Practice Relating to Rule 25. Medical Personnel

Geneva Convention (1864)
Article 2 of the 1864 Geneva Convention provides:
Hospital and ambulance personnel, including the quarter-master’s staff, the medical, administrative and transport services … shall have the benefit of the same neutrality [as military hospitals and ambulances] when on duty, and while there remain any wounded to be brought in or assisted. 
Convention for the Amelioration of the Condition of the Wounded in Armies in the Field, Geneva, 22 August 1864, Article 2.
Geneva Convention (1906)
Article 9 of the 1906 Geneva Convention provides:
The personnel charged exclusively with the removal, transportation, and treatment of the sick and wounded, as well as with the administration of sanitary formations and establishments … shall be respected and protected under all circumstances. If they fall into the hands of the enemy they shall not be considered as prisoners of war. 
Convention for the Amelioration of the Condition of the Wounded and Sick in Armies in the Field, Geneva, 6 July 1906, Article 9.
Geneva Convention (1906)
Article 10 of the 1906 Geneva Convention provides:
The personnel of volunteer aid societies, duly recognized and authorized by their own governments, who are employed in the sanitary formations and establishments of armies, are assimilated to the personnel contemplated in the preceding article, upon condition that the said personnel shall be subject to military laws and regulations. Each state shall make known to the other, either in time of peace or at the opening, or during the progress of hostilities, and in any case before actual employment, the names of the societies which it has authorized to render assistance, under its responsibility, in the official sanitary service of its armies. 
Convention for the Amelioration of the Condition of the Wounded and Sick in Armies in the Field, Geneva, 6 July 1906, Article 10.
Geneva Convention (1929)
Article 9 of the 1929 Geneva Convention provides:
The personnel engaged exclusively in the collection, transport and treatment of the wounded and sick, and in the administration of medical formations and establishments, … shall be respected and protected under all circumstances. If they fall into the hands of the enemy they shall not be treated as prisoners of war. Soldiers specially trained to be employed, in case of necessity, as auxiliary nurses or stretcher-bearers for the collection, transport and treatment of the wounded and sick, and furnished with a proof of identity, shall enjoy the same treatment as the permanent medical personnel if they are taken prisoners while carrying out these functions. 
Convention for the Amelioration of the Condition of the Wounded and Sick in Armies in the Field, Geneva, 27 July 1929, Article 9.
Geneva Convention (1929)
Article 10 of the 1929 Geneva Convention provides:
The personnel of Voluntary Aid Societies, duly recognized and authorized by their Government, who may be employed on the same duties as those of the personnel mentioned in the first paragraph of Article 9, are placed on the same footing as the personnel contemplated in that paragraph, provided that the personnel of such societies are subject to military law and regulations. Each High Contracting Party shall notify to the other, either in time of peace or at the commencement of or during the course of hostilities, but in every case before actually employing them, the names of the societies which it has authorized, under its responsibility, to render assistance to the regular medical service of its armed forces. 
Convention for the Amelioration of the Condition of the Wounded and Sick in Armies in the Field, Geneva, 27 July 1929, Article 10.
Geneva Convention I
Article 24 of the 1949 Geneva Convention I provides:
Medical personnel exclusively engaged in the search for, or the collection, transport or treatment of the wounded or sick, or in the prevention of disease, staff exclusively engaged in the administration of medical units and establishments … shall be respected and protected in all circumstances. 
Convention (I) for the Amelioration of the Condition of the Wounded and Sick in Armed Forces in the Field, Geneva, 12 August 1949, Article 24.
Geneva Convention I
Article 25 of the 1949 Geneva Convention I provides:
Members of the armed forces specially trained for employment, should the need arise, as hospital orderlies, nurses or auxiliary stretcher-bearers, in the search for or the collection, transport or treatment of the wounded and sick shall likewise be respected and protected if they are carrying out these duties at the time when they come into contact with the enemy or fall into his hands. 
Convention (I) for the Amelioration of the Condition of the Wounded and Sick in Armed Forces in the Field, Geneva, 12 August 1949, Article 25.
