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Special: Helpers in Danger – New Challenges in Armed Conflicts

Bombed hospitals and medical personnel under threat – war does not stop even for helpers. Kidnappings of employees of international aid organizations are becoming reality more and more. In recent years, the number of humanitarian workers who have come under attack in war zones and crisis areas has increased significantly. From 2012 to 2014, the International Committee of the Red Cross (ICRC) recorded 4,275 helpers and patients who fell victim to violent attacks in 11 countries. During the same period, there were 60 cases of medical facilities being misused as a military base. International aid organizations and also the UN are increasingly worried and are looking for explanations. Terrorist groups are frequently involved in attacks on humanitarian workers.

If enemies do not respect the protections conferred by the Geneva Conventions, and if they do not respect International Humanitarian Law, then all medical personnel are at risk. At least since the war in Afghanistan, the symbol of the red cross has lost its purely protective effect, and has increasingly become a target for attacks. Today, there is a fundamental concern that in military medicine a new way of thinking and accordingly “new values” may start to emerge. A wish for “new ethics” which make it acceptable to give preferential treatment to one’s own fellow soldiers seems to be evolving. This can be attributed to ongoing asymmetrical conflicts and their atrocities such as the barbarity of the Islamic State (IS) in recent years.

In today’s armed conflicts, military medical helpers face inner conflicts and dangers from all sides. This is not new, however, today it can be more dangerous to openly display a doctor’s kit on the passenger seat rather than a machine gun. This is true just as much for humanitarian aid workers as for military doctors. Aid organizations often remain in crisis areas even though the situation is too dangerous. Does that make it their fault if something happens to them, and who should help them? 

For many medical helpers, it is important to make a clear distinction between humanitarian and military missions and accordingly between NGOs and armed forces. However, when it came to Ebola during the course of this year, the first ever partnership between the Red Cross (DRK), the International Red Cross (ICRC), Doctors Without Borders (Médecins Sans Frontières, MSF) and the German armed forces was realized. They worked closely and successfully together, right from the preparatory stages.

Even helpers need helpers – in many respects. Right now, the medical department of the German Bundeswehr is working on new guiding principles. If in doubt, military medical personnel shall always decide “in favor of humanity”. Coping with principles of humanity and the reality of today’s armed conflicts is both challenge and opportunity for new guiding principles. Military medical ethics finds itself in a quandary, in several ways. All the more, contemporary, multinational, and balanced ethics education that specifically teaches moral and ethical skills will be indispensable in the future.