Hospitals must remain protected during armed conflicts, ICRC legal expert tells Rwanda moot court

By Elias Hakizimana.

Hospitals and other medical facilities must be protected during armed conflicts, and even when they lose their special protection under international humanitarian law, any attack must meet strict legal requirements, a legal expert has said.

Helen Obregón Gieseken, a legal adviser and frequent contributor to the International Committee of the Red Cross (ICRC) Humanity in War initiatives, made the remarks during a public lecture at the 10th edition of Rwanda’s National International Humanitarian Law (IHL) Moot Court Competition in Kigali on October 16.

The lecture, held during the competition’s closing ceremony at the Supreme Court, focused on the protection of medical facilities and healthcare personnel in armed conflict.

Gieseken explained that international humanitarian law, also known as the law of armed conflict, requires parties to protect wounded and sick people, medical personnel, hospitals and medical transport. These protections apply regardless of whether medical facilities treat civilians or wounded combatants from opposing sides.

She emphasised that wounded and sick people must be collected and cared for without discrimination, while unnecessary delays in evacuating them can jeopardise their chances of survival.

Using a hypothetical checkpoint scenario, she examined a case in which security forces delayed a vehicle transporting a heavily wounded fighter while conducting security checks. The fighter died before the vehicle was allowed to proceed.

The example illustrated the need to balance legitimate security checks with the obligation to avoid undue delays that put wounded and sick people at risk.

The lecture also addressed circumstances in which a medical facility may lose its special protection, such as when it is used to store weapons or support military operations outside its humanitarian function.

However, Gieseken stressed that such misuse does not automatically make an entire hospital a lawful target. Where required, a warning must be issued and remain unheeded before special protection can be lost. Any subsequent attack must still comply with the rules on military objectives, proportionality and precautions to minimise harm to patients, healthcare workers and civilians.

She further highlighted practical measures to safeguard hospitals, including mapping medical facilities, maintaining safe access to medical supplies, ensuring access to water, electricity and fuel, and coordinating with healthcare providers.

The lecture drew on the Global IHL Initiative, particularly its workstream on hospital protection, which seeks to translate states’ commitments into practical measures for safeguarding healthcare during armed conflict.

The public lecture formed part of the 10th National IHL Moot Court Competition organised by the ICRC in Rwanda. The two-day event, held on October 15 and 16, brought together law students for simulated court proceedings involving prosecution and defence arguments based on international humanitarian law.

The competition aims to strengthen students’ understanding of IHL, develop their legal research and advocacy skills, and increase awareness of the rules governing armed conflict.

The ICRC works to protect and assist people affected by armed conflict and promotes respect for international humanitarian law through engagement with academic institutions, legal practitioners and other partners.

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