Traités, États parties et Commentaires
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Commentaire of 2016 
Article 22 : Conditions not depriving medical units and establishments of protection
Text of the provision
The following conditions shall not be considered as depriving a medical unit or establishment of the protection guaranteed by Article 19:
(1) That the personnel of the unit or establishment are armed, and that they use the arms in their own defence, or in that of the wounded and sick in their charge.
(2) That in the absence of armed orderlies, the unit or establishment is protected by a picket or by sentries or by an escort.
(3) That small arms and ammunition taken from the wounded and sick and not yet handed to the proper service, are found in the unit or establishment.
(4) That personnel and material of the veterinary service are found in the unit or establishment, without forming an integral part thereof.
(5) That the humanitarian activities of medical units and establishments or of their personnel extend to the care of civilian wounded or sick.
Reservations or declarations
None
Contents

A. Introduction
1860  Article 22 expressly sets out five ‘conditions’, i.e. specific factual scenarios, which must not be regarded as acts harmful to the enemy, in spite of certain appearances which may lead to the opposite conclusion or at least create some doubt. Consequently, conduct falling within the list of acts specified in Article 22 does not lead to a loss of protection of the military medical establishment or unit in question. In this sense, this article supplements Article 21 of the First Convention, which contains the principle that only acts harmful to the enemy, committed outside their humanitarian duties, may lead military medical establishments or units to lose their protection. The list of factual scenarios described in Article 22 merely gives an illustration of situations that may not be considered as acts harmful to the enemy; as such, it is not an exhaustive list.[1] Similar illustrative lists are to be found in the Second and Fourth Conventions, as well as in Additional Protocol I.[2]
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B. Historical background
1861  Virtually all of the factual scenarios included in Article 22 of the First Convention had already appeared in previous international treaties. Provisions equivalent to Article 22(1)–(3) may be found in both the 1906 Geneva Convention[3] and the 1929 Geneva Convention on the Wounded and Sick, while the 1929 Convention also contains a provision corresponding to Article 22(4).[4] Therefore, the only addition in 1949 was Article 22(5) of the First Convention. Its inclusion was necessary, since in practice civilians may receive care in military medical establishments and units in the same way as wounded or sick combatants, and since, for the first time, an international treaty, the Fourth Convention, was exclusively devoted to civilians.
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C. Paragraph 1: Carrying or use of arms in self-defence or defence of the wounded and sick
1862  Article 22(1) governs the issue of the arming of medical, auxiliary medical, and religious personnel associated with a military medical establishment or unit and what this entails for the protection of the establishment or unit.[5] This paragraph makes it clear that such personnel may be armed and that they may, in case of need, use these arms in their own defence or in that of the wounded and sick in their charge.
1863  While this paragraph expressly refers only to the ‘wounded and sick in their charge’, the fact that religious personnel generally enjoy the same protection as medical personnel under Article 24 of the First Convention supports the conclusion that religious personnel may also be armed. Furthermore, the principle of defending oneself or those in one’s spiritual charge would so dictate. In any event, the decision on whether medical or religious personnel are entitled to be armed lies with national authorities, and, with regard to religious personnel, certain countries have chosen not to equip them with weapons.[6]
1864  Article 22(1) does not specify what type of arms personnel associated with a medical establishment or unit may carry. However, in the context of hospital ship personnel under the Second Convention, it was made clear that such personnel will need only individual portable weapons, such as pistols or rifles.[7] The understanding of the type of permitted weapons reached in the context of the Second Convention also applies to personnel associated with medical establishments or units for the purposes of Article 22(1). This was subsequently clarified during the negotiations, in connection with civilian medical units under Additional Protocol I, and in State practice.[8] Additional Protocol I extends the right to carry ‘light individual weapons’ for self-defence or defence of the wounded and sick in their charge to personnel of civilian medical units.[9] When personnel associated with military medical establishments or units were allowed to be armed in 1949, the views expressed regarding the lawful use that such personnel could make of these arms implied that they must be light individual weapons. Thus, carrying weapons which are portable by one individual yet which go beyond the purpose of self-defence, such as a man-portable missile or an anti-tank missile, would lead to a loss of specific protection. Furthermore, as the tasks to be carried out by military medical personnel covered by Article 22(1) are the same as for civilian medical personnel, any weapons heavier than those stipulated for civilian medical personnel under Additional Protocol I could not be allocated to military personnel under Article 22(1) of the First Convention, i.e. weapons that cannot easily be transported by an individual and which have to be operated by several persons, without incurring the loss of specific protection of the military medical unit in which such personnel operate.
