International Humanitarian Law

Health and Health care under IHL

Besides the killing, injury, and displacement of millions of combatants and innocent civilians, the negative effects of wars also include long-term physical and psychological harm to people, widespread contagious diseases, poverty, malnutrition, economic and social decline and psychosocial illness.

In principle, international humanitarian law (IHL) strives to limit the harm to people and property during wartime and to prevent situations in which the warring parties resort to indiscriminate or disproportionate use of force.

The core body of IHL provisions aims at protecting the lives of those who are not or no longer participating in hostilities and, in some parts, are health related and they provide for the protection of civilians’ lives, health, and their access to health care and health care facilities and services. It also provides protection to the wounded, the sick, the shipwrecked, prisoners of war and other persons deprived of their freedom in relation to conflict.

In general, the responsibilities of governmental authorities towards individuals under their jurisdiction are governed by international human rights standards.

Particularly vulnerable people, such as detainees, children, women and displaced persons enjoy special protection under IHL and are entitled to respect for their lives and for their physical and mental integrity. Women and girls’ psychological, reproductive and overall well-being is often severely compromised in times of war, where deliberate gender-based violence and discrimination occur, making the challenges of ensuring women and girls’ protection, as well as the health and educational services that are essential to family and community survival, more complex and hard to achieve.

Most importantly, IHL affords special protection to medical property and personnel whose mission is to save lives and provide health care for civilians and combatants alike. Its rules and provisions obligate fighting parties to take all necessary measures to protect and respect medical missions at all circumstances.

In cases where an armed conflict results in the occupation of all or part of the territory of one party to that conflict by the adversary, IHL places the occupying party under an obligation, to the fullest extent of the means available, to ensure sufficient hygiene and public health standards, as well as the provision of food and medical care to the population under occupation.

Yet, IHL as a body of law that aims at protecting the lives and ensuring health of individuals and/or group of people, does not provide for comprehensive protection for all those services aiming at promoting, restoring or maintaining individuals’ health –“health” is defined as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." Health services include, but not limited to, all services that are essential for maintaining health and which include nutrition, water supply, environmental hygiene and living conditions.

International Human Rights Law is the other body of law that shares this aim with IHL; nevertheless, differs significantly in the way it secures such protection, however the case may be. Unlike IHL, the rules of international human rights law are applicable at all times and are not limited to times of peace, especially those pertaining to a number of fundamental rights, such as the right to life and the prohibitions against slavery and torture, which can never be derogated from.

More on the right to health and health care - Presentation

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The Right to Health and Health Care under IHL and IHRL (May 2008, 498kB)

Civilian deaths in wars: Facts and Figures

1500's: Mexico Conquest

“In the early 1500s, during the conquest of Mexico, millions of Aztec Indians died of chicken pox introduced by Hernan Cortés and his men. Two centuries later, British troops in the American colonies on at least one occasion during the Indian uprising of 1763, known as Pontiac's Rebellion, deliberately sent blankets infected with smallpox to Shawnee and Delaware Indians. During the Revolutionary War, American troops also accused the British of spreading smallpox by forcing infected people out of cities with the design of spreading the disease among American soldiers.”

From: Eric Stover: Health Care System, Crimes of War, the Book.

World War 1

Available figures on World War I causalities, both military and civilian, which exceeded 40 million people, place the number of civilian deaths around 10 million deaths and the deaths among the military around 9.7 million deaths. Estimates on the human loss during World War II show that these numbers have more than doubled: 47 million civilian deaths, including 20 million civilian deaths as a result of war related famine and disease, and about 25 million military deaths, including the deaths of about 4 million prisoners of war in captivity.

From: Wikipedia, World War I and World War II causalities.

2003: Iraq

In more recent conflicts, some ninety percent of the casualties are estimated to be civilian. Latest figures on military death in Iraq and Iraqi civilians killed in attacks since the US-led invasion in March 2003 put the number of military deaths among US, Britain and other nations’ troops at 4493 military deaths and the number of military deaths among the Iraqis between 4,900 and 6,375. The number of Iraqi civilians’ deaths is estimated to be between 88,288 and 96,315 people.

From: Reuters

Revised
20/04/2011 Berenice Van Den Driessche ihl@diakonia.se