Remarks at a UN Security Council Open Debate on Protection of Civilians and Medical Care in Armed Conflict

Ambassador Michele J. Sison
U.S. Deputy Permanent Representative to the United Nations
U.S. Mission to the United Nations
New York City
May 25, 2017



Thank you, Mr. President. I want to thank Secretary-General Guterres for laying out his vision of how to respond to what he has rightly called a “global protection crisis.” I also want to thank Mr. Ugarte and Ms. Beerli. Your organizations do critical work to promote accountability and respect for and protection of medical personnel and facilities in armed conflict. The United States especially values the participation of civil society organizations like yours at these briefings, as well as the data and reporting provided by so many civil society groups on this issue.

There is little doubt that trends are getting worse when it comes to the protection of civilians. Parties to conflicts are using despicable tactics. Starving entire cities until they surrender. Deliberately bombing hospitals – sometimes the same hospital – over and over. Raping and torturing civilians who are trying to flee. And yet, as the Secretary-General has observed, “among the international community, there is a growing sense of fatigue, even resignation, in addressing the suffering of civilians in conflict.”

Protection of civilians remains the primary responsibility of UN Member States. So changing this attitude of resignation means that we on this Council need to change our approach to responding to protection crises on the ground. We as a Council need to be honest with ourselves when Member States are not living up to their commitments, and we need to be willing to apply meaningful pressure when parties to a conflict do not change course. We should be calling on the UN to be more active and more explicit in naming perpetrators and then follow up the UN’s efforts with specific actions from this Council – whether that means naming those responsible in our products or considering sanctions and other mechanisms for accountability. That is the way to start addressing the prevailing climate of impunity in so many of the conflicts on our agenda.

The protection of healthcare facilities and medical workers in armed conflicts remains of particularly grave concern to the United States. One year ago, this Council adopted Resolution 2286, which emphasized that attacks directed against medical personnel and facilities must cease and that perpetrators of violations must be held accountable. However, in far too many places, these attacks have not only continued, but they have gotten worse. And many of these attacks are not incidental. In some cases, warring parties are attacking hospitals precisely because medical staff are doing their jobs – treating the sick and the wounded.

In Syria, the Assad regime – with help from Russia, Iran, and Hizballah – has attacked and destroyed medical facilities in a relentless campaign of destruction. Physicians for Human Rights recorded 108 attacks against medical facilities in 2016 alone. Since the start of Syria’s civil war, the Assad regime and its allies have reportedly been responsible for 90 percent of the 454 attacks on medical facilities. The world witnessed this cruelty during the offensive last year against eastern Aleppo. Between July and November 2016, the Assad regime reportedly bombed every single hospital in eastern Aleppo, leaving as many as 250,000 civilians with virtually no access to medical care. Some hospitals were attacked by the regime more than once, and Assad’s forces would not even spare maternity wards and children’s hospitals. This Council has heard firsthand from doctors about the horror of treating patients in makeshift basement emergency rooms, where doctors had to retreat to avoid the regime’s indiscriminate attacks. The attacks on medical workers and facilities in Aleppo last year will not be forgotten – a stain on this Council and on the members that refused to stop it.

Turning to Yemen, the fighting has led to the rapid deterioration of the country’s healthcare infrastructure. Just 45 percent of medical facilities are still open, even as nearly 70 percent of the population needs humanitarian aid. The results are devastating. Over the past three weeks, Yemen has witnessed a quickly spreading cholera outbreak; the World Health Organization has reported a 50 percent increase in cases since April 27, and hundreds have already died from this treatable illness. With Yemen’s resources so overstretched, all sides of the conflict in Yemen must take all feasible precautions with a view to avoiding or in any event minimizing civilian casualties and damage to civilian infrastructure, especially medical facilities. Attacks on health facilities and health workers only exacerbate Yemen’s humanitarian crisis. The parties must do everything possible to facilitate access to humanitarian aid, both getting aid into the country and distributing it throughout the country.

Finally, in South Sudan, the challenge is not about attacks from the air, but calculated efforts by government forces and armed groups to deny humanitarian access, intimidate aid workers, and prevent health facilities from functioning. Since December 2013, not only have 100 medical facilities closed, but 29 were reportedly ransacked or destroyed. South Sudan remains one of the world’s most dangerous places to be an aid worker, and the violence is getting worse. Just two months ago, six staff members from a UNICEF partner were killed in a vehicle marked with the logo of their NGO – the worst attack on humanitarians since the war began. Humanitarian convoys carrying lifesaving aid have come under attack repeatedly. And even with famine declared and cholera on the rise in South Sudan, the government still imposes a never-ending series of bureaucratic obstacles that keep the UN and its partners from delivering food and medicine to the people who need it the most.

We could go on and on. One recent report by a coalition of NGOs documented attacks against medical personnel and facilities in no less than 23 different countries around the world. One year after the adoption of Resolution 2286, this track record is simply unacceptable.

So this Council must strengthen its resolve, Mr. President, to stop attacks directed against medical personnel and facilities and end impunity for perpetrators of violations and focus on preventing harm to tens of millions of civilians trapped in armed conflicts. This has to be a collective and continuous effort in the year to come. So we have a choice here today. We can let another year go by and then sit here again to lament still more attacks against hospitals and medical workers. Or we can come together now and take steps to reverse the rising tide of violence on the ground by using the tools at this Council’s disposal to push warring parties to live up to their obligations to protect civilians. That choice should be obvious, and we need to make the choice that saves lives.

Thank you, Mr. President.