1865  Moreover, personnel associated with medical establishments and units must make use of these ‘light individual weapons’ only for the purposes expressly permitted. Any use going beyond these permitted purposes, even with ‘light individual weapons’, would constitute an act harmful to the enemy, and, upon fulfilling the further conditions of Article 21, would result in a loss of protection of the medical establishment or unit in question.
1866  The term ‘defence’ must be understood restrictively in the sense of individual defence against unlawful violence directed either at medical personnel themselves or at the wounded and sick only.[10] The unlawful violence contemplated here may manifest itself, for example, in attacks by rioters or pillagers, or in unlawful attacks by enemy soldiers against the medical establishment or unit as such or against the wounded and sick, or other medical personnel, contained therein.[11]
1867  In delimiting the permissible scope of ‘defence’, it must always be borne in mind that the use of light individual weapons by medical personnel must not result in the commission of an act harmful to the enemy. The scope of defence would not cover cases of enemy military advances aimed at taking control over the area where the medical establishments or units are located, nor would the use of force to prevent the capture of their unit by the enemy be permitted.[12] In a similar vein, medical personnel also may not resist by force of arms inspections by the enemy that have the purpose of verifying whether the medical establishment or unit is truly engaged in medical tasks.[13] Such weapon use would go beyond the permitted defensive purposes and would result in the commission of an act harmful to the enemy.[14]
1868  Similar considerations apply to mounting weaponry, for instance on mobile military medical units. On this basis, heavy weapons, such as ‘crew-served’ machine guns (requiring a team of at least two people to operate them), could not be mounted on a mobile military medical unit without that unit losing its specific protection. Moreover, the strictly defensive purposes for which personnel could use ‘light individual weapons’ would dictate additional constraints on mounting weapons on military medical units. Ultimately, in the light of these strictly defensive purposes but also to avoid the perception that a military medical unit is armed in a manner beyond that necessary for defensive purposes, a narrow interpretation of what constitutes a ‘light’ versus a ‘heavy’ weapon is called for: the larger the weapon system, the greater the risk that its presence on the military medical unit could lead an adversary to conclude that the unit might be used to commit ‘acts harmful to the enemy’, and thus no longer be entitled to protection. The way in which the weapons are displayed, in other words, must not lead the enemy to believe that the medical unit is equipped with offensive weaponry.[15] In sum, medical units protected by Article 19 should not be armed to the extent that they could be interpreted as being capable of inflicting harm on the adversary, because this would amount to an act the purpose or effect of which is to facilitate or impede military operations of a Party to the conflict.
1869  Contrary to the Second Convention,[16] Article 22(1) does not mention, as one of the permitted purposes for bearing or using weapons, the ‘maintenance of order’ in the unit. However, it has also been recognized in the context of this provision that it is necessary for medical personnel to be in a position to ensure the maintenance of order and discipline in the units under their charge, for instance among the convalescent wounded and sick.[17]
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D. Paragraph 2: Protection of a unit or establishment by a picket, sentries or an escort
1870  This paragraph complements Article 22(1) in that it relates to armed protection of the military medical establishment or unit, and specifically to the defence of the wounded and sick contained therein. Article 22(2) addresses the question of such protection by medical and non-medical personnel, and does so from the angle of a particular scenario, namely that ‘in the absence of armed orderlies, the unit or establishment is protected by a picket or by sentries or by an escort’.
