctors to treat them outside the hospital and without registering them is putting us, and the hospital patients, in a dangerous situation," he added. Hassan said that sometimes insurgents offer huge amount of money after the treatment, especially when the injured person is someone of high rank in their group. "Once, I refused to take the payment and they told me that it was a gift from their chief. I was afraid to turn them down and bought food with it and gave the rest to displaced families near my neighbourhood," the doctor said.

To make matters worse, the doctor said that when US and Iraqi forces came to hospitals looking for insurgents, doctors were often taken away for interrogation. "Whatever we say they arrest us and treat us, doctors, as if we are terrorists. They take us for interrogation and threaten us. So, in reality, we face danger from the insurgents as well as from the [official] troops," the doctor said.

Sectarian violence

Another problem facing Iraq's health system is that the bloody sectarian violence plaguing the country, the capital in particular, has spilled into its hospitals. "There are lots of reports of militias entering hospitals, particularly in Baghdad, where they check people and arrest them if they suspect them of being from another sect," Turlan said. "There is also the continuous targeting of doctors which has pushed more than half of the country's 34,000 physicians to leave the country."

Patients are the ones who are suffering the most from the violence in Iraq's hospitals. "When hospitals are occupied we cannot get medical access and during the night, because of the curfew, we cannot go far to look for help," said mother-of-three Mariam Ahmed Rabia'a, 39, from Ramadi. "If you insist on going to such a hospital, you might get killed, so it's better to die at home with your family than to die from a bullet from a sniper on the roof of the hospital," she added.