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4.9. Doctors, other medical personnel and civil defence volunteers

COMMON ANALYSIS
Last update: February 2023

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 2022, 8, pp. 80-84; Targeting 2020, 9, pp. 72-74]

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

Targeting by government forces and affiliated armed groups

[Targeting 2022, 8.1, pp. 80-83]

As of June 2022, the killing of 945 medical personnel since 2011 has been recorded, with 93 % of deaths attributed to GoS or their allied forces. As of March 2022, at least 167 health personnel have been executed or tortured before their death by GoS forces since the start of the conflict. Detention and enforced disappearance of medical personnel aimed not only at punishing medical professionals for helping injured opponents, but also to deprive non-government-controlled areas of access to medical care. The continued displacement of doctors and medical personnel in north-eastern Syria because of threats, abductions and being targeted by GoS and terrorist groups was noted in November 2021.

Attacks by GoS forces on medical personnel have been described as ‘calculated tactics’ since the start of the conflict. In 2022, a decrease in GoS attacks on such targets in areas controlled by other conflict parties was reported. However, the GoS continued to arrest, detain, or forcibly disappear medical personnel in the areas they held [Security 2023, 1.5.1, p. 36]. 

GoS forces and allied militia were considered to be responsible for the death of nine medical workers and for at least nine attacks on medical facilities in 2020, as well as for the death of one medical worker and attacks on at least two medical facilities in 2021. Russian forces were held responsible for the death of four medical professionals as well as for at least 13 attacks on medical facilities in 2020. In February 2022, the extrajudicial killing of one medical worker by GoS forces has been reported. In February 2022, the UNCOI reported on the use of precision-guided artillery shells by pro-GoS forces in north-western Syria against medical personnel and facilities.

The members of the White Helmets are also targeted. Arrests of members of the group were, for example, reported in Douma [Recaptured areas, 3.1.5.1, pp. 29-30]. 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, 2.5.3.3, p. 19]. No recent information could be found.

Targeting by non-state armed groups

[Targeting 2022, 8.2, pp. 82-84]

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.

As of March 2022, the killings of at least 53 medical personnel by non-state armed groups since the beginning of the conflict have been recorded. At least 14 medical personnel detained or forcibly disappeared by SDF in the period March 2011 to February 2021, remained in detention or were unaccounted for. Other perpetrators included ISIL which was responsible for the detention or enforced disappearance of five medical personnel, as well as HTS and the SNA, with each presumably being responsible for eight detained or forcibly disappeared medical personnel. Verbal and physical abuses and abductions against medical personnel have also been recorded by non-state actors as well as attacks in health facilities.

In March 2021, SDF fighters reportedly raided the Public Surgical Hospital of Al-Shiheel city in Deir Ez-Zor governorate, where they verbally and physically abused medical personnel and accused them of being ‘terrorists’. In June 2021, 2 medical personnel were killed and 3 more injured in a rocket attack on Al -Shifa hospital in the city of Afrin, which caused the death of all together 15 persons, while 43 were injured. Moreover, artillery shelling destroyed the emergency ward, as well as other parts of the hospital. Six other incidents in which medical personnel and facilities were involved/targeted, were reported to have taken place in the reference period. These took place in the territories controlled by SDF and HTS.

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.

Targeting by unspecified armed actors

[Targeting 2022, 8.3, pp. 84-85]

As of March 2022, the killing of at least 43 medical personnel by unknown forces since the beginning of the conflict have been recorded and more than 20 attacks on medical facilities by unknown actors were recorded since the beginning of the conflict.

Eleven killings of medical professionals committed by unknown perpetrators in 2020 - 2021 were reported. In the first half of 2022, six attacks on medical facilities and the death of five medical personnel killed at the hands of unspecified parties were reported. During the reference period, an increase was observed in reports on targeted killings across Sweida and Dar’a Governorates, including where medical personnel were among the victims of targeted killings. Several local sources reported on the killing or attempted killing of medical personnel by unknown perpetrators during the reporting period in 2020, 2021 and 2022, in Dar’a governorate, Idlib city, Deir-Ez-Zor governorate, Al-Hol camp in Hasaka governorate and Al-Bab city in Aleppo governorate.

Risk analysis

Acts reported to be committed against individuals under this profile are of such severe nature that they amount to persecution (e.g. arbitrary arrest, kidnapping, killing).

The individual assessment of whether 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), gender (especially with regard to targeting by ISIL and HTS), 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.