Staff at Aqeirbat hospital call on the UN Secretary General to visit Idlib and see the evidence of deliberate targeting of hospitals by Syrian government and Russian forces firsthand – picture: Al-Atareb news website via Facebook

Medical staff at Aqeirbat hospital in the countryside near Idlib in Syria staged a desperate protest on 6 February in a bid to draw attention to the destruction of health care facilities and hospitals [1]. They carried banners inviting António Guterres, the UN Secretary General to visit Idlib and “see for himself” a rapidly growing list of medical facilities destroyed or badly damaged by the Assad regime and allies. Just hours before, the Independent Doctors Association, a medical NGO which provides health services to hundreds of thousands of people in the Idlib and Aleppo areas, reported that artillery fire had targeted its primary health care centre in Anadan.

The systematic destruction of the health system in Idlib is part of a wider offensive by the Assad regime and its allies, Russia and Iran, to take back military control over the area around Idlib, the last remaining pocket of opposition-held territory. Over half a million people have fled the area in the last two months.

Motaz, a former programme manager at a Syrian medical NGO, told Middle East Solidarity that UN agencies including the Office for the Coordination of Humanitarian Affairs (UNOCHA) have become “partners in Assad and Russia’s killing machine in Syria,” by providing information about the location of medical facilities directly to Russian forces under a so-called “deconfliction mechanism.”

The scheme involved Syrian health NGOs sharing coordinates of medical facilities with “Coalition Forces, the Government of Turkey, the Russian Federation, as well as the International Syria Support Group Chairs (Government of the United States and the Russian Federation)”. Humanitarian NGOs were asked to confirm detailed information about mobile and fixed humanitarian missions such as the “location, coordinates (Global Positioning System (GPS), Latitude\ longitude in degrees, the function of the building (office, lodging, school, warehouse, hospital…etc., the exact street address of the building and its location.”

The Anadan health centre in ruins after artillery bombardment on 6 February. Picture: Independent Doctors Association via Facebook

Although the aim of the scheme was ostensibly to help combatants avoid attacking hospitals, Motaz told us that the information-sharing exercise has in fact increased the threat to medical facilities.

“Syrian NGOs working from the city of Gaziantep in Turkey and attending the various humanitarian cluster meetings believed OCHA’s claims of ‘protecting’ humanitarians and their facilities. Medical NGOs, for example, shared not only the geographical coordinates but also ‘medical maps’ for their facilities”, he explained.

“Although sharing coordinates with OCHA was “voluntary”, NGOs felt pressurized to share them with the OCHA.” Some were afraid that failure to sign up would lead to funding cuts, while others believed that providing this information would protect their staff members, patients and facilities.

Yet the “deconfliction mechanism” did not work. The New York Times found dozens of examples of hospitals and clinics which appeared on the UN’s no-strike list being damaged or destroyed by Russian or Syrian attacks since April last year [2].

For Motaz, the UN must bear responsibility for providing this information to allies of a regime determined to wipe out all opposition, including health services not under its own control. “With OCHA sharing the geographical coordinates with the Russian Federation, the mission of neutralizing these viable facilities becomes easier, less time consuming and less costly. Indeed, targeting would be a matter of ticking boxes rather than spending more time identifying where these facilities are located. UN agencies, whether directly or indirectly, have become a partner of the Assad regime and Russia in increasing the suffering of the Syrian people.”

For several years, millions of people in opposition-held areas of Syria have relied on aid arriving over the borders with Turkey and Iraq. These “cross-border” operations have been enabled by a UN Security Council Resolution. Now Russia and China are pushing to close down this lifeline by refusing to extend the resolution beyond June 2020 [3]. UN agencies and other aid donors will then be forced to channel relief funding through Damascus, working with organisations closely tied to the regime, such as the Syrian Arab Red Crescent.

“Destroying medical facilities in the opposition areas has both political and military dimensions,” Motaz explained. “On the one hand, the Assad regime wants to retake full control over Syrian territory. On the other, the regime seeks to become the only service provider in Syria and eliminate any institutions established by the opposition.”

After Idlib, the next phase in the Assad regime’s brutal campaign is likely to target the Aleppo countryside. Medical facilities there are now acutely vulnerable, Motaz told us. “They have been lined up as sitting ducks for Syrian and Russian attacks as UN OCHA has already shared their geographical coordinates with the Russian Federation.”

What you can do:

• Send a letter of protest to the Russian, Syrian and Iranian embassies in your country, condemning attacks on civilians, medical facilities and personnel in Syria.

Mena Solidarity Network