Wounded, sick and shipwrecked

Introductory text

The sight of thousands of wounded soldiers on the battlefield at Solferino moved Henry Dunant to initiate the process that resulted in the Geneva Conventions. Conventions I and II are entirely given over to safeguarding not only the wounded, sick and shipwrecked, but also the support services (personnel and equipment) needed to come to their aid. Once wounded, sick or shipwrecked and provided that they refrain from any act of hostility, even former combatants become “protected persons”.[ 1] They may not be attacked and must be respected and cared for, often by removing them from the combat zone for impartial care. Protocol I extends this protection to wounded, sick and shipwrecked civilians refraining from any acts of hostility.[2]

The necessary care can often only be given, however, if the people who provide it are not attacked. On the battlefield this will only work if they constitute a separate category, never participating in hostilities and caring for all the wounded without discrimination, and if they are identifiable by an emblem.

Readings

Suggested reading:

  • DE CURREA-LUGO Victor, “Protecting the health sector in Colombia: A step to make the conflict less cruel”, in IRRC, No. 844, December 2001, pp. 1111-1126.
  • PERRIN Pierre (ed.), Handbook on War and Public Health, Geneva, ICRC, 1996, 446 pp.

I. The idea of Solferino

Readings

Suggested reading:

II. Respect, protection and care for the wounded, sick and shipwrecked, without any adverse distinction

Readings

Suggested reading:

  • JUNOD Sylvie S., Protection of the Victims of Armed Conflict Falkland-Malvinas Islands (1982): International Humanitarian Law and Humanitarian Action, Geneva, ICRC, 1985, 45 pp.
  • SOLF Waldemar A., “Development of the Protection of the Wounded, Sick and Shipwrecked under the Protocols Additional to the 1949 Geneva Conventions”, in Studies and Essays on International Humanitarian Law and Red Cross Principles in Honour of Jean Pictet, Geneva/The Hague, ICRC/M. Nijhoff, 1984, pp. 237-248.

 1. Beneficiaries

Provided that they refrain from any act of hostilities.

Cases and Documents

  1. under Conventions I and II: military personnel
    GC I-II, Art 13

Cases and Documents

  1. under Protocol I: extension to civilians
    P I, Art. 8(a) and (b)

 2. Respect

Cases and Documents

 3. Protection

Cases and Documents

 4. Care

Cases and Documents

Cases and Documents

Cases and Documents

III. Medical and religious personnel

Introductory text

Conventions I and II, which aim to protect the wounded, sick and shipwrecked, also extend protection to medical personnel, administrative support staff and religious personnel.[3] They are not to be attacked on the battlefield and must be allowed to perform their medical or religious duties.[4] If they fall into the hands of the adverse party, medical and religious personnel are not to be considered prisoners of war and may only be retained if they are needed to care for prisoners of war.[5] Conventions I and IV provide protection for civilians caring for sick and wounded combatants and civilians.[6] Protocol I further expanded the category of persons (permanent or temporary personnel, military or civilian) protected by virtue of their medical or religious functions.[7] Aid societies are granted the same protection if they meet the requirements laid out in the Conventions.[8]

Readings

Suggested reading:

  • BACCINO-ASTRADA Alma, Manual on the Rights and Duties of Medical Personnel in Armed Conflicts, Geneva, ICRC/League, 1982, 77 pp.
  • DE CURREA-LUGO Victor, “Protecting the Health Sector in Colombia: A Step to Make the Conflict Less Cruel”, in IRRC, No. 844, December 2001, pp. 1111-1126.
  • O’BRIEN R., A Manual of International Humanitarian Law for Religious Personnel, Adelaide, Australian Red Cross, 1993, 31 pp.
  • PICTET Jean, “The Medical Profession and International Humanitarian Law”, in IRRC, No. 247, July 1985, pp. 191-209.

Further reading:

  • HIEBEL Jean-Luc, “Human Rights Relating to Spiritual Assistance as Embodied in the Geneva Conventions of 1949”, in IRRC, No. 214, January 1980, pp. 3-28.
  • LUNZE Stefan, “Serving God and Caesar: Religious Personnel and their Protection in Armed Conflict”, in IRRC, No. 853, March 2004, pp. 69-91.
  • TOOLE Mike, “Frontline Medicine”, in Médecins Sans Frontières (ed.), World in Crisis, New York, Routlege, 1996, pp. 16-36.

