Violence against medical aid organisations in crisis areas

Together with a group of 16 colleagues, on 6 October 2025 we sent an appeal to Federal Councillor Cassis and Federal Councillor Baume-Schneider addressed to the medical profession and medical societies. This appeal calls for binding protection for doctors, medical and humanitarian institutions, medical health personnel and staff members of humanitarian organisations in crisis areas. Our concern was and is that the two Federal Councillors take a clear public stance on behalf of Switzerland as the depositary state of the Geneva Conventions. We have so far received a response from Federal Councillor Cassis, in which he shares our concern. Mr Cassis mentions that he is strongly calling for compliance with international law at bilateral and multilateral level, for example at the UN General Assembly in September 2025. We have not yet received a response from Federal Councillor Baume-Schneider.

Blatant violation of the protection
of humanitarian aid organisations

According to the Geneva Conventions, humanitarian aid organisations and health facilities in war zones must be protected under all circumstances. However, these conventions are being increasingly and blatantly violated in all conflicts. The result is unbearable suffering for innocent civilians, of families, children, women, men, grandparents, the vulnerable, the sick, the injured, aid workers and aid organisations. Hospitals are coming under fire, humanitarian workers are being killed, injured or kidnapped, civilians and children are suffering the most severe war injuries, which deeply shock even experienced doctors. Urgently needed aid supplies, medicines, etc. are deliberately blocked or destroyed. Never-before-seen infections are developing, and children with amputated limbs are often left behind as orphans, as Italian traumatologist Dr Tiziana Roggio reported from Gaza in an interview on Italian television RSI and Swiss television SRF on 27 June 2025. “I remember a seven-year-old girl whom I still treat from afar. She had two limbs amputated, and her condition worsened due to an infection. Her mother has also had an amputation, as has her sister. I could tell countless stories like this. And often the children who have had amputations have no family support or are orphans. You notice this when you enter their names in the register and see that their parents are dead ... I’ve never seen anything like it.”¹

Breaking the unbearable silence

Despite such shocking reports documenting countless war crimes worldwide, the outraged voices of medical organisations and societies are rarely heard in the official media or are hushed up. The reasons for this may be manifold and very diverse. With our statement, we would like to break this unbearable silence on this issue and decidedly call attention to international humanitarian law. We would also like to explain the infinitely valuable provisions of the Geneva Conventions in more detail. For decades, these humanitarian conventions have been routinely and flagrantly violated, against better judgement. During our inquiries, we gained the impression that the Geneva Conventions are in the meantime too little known or have been forgotten, even among the medical profession. It is therefore a genuine concern of ours to raise awareness of these abuses among the medical profession and to call on them to raise their voices much more clearly and decisively.

Steady increase in armed crises

The number of armed conflicts is steadily increasing. While the world faced around 20 conflicts at the turn of the millennium, this figure has now risen to over 130 armed conflicts.² At the same time, violence against humanitarian organisations, hospitals, doctors and other medical professionals is also on the rise. The list of attacks on humanitarian and medical institutions and personnel is endless and continues to grow. In 2023 alone, more than 500 humanitarian aid workers were victims of violence, with over 250 losing their lives. In 2024, 281 staff members of humanitarian organisations died worldwide while working in wars and conflicts.³ Over the past ten years, the number of victims within humanitarian aid organisations has risen by more than 50 per cent. If the rules of international humanitarian law are no longer observed in conflicts, it will be a race to a moral low point – a fast track to chaos and irreversible despair, says Mirjana Spoljaric, President of the ICRC.⁴ Recent reports from July 2025 cite more than 1,800 casualties among medical personnel.⁵

Attacks on health services
are a serious violation of
international humanitarian law

International humanitarian law, the core of which is formed by the Geneva Conventions, provides clear guidelines for the protection of civilians and civilian objects in situations of war. “Civilians and civilian objects must not be attacked under any circumstances. Parties to a conflict must distinguish between military targets and civilians or civilian objects at all times.”⁶ Since 1949, the Geneva Conventions have laid down binding international rules for the protection of persons and institutions involved in war. The warring parties are obliged therein to give special protection to the wounded, sick and shipwrecked, as well as to medical personnel, ambulances and hospitals; in addition, they must be rescued and cared for by the party to the conflict in whose hands they are. The Geneva Conventions protect civilians and contain detailed rules on the treatment of prisoners of war. These conventions have been ratified by all 196 countries in the world, which are obliged to comply with these agreements. More than two-thirds of all countries are also signatories to the two additional protocols to the Geneva Conventions, which protect those affected by international and non-international armed conflicts. Violations of these conventions and thus of international humanitarian law are considered war crimes.

