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Stephen Cornish is executive director, Doctors Without Borders/Médecins Sans Frontières Canada


The day was just beginning at the Maarat al-Numaan health facility in Syria's Idlib province on Feb. 15 when the hospital suddenly came under attack. Two airplanes fired four missiles that destroyed parts of the building and buried patients, staff and caregivers under rubble. Amid the chaos, first responders arrived to pull victims from the destruction. But as they began their work, in came a second round of missiles – this time with the rescuers as the apparent targets.

This double-tap approach, in which a military attacks a target a second time to cause greater carnage, is an appalling tactic, one that is far more brutal than its euphemistic name suggests. Not only does it illegally treat civilians as targets by killing people who are not active participants in war, but it also punishes the doctors, nurses and others who try to help them. It is also a failure to protect civilians and civilian spaces in conflict, a clear violation of the rules of war.

The air strikes in Idlib, which targeted a hospital supported by Médecins Sans Frontières (MSF), were not the first time that participants in Syria's civil war, or the international allies who support them, have launched assaults on hospitals. Nor were they the only attacks that day, which saw facilities in Maarat al-Numaan and Azaz come under similar fire. MSF saw 63 of the hospitals and clinics it supports in Syria bombed or shelled on 94 separate occasions in 2015, with 12 facilities destroyed and 23 staff members killed – and MSF's operations account for only a fraction of the health structures targeted in Syria.

An MSF report released last week found that in 70 of our supported medical centres in Syria, between 30 and 40 per cent of war-wounded patients were women and children. The planes flying over Syria are not just dropping bombs on soldiers or militants, but also on civilians struggling to survive.

This is part of an atrocious and emerging pattern that goes beyond Syria. In Yemen, a military coalition led by Saudi Arabia and supported by Britain, France and the United States has not only attacked public spaces and facilities with little apparent care for civilian casualties, it has also blocked humanitarian aid from entering the country, reducing the people of Yemen to pawns in a military game. In Afghanistan, U.S. planes bombed MSF's hospital in Kunduz, the only advanced health facility in the region, last October, killing more than 40 patients, staff and caregivers and depriving residents of medical care.

Having worked in conflict zones for more than 40 years, MSF knows that war has never been a humane activity. But we have reached a tipping point. It's no longer just groups of rebel fighters who are ignoring the Geneva Conventions, but also the nation-states who actually signed and vowed to uphold them.

When the world's governments came together last century to help codify international humanitarian law, it was not a naive exercise: In the aftermath of the Second World War, there was a collective will to find ways to mitigate the horrors of conflict, and to spare civilians and the wounded from its violence.

Today, those commitments are hollow. The world's biggest military powers use their most advanced weaponry and so-called smart weapons with complete recklessness. Men, women and children trapped inside conflict zones are paying for it with their lives, and the infrastructure and services they depend upon are being destroyed.

Parties to wars today – in Syria, Yemen, South Sudan, Afghanistan and elsewhere – seem to use attacking health-care workers and structures as part of a combat strategy, instead of keeping vulnerable people out of their crosshairs. We have also seen the re-emergence of medieval tactics in which civilians are attacked, tortured, brutalized, besieged, starved and killed. All military forces must respect the right to health care held by everyone, whether they are civilians, wounded soldiers, friends or foes. We must move beyond condemnation to action.

If we – as Canadians, as global citizens, as humans – fail to hold our governments and allies to account, and let them make a mockery of international humanitarian law and the fundamental principles it is meant to uphold, then we, too, will be turning our backs on any hope for a world governed by law, justice and an unwillingness to accept needless human suffering.

Hospitals are not targets. Patients are not targets. Doctors are not targets. Schools, bread lines and market places are not targets. In Canada, we consider violence directed against public institutions and the people they serve an unthinkable outrage. We cannot call ourselves humanitarians if we stand by when it happens in other countries.

Targeting civilians is never acceptable. When warring parties kill with impunity and abandon, it is our shared humanity that is at stake.