1871  None of the above terms is defined in the Convention. In accordance with its ordinary meaning, while acknowledging differences may exist at the national level, ‘orderly’ may be understood as an attendant in a hospital who assists in the medical care of patients as well as with cleaning and other non-medical tasks,[18] ‘picket’ as ‘a soldier or small body of troops sent out to watch for the enemy’,[19] ‘sentry’ as ‘a soldier stationed to keep guard or to control access to a place’,[20] and an ‘escort’ as ‘a person, vehicle, or group accompanying another to provide protection or as a mark of rank’.[21] Therefore, Article 22(2) is broader than Article 22(1), in that the protection of a medical establishment or unit by non-medical members of the armed forces is also envisaged.
1872  The formulation ‘in the absence of armed orderlies’ may give the impression that the simultaneous presence of armed orderlies and a military guard is prohibited. However, the intention was that the guard of a medical unit would, as a rule, be provided by its own personnel, but that armed soldiers would be brought in to help in exceptional cases, when this was necessary, e.g. where the orderlies were too few in number.[22] Whether there is such a need for protection of a medical establishment or unit by external military guards may depend on such factors as the importance of the establishment or unit for the delivery of medical care to the wounded and sick, the severity of the threat, and the number of wounded and sick people to be cared for.[23]
1873  Article 22(2) does not specify whether there are restrictions as to the number of non-medical members of the armed forces who could be employed to protect a medical establishment or unit without that establishment or unit losing protection. While this leaves the authorities in charge with some discretion in the light of particular circumstances, the aforesaid intention behind this paragraph, i.e. that non-medical members of the armed forces would be assigned guard duties only in exceptional cases, where this is necessary, would call for a certain restraint in this regard. Such restraint is also required given that the presence of a large number of combatants in or around a medical establishment or unit will likely lead the enemy to perceive this presence as an act harmful to the enemy, thus putting the establishment or unit at greater risk of attack.[24]
1874  Therefore, the underlying assumption of Article 22(2) is that, as a rule, the medical personnel of the medical establishment or unit would be sufficient to ensure its defence against attacks by rioters or pillagers and unlawful attacks by enemy soldiers, as well as the defence of the wounded and sick therein, or to ensure the maintenance of order.[25] Yet where armed orderlies are not sufficient to ensure the protection of the establishment or unit, non-medical members of the armed forces may also be called upon to reinforce their protective presence. It is clear that, regardless of whether protection is ensured by armed orderlies or by non-medical members of the armed forces, only the same type of weapons, notably ‘light individual weapons’, may be carried and, where necessary, used for defensive purposes only. Therefore, in the same way as armed orderlies, those non-medical members of the armed forces who have been assigned to protect the unit must not attempt to prevent or resist capture by the enemy by force.[26] Moreover, escort vehicles dedicated exclusively to protecting a mobile medical unit must not have heavy weapons, such as crew-served automatic machine guns, mounted on them, in the same way as such weapons cannot be mounted on medical establishments or units themselves. Where combatants are assigned to provide protection for a medical establishment or unit as well as for military objectives surrounding it, this constitutes an act harmful to the enemy and must be avoided in order to prevent the whole establishment or unit from losing protection.[27] In such circumstances, there would also be a real danger of the medical establishment or unit incurring collateral damage as a result of attacks on the combatants in their vicinity.
1875  Apart from these traditional ways of physically protecting medical establishments or units, when it comes to protecting computers which process medical data forming an integral part of the functioning or the administration of a medical establishment or unit, there are, for instance, non-physical means of protecting these data. This could include software applications, such as the installation of intrusion detection or prevention software designed to prevent and react to harmful interferences with data by the enemy. The reactions to harmful interferences may consist in resetting the connection or reprogramming the software to block traffic from a suspected malicious source. Such blocking of access may be regarded as serving the function of an electronic guard of the protected computer system. The installation and operation of such software applications would be compatible with the strictly defensive purposes for which physical guards could be employed in the context of Article 22(2), even if the effects of these methods could be perceived as impeding the adversary’s military operations.[28]
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E. Paragraph 3: The presence of small arms and ammunition
1876  This paragraph is a reminder of the fact that the First Convention is essentially concerned with the protection of wounded and sick members of armed forces. Therefore, when such wounded and sick persons arrive in a military medical establishment or unit, they may still be in possession of small arms or ammunition, which will be taken from them and handed to the proper service, i.e. authorities outside the medical establishment or unit. However, this may take some time, and it may happen that the establishment or unit falls into the hands of the enemy or is searched by the enemy before those in charge of the establishment or unit have had an opportunity to hand over the weapons collected. In that scenario, this paragraph makes it clear that the temporary presence of small arms and ammunition found inside a military medical establishment or unit may not be considered an act harmful to the enemy.