The four Geneva Conventions

There are four detailed conventions and three additional protocols, which we have summarised in a less legalistic and more understandable form. Of the three additional protocols, the first two are relevant to our context.
  The first Geneva Convention was adopted in August 1949 and is considered the core of international humanitarian law. It covers the protection of wounded and sick members of armed forces in the field or in crisis areas. The second Geneva Convention regulates the protection of wounded, sick and shipwrecked persons in armed conflicts at sea. Similar to the first Geneva Convention, it regulates the treatment of the wounded, sick and medical personnel at sea. Shipwrecked persons may not be attacked under any circumstances. If they are under control of a foreign party, they must be treated and cared for humanely. Hospital ships carrying medical personnel to assist people in need may not be attacked. The third Geneva Convention contains rules for the treatment of prisoners of war. It guarantees the protection of prisoners of war. Prisoners of war are defined as not only members of regular armed forces, but also members of militias and organised resistance movements. Civilians such as war correspondents who are associated with regular armies also enjoy protection. Prisoners of war must be treated humanely. Actions that would result in death or serious health impairment are expressly prohibited. Furthermore, prisoners must be protected from intimidation, insults and humiliation. The Convention regulates in detail the living conditions that should apply to prisoners of war. For example, prisoner-of-war camps must comply with certain hygiene standards. Food, clothing and medical personnel must be provided. The fourth Geneva Convention calls for the protection of civilians in times of war. It grants protection to civilians who are in areas controlled by enemy armies. They are entitled to respect for their person, family rights, the practice of their religion and their culture-specific customs. According to the agreement, women are explicitly to be protected from rape and forced prostitution. Deliveries of medicines, medical supplies and urgently needed food must be allowed to pass. If it does not jeopardise the national security interests of a state, every civilian must be given the opportunity to leave the country.

The Additional Protocols

To supplement the conventions mentioned above, three additional protocols were formulated in June 1977, the first two of which we would like to list here.
  The first Additional Protocol formulates the protection of victims of international armed conflicts. This document defines more exactly and expands the rules of the first four conventions on international conflicts. For example, this protocol includes international armed struggles for independence against colonial rule and struggles for self-determination against racist regimes among the conflict situations. It also restricts the methods of warfare, for example by prohibiting the use of weapons or materials that cause unnecessary suffering. Attacks against non-military targets or attacks on military targets that involve the disproportionate wounding of civilians or destruction of civilian facilities are prohibited. Actions that cause long-term environmental damage are also prohibited. The Second Additional Protocol covers the protection of victims of non-international armed conflicts such as civil wars. This protocol contains specific provisions for the protection of the lives and mental and psychological well-being of civilians and soldiers who have already surrendered. Collective punishment, hostage-taking, terrorist acts, slavery and looting are prohibited. Children are to be given special “care and assistance”. The prosecution of criminal acts committed in the context of an armed conflict may only be carried out by independent courts.⁷

The International Committee
of the Red Cross (ICRC)

The history of international humanitarian law is closely linked to the activities of the International Committee of the Red Cross (ICRC). Its founder, Henry Dunant, witnessed the Battle of Solferino in 1859 during the Sardinian War between the Austrian Empire on one side and the Kingdom of Sardinia and the French Empire on the other. Overwhelmed by the horrific reality, he subsequently formulated the idea of founding an international aid society for the wounded, regardless of their origin. In 1863, the ICRC was founded by a committee of five consisting of Henry Dunant, Gustave Moynier, General Guillaume Henri Dufour and the two doctors Louis Appia and Theodore Maunoir. In October of the same year, representatives from 16 countries met in Geneva to discuss improving the care of wounded soldiers. In 1864, twelve countries signed the Geneva Convention, which for the first time established the protection of the wounded, the neutrality of medical personnel and the red cross as a protective symbol for medical personnel. This document served as the basis for today’s first Geneva Convention.⁸ Today, the Red Cross is one of the largest humanitarian organisations in the world, whose principles are humanity, impartiality, neutrality, independence, voluntary service and universality.⁹

