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2.10. Doctors, other medical personnel and civil defence volunteers

Last update: September 2020

This profile refers to doctors and medical personnel in all parts of Syria. It also refers to members of the White Helmets, also known as Syria Civil Defence, a humanitarian organisation providing support to civilians in Syria, especially after airstrikes, attacks and clashes.

COI summary

[Main COI reference: Targeting, 9]

Different actors have been reported to target individuals falling within the scope of this profile. The COI summary is structured by actor:

a. Targeting by government forces and affiliated armed groups

[Targeting, 9.1]

Pro-government forces systematically target healthcare infrastructure in opposition-held areas to deprive both civilians and belligerents of medical treatment. From March 2011 through August 2019, a US-based NGO documented and mapped 583 attacks on at least 350 health facilities; more than 90 % of these attacks were attributed to GoS forces. The source further reported that 912 medical personnel were killed in military attacks in the same period.

The GoS and its allies have been accused of carrying out deliberate and systematic attacks on hospitals and other medical facilities in Idlib and Hama [Targeting 9.1]. An UN  investigation on seven specific incidents involving facilities on the UN deconfliction list concluded that it is ‘highly probable’ that the GoS or its allies carried out the airstrikes on four civilian facilities, including three hospitals in Idlib and Hama provinces, although it noted that the evidence was not sufficient to reach a conclusive finding. The board also found that it is ‘plausible’ that damage done to another hospital in Hama was attributable to GoS and its allies [Security 2020, Annex II].

It was also reported that in Eastern Ghouta, where the security presence is very high, there are routinely arrests of medical personnel and others suspected of affiliation with the opposition. [Targeting, 1.2.3]

The members of the White Helmets are also targeted. Arrests of members of the group were, for example, reported in Douma [Recaptured areas,]. The GoS considers the White Helmets as a terrorist organisation, because the group helps the opposition and anti-government armed groups. The group itself denies this, emphasising that it is impartial. However, it works only in the rebel-held parts of the country. Members of the group are usually evacuated to Idlib. In July 2018, there were a few hundred persons of this group, including family members, evacuated from the Golan Heights to Jordan by the Israeli military. [Recaptured areas,]

b. Targeting by non-state armed groups

[Targeting, 9.2]

The same NGO reported that anti-government armed groups were responsible for 24 attacks on medical facilities. Furthermore, ISIL attacked 10 medical facilities since the start of the conflict in 2011.

Several reports pointed out that medical personnel were arbitrarily arrested and mistreated by non-state armed groups. Attacks, killings and kidnappings of were also reported by different actors, including SNA, HTS, Turkish-backed militias and ISIL. Incidents reported in 2019 included several kidnappings of doctors, especially in Afrin and Idlib. In January 2019, ISIL had raided makeshift hospitals and dispensaries and abducted some of the wounded, doctors and paramedics.

There were also reports of incidents or attacks, which could have been indiscriminate or unintended when being carried out in connection with other military activity.

c. Targeting by unspecified armed actors

[Targeting, 9.3]

The same NGO reported around 20 attacks on medical facilities by unknown actors since the start of the conflict in 2011.

According to reports from November 2018, at least 12 doctors, as well as pharmacists and administrative health personnel were abducted in Idlib by gangs and unnamed militias during the year. In 2018, kidnapping for ransom in Idlib had increased, and another source reported 10 such cases involving ‘armed gangs’ recorded in northwest Syria in 2018. According to the source, doctors became targeted because they are well-known, comparatively well-paid and inclined to express views that put them at odds with their kidnappers.

In June 2018, doctors and pharmacists in Idlib suspended their work for three days in protest against violations committed against the medical sector in the province.

Risk analysis

The acts to which individuals under this profile could be exposed are of such severe nature that they would amount to persecution (e.g. arbitrary arrest, kidnapping, killing).

Not all individuals under this profile would face the level of risk required to establish well-founded fear of persecution. The individual assessment of whether or not there is a reasonable degree of likelihood for the applicant to face persecution should take into account risk-impacting circumstances, such as: regional specifics (the risk is higher in areas affected by armed confrontations), perceived support for anti-government armed groups, the nature of activities (e.g. members of the White Helmets would generally be at higher risk), etc.

Nexus to a reason for persecution

Available information indicates that persecution of this profile may be for reasons of (imputed) political opinion, in particular when they are targeted by the GoS.

In cases where the well-founded fear is related to risks such as kidnapping for ransom, nexus to a reason for persecution would generally not be substantiated. However, individual circumstances always need to be taken into account.


   Note that some medical personnel may have been involved in excludable acts, such as discriminating practices with regard to treatment of wounded or aiding and abetting torture (see the chapter 6. Exclusion).