1877  Article 22(3) does not define the term ‘small arms or ammunition’. However, the equally authentic French text uses the term ‘armes portatives(portable weapons). Therefore, the decisive criterion for these weapons is that of being capable of being carried by people, i.e. portability. The category of portable arms is to be understood more broadly here than in Article 22(1) and (2). As emphasized above in relation to Article 22(1), the understanding of the type of arms that medical personnel may carry is that these are individual portable weapons. Moreover, this has been explicitly confirmed in the case of civilian medical units under Additional Protocol I. That treaty contains the exact same grounds as Article 22(3) for not entailing a loss of protection, and, in that context, the arms concerned are small arms, in other words, arms which can be carried by people. On the other hand, there is no indication that they must be individual arms. Thus, some weapons which are slightly heavier than those which are authorized for medical personnel could be involved, such as, for example, small machine guns, provided that they are portable, even if this should require two or three soldiers. This difference between Article 22(1) and (3) in the type of weapons covered can also be found in State practice.[29] Therefore, certain weapons that may temporarily be found inside the medical establishment or unit without entailing an act harmful to the enemy would constitute such an act were they to be used by personnel associated with such an establishment or unit. On the other hand, the presence of any weapons other than portable weapons inside a medical establishment or unit could not be justified even on a temporary basis.
1878  While the temporary presence of portable arms that are heavier than light individual weapons may be allowed, the personnel of a medical establishment or unit are well advised to hand over those weapons and ammunition to authorities outside the unit as soon as possible to dispel any doubt about their intention not to commit an act harmful to the enemy. Arrangements should thus be made by the authorities in charge to avoid an excessive accumulation of portable arms inside the establishment or unit, in particular where a large number of wounded and sick people will likely be cared for therein.[30]
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F. Paragraph 4: The presence of personnel and material of the veterinary service
1879  This particular condition not entailing a loss of protection of a military medical establishment or unit goes back to the 1929 Geneva Convention.[31] At the time, it was deemed necessary to specify that, while members of the veterinary service may be found inside medical formations or establishments without forming an integral part thereof, those formations or establishments would not lose protection. This took into account the evolution of tasks that veterinarians performed within State armed forces, from a traditional role of purely combat-related activities to activities that also fall under protected medical services.[32]
1880  The activities of veterinarians have evolved from caring for horses used by cavalries, to training or caring for dogs used for combatant purposes, such as demining, searching or guarding, to inspecting food supplies to prevent contamination with animal disease agents, or taking vector-control measures such as delousing or disinfection.[33] While food inspections or the performance of delousing or disinfection may fall within the medical purpose of ‘prevention of disease’ (such as diseases transmitted by animals (e.g. rabies), cholera or dysentery, in line with comprehensive public health measures) under Article 24 of the First Convention, the other activities mentioned above would not serve any medical purposes. Both combat purposes, such as training and caring for watchdogs or demining dogs, and the medical tasks associated with ‘prevention of disease’ remain relevant in today’s armed forces.
1881  Where veterinarians are assigned to duties not covered by Article 24, they would be considered combatants.[34] On the other hand, where they are exclusively assigned to medical purposes, they may be considered ‘medical personnel’ in accordance with Article 24.[35] The assumption underlying Article 22(4) is, however, that they would not qualify as medical personnel within the meaning of Article 24, but that they might be closely associated with medical establishments or units without being part of them. In that sense, Article 22(4) makes it clear that the mere presence of such personnel inside a medical establishment or unit could not be regarded as an act harmful to the enemy.
