In the ongoing conflict that began in March 2011, Syrian healthcare facilities are significant military targets. There have been 454 air attacks on hospitals, 91 percent of the raids were carried out by aircraft under the control of the Assad government and Russia. The rate of attacks on hospital facilities is said to be increasing. In April 2017, there were 25 attacks on health installations. Between March 2011 and February 2017, over 800 healthcare workers and hundreds patients have been killed as a result of air strikes. Although the UN Security Council has condemned attacks on medical facilities, the repulsive goal of the Assad government (and its supporting Russian air power) is to stop the delivery of medical services to the inhabitants of areas controlled by the opposition.
After many tries, the UN-sponsored peace talks have failed to halt the fighting. The seemingly endless conflict has turned Syria into the world’s largest current humanitarian catastrophe. The country now has 13.5 million people in need of humanitarian assistance. Estimates of the dead range between 400,000 and 470,000, they include Syrian government forces, civilians and opposition forces. As a result of the fighting, 6.3 million people have been displaced within Syria. There are another 4.8 million Syrian refugees living outside of the country. Syria’s unemployment rate has climbed to 50% as the war battered economy continues to decline. About half of Syria’s 30,000 doctors have fled the country.
In response to the bombing by aircraft, the fortification of hospitals and medical facilities has become standard practice. Hospitals are being constructed completely underground, moved to protected basements and installed in caves. The international donors supporting Syria’s medical efforts are being asked to pay for the needed sand bags, concrete and other construction costs related to protecting the patients and donated medical equipment in the strengthened hospital sites. Cost estimates to establish a protected basement hospital vary from $80,000 to $175,000. Cave hospital costs can run $200,000 to $800,000 depending on the size and amount of construction work required. A hospital fully constructed underground can cost from $800,000 to $1.5 million.
Although the deliberate bombing of hospitals is considered a war crime, will the sorry precedent being set in Syria help make the targeting of hospitals a more routine military procedure in conflicts?