 1. Definition

  1. military (permanent or temporary) medical personnel
    GC I, Arts 24-25; GC II, Arts 36-37
  1. civilian medical personnel assigned by a party to the conflict
    GC IV, Art. 20; P I, Art. 8
  1. religious personnel attached to the armed forces or medical units
    P I, Art. 8
  1. medical personnel made available by third States or organizations to a party to the conflict
    P I, Art. 8
  1. personnel of a National Society recognized and specifically authorized by a party to the conflict
    GC I, Art. 26; GC II, Art. 24; P I, Art. 8

Readings

Suggested reading:

  • “Technical Note: The Red Cross and its Role as an Auxiliary to Military Medical Services”, in IRRC, No. 234, May 1983, pp. 139-141.

 2. Protection

  1. on the battlefield (including inhabitants of the combat zone)
    • may not be attacked
      GC I, Arts 24-25; GC II, Arts 36-37; P I, Arts 15-16 [CIHL, Rules 25 and 30]

Cases and Documents

  • may perform medical duties in conformity with medical ethics

Cases and Documents

  1. once in enemy hands
    GC I, Arts 28-32
    • immediate repatriation, or
    • employment caring for prisoners of war

Cases and Documents

  c. under control of the enemy
  P I, Arts 15-16 [CIHL, Rule 26]
  • right to perform their medical mission

Cases and Documents

  • right not to perform acts contrary to medical ethics
  • right to confidentiality in patient relationships (medical privilege), except as required by the law of their party

Cases and Documents

 3. Duties of medical personnel

Cases and Documents

Suggested reading:

  • BOTHE Michael, “International Medical and Humanitarian Law”, in ILA Report, Vol. 59, 1980, pp. 520-530.
  • HIEBEL Jean-Luc, “Human Rights Relating to Spiritual Assistance as Embodied in the Geneva Conventions of 1949”, in IRRC, No. 214, January 1980, pp. 3-28.
  • PICTET Jean, “The Medical Profession and International Humanitarian Law”, in IRRC, No. 247, July 1985, pp. 191-209.
  • SCHOENHOLZER Jean-Pierre, Nurses and the Geneva Conventions of 1949, Geneva, ICRC, 1957, 32 pp.
  • SCHOENHOLZER Jean-Pierre, “The Doctor in the Geneva Conventions of 1949”, in IRRC Supplement, Vol. VI, No. 11, 1953, pp. 191-213.
  • TORRELLI Maurice, Le médecin et les droits de l’homme, Paris, Berger-Levrault, 1983, 466 pp.

Further reading:

  • HIEBEL Jean-Luc, Assistance spirituelle et conflits armés: droit humain, Geneva, Henry-Dunant Institute, 1980, 463 pp.
  1. no direct participation in hostilities
    • they may be armed, but only with light weapons
    • and may only use them for their own defence of for that of the wounded and sick under their care

Cases and Documents

  1. respect for medical ethics

Cases and Documents

Readings

Suggested reading: 

  • Board of Science of the British Medical Association, The Use of Drugs as Weapons: the Concerns and Responsibilities of Healthcare Professionals, London, British Medical Association, May 2007, 34  pp.
  • ENEMARK Christian, “Triage, Treatment and Torture: Ethical Challenges for US Military Medicine in Iraq”, in Journal of Military Ethics, Vol. 7, Issue 3, 2008, pp. 186-201.
  • GOODMAN Ryan & ROSEMAN Mindy Jane (eds), Interrogations, Forced Feedings, and the Role of Health Professionals: New Perspectives on International Human Rights, Humanitarian Law and Ethics, Cambridge (USA): Human Rights Program at Harvard Law School, 2009, 228 pp.
  1. give care without discrimination

Cases and Documents

  1. respect principle of neutrality
  2. identification
    GC I, Annex II

Cases and Documents

IV. Protection of medical goods and objects

(including hospitals and ambulances)

Introductory text

International Humanitarian Law (IHL) establishes comprehensive and detailed protection for medical units,[9] medical transports[10] and medical material.[11]
These goods must be respected and protected at all times by the belligerents[12] and are not to be the object of attack. Under no circumstances are protected installations to be used in an attempt to shield military objectives from attack.

The protection to which medical installations are entitled does not cease unless they are used to commit, outside their humanitarian function, acts harmful to the enemy.[13] In such instances their protection may, however, cease only after a warning has been given setting, whenever appropriate, a reasonable time-limit, and after such warning has remained unheeded.

Cases and Documents

Readings

Suggested reading:

  • RUFIN Jean-Christophe, “The Paradoxes of Armed Protection”, in Médecins Sans Frontières (ed.), Life, Death and Aid, New York, Routledge, 1993, pp. 111-123.