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G. Paragraph 5: Care for wounded and sick civilians
1882  While the First Convention is concerned with wounded and sick members of the armed forces, and the protection of wounded and sick civilians is regulated in the Fourth Convention, Article 22(5) makes it clear that, where the humanitarian activities of military medical establishments or units extend to wounded and sick civilians, this would not constitute an act harmful to the enemy. This paragraph has its counterpart in Article 19(2) of the Fourth Convention, which does not regard as an act harmful to the enemy leading to a loss of protection of civilian hospitals the fact that ‘sick or wounded members of the armed forces are nursed in these hospitals’.
1883  One may wonder if inclusion of this paragraph was even necessary, since the activities described would undoubtedly be humanitarian, and could not in any event be interpreted as acts harmful to the enemy outside the humanitarian duties of medical establishments and units. Still, at the time of the adoption of the Conventions, the reason for this additional paragraph was that, in view of the changes seen in warfare – the effects of which often struck civilians as much as members of armed forces – it had to be explicitly made possible for wounded and sick soldiers and civilians to be treated in the same medical establishments or units. This humanitarian principle, i.e. that all wounded and sick people, including civilians, who do not fall within the scope of the protection afforded by the First Convention, may be cared for in a military medical establishment or unit, is now uncontested. Furthermore, for States party to Additional Protocol I, Article 22(5) of the First Convention and Article 19(2) of the Fourth Convention have been overtaken by the fact that the definition of the ‘wounded and sick’ under Additional Protocol I expressly applies to both military and civilian wounded and sick, all of whom enjoy the same protection.[36]
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Select bibliography
See the select bibliography of the commentary on Article 19 of the First Convention.

1 - See also, in this respect, Switzerland, Military Manual, 1984, Article 83, which paraphrases the scenarios contained in Article 22 and refers to them as ‘examples of cases that do not give rise to a loss of protection’ (emphasis added). This is also evident from Sierra Leone’s military manual, which considers the following scenario, spelt out neither in Article 22 nor in any other provision of international humanitarian treaty law, as not leading to a loss of protection of a medical unit: ‘The delivery to [a] medical unit of wounded and sick personnel is in non-medical transport[s], such as ordinary, unmarked military vehicle[s] or helicopters’; see Sierra Leone, Instructor Manual, 2007, p. 59.
2 - The lists of acts not leading to a loss of protection for hospital ships under Article 35 of the Second Convention and for civilian hospitals under Article 19 of the Fourth Convention overlap with Article 22(1), (3) and (5) and with Article 22(3) and (5), respectively. Furthermore, the list of acts not constituting acts harmful to the enemy for civilian medical units under Article 13(2) of Additional Protocol I corresponds to the scenarios addressed by Article 22(1), (2) and (3).
3 - Geneva Convention (1906), Article 8.
4 - Geneva Convention on the Wounded and Sick (1929), Article 8.
5 - While the subjects of this factual scenario are personnel, the relevant Articles 24 and 25 of the First Convention are not explicit as to which acts would not result in a loss of protection, including whether the respective personnel may be armed. But see, on the analogous applicability of Article 22(1) to personnel, the commentaries on Article 24, section F, and Article 25, paras 2040–2042.
6 - See Stefan Lunze, ‘Serving God and Caesar: Religious personnel and their protection in armed conflict’, International Review of the Red Cross, Vol. 86, No. 853, March 2004, pp. 69–90, at 76, and Nilendra Kumar, ‘Protection of Religious Personnel’, in Dieter Fleck (ed.), The Handbook of International Humanitarian Law, 3rd edition, Oxford University Press, 2013, pp. 413–424, at 420.
7 - Pictet (ed.), Commentary on the Second Geneva Convention, ICRC, 1960, commentary on Article 35, p. 194. See also the commentary on Article 35 of the Second Convention.
