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ICRC Welcome Address


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Emergency Surgery Workshop Davos 2011: Presentation by Prof Jürg Kesselring, MD, Member of the International Committee of the Red Cross ICRC, Valens, Switzerland

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ICRC Welcome Address

  1. 1. Mandate <ul><li>Mandate: the ICRC is an impartial, neutral and independent organization whose exclusively humanitarian mission is to protect the lives and dignity of victims of war and internal violence and to provide them with assistance </li></ul>
  2. 2. The diversity of situations of armed conflict <ul><ul><li>International armed conflicts </li></ul></ul><ul><ul><li>Classic internal armed conflicts </li></ul></ul><ul><ul><li>Internal conflicts: </li></ul></ul><ul><ul><li>with a diversity of actors </li></ul></ul>
  3. 3. <ul><li>“ The spectacle of a doctor in action among soldiers in equal danger with equal courage, saving lives where all others are taking them, allaying suffering where all others are causing it, is one which must always seem glorious, whether to God or men.” </li></ul><ul><li>Sir Winston Churchill </li></ul>
  4. 4. Consequences for ICRC Health activities <ul><li>Access, proximity, security </li></ul><ul><li>Perceptions, acceptance </li></ul><ul><li>Epidemiology of wounded </li></ul><ul><li>Collapse of health system </li></ul><ul><li>Added-value of NIHA and relevance of IHL </li></ul>
  5. 5. First Aid & Transport
  6. 6. War Surgery
  7. 8. Health Care Delivery in Conflict
  8. 9. Physical Rehabilitation
  9. 10. Health in Detention
  10. 11. Historical Background: <ul><li>Henri Dunant - Solferino 1859 </li></ul><ul><ul><li>Red Cross founded 1863 </li></ul></ul><ul><ul><li>1st Geneva Convention 1864 </li></ul></ul><ul><ul><ul><li>Amelioration of the condition of the wounded </li></ul></ul></ul><ul><ul><ul><li>in armies in the field </li></ul></ul></ul>
  11. 12. Historical Background: <ul><li>Lieber Code 1863 </li></ul><ul><ul><li>Professor Francis Lieber, Columbia University </li></ul></ul><ul><ul><li>American Civil War & maltreatment of PWs </li></ul></ul>
  12. 13. Historical Background: <ul><li>Hague Peace Conferences of 1899 & 1907 </li></ul><ul><ul><li>Drafters emphasised that the regulations were not exhaustive and that, insofar as they were silent, customary law would continue to govern the situation: </li></ul></ul>“ The High Contracting Parties clearly do not intend that unforeseen cases should, in the absence of a written undertaking, be left to the arbitrary judgment of military commanders. Until a more complete code of the laws of war is issued, the High Contracting Parties deem it expedient that in cases not included in the Regulations adopted by them , the inhabitants and the belligerents remain under the protection and the rule of the principles of the law of nations, as they result from the usages established between civilised nations, from the laws of humanity, and dictates of the public conscience .” Martens Clause
  13. 14. Historical Background: <ul><li>World War I </li></ul><ul><ul><li>The cycle begins... </li></ul></ul>
  14. 15. <ul><li>Geneva protocol 1925 </li></ul><ul><ul><li>Prohibition of the use in war of asphyxiating, poisonous or other gases and of bacteriological methods of warfare </li></ul></ul>
  15. 16. Historical Background: <ul><li>Geneva Conventions 1929 </li></ul><ul><ul><li>1st Geneva Convention (Review & Development) </li></ul></ul><ul><ul><li>Treatment of PWs (New) </li></ul></ul>
  16. 17. Historical Background: <ul><li>International Military Tribunals after WWII </li></ul><ul><ul><li>London Charter 1945 established jurisdiction for Nuremberg </li></ul></ul><ul><ul><li>Same jurisdiction established for Tokyo </li></ul></ul>
  17. 18. Historical Background: <ul><li>“ Nuremberg Principles” </li></ul><ul><ul><li>1946: UN General Assembly adopted Resolution Affirming the Principles of International Law recognised by the Charter of the Nuremberg Charter </li></ul></ul>
  18. 19. Historical Background: <ul><li>Conventional Weapons Convention 1981 </li></ul><ul><ul><li>Creates restrictions and prohibitions on certain conventional weapons </li></ul></ul><ul><ul><li>Protocol I : Prohibits use of weapons that injure by use of fragments not detectable by X-rays </li></ul></ul><ul><ul><li>Protocol II : Prohibitions and limitations on use of mines, booby traps and other devices for protection of civilians but does not absolutely proscribe their use against military objects </li></ul></ul><ul><ul><li>Protocol III : Prohibitions and limitations on use of incendiary devices for protection of civilians but does not absolutely proscribe use against military objects </li></ul></ul><ul><ul><li>Protocol IV : Blinding laser weapons prohibited (1995) </li></ul></ul><ul><ul><li>Protocol V: Explosive Remnants of War </li></ul></ul>Prevention of Unnecessary Suffering
  19. 20. Historical Background: <ul><li>Torture Convention </li></ul><ul><ul><li>Adopted by UN General Assembly in 1984 </li></ul></ul>
  20. 21. Historical Background: <ul><li>International Military Tribunals after WWII </li></ul><ul><ul><li>Nuremberg & Tokyo </li></ul></ul><ul><li>International Criminal Tribunals </li></ul><ul><ul><li>Former Yugoslavia (ICTY) (1993) </li></ul></ul><ul><ul><li>Rwanda (1994) </li></ul></ul><ul><li>International Criminal Court (ICC) </li></ul><ul><li>Permanently based in The Hague </li></ul><ul><li>Rome Statute 1998 </li></ul>TODAY
  21. 22. THE RULES: <ul><li>Medical Personnel (and religious personnel): </li></ul><ul><li>must be respected and protected; </li></ul><ul><li>must not be the subject of attack; </li></ul><ul><li>must be granted all available help in the performance of their duties; </li></ul><ul><li>must not be compelled to carry out tasks that are not compatible with their humanitarian functions; </li></ul><ul><li>must not be compelled to give priority to to any person except on medical grounds; </li></ul><ul><li>must not be punished for carrying out medical activities compatible with medical ethics, regardless of the person benefiting from that treatment; </li></ul><ul><li>must not be required to breach their code of ethics or their obligations under IHL; and </li></ul><ul><li>must not be required to provide information that they have obtained concerning the sick and the wounded under their care, except as required by national law. </li></ul>
  22. 26. Triage and surgery in successive phases (echelons)
  23. 28. Differences between military and non-military war surgery: the ICRC approach <ul><li>Military-civilian co-operation </li></ul><ul><li>Constraints </li></ul><ul><ul><li>Security </li></ul></ul><ul><ul><li>Logistics </li></ul></ul><ul><ul><li>Hospital equipment </li></ul></ul><ul><ul><li>Blood transfusion </li></ul></ul><ul><ul><li>Geography and climate </li></ul></ul><ul><ul><li>Culture shock </li></ul></ul><ul><ul><li>The human factor </li></ul></ul>