Geneva Convention I
Article 26 of the 1949 Geneva Convention I provides:
The staff of National Red Cross Societies and that of other Voluntary Aid Societies, duly recognized and authorized by their Governments, who may be employed on the same duties as the personnel named in Article 24, are placed on the same footing as the personnel named in the said Article, provided that the staff of such societies are subject to military laws and regulations.
Each High Contracting Party shall notify to the other, either in time of peace or at the commencement of or during the course of hostilities, but in any case before actually employing them, the names of the societies which it has authorized, under its responsibility, to render assistance to the regular medical service of its armed forces. 
Convention (I) for the Amelioration of the Condition of the Wounded and Sick in Armed Forces in the Field, Geneva, 12 August 1949, Article 26.
Geneva Convention II
Article 36 of the 1949 Geneva Convention II provides that “medical and hospital personnel of hospital ships and their crews shall be respected and protected”. 
Convention (II) for the Amelioration of the Condition of the Wounded, Sick and Shipwrecked Members of Armed Forces at Sea, Geneva, 12 August 1949, Article 36.
Geneva Convention IV
Article 20, first paragraph, of the 1949 Geneva Convention IV provides:
Persons regularly and solely engaged in the operation and administration of civilian hospitals, including the personnel engaged in the search for, removal and transporting of and caring for wounded and sick civilians, the infirm and maternity cases, shall be respected and protected. 
Convention (IV) relative to the Protection of Civilian Persons in Time of War, Geneva, 12 August 1949, Article 20.
Additional Protocol I
Article 8(c) of the 1977 Additional Protocol I defines medical personnel as “those persons assigned, by a Party to the conflict, exclusively to … medical purposes … or to the administration of medical units or to the operation or administration of medical transports”. It adds that “[s]uch assignments may be either permanent or temporary”. The definition covers both military and civilian medical personnel. Article 8(c)(ii) requires that personnel of aid societies be duly recognized and authorized by a party to the conflict. 
Protocol Additional to the Geneva Conventions of 12 August 1949, and relating to the Protection of Victims of International Armed Conflicts (Protocol I), Geneva, 8 June 1977, Article 8(c). Article 8 was adopted by consensus. CDDH, Official Records, Vol. VI, CDDH/SR.37, 24 May 1977, p. 68.
Additional Protocol I
Article 15(1) of the 1977 Additional Protocol I provides: “Civilian medical personnel shall be respected and protected.” 
Protocol Additional to the Geneva Conventions of 12 August 1949, and relating to the Protection of Victims of International Armed Conflicts (Protocol I), Geneva, 8 June 1977, Article 15(1). Article 15 was adopted by consensus. CDDH, Official Records, Vol. VI, CDDH/SR.37, 24 May 1977, p. 70.
Additional Protocol II
Article 9(1) of the 1977 Additional Protocol II provides: “Medical … personnel shall be respected and protected and shall be granted all available help for the performance of their duties.” 
Protocol Additional to the Geneva Conventions of 12 August 1949, and relating to the Protection of Victims of Non-International Armed Conflicts (Protocol II), Geneva, 8 June 1977, Article 9(1). Article 9 was adopted by consensus. CDDH, Official Records, Vol. VII, CDDH/SR.51, 3 June 1977, p. 112.
Additional Protocol II (draft)
Article 11(f) of the draft Additional Protocol II submitted by the ICRC to the CDDH provided:
“medical personnel” means: (i) the medical personnel of the parties to the conflict, whether military or civilian, permanent or temporary, exclusively engaged in the operation or administration of medical units and means of medical transport, including their crews, and assigned inter alia to the search for, removal, treatment or transport of the wounded and sick;
(ii) the civil defence medical personnel referred to in Article 30 and the medical personnel of the National Red Cross (Red Crescent, Red Lion and Sun) Societies referred to in Article 35. 
CDDH, Official Records, Vol. I, Part Three, Draft Additional Protocols, June 1973, p. 37.
