Could Coalition Airstrikes Have Hit Medical Facilities in Syria? A Review of Open Source Data
Organizations such as Airwars, a United Kingdom-based nonprofit aimed at tracking casualties in conflicts, have long documented civilian harm in the Syrian civil war.
Amidst the thousands of strike assessments on its website are reports that claim Russian or Syrian regime forces have struck medical facilities over the course of the near decade-long conflict. Other nongovernmental organizations like the Syrian Archive have covered the issue of attacks on Syrian hospitals, too.
Yet Airwars’ incident database also contains several reports that claim that U.S.-led Coalition airstrikes have hit either hospitals or makeshift medical sites in recent years, as well.
While these reports are not conclusive on their own, this investigation seeks to further explore such claims and gather more details about selected alleged strikes.
Using analysis from Airwars, as well as other international monitoring groups, as source data, the authors of this article were able to identify five occasions in 2018 where Coalition airstrikes were reported to have hit either hospitals or makeshift medical facilities in eastern Syria.
Additional open source information, such as satellite data and user-generated content, was then used to glean further evidence as to what had actually occurred.
In times of war, international humanitarian law (IHL) enshrines special protection for civilian healthcare facilities. Under no circumstances can they be attacked if they’re exclusively organized for medical purposes. They may lose special protection only if they are used to commit, outside their humanitarian duties, acts harmful to the enemy. But even then, principles such as proportionality, distinction and precaution, must be respected.
This research is not able to conclude whether or not these laws were violated; it is also not able to speculate on potential motives, strategies, unintentional errors on the part of the Coalition, or confirm if they did indeed strike medical facilities or carry out the strikes in question.
At least three of the medical facilities detailed in the strike data (below) appeared to be makeshift or were operating from within a house or apartment. It was not clear if these had been clearly demarcated, and it is often difficult to ensure such operations are granted the appropriate protections under IHL.
While the data sources point to the U.S.-led Coalition, Russian and Syrian regime forces were active in Deir ez-Zor Governorate in 2018, as well. But neither Russian nor Syrian forces are mentioned in the reports gathered from multiple sources detailing the strikes.
The authors provided dates and coordinates for each of the five strikes to Combined Joint Task Force – Operation Inherent Resolve (CJTF-OIR), the U.S. Department of Defense’s task force that leads its efforts to fight the Islamic State (IS) in Syria and Iraq.
A spokesperson for CJTF-OIR said: “CJTF-OIR reviewed each investigation that was previously conducted in relation to the allegations you cited. It is advised that each allegation was found to be NOT CREDIBLE. This was determined either on the basis that no potentially corroborating CJTF-OIR strikes were carried out on the date and in the geographic area alleged, or on the basis that the allegation provided insufficient information to conduct an assessment of credibility. CJTF-OIR applies a rigorous validation process to ensure all strikes conducted comply with the rules of engagement and International Humanitarian Law. No evidence available to CJTF-OIR suggests that any healthcare facilities were affected by CJTF-OIR strikes on the dates you provided.”
The spokesperson did not provide further details on specifics of the strike investigations mentioned, which they said were not for public release, nor did they provide evidence to back up the conclusion that the strike data detailed was “not credible.”
At least one of the strikes identified by the authors was previously dismissed as non-credible by CJTF-OIR, although few details were provided at the time as to why it had concluded that no civilian casualties occurred.
CJTF-OIR has previously been criticized for undercounting civilian harm relating to airstrikes in Syria. A 2018 report from Amnesty International stated that CJTF-OIR found that allegations of civilian harm were non-credible at a rate of more than 95% for a specific sample of allegations concerning strikes mainly from 2017. Amnesty suggested “that some, possibly many, allegations [might have been] dismissed before all necessary efforts are deployed to investigate them.”
An Airwars report from 2016 also stated that Coalition forces had admitted to having caused an “unprecedentedly low number” of civilian casualties compared to recent airpower conflicts.
Despite this, the reports from local media and monitoring groups detailed below should still be read with informed skepticism until more evidence comes to light, can be gathered on the ground or additional information is released.
Methods
The authors used data from a variety of sources and monitoring groups to compile information about each strike.
