Hospitals under fire: legal and practical challenges to strengthened protection

When states adapt “total defence” strategies that mobilize entire populations in preparation for armed conflict, the line between civilian and combatant can become dangerously blurred. This raises pressing legal, ethical, and humanitarian questions about the risks to civilians in warfare. In this post, Ruben Stewart, ICRC Adviser on Technology in Warfare, traces the roots of “total defence” to the Napoleonic Wars, when conscription, guerrilla resistance, economic blockades, and propaganda drew civilians into the machinery of war. Through this historical lens, he shows how involving civilians in defence efforts – then and now – can expose them to harm, complicate their legal protection, and increase the burden on states to safeguard those not taking direct part in hostilities.

Amid the complexities of contemporary armed conflicts, damage to water infrastructure and the use of water as a means or method of warfare have devastating consequences for both civilian populations and the environment. Despite existing legal protections, gaps in compliance and enforcement leave water systems vulnerable, exacerbating humanitarian crises and ecological harm. Addressing these challenges requires a renewed focus on legal frameworks, accountability, and practical measures to strengthen the protection of water in conflict settings. In this post, part of the Emerging Voices series, Tadesse Kebebew, Researcher and Project Manager at the Geneva Water Hub, examines the severe consequences of attacks on water systems and the weaponization of water in armed conflicts. He assesses the strengths and limitations of current international legal protections and offers concrete recommendations to enhance safeguards for freshwater resources, emphasizing the need for stronger compliance with international humanitarian law.

Landmines, a persistent threat in post-conflict zones, pose severe risks to both human lives and the environment. These explosive devices, often buried underground, remain dormant for years, contaminating soil and water and causing long-term ecological damage. While robust legal frameworks governing landmines exist under international humanitarian law (IHL), landmine instruments have only recently begun to incorporate more explicit environmental protections. In this post, and as part of the Emerging Voices series, Goran Sandić, Researcher at the University of Belgrade and Coordinator of the Belgrade International Law Circle, argues that the “polluter pays” principle – originally formulated in international environmental law – can serve as an interpretive lens to reinforce the responsibility of states and other actors for environmental harm arising from landmine use. By weaving this principle into existing processes, we can more effectively address the ongoing costs of landmine remediation and underscore the responsibility of parties that violate fundamental obligations under IHL. This approach aims to support environmental justice while enhancing the legal framework for armed conflicts, which could influence post-conflict recovery efforts and mine action globally.

As public opinion is critical in shaping decision-making during armed conflict, engaging with and informing youth and the broader public about international humanitarian law (IHL) is essential for ensuring compliance with the law and promoting accountability. IHL education – both formal and non-formal – is key to this endeavor. Engagement across all generations and audiences – both military and civilian – is important to ensure a broad and enduring understanding of the goals of IHL and ultimately contribute to prevent and reduce suffering in armed conflict through an informed and motivated public. With over 42% of the global population under the age of 25, young people are especially critical to these efforts. In this post, Etienne Kuster, Catherine Gribbin, Jonathan Somer, Thomas Harper and Charlotte Tocchio share insights from IHL educators and IHL experts around the world on how IHL education needs further investment in order to build a universal culture of compliance.

As states increasingly focus on strengthening their defense capabilities, discussions on military preparedness are gaining prominence, particularly in relation to large-scale conflicts. Such conflicts, involving major powers, advanced weaponry, and extensive resources, would unfold with considerable intensity, scale, and tempo. The humanitarian consequences would be far-reaching and severe, potentially causing mass casualties, mass displacement, and the disruption of essential services. The Geneva Conventions, adopted in the aftermath of two world wars, were designed precisely to help mitigate the suffering in armed conflict. Yet ratification alone is not enough: for these rules to be upheld in practice, extensive legal and operational preparations must begin in times of peace. This introductory post sets the stage for a new series examining the steps needed to ensure compliance with international humanitarian law (IHL) in large-scale conflicts. Isabelle Gallino, ICRC Prevention Adviser, and Sylvain Vité, ICRC Senior Legal Adviser, argue that states must do more than recognize their legal obligations. Applicable rules must be understood, internalized, and backed by legal and practical measures today if they are to be effective once an armed conflict erupts. Ultimately, failure to prepare can undermine even the best-intentioned efforts to comply with IHL.