This proposal was amended and adopted by consensus in Committee II of the CDDH. The adopted text provided:
“Medical personnel” means those persons assigned exclusively to the medical purposes enumerated in sub-paragraph (c) [the search for, collection, transportation, diagnosis or treatment – including first aid treatment – of the wounded, sick and shipwrecked, and for the prevention of disease] and also those persons assigned exclusively to the administration of medical units or to the operation or administration of medical transports. Such assignments may be either permanent or temporary. The term shall include:
(i) medical personnel of a Party to the conflict, whether military or civilian, including those assigned to medical tasks of civil defence;
(ii) medical personnel of Red Cross (Red Crescent, Red Lion and Sun) organizations recognized and authorized by a Party to the conflict;
(iii) medical personnel of other aid societies recognized and authorized by a Party to the conflict and located within the territory of the High Contracting Party in whose territory an armed conflict is taking place. 
CDDH, Official Records, Vol. XIII, CDDH/406/Rev.1, 17 March-10 June 1977, pp. 241 and 242.
Eventually, however, Article 11(f) of the draft Additional Protocol II was deleted by consensus in the plenary. 
CDDH, Official Records, Vol. VII, CDDH/SR.51, 3 June 1977, p. 109.
Oxford Manual
Article 13 of the 1880 Oxford Manual provides:
Persons employed in hospitals and ambulances – including the staff for superintendence, medical service, administration and transport of wounded, as well as … the members and agents of relief associations which are duly authorized to assist the regular sanitary staff – are considered as neutral while so employed, and so long as there remain any wounded to bring in or to succour. 
The Laws of War on Land, adopted by the Institute of International Law, Oxford, 9 September 1880, Article 13.
Hague Statement on Respect for Humanitarian Principles
In the 1991 Hague Statement on Respect for Humanitarian Principles, the Presidents of the six republics of the former Yugoslavia reminded all the parties to the conflicts in Bosnia and Herzegovina and in Croatia that: “All Red Cross personnel and medical personnel assisting civilian populations and persons hors de combat must be granted the necessary freedom of movement to achieve their tasks.” 
Statement on Respect for Humanitarian Principles, signed by the Presidents of the Six Republics of the former Yugoslavia, The Hague, 5 November 1991.
UN Secretary-General’s Bulletin
Section 9.4 of the 1999 UN Secretary-General’s Bulletin provides: “The United Nations force shall in all circumstances respect and protect medical personnel exclusively engaged in the search for, transport or treatment of the wounded or sick.” 
Observance by United Nations Forces of International Humanitarian Law, Secretary-General’s Bulletin, UN Secretariat, UN Doc. ST/SGB/1999/13, 6 August 1999, Section 9.4.
Argentina
Argentina’s Law of War Manual (1969) restates Articles 24–26 of the 1949 Geneva Convention I. 
Argentina, Leyes de Guerra, RC-46-1, Público, II Edición 1969, Ejército Argentino, Edición original aprobado por el Comandante en Jefe del Ejército, 9 May 1967, §§ 3.008–3.010.
Argentina
Argentina’s Law of War Manual (1989) defines medical personnel with reference to Articles 24–25 of the 1949 Geneva Convention I and Article 8 of the 1977 Additional Protocol I. 
Argentina, Leyes de Guerra, PC-08-01, Público, Edición 1989, Estado Mayor Conjunto de las Fuerzas Armadas, aprobado por Resolución No. 489/89 del Ministerio de Defensa, 23 April 1990, § 2.10.
The manual states: “Medical personnel, whether civilian or military, permanent or temporary, shall be protected and respected in all circumstances.” 
Argentina, Leyes de Guerra, PC-08-01, Público, Edición 1989, Estado Mayor Conjunto de las Fuerzas Armadas, aprobado por Resolución No. 489/89 del Ministerio de Defensa, 23 April 1990, § 2.11.
With respect to non-international armed conflicts in particular, the manual states that medical personnel “shall be respected, protected and assisted in the performance of their duties in favour of all wounded and sick without any discrimination”. 
Argentina, Leyes de Guerra, PC-08-01, Público, Edición 1989, Estado Mayor Conjunto de las Fuerzas Armadas, aprobado por Resolución No. 489/89 del Ministerio de Defensa, 23 April 1990, § 7.06.