8 - See e.g. Belgium, Law of Armed Conflict Training Manual, 2009, Course V, p. 13 (‘Le personnel sanitaire doit pouvoir assurer sa propre sécurité et protection ainsi que celles des blessés et des malades dont il a la charge, et ce, contre des actes de pillage, de brigandage ou simplement pour maintenir l’ordre et la discipline parmi les blessés (Ex: garde de PG blessés). Il s’agit, donc, d’une mission de police et non de combat. A cet effet, il peut être en possession d’armes légères individuelles (Ex: pistolets et fusils)’) (‘Medical personnel must be able to ensure their own safety and protection, and those of the wounded and sick in their charge, against looting and robbery, or simply to maintain order and discipline among the wounded (e.g. while guarding wounded prisoners of war). To this end, they may be in possession of individual light weapons (e.g. pistols and rifles)’); Peru, IHL Manual, 2004, paras 83(c) and (d) and 88(b)(2) (‘Medical personnel may only carry light individual weapons and are only permitted to use them to defend themselves and the wounded in their charge. The circumstances of armed conflict often lead to a state of internal disruption which, in addition to the conflict itself, results in acts of violence, such as looting, rape and pillage. The weapons carried by medical personnel are limited to light, individual firearms, which can only be used for the purposes mentioned above … The following are not considered harmful to the adverse Party: medical personnel equipped with light individual weapons for their own defence or for that of the wounded and sick in their charge (defence against an offence committed against them, but not against an attack by the enemy))’; United Kingdom, Manual of the Law of Armed Conflict, 2004, paras 7.15 and 7.15.1 (‘Medical personnel may be equipped with “light individual weapons for their own defence or for that of the wounded and sick in their charge”. Light individual weapons are those that can be handled and fired by one person and primarily intended for personnel targets. It follows that medical personnel may be armed with sub-machine guns, self-loading rifles, and handguns’); and United States, Army Health System, 2013, para. 3-31 (‘Medical personnel are not authorized crew-served or offensive weapons. They may carry small arms, such as rifles, pistols, squad automatic weapons, or authorized substitutes in the defense of medical facilities, equipment, and personnel/patients without surrendering the protections afforded by the Geneva Conventions.’). For details on the type of weapons permissible under Additional Protocol I, see the commentary on Article 13 of Additional Protocol I.
9 - Additional Protocol I, Article 13(2)(a).
10 - This implies that no defence against violence directed at other persons, including combatants, would be covered. For further details, see the commentary on Article 24.
11 - See Belgium, Law of Armed Conflict Training Manual, 2009, Course V, p. 13; Peru, IHL Manual, 2004, paras 83(c) and (d) and 88(b)(2); and United States, Army Health System, 2013, para. 3-31 (‘In recognition of the necessity of self-defense, however, medical personnel may be armed for their own defense or for the protection of the wounded and sick under their charge. To retain this privileged status, they must refrain from all aggressive action and may only employ their weapons if attacked in violation of the Conventions.’). See also Hyder Gulam, ‘Medical personnel and the law of armed conflict’, Australian Defence Forces Health Journal, Vol. 6, 2005, pp. 31–32.
12 - See e.g. Belgium, Law of Armed Conflict Training Manual, 2009, Course V, p. 16 (‘le personnel ne peut toutefois pas s’opposer par les armes à la capture pacifique de son unité par l’adversaire’) (‘the personnel may not, however, resist by force of arms the peaceful capture of their unit by the enemy’); Netherlands, Military Handbook, 2003, p. 7-45; Peru, IHL Manual, 2004, para. 83(d) (‘If they try to resist a military advance using weapons, they lose their “neutrality” in the conflict and, therefore, their right to protection, unless the enemy deliberately tries to kill the wounded and sick or the medical personnel themselves’); South Africa, LOAC Manual, 1996, para. 59 (‘A medical unit must not be defended against the enemy in the event of penetration by the enemy into the territory where it is located. Such defence would constitute a hostile act, causing the unit to forfeit its right to protection’); and United States, Army Health System, 2013, para. 3-31 (‘They may not employ arms against enemy forces acting in conformity with the Law of Land Warfare and may not use force to prevent the capture of their unit by the enemy.’).
