Translating Humanitarian Emergency into Medical Aid in Syria

Claire Glasscoe

Human Rights Violations

Legislation and the Law

The law relating to the practice of medicine in the Syrian Arab Republic changed substantially in July 2012 with the introduction by the Assad Regime of anti-terrorism laws, which effectively criminalized any kind of medical assistance to those opposing the government or anyone associated with the opposition. These laws therefore compromised the 'Hippocratic Oath,' or its equivalent that doctors universally make when they are registered to practice; a vow made to provide medical assistance solely on the basis of need together with a promise to 'do no harm.' In Arabic this oath is called 'Kasan Abu Krat.' In order to retain their integrity as medical practitioners, many doctors chose to leave Syria at that point, or at least move to a 'liberated area.' Continuing to practice medicine while honouring internationally recognised medical ethics in Regime controlled areas attracts harsh penalties including routine imprisonment for three years, torture and sometimes death. This change in the law led to the extension in Regime policy to the targeting of medical facilities and all healthcare personnel that are suspected to be harbouring or treating those in the opposition.

In my interview with Mr Ebrahim Al Hajji, former President of the Court in Aleppo he explains the introduction of these laws and what it has meant in practice from a legal perspective. He goes on to outline the past and present legal systems operating in Syria, both within Regime controlled and liberated areas.

Imprisonment, Torture and Death

The Syrian Arab Republic could reasonably be described as a 'police state'; arbitrary arrest and detention is routine and every public building has holding areas and facilities for interrogation with violence. This includes children's schools, hospitals and university academic departments. Further to this, a system of security branches is responsible for the different aspects of state security where more concerted interrogation techniques are used together with a complex prison system that is without exception brutal - in 2012 the Human Rights Watch located 27 such detention centres around Syria. Official prisons vary in what category of prisoner they detain and for each prison there is an associated hospital where, under the guise of 'treatment' interrogation and torture continues often until death. The satellite image (left) depicts Sednaya prison, possibly one of the most feared and secret of them all, where prisoners are blindfolded when they are taken there and many die in custody. In December 2014 though the Syrian Network for Human Rights highlighted the existence of unofficial secret detention centres that surpassed the level of brutality imposed on those detained in official prisons. They estimated the total number detained in Syria, frequently without any charge, exceeds 215,000 and they provide a database for relatives trying to locate missing family members. Secret Detention Centers in Syria

Under Siege

Fred Hoff, Senior Fellow at the Atlantic Council, Rafik Hariri Center describes a siege within the Syrian Arab Republic as: 'one facet of an Assad Regime political survival strategy that has helped to produce in Syria the signature humanitarian abomination of the twenty first century.' A 'siege' is characterized by armed forces completely surrounding a populated area and taking control of all the passable terrain and roads. Military checkpoints are set up to restrict or completely prevent the flow of people and basic supplies such as food, water, and medicine. Once surrounded, the area is treated to prolonged bombing campaigns with the objective of starving the neighbourhood into submission, weakening the resolve of the popular base that supports the revolution and expelling rebels operating within its boundary. The Syria Institute estimates that there are currently 1 million living under siege in Syria. 'Slow Death' documents the premature death of 560 civilians in besieged areas and describes the challenges for the young, old and those already suffering with chronic health problems from malnutrition, dehydration and no medicines.