Australia
Australia’s Commanders’ Guide (1994) provides: “Civilian medical personnel are deemed to be protected persons under the Geneva Conventions … Military medical personnel … are also entitled to general protection under the Geneva Conventions.” 
Australia, Law of Armed Conflict, Commanders’ Guide, Australian Defence Force Publication, Operations Series, ADFP 37 Supplement 1 – Interim Edition, 7 March 1994, §§ 614–615.
Australia
Australia’s Defence Force Manual (1994) states: “Military and civilian medical personnel are protected persons.” 
Australia, Manual on Law of Armed Conflict, Australian Defence Force Publication, Operations Series, ADFP 37 – Interim Edition, 1994, § 963.
The manual defines medical personnel as follows:
Medical personnel are those persons, military or civilian, assigned exclusively to medical tasks or to the administration of medical units or the operation or administration of medical transports. Such assignment may be permanent or temporary. In addition to doctors, dentists, nurses, medical orderlies and hospital administrators attached to the forces of military and civilian establishments, medical personnel include:
a.personnel of national Red Cross and other voluntary aid societies recognised and authorised by a party to the conflict;
b.medical personnel attached to civil defence units; and
c.any persons made available for humanitarian purposes by a neutral state, a recognised and authorised aid society of such a state, or an impartial international humanitarian organisation. 
Australia, Manual on Law of Armed Conflict, Australian Defence Force Publication, Operations Series, ADFP 37 – Interim Edition, 1994, § 521.
Australia
Australia’s LOAC Manual (2006) states that protected persons include “military and civilian medical personnel”. 
Australia, The Manual of the Law of Armed Conflict, Australian Defence Doctrine Publication 06.4, Australian Defence Headquarters, 11 May 2006, § 9.55; see also 9.68.
The manual defines medical personnel as follows:
Medical personnel are those persons, military or civilian, assigned exclusively to medical tasks or to the administration of medical units or the operation or administration of medical transports. Such assignment may be permanent or temporary. In addition to doctors, dentists, nurses, medical orderlies and hospital administrators attached to the forces or military and civilian establishments, medical personnel include:
• personnel of national Red Cross and other voluntary aid societies recognised and authorised by a party to the conflict;
• medical personnel attached to civil defence units; and
• any persons made available for humanitarian purposes by a neutral state, a recognised and authorised aid society of such a state, or an impartial international humanitarian organisation. 
Australia, The Manual of the Law of Armed Conflict, Australian Defence Doctrine Publication 06.4, Australian Defence Headquarters, 11 May 2006, § 9.71.
With regard to the identification of medical personnel, the manual states:
Identity cards are to be issued to … medical … personnel regardless of whether they are of permanent or temporary status. Under no circumstances are they to be deprived of this identification. Should circumstances prevent the issue of an identity card, a certificate may be issued temporarily until such time as a proper card can be issued. 
Australia, The Manual of the Law of Armed Conflict, Australian Defence Doctrine Publication 06.4, Australian Defence Headquarters, 11 May 2006, § 9.9.
In its chapter on “Weapons”, the manual states that “non-combatants and those who have not been or are no longer in the fight (sick and wounded, shipwrecked, medical personnel, chaplains and most civilians) must not be targeted”. 
Australia, The Manual of the Law of Armed Conflict, Australian Defence Doctrine Publication 06.4, Australian Defence Headquarters, 11 May 2006, § 4.30.
In its chapter on “Air Operations”, the manual states:
It is permitted to attack those who are not protected persons under the conventions while they are attempting to rescue aircrew who have crashed. However, rescuers such as medical personnel attempting to rescue injured airmen are protected. In such cases, the airman and his rescuers are protected in accordance with the Geneva Conventions. 
Australia, The Manual of the Law of Armed Conflict, Australian Defence Doctrine Publication 06.4, Australian Defence Headquarters, 11 May 2006, § 8.55.
Regarding loss of protected status, the manual states:
9.11 [Medical] personnel lose their protected status when … they engage in hostile acts, or attempt to shield military objectives from attack, other than circumstances in which:
- they use arms in self-defence or for the defence of the wounded and sick;
- they are used as guards, pickets and sentries for unit protection; and
- small arms and ammunition taken from the wounded and sick are found within a medical unit.