Further reading:

  • CASSESE Antonio, “Under What Conditions May Belligerents Be Acquitted of the Crime of Attacking an Ambulance?”, in Journal of International Criminal Justice, Vol. 6, No. 2, 2008, pp. 385-397.

 1. Protection

GC I, Arts 19 and 35 [CIHL, Rules 28, 29 and 30]

Cases and Documents

 2. Loss of protection

GC I, Arts 21 and 22

Cases and Documents

V. Possible constitution of hospital, safety and neutralized zones

GC I, Art. 23; GC IV, Arts 14-15 [CIHL, Rules 28 and 29]
(See also infra, Conduct of Hostilities, II.The protection of the civilian population against the effects of hostilities, 13. Zones created to protect war victims against the effects of hostilities)

Cases and Documents

Readings

Suggested reading:

  • BOUVIER Antoine, “Zones protégées, zones de sécurité et protection de la population civile”, in BOUSTANY Katia & DORMOY Daniel, Perspectives humanitaires entre conflits, droit(s) et action, Brussels, Bruylant, 2002, pp. 251-269.
  • LAVOYER Jean-Philippe, “International Humanitarian Law, Protected Zones and the Use of Force”, in BIERMANN Wolfgang & VADSET Martin (eds), UN Peacekeeping in Trouble: Lessons Learned from the former Yugoslavia, Aldershot, Ashgate, 1998, pp. 262-279.
  • SANDOZ Yves, “Localités et zones sous protection spéciale”, in Quatre études du droit international humanitaire, Geneva, Henry-Dunant Institute, 1985, pp. 35-47.

VI. The emblem of the Red Cross/Red Crescent/Red Crystal

Introductory text

The Conventions and Additional Protocols authorize the use of four emblems – the red cross, the red crescent, the red crystal and the red lion and sun – on a white background.[14] However, today only the first three authorized emblems are utilized. For a number of years the International Red Cross and Red Crescent Movement has encountered problems arising from the use of a host of other emblems. This threatens the emblem’s essential universality, neutrality and impartiality, and ultimately undermines the protection it provides. Hopefully, these problems have been solved with the entry into force of Protocol III enabling States to adopt the red crystal.

The emblem serves both protective and indicative functions. It is used mainly as a protective device in times of conflict to distinguish combatants from certain persons and objects protected by the Conventions and the Additional Protocols (e.g., medical personnel, medical units and medical means of transport[15]).[16] To be effective in such circumstances the emblem must be visible and therefore large.[17] It may only be displayed for medical purposes, and such use must be authorized by and under the control of the State.

The emblem is used as an indicative device mainly in peacetime, as such use does not signify protection but rather identifies persons, equipment and activities (in conformity with Red Cross principles) affiliated with the Red Cross or the Red Crescent.[18]
Utilization for indicative purposes must comply with national legislation, and ordinarily the emblem must be small in size. In contrast to the above-mentioned limitations placed on National Red Cross or Red Crescent Societies and other users, International Red Cross organizations may use the emblem at all times and for all their activities.

In order to avoid undermining the protection the emblem provides, abuse and misuse of the emblem, which in certain situations constitutes a war crime,[19] must be prevented; thus, the emblem may be neither imitated nor used for private or commercial purposes.[20] States Parties have an obligation to implement national legislation, consistent with the Conventions and Additional Protocols, regarding not only appropriate authorization of the emblem’s use but also punishment of abuse and misuse of the emblem.[21]

Cases and Documents

Readings

Suggested reading:

  • BOUVIER Antoine, “Special Aspects of the Use of the Red Cross or Red Crescent Emblem”, in IRRC, No. 272, September-October 1989, pp. 438-458.
  • BUGNION François, The Emblem of the Red Cross: a Brief History, Geneva, ICRC, 1977, 81 pp. & in IRRC, No. 193/194/195, April/May/June 1977, pp. 167-190/229-256/283-296.
  • MACCORMACK Timothy L.H., “What’s in an Emblem? Humanitarian Assistance under any other Banner Would be as Comforting”, in Melbourne Journal of International Law, Vol. 1/1, 2000, pp. 175-183.
  • MERIBOUTE Zidane, “The Emblems of the 1949 Geneva Conventions: their Content and Meaning”, in YIHL, Vol. 3, 2000, pp. 258-272.
  • SLIM Habib, “Protection of the Red Cross and Red Crescent Emblems and the Repression of Misuse”, in IRRC, No. 272, September-October 1989, pp. 420-437.