13 - As has been observed in the context of Article 19 of the First Convention, such inspections are, in principle, compatible with the obligation to respect that establishment or unit. See the commentary on that article, paras 1800–1803.
14 - International humanitarian law recognizes the possibility of withdrawing in the face of an advancing enemy. See e.g. Belgium, Law of Armed Conflict Training Manual, 2009, Course V, p. 16 (‘le personnel ne peut toutefois pas s’opposer par les armes à la capture pacifique de son unité par l’adversaire. Il peut, néanmoins, tenter d’échapper à celle-ci par un repli’) (‘the personnel may not, however, resist by force of arms the peaceful capture of their unit by the enemy. Nevertheless, they may try to escape such capture by withdrawing’); and United States, Army Health System, 2013, para. 3-31 (‘it is, on the other hand, perfectly legitimate for a medical unit to withdraw in the face of the enemy’). This possibility may, however, be precluded by national military laws and regulations.
15 - See the commentary on Rule 74(c)(i) of the 2009 Manual on International Law Applicable to Air and Missile Warfare. Transposed to the situation of military medical units, see also San Remo Manual on International Law Applicable to Armed Conflicts at Sea (1994), para. 170.2 (‘[A]s there is no prohibition on [such units] defending themselves, it would be unreasonable not to allow them to do so as long as it is in a way that cannot be interpreted as being potentially aggressive’), and Canada, Code of Conduct, 2007, p. 2-16, para. 6 (‘As a general rule medical transports should not have any weapons “mounted” on them to avoid being mistaken for fighting vehicles.’)
16 - Second Convention, Article 35(1).
17 - In this regard, see Netherlands, Military Manual, 2005, para. 1058: ‘The following do not constitute grounds for the ending of protection [of medical units]: – if the personnel of the medical unit are equipped with personal small arms for their own defence or for that of the wounded and sick in their charge, and for the preservation of order and calm within the unit’ (emphasis added). See also Belgium, Law of Armed Conflict Training Manual, 2009, Course V, pp. 13 and 16.
18 - Concise Oxford English Dictionary, 12th edition, Oxford University Press, 2011, p. 1007. It should be noted that ‘orderlies’ are recognized, for the purposes of Article 24 of the First Convention, as capable of falling within the category of medical personnel proper, i.e. those ‘exclusively engaged in the search for, or the collection, transport or treatment of the wounded and sick, or in the prevention of disease’. Depending on the circumstances, they may also fall within the category of auxiliary medical personnel of the armed forces under Article 25 of the First Convention. See the commentaries on Article 24, para. 1955, and Article 25, para. 2029.
19 - Concise Oxford English Dictionary, 12th edition, Oxford University Press, 2011, p. 1083.
20 - Ibid. p. 1312.
21 - Ibid. p. 487.
22 - Pictet (ed.), Commentary on the First Geneva Convention, ICRC, 1952, commentary on Article 22, pp. 203–204.
23 - See e.g. Belgium, Law of Armed Conflict Training Manual, 2009, Course V, p. 13.
24 - Subsequent to the adoption of the First Convention, during the preparatory work on Article 13(2)(b) of Additional Protocol I, the paragraph equivalent to Article 22(2) of the First Convention, Cuba submitted a proposed amendment specifying that a civilian medical unit under the Protocol could only be guarded by ‘a reasonable number of’ sentries. See Official Records of the Diplomatic Conference of Geneva of 1974–1977, Vol. XI, pp. 127–128 and 230. See also United Kingdom, Manual of the Law of Armed Conflict, 2004, para. 7.18 (‘medical personnel must be careful that the protected status of their unit is not put at risk by the presence of a disproportionate number of … combatants’).
25 - The scenarios arising under the ‘maintenance of order’ purpose mentioned earlier in the context of Article 22(1) are of particular relevance in this context, since the ‘maintenance of order’ is even one of the tasks included in the definition of ‘orderly’.
