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Humanitarians in the Face of

Atrocities
Case Studies: Syria and CAR





Stephen Cornish

Executive Director Mdecins sans Frontires/ Doctors Without Borders Canada



Operational Humanitarian
Organizations

MSFs Space to Operate
Our Principles
Humanity

Neutrality

Impartiality

Independence

War Crimes & Atrocities
1
st
- Save lives

2
nd
- Speak Out
Humanitarian Notion of Protection
Do No Harm?

Built around compromise
Access/ Accompaniment vs Witnessing/ Justice?

Speaking out Options
1. Civilian Protection
- Call for military intervention
- Call on parties to respect IHL
2. Denunciation
- Naming and shaming

3. Public Statement
- Witnessing what we see (only facts)

4. Discrete Advocacy
- Behind the scenes advocacy

5. Solidarity
- Safeguard presence to accompany
population & provide lifesaving services
R2P Seen from the Field
North Kivu & Libya

Case Study Syria
August 2013
Violence ongoing since 2012

Syrian Population: 22.4 million
Displaced population
-2.5 million Refugees
-4.25 million IDPs

Collapse of Syrian health care system
Hospitals used as a conflict tool on
both sides
IHL violations on both sides
Civilians risk lives to access care

Case Study - Syria
MSF is Syria
Present in Syria since 2012

MSF operated health facilities
-6 hospitals
-4 health centers
MSF supported health facilities
-27 hospitals
-56 medical posts

June 2012 - June 2013, MSF
- 55,000 medical consultations
- 2,800 surgical procedures
- 1,000 births assisted
- 140,000 medical consultations for
Syrian refugees
Case Study - Syria
August 21
st
, 2013
Damascus Governorate

3 MSF supported hospitals in Damascus:
-Admitted 3,600 patients displaying
neurotoxic symptoms in under 3 hours
-Of those patients, 355 died

Symptoms included convulsions, excess
saliva, pinpoint pupils, blurred vision and
respiratory distress associated with mass
exposure to a neurotoxic agent.

Chemical and biological weapons
constitute a violation of international
humanitarian law


What to do?
Options
1. Call to respect IHL / Civilian
Protection ( belligerents/gvt)
2. Denunciation (name & shame)
3. Public Statement (facts only)
4. Discrete Advocacy (behind scenes)
5. Solidarity
6. R2P ( external protection)
As external consultants preparing for an MSF advisory meeting on August 22, 2013
(15 minutes to prepare)

1a. Choose one primary action to take and explain your selection.
1b. What is the action going achieve?
1c. What are the limitations of this action?

2a. List the potential risks for the MSFs operations associated with this action.
2b. List the potential benefits & risks for the population associated with this action.

Case Study - CAR




December 2013
Violence ongoing since 2012

CAR Population: 4.5 million
Displaced population
-280,000 Refugees
-714,00 IDPs

Complete collapse of CAR health
care system
Increasing intensity of retaliation
violence
Civilians risk lives to access care

Humanitarian vacuum. UN
agencies on lock down &
insufficient aid reaching
population.


Case Study - CAR
MSF is CAR
Present in CAR since 1997

MSF operated
- 7 hospitals
- 2 health centers
-40 health posts

In 2013 MSF:
- Provided medical care for
400,000 people
- Doubled operations with
mobile emergency teams to
respond to violent incidents




MSF is one of only health
providers in the country
Case Study - CAR



December 5-7
th
, 2013
Bangui

Intense violence started in Bangui

Stories of anti-balaka forces going
door to door, killing approximately
60 Muslim men

Summary executions carried out
by armed men inside the Hpital
de lAmiti

MSF supported hospital received
260 wounded patients (gunshot,
machete and knife wounds)
200 dead bodies brought by Red
Cross & ICRC to hospital morgue
Senior UN and French officials warned
that cycles of violence between the
Muslim minority and Christian majority
could become a genocide - Nov 21 & 26
th

2013

What to do?
Options
1. Call to respect IHL / Civilian
Protection ( belligerents/gvt)
2. Denunciation (name & shame)
3. Public Statement (facts only)
4. Discrete Advocacy (behind scenes)
5. Solidarity
6. R2P ( external intervention)
As external consultants preparing for an MSF advisory meeting on August 22, 2013
(15 minutes to prepare)

1a. Choose one type of action to take and explain your selection.
1b. What is the action going to achieve?
1c. What are the limitations of this action?

2a. List the potential risks for the MSFs operations associated with this action.
2b. List the potential benefits & risks for the population associated with this action.

Key Points

Difference between operational
humanitarian & HR org.
Speaking out risks vs benefits to
operations/populations
Protection of civilians remains a
challenge & limited use preventive
R2P actions

Neither Hum. Org or HR can control
outcomes on the ground of R2P -
Be thoughtful, humble and be
careful what you wish for?






Thank You