Healthcare in war zones

Summary

• Humanitarian medicine is care for people caught up in war or disaster, given on need alone. The Red Cross movement sets out its aims as humanity, impartiality and neutrality: relieving suffering "guided solely by their needs", and taking no side in the fighting.
• The rules are in the Geneva Conventions, treaties agreed in 1949. Wounded soldiers must be cared for without any adverse distinction of nationality, religion or politics, and "only urgent medical reasons" may decide who is treated first. Military hospitals and medical units may in no circumstances be attacked.
  • An extra treaty of 1977, a protocol, extends that protection to civilian hospitals.
  • The Geneva Conventions Act 1957 makes the worst violations, called grave breaches, an offence under UK law wherever they happen.
• A hospital loses that protection only if it is used, outside its humanitarian duties, to commit acts harmful to the enemy, and a warning with a reasonable time limit has been ignored. This is the ground on which an armed force can argue that a strike on a hospital was lawful.
  • The International Committee of the Red Cross (ICRC) says that in case of doubt a hospital is presumed not to be misused, and that armed guards do not count.
• The World Health Organization (WHO) has counted more than 10,400 attacks on health care in 29 countries and territories since December 2017, with more than 5,700 deaths. It keeps a separate count for each war.
  • Sudan: 217 verified attacks since fighting began in April 2023, with 2,052 deaths. 37% of health facilities no longer work.
  • Gaza: 937 attacks by 31 January 2026. All 36 hospitals had been damaged, half were partly working, and more than 18,500 patients were waiting to leave for treatment.
  • Ukraine: more than 3,300 attacks since February 2022, which have killed 247 people.
• The UK government says it supports two field hospitals in Gaza, run by a British charity whose teams include NHS staff. In 2025 it also brought 50 sick and injured children from Gaza to NHS hospitals, working with WHO to choose them.

Dig deeper

• On 3 May 2016 the UN Security Council unanimously adopted Resolution 2286 on violence against medical care in war. Ten years on, the heads of the ICRC, WHO and the medical charity Médecins Sans Frontières (MSF) wrote that the situation "is even worse", and asked states to write the protection of health care into their military rules.
• WHO data reported by MSF show 1,348 attacks and 1,981 deaths in 2025, up from 944 deaths in 2024. Sudan accounted for 1,620 of those deaths. In March 2026 a strike on Al Deain Teaching Hospital, in the Darfur region of Sudan, killed 64 people, 13 of them children.
• WHO's health cluster cites an estimate that 97% of aid workers killed in 2024 came from the country in crisis.
• The ICRC and MSF disagree about speaking out in public.
  • The ICRC keeps its talks with armed forces private, saying that "confidentiality is the key that opens doors", and goes public only in exceptional cases.
  • MSF practises témoignage, or bearing witness, and publishes what its teams see.
• The 1977 protocol says no one may be punished for carrying out medical activities compatible with medical ethics, whoever the patient is. The World Medical Association, which represents national doctors' associations, says that in war the ethical standards of the profession apply as in times of peace.
• War also spreads disease. WHO names conflict and mass displacement among the conditions that help cholera spread, and Sudan and Yemen were among seven countries with about 90% of cholera cases in 2025.

Ethical issues

Interview questions

• What do you know about the protection of hospitals and doctors in war?
• What do the Geneva Conventions say about treating a wounded soldier from the other side?
• You are a doctor in a field hospital. A badly injured soldier from the force fighting near your town arrives at the same time as a local child with a broken arm. What do you do?
• What are the arguments for and against medical charities speaking out in public about what they see in a war?
• More than 18,500 patients were waiting to leave Gaza for treatment, and the UK took 50 children. How should those few places be shared out?
• Why do attacks on health care continue when the law forbids them?
• A colleague plans to spend eight weeks in a field hospital in a war zone. What would you want them to think about first?
• What is the difference between recording an attack on a hospital and deciding who is responsible for it?