9.69 Military medical personnel, facilities and equipment are also entitled to general protection. However, they may lose this protection if they engage in acts harmful to the enemy. Before the protection of medical personnel and facilities is lost, a warning will normally be provided and reasonable time allowed to permit cessation of improper activities. In extreme cases, overriding military necessity may preclude such a warning. Protection will not be lost if medical members act in self-defence. Weapons may be carried. 
Australia, The Manual of the Law of Armed Conflict, Australian Defence Doctrine Publication 06.4, Australian Defence Headquarters, 11 May 2006, §§ 9.11 and 9.69; see also § 5.23.
The LOAC Manual (2006) replaces both the Defence Force Manual (1994) and the Commanders’ Guide (1994).
Belgium
Belgium’s Law of War Manual (1983) defines medical personnel with reference to Articles 24–25 of the 1949 Geneva Convention I and Article 8 of the 1977 Additional Protocol I. The manual states that permanent medical personnel “shall be respected and protected at all times: they may not be made the object of attack but may not participate in hostilities either”. According to the manual, temporary medical personnel “enjoy the same protection only when they perform medical functions”. 
Belgium, Droit Pénal et Disciplinaire Militaire et Droit de la Guerre, Deuxième Partie, Droit de la Guerre, Ecole Royale Militaire, par J. Maes, Chargé de cours, Avocat-général près la Cour Militaire, D/1983/1187/029, 1983, pp. 47–48.
Belgium
Belgium’s Teaching Manual for Soldiers states:
The protection accorded to the wounded would be illusory if the civilian and military medical services which are specifically set up to treat them could be attacked. Hence, medical services, identified by the Red Cross (or Red Crescent in certain countries), are not considered combatants or military objectives even if they wear the enemy uniform or bear its insignia. Enemy medical personnel … may not be attacked. 
Belgium, Droit de la Guerre, Dossier d’Instruction pour Soldat, à l’attention des officiers instructeurs, JS3, Etat-Major Général, Forces Armées belges, undated, p. 17; see also p. 8.
Benin
Benin’s Military Manual (1995) lists military and civilian medical personnel as specially protected persons. 
Benin, Le Droit de la Guerre, III fascicules, Forces Armées du Bénin, Ministère de la Défense nationale, 1995, Fascicule I, p. 13.
The manual states: “Specially protected persons may not take a direct part in hostilities and must not be attacked. They shall be allowed to carry out their tasks as long as the tactical situation permits.” 
Benin, Le Droit de la Guerre, III fascicules, Forces Armées du Bénin, Ministère de la Défense nationale, 1995, Fascicule III, p. 5; see also Fascicule II, p. 8.
The manual further states that military medical personnel must be respected. 
Benin, Le Droit de la Guerre, III fascicules, Forces Armées du Bénin, Ministère de la Défense nationale, 1995, Fascicule II, p. 16.
Bosnia and Herzegovina
Bosnia and Herzegovina’s Military Instructions (1992) provides: “It is prohibited to intentionally attack military medical personnel.” 
Bosnia and Herzegovina, Instructions on the Implementation of the International Law of War in the Armed Forces of the Republic of Bosnia and Herzegovina, Official Gazette of ABiH, No. 2/92, 5 December 1992, Item 15, § 3.
Burkina Faso
Burkina Faso’s Disciplinary Regulations (1994) provides that, under the laws and customs of war, soldiers in combat must respect medical personnel. 
Burkina Faso, Règlement de Discipline Générale dans les Forces Armées, Décret No. 94-159/IPRES/DEF, Ministère de la Défense, 1994, Article 35(1).
Burundi
Burundi’s Regulations on International Humanitarian Law (2007) states: “The medical personnel must be respected and protected. They may not be attacked.” 
Burundi, Règlement n° 98 sur le droit international humanitaire, Ministère de la Défense Nationale et des Anciens Combattants, Projet “Moralisation” (BDI/B-05), August 2007, Part I, p. 15; see also Part I, p. 11 and Part I bis, pp. 4, 9, 31, 34, 57 and 80.