Committed to medical,
humanitarian and ethical principles

Despite the serious abuses mentioned at the outset, critical, appealing or admonishing voices from doctors, medical institutions or societies are still too rare in our opinion, but would be of great importance. This makes the statements of colleagues who oppose the “mainstream of silence” even more commendable. As early as October 2022, the World Medical Association (WMA) published a declaration on the protection and preservation of the integrity of medical personnel in armed conflicts and other situations of violence.¹⁰ On 23 September 2025, the South Tyrolean Medical and Dental Association expressed its solidarity with the population of the Gaza Strip. In its statement, it pointed to the significant increase in attacks on health facilities and medical personnel.¹¹ More of such statements and voices from our ranks are urgently needed here.

Switzerland’s obligations as depositary state
of the Geneva Conventions

Switzerland is the depositary state of the Geneva Conventions. In this role, it has special administrative tasks and is obliged to remain impartial. It must work to ensure compliance with international humanitarian law in specific conflict situations, for which it has various instruments at its disposal. It can publicly condemn violations, call on the parties to the conflict to respect international humanitarian law, or initiate diplomatic action. Switzerland is also committed to combating impunity. It must support the International Criminal Court and the International Humanitarian Investigation Commission.¹²

Together against violence
against medical aid organisations

We, a group of colleagues from various medical disciplines in Switzerland, Germany and Austria, have decided to launch a broader appeal for awareness and solidarity to ensure the binding protection of medical organisations in crisis areas. We fully agree with our American colleagues, who have also issued an appeal to the American Medical Association: “The American Medical Association and other medical leaders and organisations have not only a professional but also an ethical duty to take a stand on such disasters.”¹³
  We also call on the Federal Council to pursue its obligations in this matter decidedly more determined, to issue appropriate public statements and to initiate concrete action. This would give Switzerland an irrevocable opportunity to position itself as an international humanitarian lighthouse and to credibly and convincingly uphold the humanitarian tradition that we have described in detail. •

¹ https://www.srf.ch/news/dialog/gaza-krieg-aerztin-ich-hab-noch-nie-etwas-aehnliches-gesehen
² https://www.icrc.org/de/artikel/ikrk-2024-fuer-mehr-menschlichkeit-in-konflikten
³ https://news.un.org/en/story/2024/11/1157371  of 22 November 2024
⁴ Spoljaric, Mirjana. “Im Wettlauf Richtung moralischer Tiefpunkt”, (In the race towards a moral low point), Tagesgespräch, SRF of 11 August 2025
⁵ https://reliefweb.int/report/occupied-palestinian-territory/position-paper-destruction-conditions-life-health-analysis-gaza-genocide
⁶ https://www.eda.admin.ch/eda/de/home/aussenpolitik/voelkerrecht/humanitaeres-voelkerrecht/genfer-konvention.html
⁷ https://www.fedlex.admin.ch
⁸ Das Buch vom Roten Kreuz, Auszüge (The Book of the Red Cross, excerpts), Dr Eugen Th. Rimli, 1944 Fraumünster-Verlag A.G. Zurich
⁹ https://www.icrc.org/de/unsere-grundsaetze
¹⁰ WMA statement on the protection and integrity of medical personnel in armed conflicts and other situations of violence, 22^nd December 2022
¹¹ “Südtiroler Ärzte warnen vor Angriffen auf Spitäler in Gaza”. (South Tyrolean doctors warn against attacks on hospitals in Gaza). In: Network rai. https://www.rainews.it/tgr/tagesschau/articoli/2025/09/sudtiroler-arzte-warnen-vor-angriffen-auf-spitaler-in-gaza-52427f44-de7e-469c-bba8-13ab89ec775d.html of 29 September 2025.
¹² https://www.eda.admin.ch/eda/de/home/aussenpolitik/voelkerrecht/humanitaeres-voelkerrecht/engagement-der-schweiz.html
¹³ Sidhwa, Feroce et al. “Standing by Our Colleagues in Gaza – a Plea to the U.S. Medical Community.” In: The New England Journal of Medicine of 6 October 2025