Further reading:

  • CAUDERAY Gérald C, “Visibility of the Distinctive Emblem on Medical Establishments, Units, and Transports”, in IRRC, No. 277, July-August 1990, pp. 295-321.
  • EBERLIN Philippe, Protective Signs, Geneva, ICRC, 1983, 73 pp. PICTET Jean, “The Sign of the Red Cross”, in IRRC Supplement, Vol. II, No. 4, April 1949, pp. 143-175.

 1. Three distinctive signs

GC I, Art. 38

Cases and Documents

Readings

Suggested reading:

  • BUGNION François, “The Red Cross and Red Crescent Emblems”, in IRRC, No. 272, September-October 1989, pp. 408-419.
  • BUGNION François, Towards a Comprehensive Solution to the Question of the Emblem, Geneva, ICRC, 4th ed., 2006, 99 pp.
  • BUGNION François, Red Cross, Red Crescent, Red Crystal, Geneva, ICRC, May 2007, 111 pp.
  • PULLES Gerrit Jan, “Crystallising an Emblem: on the Adoption of the Third Additional Protocol to the Geneva Conventions”, in YIHL, Vol. 8 (2005), 2007, pp. 296-319.
  • SANDOZ Yves, “The Red Cross and Red Crescent Emblems: What is at Stake?”, in IRRC, No. 272, September-October 1989, pp. 405-407.
  • SOMMARUGA Cornelio, “Unity and Plurality of the Emblems”, in IRRC, No. 289, July-August 1992, pp. 333-338.

Further reading:

  • BUGNION François, “The 29th International Conference of the Red Cross and Red Crescent, Geneva, 20-22 June 2006: Challenges and Outcome”, in IRRC, Vol. 89, No. 865, March 2007, pp. 163-173.
  • EBERLIN Philippe, “Technical Note on the Colours of the Red Cross and Red Crescent Emblem”, in IRRC, No. 233, March 1983, pp. 77-80.
  • LANORD Christophe, “Quelques considérations sur le projet de Protocole III additionnel aux Conventions de Genève de 1949”, in L’observateur des Nations Unies, No. 10, Spring-Summer 2001, pp. 13-34.
  • ROSENNE Shabtai, “The Red Cross, Red Crescent, Red Lion and Sun and the Red Shield of David”, in IYHR, Vol. 5, 1975, pp. 9-54.

 2. Technical means of identification

P I, Annex I

Readings

Suggested reading:

  • BOUVIER Antoine, “Humanitarian Protection and Armed Conflicts at Sea: Means and Methods of Identifying Protected Craft”, in Syracuse Journal of International Law and Commerce, Vol. 14, 1988, pp. 759-765.
  • CAUDERAY Gérald C., “Means of Identification for Protected Medical Transports”, in IRRC, No. 300, May-June 1994, pp. 266-278.
  • CAUDERAY Gerald C. & BOUVIER Antoine, Manual for the Use of Technical Means of Identifications by Hospital Ships, Coastal Rescue Craft, Other Protected Craft and Medical Aircraft, Geneva, ICRC, 1995, 196 pp.
  • EBERLIN Philippe, “La modernisation de la signalisation protectrice et les communications des unités et moyens de transport sanitaires”, in Studies and Essays on International Humanitarian Law and Red Cross Principles in Honour of Jean Pictet, Geneva/The Hague, ICRC/M. Nijhoff, 1984, pp. 47-75.
  • EBERLIN Philippe, “Underwater Acoustic Identification of Hospital Ships”, in IRRC, No. 267, November-December 1988, pp. 505-518.

 3. Protective use

GC I, Arts 39-43 and 53-54 [CIHL, Rule 30]

Cases and Documents

  1. to distinguish medical personnel and units

Cases and Documents

  1. to be displayed with the permission and under the control of the competent authority
  2. may be used at all times by the ICRC and the International Federation

Cases and Documents

 4. Indicative use

GC I, Art. 44

Cases and Documents

Readings

Suggested reading:

  • BOUVIER Antoine, “Special Aspects of the Use of the Red Cross or Red Crescent Emblem”, in IRRC, No. 272, September-October 1989, pp. 438-458.

 5. Repression of abuse and misuse

GC I, Arts 53-54

Cases and Documents

Readings

Suggested reading:

  • MEYER Michael, “Protecting the Emblems in Peacetime: The Experiences of the British Red Cross”, in IRRC, No. 272, September-October 1989, pp. 459-464.
  • SLIM Habib, “Protection of the Red Cross and Red Crescent Emblems and the Repression of Misuse”, in IRRC, No. 272, September-October 1989, pp. 420-437.

