Yemen: Hospitals and medical workers under attack by anti-Huthi forces in Ta’iz

Anti-Huthi forces in Yemen’s southern city of Ta’iz are leading a campaign of harassment and intimidation against hospital staff and are endangering civilians by stationing fighters and military positions near medical facilities.

During a visit to Ta’iz earlier this month, the organization’s researchers interviewed 15 doctors, and other hospital staff, who described how members of anti-Huthi armed forces regularly harassed, detained or even threatened to kill them over the past six months.

“There is compelling evidence to suggest that anti-Huthi forces have waged a campaign of fear and intimidation against medical professionals in Ta’iz. By positioning fighters and military positions near medical facilities they have compromised the safety of hospitals and flouted their obligation to protect civilians under international law,” said Philip Luther, Research and Advocacy Director for the Middle East and North Africa at Amnesty International.

“There can be no excuse for harassing medical staff or preventing doctors from carrying out their life-saving work. Attacks targeting health professionals or medical facilities are prohibited by international humanitarian law and can constitute war crimes.”

Philip Luther, Research and Advocacy Director for the Middle East and North Africa

Anti-Huthi forces, also known as Popular Resistance Forces, are allied with Yemeni President Abd Rabbu Mansour Hadi and the Saudi Arabia-led military coalition.

Hospitals shut down

In at least three cases hospitals were shut down because of threats against staff. In the latest incident, on Monday 21 November, one faction of anti-Huthi forces raided and shut down al-Thawra hospital, the biggest public hospital in Ta’iz, apparently in retaliation for hospital staff providing emergency medical treatment to three injured Huthi fighters.

According to eyewitnesses three armed men stormed an office at the hospital and threatened to kill medical staff if it was not shut down immediately. They also tried to drag the two surviving Huthi fighters out of the hospital’s intensive care and recovery units, but were prevented by medical staff. The third Huthi fighter had died while receiving treatment. The hospital is now only partially functioning, providing only limited emergency services and dialysis, despite a renewal in heavy fighting since the first week of November.

“It is a fundamental rule of international humanitarian law that the wounded – whether civilians or fighters – must be collected and cared for. It is outrageous and unacceptable that anti-Huthi forces are retaliating against medical staff for performing their duties,” said Philip Luther.

Medical staff threatened

Several of the doctors told Amnesty International that the lawlessness that has engulfed Ta’iz has created a security vacuum exposing them to greater risks from anti-Huthi forces who are trying to exert control at the hospitals.

One administrative staff member described the anti-Huthi forces as “the de facto authority”. He said that they often came to the hospital asking for fighters with war wounds to be treated. Doctors told Amnesty International that if anti-Huthi fighters were turned away due to lack of capacity at the hospital in some cases they turned violent or abusive. In other cases, medical staff said that doctors were forced to carry out their work at gunpoint.

According to one doctor from al-Jamhouri hospital who spoke to Amnesty International, one man opened fire inside the hospital compound after being told his son, an anti-Huthi fighter with a minor leg injury, did not require emergency care and could be treated by a nurse. His violent outburst injured hospital staff and killed a patient.

Hospital staff also said armed men refused to leave weapons outside and routinely caused trouble inside, verbally abusing doctors and having physical fights with medical staff.

“Hundreds of times [anti-Huthi fighters] threatened us and interfered with the hospital’s administration and our decision-making. When we stand up to them, they threaten us with being killed,” said an administrative worker who was detained by gunmen along with another doctor, after trying to stop them from interfering in hospital affairs.

Staff at al-Thawra hospital also said that anti-Huthi forces diverted electricity for their own personal use, disrupting power to crucial services.

In other instances fighters demanded medicines and supplies, and confiscated equipment from hospitals.

Setting up military positions near hospitals

Staff at al-Thawra hospital told Amnesty International that fighters set up defensive positions, including by parking tanks around the hospital compound ignoring pleas by staff and local authorities not to do so. This has put hospital buildings, staff and patients at serious risk amid retaliatory fire from Huthi forces.

Al-Thawra’s director said the hospital guards were unable to stand up to members of the armed forces:

“There are dozens of armed men in the hospital. Am I running a hospital or a battalion?… The armed men will create any problem with you outside the hospital if you refuse them.”

Director of al-Thawra hospital, the biggest public hospital in Ta’iz

One doctor who used to live and work in the hospital until July said fighters would launch attacks from next to the hospital at least twice a week on average. This in turn would result in fierce retaliatory attacks by Huthi forces on and around the hospital.

On 28 September, a mortar fired by Huthi forces stuck the hospital, damaging its solar panels, water tanks and pipes, which led to it temporarily suspending surgical operations.

A doctor at al-Jamhouri Hospital also told Amnesty International:

“No weapons are fired from [inside] our location… There are three gates to the hospital – they have armed guards there. Inside the hospital they have people but they are not armed… The guards outside have arms and grenades.”

He also said that in early November a mortar attack hit the roof of the hospital and broke through one floor of the hospital.

“There was only 12 metres between where it fell and where we work,” he said, adding that up to 50 staff were present in the area at the time.

“By positioning fighters and military vehicles in and around medical facilities in Ta’iz, anti-Huthi forces are endangering civilians and hospital staff, flouting a fundamental principle of international humanitarian law,” said Philip Luther.

“All parties to the conflict must cease attacks that fail to discriminate between military targets and civilians. They must stop using artillery and mortars in the vicinity of civilian areas, and they must do everything feasible to avoid locating military objectives near densely populated areas, particularly hospitals and medical facilities.”

Amnesty International has repeatedly called for a comprehensive arms embargo on arms transfers that could be used by any of the warring parties in Yemen. Anti-Huthi forces are backed by the Saudi Arabia-led military coalition, which has been armed by the UK and USA.

The organization is also calling on the Yemeni authorities to enhance security at medical facilities and protect staff and patients from attack.

Background

The failure to protect hospitals and civilian infrastructure has emerged as a consistent pattern during the conflict in Yemen. During 2015 Amnesty International witnessed fighters from both sides launching attacks from within or near hospitals and in a July 2015 visit surveyed damage to al-Thawra hospital due to Huthi shelling.

Under international humanitarian law, medical facilities enjoy special protection from attacks and should not be used for military purposes or targeted by parties to the conflict. They remain protected unless they are used outside their humanitarian function to commit harmful acts to enemy.

Treating wounded soldiers or fighters is part of the humanitarian function of a hospital and medical facilities may never be attacked for doing so. Even if a hospital is being misused to launch attacks at the enemy, a warning must be issued giving a reasonable time limit and an attack may not proceed unless such a warning has gone unheeded.

Amnesty International has documented unlawful attacks, including war crimes, by all parties to the conflict in Yemen. During its visit to eastern parts of Ta’iz in November 2016, researchers spoke to witnesses – including medical staff – and victims from one attack launched by anti-Huthi forces in early October that hit a local market called Sofitel in Huthi-controlled areas. The attack on the Sofitel Market killed at least three civilians and injured four others.