In addition to Airwars, the authors used data from sources such as New York-based nonprofit Physicians for Human Rights (PHR) and the Safeguarding Health in Conflict Coalition (SHCC), a group of international NGOs “working to protect health workers, services, and infrastructure.” Insecurity Insight, a Switzerland-based non-political association focused on “research methods to examine threats facing people who live and work in dangerous environments” and an SHCC member, collates the data for SHCC.
Relevant public strike releases from CJTIF-OIR were also consulted and are detailed in relation to each strike below.
Where possible, the strikes were verified using time-stamped satellite imagery, user-generated content posted to social media, and other open source materials. Thirteen strikes — all of which took place between February 2016 and November 2018 — were initially selected for review, as data indicated they may have resulted in Coalition armed forces striking hospitals, clinics, or other medical facilities.
However, the investigation was narrowed to five incidents after evaluating the availability and reliability of the data and evidence. The five strikes took place in 2018 in Deir ez-Zor Governorate, which is located in the eastern portion of the country along the Euphrates River and the border with Iraq. The region is strategically important, rich in oil and was heavily disputed by several parties to the conflict, notably IS (also referred to as ISIS or ISIL), the U.S.-backed Syrian Democratic Forces (SDF) and Syrian pro-government forces supported by Russia.
Deir ez-Zor Governorate (highlighted) is situated in the east of Syria and borders Iraq. The airstrikes detailed in this investigation all occurred in the east of the governerate, close to the border with Iraq. Map Credit: Logan Williams/Bellingcat
By the end of 2017, IS had lost the vast majority of its previously held territory across Syria. In Deir ez-Zor, SDF and Syrian government forces had both managed to consolidate their respective grips on the governorate. By May 2018, IS retained control over three areas: Hajin, Al Susah and Al Sha’afa, according to a report by the OCHA Syria Crisis offices. Towards the end of the year, the U.S.-led Coalition began to push IS out of Hajin, as The New York Times reported. Syrian government forces would eventually take control of most IS-held territories west of the Euphrates River, whereas SDF would control most of the territory to the east.
Most of the media coverage available documenting the strikes detailed by the authors is from local sources, ranging from IS-sponsored news media (i.e., Amaq) to pro-opposition and regime-friendly sources. Future investigation should be carried out to verify whether strikes on medical facilities could have taken place in other governorates and time periods.
The strikes detailed below are presented in chronological order. Source websites and data are linked in the text for open sources, but some of the source data analyzed is not available on the open web (i.e., it was obtained directly from individual organizations). Where this was the case, the authors have provided detailed information for clarity. The authors used a combination of Maxar’s SecureWatch platform and Google Earth Pro for satellite imagery discovery and analysis.
PLEASE BE ADVISED: The below content contains graphic descriptions and imagery.
1. Alleged Coalition Airstrike in Al Sha’afa (الشعفة) (approx. between 2018/01/23 and 2018/01/27) Coordinates of exact location: 34.595858, 40.938138
Several sources, such as Syrian Network for Human Rights (SNHR), Airwars (Airwars code CS1716), and the UK-based independent NGO Syrian Observatory for Human Rights, reported that between four and 15 civilians were killed in an airstrike in the town of Al Sha’afa. Airwars cited a wide variety of local media and social media sources, some of which are detailed below. Between three and seven of the deceased were identified as women, according to various reports.
There is some confusion as to the exact date of the strike as different sources reported different dates. Euphrates Post, a news organization founded by journalist Ahmad Ramadan, who has since emigrated to Turkey, reported that the victims were killed as a result of airstrikes that targeted Sha’afa Hospital on January 27, while the Shaam News Network, a pro-opposition activist-founded media outlet, reported that the international Coalition bombed a hospital in Al Sha’afa on January 24, causing the death of 14 people, including seven women.
Baladi News, a pro-opposition Syrian local news service, reported that on Tuesday, January 23, “warplanes targeted the ‘Al-Boomsir’ complex in the town of ‘Al-Sha’afa’ in the Al-Boukamal countryside east of Deir ez-Zor, which caused its complete destruction.” Another source, Qasioun News, a Syrian news agency licensed in Turkey that has been operating since 2014, reported that “international Coalition fighter jets” caused the destruction of Al-Boomsir complex.
Deir ez-Zor Free Radio, a Syrian news broadcaster, reported on Facebook that the building was a hospital. It also cited the death of 14 people, including seven women.
The views expressed in this article do not necessarily reflect the views and editorial stance of the SOHR.