The conflict in Syria presents new and unprecedented challenges that undermine the
principles and practice of medical neutrality in armed conflict. With direct and repeated
targeting of health workers, health facilities, and ambulances, Syria has become the
most dangerous place on earth for health-care providers. The weaponisation of health
care-a strategy of using people's need for health care as a weapon against them by
violently depriving them of it-has translated into hundreds of health workers killed,
hundreds more incarcerated or tortured, and hundreds of health facilities deliberately
and systematically attacked. Evidence shows use of this strategy on an unprecedented
scale by the Syrian Government and allied forces, in what human rights organisations
described as a war-crime strategy, although all parties seem to have committed violations.
Attacks on health care have sparked a large-scale exodus of experienced health workers.
Formidable challenges face health workers who have stayed behind, and with no health
care a major factor in the flight of refugees, the effect extends well beyond Syria.
The international community has left these violations of international humanitarian
and human rights law largely unanswered, despite their enormous consequences. There
have been repudiated denunciations, but little action on bringing the perpetrators
to justice. This inadequate response challenges the foundation of medical neutrality
needed to sustain the operations of global health and humanitarian agencies in situations
of armed conflict. In this Health Policy, we analyse the situation of health workers
facing such systematic and serious violations of international humanitarian law. We
describe the tremendous pressures that health workers have been under and continue
to endure, and the remarkable resilience and resourcefulness they have displayed in
response to this crisis. We propose policy imperatives to protect and support health
workers working in armed conflict zones.