It has also laid bare the contrast with decimated health systems in places like Syria, where doctors have, for far too long, been targeted with violence and where hospitals have been bombed.
The truth of this pandemic is that it cannot be defeated anywhere unless it is defeated everywhere. This is why an attack on health care anywhere is an attack on health care everywhere — and why the targeting of health workers and their facilities globally must be brought to an end and the perpetrators held accountable.
Nowhere has the international community failed more appallingly at protecting health workers than in Syria, where doctors and nurses have labored for nearly a decade under the constant threat of airstrikes and shelling.
According to the World Health Organization, there were 494 attacks on Syria’s health system between 2016 and 2019, which include at least 13 bombings of hospitals supported by our group, the International Rescue Committee (IRC).
(According to WHO, 470 people died in attacks on health care facilities in Syria from 2016 through 2019.)
Between December and the end of February, 84 health facilities in northwest Syria were forced to suspend their operations due to hostilities.
So real and persistent is the threat of airstrikes, health facilities have been forced to move underground or go mobile.
Such attacks were always illegal, immoral and inhumane, and the reality of Covid-19 underscores their impact. The disease is stretching the limits of even the most high-functioning and well-resourced health systems.
It is not hard to imagine the devastation that will unfold if hundreds of thousands fall ill in northwest Syria, where 3 million people are displaced and live in cramped and unhygienic conditions. There, social distancing and handwashing are luxuries.
So, too, is seeking medical attention. Half of northwest Syria’s health facilities have been forced offline due to damage or insecurity. And while the IRC is urgently working to establish an intensive care unit in one of the facilities we support, there are just 30 ventilators and 105 ICU beds.
Most are already occupied, leaving few, if any, beds available for Covid-19 patients. Humanitarian organizations like ours depend on cross-border delivery mechanism for supplies of medical and other humanitarian supplies. A UN Security Council resolution cut the number of border crossings providing access into Syria from four to just two at the beginning of 2020, creating dangerous choke points in the supply chain as Covid-19 looms.
In August 2019, after pressure from some governments, the UN Secretary General established a UN Board of Inquiry for Syria, but the board looked at just six attacks. This month, its findings were released, affirming that in some cases, it was “highly probable that the Government of Syria and/or its allies had carried out the airstrike.”
However, it also stated that the evidence gathered was “not sufficient” for the board “to reach a conclusive finding.” The Syrain government has denied it targets civilian areas.
The report also did not name Russia (a permanent member of the UN Security Council), despite a UN inquiry having found in March that Russia has indiscriminately bombed civilian targets, including hospitals — allegations the Kremlin has denied.
Now, the board risks becoming a box-ticking exercise. With no accountability, no follow-on mechanisms, and unclear next steps, the message is clear to those who attack hospitals and care givers: there are no consequences or condemnation; the laws of war no longer apply.
And during this time of global health crisis, it sends a message to health-care workers everywhere, including to our IRC colleagues in Syria and over 40 other countries around the world working to stem the spread of Covid-19 — that the world does not stand with them.
The UN Security Council is discussing Wednesday the humanitarian situation in Syria and, specifically, the Board of Inquiry’s report.
Five steps should be taken to ensure a precedent of accountability for heinous crimes against those risking their lives on the front lines — only made more urgent by the threat of Covid-19: press to hold accountable anyone who attacks health facilities, appoint a permanent body or special representative to speak out about the issue and investigate, preserve evidence from its inquiries, incorporate explicit calls for the protection of health workers in UN resolutions and official discussions, and ensure the free flow of medical and other humanitarian supplies and staff into Syria.
Covid-19 has shown us, in the starkest terms, the value of health workers. And this virus, which respects no borders, has also made clear that our global health depends on health-care systems everywhere. We should all demand world leaders commit to ensuring attacks on health-care workers and facilities will not be tolerated.
Nothing will build back the hospitals decimated by airstrikes or bring back health workers who lost their lives. But with a global pandemic spreading, the international community owes it to them and to all our health workers on the front lines around the world to prevent future attacks.
How the UN handles this Board of Inquiry report will not only send a message to health-care workers in Syria, but to the rest of the world about how seriously it takes these attacks.