References to Islamic law made by the delegations of Egypt, Saudi Arabia, Sudan and Syria during the 1974–1977 Diplomatic Conference – which led to the adoption of the two Additional Protocols to the 1949 Geneva Conventions – offer a partial glimpse into the contributions of Islamic law to the development of some modern international humanitarian law (IHL) principles. In this post, ICRC’s legal adviser for Islamic law and jurisprudence, Ahmed Al-Dawoody and ICRC Associate Medha Damojipurapu examine some of the contributions of Islamic law to the development of the Additional Protocols, as well as the motivations for ratification by Muslim-majority states. They maintain that studying these perspectives can support humanitarian organizations to effectively communicate and anchor the protection owed to people affected by armed conflict during their dialogue in relevant contexts.

International law recognizes the importance of environmental protection during armed conflict. Additional Protocol I of the Geneva Conventions was the first treaty to formally prohibit warfare methods that cause widespread, long-term, and severe environmental damage. The Rome Statute of the International Criminal Court (ICC) further criminalizes damage to the natural environment as a war crime, though its high threshold has so far prevented its use. The existing initiatives to define “ecocide” aim, among other things, to broaden accountability beyond armed conflict and include corporations. In this post, part of the Emerging Voices series, Iryna Rekrut, Legal Fellow at the Center for Gender & Refugee Studies, proposes an additional potential avenue that could also be used to improve accountability for environmental damage under the Rome Statute. She argues that a more expansive interpretation of existing provisions – particularly refining the definitions of “widespread,” “long-term,” and “severe” damage – could meet the evidentiary burden and make prosecution more viable under current international law.

Earlier this month, Lithuania’s unprecedented withdrawal from the Convention on Cluster Munitions (CCM) took effect. Meanwhile, several states are openly questioning their continued adherence to other humanitarian treaties, including the Anti-Personnel Mine Ban Convention (APMBC). These developments take place amid heightened international tensions and mounting security concerns, both in Europe and globally. They come at a time when respect for fundamental humanitarian norms is shockingly insufficient, as the immense devastation in ongoing conflicts demonstrates. In this post, ICRC Chief Legal Officer Cordula Droege and ICRC Legal Adviser Maya Brehm caution that recent challenges to the APMBC mirror broader threats to the life-saving protections of international humanitarian law (IHL). They argue that justifications for using anti-personnel mines (APM) tend to be divorced from battlefield realities and overlook the appalling impacts of these treacherous weapons. The authors also show how efforts to circumvent or abandon the APMBC challenge fundamental precepts of IHL and undermine the international rule of law. The post concludes with a call to reinforce humanitarian norms as essential safeguards for upholding humanity in war.

Amid the devastation of armed conflict, hospitals stand as fragile sanctuaries, overwhelmed by demand and depleted of essential supplies. Struggling to function under relentless strain, they remain uniquely vulnerable – yet, rather than being protected, they are too often caught in the crosshairs of tactical attacks and political allegations. In this installment of the Emerging Voices series, Khang Phan and Thao Nguyen, recent graduates of Ritsumeikan Asia Pacific University, trace patterns in attacks on hospitals in contemporary conflicts. They examine the legal protections in place and the practical challenges that undermine compliance and enforcement. In doing so, they underscore the need for more effective warning systems and stronger communication among stakeholders to ensure hospitals receive the fullest possible protection.

Contemporary armed conflicts are increasingly complex and, through rapid technological development, increasingly remote. This calls into question the capacity of a machine to apply human emotional traits such as empathy and caution, crucial for effective judgement and evaluation in challenging situations. Despite the precision and reliability that might be achieved through the increased automation of military activities such as target identification, from a humanitarian perspective, outsourcing such high-stakes decisions to machines is highly problematic. In this post, Dr Joanna Wilson, Lecturer in Law at the University of the West of Scotland, calls for the urgent ‘rehumanization’ of military decision-making. Emotions play a key role in this. While sometimes blamed for unpredictable, erratic human behaviour, for which a machine might therefore be viewed to be a welcome alternative, emotions are indispensable for effective and flexible moral reasoning, intuition, and self-regulation. The use of artificial intelligence (AI) should thus be exclusively limited to effectively supplementing and facilitating human agency and decision-making: a technological means for strictly human ends.