26 - United Kingdom, Manual of the Law of Armed Conflict, 2004, para. 7.16 (‘However, the guard also may only act in a purely defensive manner and may not oppose the occupation or control of the unit by the enemy’); United States, Army Health System, 2013, para. 3-32 (‘But, as in the case of medical personnel, the Soldiers may only act in a purely defensive manner and may not oppose the occupation or control of the unit by an enemy who is respecting the unit’s privileged status.’). If captured, these non-medical members of the armed forces are prisoners of war. For an elaboration of the individual status of medical personnel and non-medical members of armed forces assigned to guard duties, see the commentary on Article 24, para. 2007.
27 - See Belgium, Law of Armed Conflict Training Manual, 2009, Course V, p. 13 (‘Le personnel sanitaire ne peut pas être utilisé à la garde d’autres installations que des installations sanitaires. Cela constituerait une participation aux hostilités qui lui ferait perdre sa protection et constituerait, aux yeux de l’ennemi, un précédent mettant en cause la confiance réciproque’) (‘Medical personnel may not be used to guard facilities other than medical facilities. This would constitute participation in hostilities, which would cause them to lose their protection and would, in the enemy’s eyes, set a precedent undermining mutual confidence.’). See also Peter De Waard and John Tarrant, ‘Protection of Military Medical Personnel in Armed Conflicts’, University of Western Australia Law Review, Vol. 35, No. 1, 2010, pp. 157–183, at 176.
28 - See Tallinn Manual on the International Law Applicable to Cyber Warfare (2013), p. 209.
29 - See e.g. Germany, Military Manual, 1992, para. 619 (‘To this effect, the following acts shall not be considered as hostile acts: – that medical personnel use arms for their own protection, and that of the wounded and sick; … – that war material taken from the wounded and sick is retained’) (emphasis added); the Netherlands, Military Manual, 2005, para. 0622 (‘The following do not constitute grounds for the ending of protection: – if the personnel of the medical unit are equipped with personal small arms … ; – if small arms and ammunition, taken from the wounded and sick and not yet handed in, are found in the units’) (emphasis added); and Sierra Leone, Instructor Manual, 2007, p. 59 (‘However, their [medical units’] protection will not be lost if: a. They are armed only with light individual weapons. … c. Small arms and equipment taken from patients are stored temporarily in the medical unit pending their return to combat unit’) (emphasis added). While historically, notably in the context of the 1929 Geneva Convention, the understanding was effectively that of individual portable arms, that can be regarded as outdated in the light of these subsequent developments. On this historical understanding, see Des Gouttes, Commentaire de la Convention de Genève de 1929 sur les blessés et malades, ICRC, 1930, pp. 45–46.
30 - See e.g. United Kingdom, Manual of the Law of Armed Conflict, 2004, para. 7.17.
31 - Geneva Convention on the Wounded and Sick (1929), Article 8(4).
32 - Another proposal to place the veterinary service on the exact same footing as the medical service was rejected at the 1929 Diplomatic Conference. See Des Gouttes, Commentaire de la Convention de Genève de 1929 sur les blessés et malades, ICRC, 1930, p. 46.
33 - On the evolution of the tasks of veterinarians, see Eric Darré and Emmanuel Dumas, ‘Vétérinaires et droit international humanitaire: réflexions sur une controverse’, Revue de Droit Militaire et de Droit de la Guerre, Vols 3–4, No. 43, 2004, pp. 111–136, at 116–121. For a contemporary understanding of the activities encompassed by veterinary health, see Food and Agriculture Organization, Veterinary Public Health and Control of Zoonoses in Developing Countries, Rome, 2003.
34 - See e.g. United States, Veterinary Service Manual, 2004, para. 1-4. See also Yoram Dinstein, The Conduct of Hostilities under the Law of International Armed Conflict, 2nd edition, Cambridge University Press, 2010, p. 165.
35 - For a discussion of the current legal status of members of the armed forces’ veterinary service, see the commentary on Article 24, para. 1959.
36 - Additional Protocol I, Article 8(a). See also Article 13(2)(d) of the Protocol, which provides that, for the purposes of this treaty, the presence of combatants in the unit for medical reasons must not be considered an act harmful to the enemy on the part of civilian medical units.