Effects of Geneva Conventions on Medical Evacuation

INTRODUCTION

The conduct of hostilities on land is regulated by customary international law and lawmaking treaties such as the Hague Conventions.  The rights and duties set forth in the Conventions are part of the supreme law of the land.  The United States is obligated to adhere to these obligations even when an opponent does not.  It is a DOD and Army policy to conduct operations in a manner consistent with these obligations.  An in-depth discussion of the provisions applicable to medical units and personnel is provided in FM 8-10.  This lesson plan discusses only those articles or actions which affect medical evacuation operations. Questions regarding the implementation and interpretation of applicable treaties should be directed to the servicing Staff Judge Advocate.

Identify Distinctive Markings and Camouflage of Medical Facilities and Evacuation Platforms

All US medical facilities and units, except veterinary, display the distinctive flag of the Geneva Conventions.  The flag consists of a red cross on a white background.  It is displayed over the unit or facility and in other places as necessary to adequately identify the unit or facility as a medical facility

The Geneva Conventions authorizes the use of the following distinctive emblems on a white background:

(1)        Red Cross

(2)        Red Crescent

(3)        Red Lion

(4)        Sun

In operations conducted in countries using an emblem other than the Red Cross on a white background, US soldiers must be made aware of the different official emblems

United States forces are legally entitled to only display the Red Cross

(1)        However, commanders have authorized the display of both the Red Cross and the Red Crescent to accommodate Host Nation concerns and to ensure that confusion of emblems would not occur

(2)       Such use of the Red Crescent must be in a smaller size than the Red Cross

Camouflage of medical facilities (medical units, medical vehicles, and medical aircraft on the ground) are authorized when the lack of camouflage might compromise tactical operations

(1)        The marking of facilities may be ordered by a NATO commander of at least brigade level or equivalent

(2)        Such an order is to be temporary and local in nature and is rescinded as soon as circumstances permit

(3)        It is not envisioned that fixed, large medical facilities will be camouflaged

Identify Medical Aircraft

Medical aircraft used exclusively for the removal of the sick and wounded and for the transport of medical personnel and equipment shall not be attacked, but shall be respected by belligerents, while flying at heights, times, and on routes specifically agreed upon between belligerents concerned

Medical aircraft shall bear, clearly marked, the distinctive emblem together with their national colors on their lower, upper, and lateral surfaces

Unless agreed otherwise, flights over enemy or enemy-occupied territory are prohibited

Medical aircraft shall obey every summons to land.  In the event that a landing is thus imposed, the aircraft with it’s occupants may continue it’s flight after examination, if any

In the event of involuntary landing in enemy or enemy-occupied territory, the wounded and sick, as well as the crew of the aircraft, shall be prisoners of war; medical personnel will be treated as designated in the Geneva Conventions

Understanding Self-Defense and Defense of Patients

When engaging in medical evacuation operations, medical personnel are entitled to defend themselves and their patients.  They are only permitted to use small arms.

The mounting of offensive weapons on dedicated medical evacuation vehicles and aircraft jeopardizes the protections afforded by the Geneva Conventions.  These offensive weapons can include, but are not limited to:

(1)        Machine guns

(2)        Grenade launchers

(3)        Hand grenades

(4)        Light antitank weapons

Medical personnel are only permitted to fire in their personal defense and for the protection of the wounded and sick in their charge against marauders and other persons violating the law of war

Treating and Guarding Enemy Prisoners of War

Care and treatment of Enemy Prisoners of War

(1)        The standard of care for EPW's is the same as for U.S. forces IAW the Geneva Convention

(2)        The standard of evacuation for EPW's is the same as for U.S. forces IAW the Geneva Convention

(3)        Sick, injured, or wounded EPWs are treated and evacuated through normal medical channels, but are physically segregated from US, allied, or coalition patients

(4)        Practice the five S's when dealing with wounded EPW's

(a)        Search, for weapons and documents. Report findings

(b)        Segregate into groups of Enlisted, NonCommissioned Officers, and Officers

(c)        Silence, keep em quiet

(d)        Safeguard, protect them

(e)        Speed to the rear, The EPW patient is evacuated from the Combat Zone as soon as his medical condition permits

(f)                 Inform Higher headquarters of the situation

Personnel resources to guard EPW patients are provided by the echelon commander.  Medical personnel do not guard EPW patients

Compliance with the Geneva Conventions

The US is a party to and signatory of the Geneva Conventions.  These Conventions afford protection for medical personnel, facilities, and evacuation platforms (to include aircraft on the ground)

Violation of these Conventions can result in the loss of protection afforded by them

Medical personnel (Medical Platoon Leader's, Platoon Sergeant's, Senior Line Medic's) should inform the tactical commander of the consequences of violating the provisions of these conventions.  The consequences can include the following:

(1)        Medical evacuation assets subjected to attack and destruction by the enemy

(2)        Combat health support capability degraded

(3)        Captured medical personnel becoming prisoners of war rather than retained persons  They may not be permitted to treat fellow prisoners

(4)        Loss of protected status for medical unit, personnel, or evacuation platforms (to include aircraft on the ground)

Even the perception of impropriety can be detrimental to the mission and US interests.  Combat Health Support commanders must ensure that they do not give the impression of impropriety in the conduct of medical evacuation operations

SUMMARY

It is essential that you know the rights and duties set forth in the Conventions are part of the supreme law of the land.  The United States is obligated to adhere to these obligations even when an opponent does not.  It is a DOD and Army policy to conduct operations in a manner consistent with these obligations.