VII. Provisions on the dead and missing

Introductory text

It is not primarily to protect the dead and the missing themselves that IHL contains specific rules concerning them. The main concern is “the right of families to know the fate of their relatives”.[22] Persons are considered missing if their relatives or the power on which they depend have no information on their fate. Each party has an obligation to search for persons who have been reported as missing by the adverse party.[23]

In reality, missing persons are either dead or alive. If they are alive, they are missing either because they have been detained by the enemy or separated from their families by front-lines or borders. In that case, they benefit from the protection IHL offers to the category to which they belong (civilian, prisoner of war, wounded and sick, etc.). In any case, IHL contains rules designed to ensure that they do not remain missing – except if they wish to sever their links with their family or country.[24]

If the person is missing because, as is regularly the case in armed conflicts, postal services have been interrupted or groups of people displaced, family links should soon be re-established, inter alia through the ICRC Central Tracing Agency, as long as the parties respect their obligation to promote the exchange of family news and reunification of families.[25] If a person is missing because he or she has been detained or hospitalized by the enemy, the family’s uncertainty should not last for long, as IHL prescribes that information on their hospitalization or detention be forwarded rapidly to their family and the authorities through three channels: notification of hospitalization, capture or arrest,[26] transmission of capture or internment cards,[27] and the right to correspond with the family.[28] A lawfully detained person can therefore not be missing for long, as the detaining authorities are also under an obligation to answer inquiries about protected persons.[29]

If the missing person is dead, it is as important but more difficult to inform the family. There is no obligation for each party to identify every dead body found, as this would be an impossible task. Every party has to simply try and collect information serving to identify dead bodies,[30] – which is easier to do if the deceased wear identity cards or tags as prescribed for combatants by IHL[31] – including by agreeing to establish search teams.[32] If such identification is successful, the family has to be notified. In any case, the remains must be respected and given decent burial, and the gravesites marked.[33]

Understandably, relatives will wish to have access to the graves and often even to have the remains of their loved ones returned to them. This requires an agreement between the parties concerned, which can generally only be reached once the conflict has ended.[34]

[See “The Missing: Documentation of Reference Database” available on https://www.icrc.org/eng/assets/files/other/icrc_002_0857.pdf]

Cases and Documents

Readings

Suggested reading:

  • Special Issue “Missing Persons”, in IRRC, No. 848, December 2002, pp. 720-902.
  • SASSÒLI Marco, “Les disparus de guerre : Les règles du droit international et les besoins des familles entre espoir et incertitude”, in Frontières, vol. 15/2, Spring 2003, pp. 38-44.
  • ICRC & Inter-Parliamentary Union, Missing Persons: A Handbook for Parliamentarians, Geneva, ICRC, 2009, 92 p.
  • ICRC, Missing people, DNA analysis and identification of human remains: a guide to best practice in armed conflicts and other situations of armed violence, Geneva, ICRC, 2009, 48 p.
  • PETRIG Anna, “The War Dead and their Gravesites”, in IRRC, Vol. 91, No. 874, June 2009, pp. 341-369.

 1. Relationship between the dead and the missing

Cases and Documents

 2. Obligation to identify dead bodies and notify deaths

GC I, Art. 16; P I, Art. 33(2) [CIHL, Rules 112 and 116]

Cases and Documents

 3. Obligation to search for persons reported missing

P I, Art. 33(1) [CIHL, Rule 117]

Cases and Documents

 4. Treatment of remains

Cases and Documents

  1. respect
    GC I, Art. 15; P I, Art. 34(1) [CIHL, Rule 113]

Cases and Documents

  1.  decent burial
    GC I, Art. 17; P I, Art. 34(1) [CIHL, Rule 115]

Cases and Documents

  1. marking of gravesites
  2. access to gravesites
  3. agreements on the return of remains
    P I, Art. 34(2) and (4)

Cases and Documents

VIII. Transmission of information

Cases and Documents

 1. Recording of information

GC I, Art. 16; GC II, Art. 19

 2. Notification (to the power of origin through the Central Tracing Agency)

GC I, Art. 16; GC II, Art. 19

 3. Transmission of death certificate and belongings (to the next-of-kin through the Central Tracing Agency)

GC I, Art. 16; GC II, Art. 19 [CIHL, Rule 114]

 Footnotes