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Persisting trend in the breach of medical neutrality: a wake-up call to the international community
  1. Soumitra S Bhuyan1,
  2. Ikenna Ebuenyi2,
  3. Jay Bhatt3
  1. 1Division of Health Systems Management and Policy, School of Public Health, The University of Memphis, Memphis, Tennessee, USA
  2. 2King's College London, and London School of Hygiene and Tropical Medicine, London, UK
  3. 3Health Research and Educational Trust, Chicago, Illinois, USA
  1. Correspondence to Dr Soumitra S Bhuyan; sbhuyan{at}

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History is dotted with stories of war crimes in which civilians, patients and health personnel have been killed and health facilities destroyed by warring factions. In 1949, the International Humanitarian Law (IHL) as contained in the four 1949 Geneva Conventions was officially ratified by 196 countries.1 The law promoted medical neutrality and non-interference with medical services for people in war zones. The breach of medical neutrality became regarded as war crime, due to its impact on civilians and the health personnel who have a duty to save lives and treat the wounded in and around war zones.

In time, the IHL, which has its roots on principles of humanity, impartiality and neutrality, have undergone modifications with the Additional Protocols in 1977 (to protect the victims of international and non-international armed conflicts) and 2005 (to adopt the Red Crystal, in countries where the Red Cross and Red Crescent emblems may be objectionable).1 But over the years, war crimes have persisted with little or no definitive action by the international community to stem the tide.2 From the 1970s, when facilities and human lives were destroyed in Mozambique to the 1990s in Chechnya, Thailand and El Salvador where similar acts were perpetrated. The destruction of health facilities in Syria, Iraq, Afghanistan …

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