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Rt Hon Dominic Raab MP
Secretary of State for Foreign, Commonwealth and Development Affairs
Foreign, Commonwealth and Development Office
King Charles Street

February 2021

Dear Foreign Secretary,
Re: Request for continued UK protection for medical workers, facilities, and patients in conflict

We are writing to ask you, on behalf of the UK Government, to act urgently to strengthen the protection of healthcare facilities, nursing and health workers, and their patients in conflict by answering the UN Secretary-General’s call and endorsing an international Political Declaration on explosive weapons.

The UK Medical and Nursing Royal Colleges represent UK healthcare professionals across multiple medical specialties and together we have many members and fellows carrying out life-saving work on the frontlines in some of the most dangerous places on Earth. They work alongside dedicated local healthcare professionals to help to deliver humanitarian aid and provide emergency and aftercare to children and other civilians injured by blasts, often while the bombs are still falling. In areas of high conflict like Syria and Yemen, health facilities have been targeted and hospitals damaged, destroyed, or forced to close, while medical personnel have been killed, injured, or forced to relocate.

Two years ago, Medical Royal Colleges and Associations wrote a joint letter to your predecessor asking for UK Government support to help prevent attacks on medical workers and facilities in conflict zones, and to protect the universal right to access healthcare. Jeremy Hunt MP went on to condemn the attacks on the public record in the House of Commons Chamber. However, since then, parties to the conflict have continued to target healthcare with impunity. According to the World Health Organization, there were over 1,000 confirmed incidents of attacks on healthcare services in 2019.

Even when civilians and civilian infrastructure are not the targets, the use of explosive weapons, with wide area effects in towns and cities, can lead to the indiscriminate destruction of healthcare facilities and personnel. A report by Action on Armed Violence stated that 90% of people killed or maimed by explosive weapons used in populated areas are civilians, and we know that they cause particularly devastating harm to children, in both the short and long term.

Save the Children’s latest ‘Stop the War on Children’ report, published in November 2020, highlighted our concerns, as it stated that the number of children killed or maimed in conflict over the past decade has now almost reached 100,000 and that the use of explosive weapons in populated areas has significantly contributed to this horrific milestone.

Furthermore, the destruction of health infrastructure caused by explosive weapons is undermining efforts to develop strong and resilient health systems and to be able to respond effectively to the ongoing COVID-19 pandemic.

We note that the UN Secretary-General and the President of the International Committee of the Red Cross – the guardians of international humanitarian law – have called on States to develop and support a Political Declaration to address the humanitarian harm caused by the use of explosive weapons in populated areas. We are calling on the UK to endorse and promote this Political Declaration in order to strengthen the protection of civilians, but also the protection of medical workers and health centres, whom civilians rely on to survive.

As professional medical organisations, we collectively represent thousands of doctors, nurses, and health workers across the UK. We are coming together to call on the Government to support efforts that will ensure that health workers across the world can provide healthcare in a safe and protected environment without disruption from acts of violence. The vulnerability of healthcare professionals and the facilities they use whilst caring for the populations they serve is one that transcends both borders and our clinical specialties. We urge the Government to agree to the following commitments to:

1. Condemn the attacks on healthcare facilities, healthcare workers, and vehicles in conflict zones.
2. Reaffirm the belief that all people regardless of gender, sexuality, race, ethnicity, political affiliation, or religious beliefs should have the right to access health care, and all medical professionals should be able to deliver this care in facilities without threat of attack.
3. Support the UN Secretary-General’s call for States to develop and support a Political Declaration to address the humanitarian harm caused by the use of explosive weapons in populated areas.
4. Call upon all Member States to uphold and comply with the Geneva Conventions: to commit to making attacks against healthcare in conflict zones an absolute redline; to support the enforcement of UNSC Resolution 2286; and to call for an immediate cessation to any further attacks on healthcare facilities.

We look forward to hearing from you regarding the actions that the UK Government is taking to ensure medical facilities and personnel are better protected in war, including addressing the use of explosive weapons in populated areas.

Yours sincerely,
Dr Katherine Henderson
President, Royal College of Emergency Medicine

Professor Dame Donna Kinnair
Chief Executive & General Secretary, Royal College of Nursing

Professor Ravi Mahajan
President, Royal College of Anaesthetists

Professor Michael Griffin OBE
President, Royal College of Surgeons Edinburgh

Dr Edward Morris
President, Royal College of Obstetricians and Gynaecologists

Professor Russell Viner
President, Royal College of Paediatrics and Child Health

Dr Mike Osborn,
President, Royal College of Pathologists

Professor Helen Stokes-Lampard
Chair, Academy of Medical Royal Colleges

Dr Adrian James,
President, Royal College of Psychiatrists

Dr Chaand Nagpaul CBE
Council Chair, British Medical Association

CC: Ben Wallace MP, Secretary of State for Defence

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