The Regulations also states: “Medical personnel … attached to armed forces must be protected so that they can pursue their tasks independently from possible or actual military operations.” 
Burundi, Règlement n° 98 sur le droit international humanitaire, Ministère de la Défense Nationale et des Anciens Combattants, Projet “Moralisation” (BDI/B-05), August 2007, Part I bis, p. 34.
The Regulations further provides: “The protection accorded to the wounded, sick and shipwrecked extends to the medical personnel … tasked with assisting them.” 
Burundi, Règlement n° 98 sur le droit international humanitaire, Ministère de la Défense Nationale et des Anciens Combattants, Projet “Moralisation” (BDI/B-05), August 2007, Part I bis, p. 57.
The Regulations adds:
The protection granted to the wounded would be illusionary if the civilian and military medical services, which are specifically designated to care for them, could be attacked.
The medical services … are therefore not considered as combatants or military objectives even if they wear the same uniform or insignia as the adversary.
Medical personnel … of the adversary may not be attacked.
They may not even be distracted from their activities if, at the moment of capture, they are busy with assisting the wounded. 
Burundi, Règlement n° 98 sur le droit international humanitaire, Ministère de la Défense Nationale et des Anciens Combattants, Projet “Moralisation” (BDI/B-05), August 2007, Part I bis, p. 84.
The Regulations, referring to the “red cross on white ground”, further states that “[p]ersons and material that bear this sign are protected …[, namely] military or civilian personnel … [and] personnel attached permanently or temporarily to medical units or means of transport”. 
Burundi, Règlement n° 98 sur le droit international humanitaire, Ministère de la Défense Nationale et des Anciens Combattants, Projet “Moralisation” (BDI/B-05), August 2007, Part I bis, p. 7.
The Regulations further states: “Captured enemy military medical personnel may not be considered as prisoners of war. But they may nonetheless be retained for the sole purpose of caring for the wounded and sick without any distinction.” 
Burundi, Règlement n° 98 sur le droit international humanitaire, Ministère de la Défense Nationale et des Anciens Combattants, Projet “Moralisation” (BDI/B-05), August 2007, Part I bis, p. 25; see also Part I bis, pp. 11 and 57.
The Regulations adds: “Concerning captured enemy military medical personnel … , they must be repatriated as quickly as possible if their presence with the prisoners of war is no longer necessary.” 
Burundi, Règlement n° 98 sur le droit international humanitaire, Ministère de la Défense Nationale et des Anciens Combattants, Projet “Moralisation” (BDI/B-05), August 2007, Part I bis, p. 105.
Cameroon
Cameroon’s Disciplinary Regulations (1975) provides that, under the laws and customs of war, each soldier must respect medical personnel, “provided they wear the distinctive emblem and carry the special identity card defined by the Geneva Conventions”. 
Cameroon, Règlement de discipline dans les Forces Armées, Décret No. 75/700, 6 November 1975, Article 31.
Cameroon
Cameroon’s Instructor’s Manual (1992) considers both military and civilian medical personnel as specially protected persons. 
Cameroon, Droit international humanitaire et droit de la guerre, Manuel de l’instructeur en vigueur dans les Forces Armées, Présidence de la République, Ministère de la Défense, Etat-major des Armées, Troisième Division, Edition 1992, p. 18, §§ 220–221.
Cameroon
Cameroon’s Instructor’s Manual (2006) states:
352.2 – Special Protection: (Persons and Objects Specially Protected.)
Certain categories of persons and objects benefit from special protection under the law of armed conflict and international humanitarian law, both in the civilian domain and in the military domain.
352.20. Military Medical Services
… Medical personnel are those assigned to medical units generally integrated in hospital zones and localities which are protected and can equally comprise safety zones and localities.
352.21 Civilian Medical Services
The legislation is identical to that regarding military medical services. Nonetheless, one of the following conditions must [also] be fulfilled:
- belonging to a party to the conflict;
- being recognized by a competent authority (of one of the parties to the conflict);
- being at the service of one of the parties to the conflict. 
Cameroon, Droit des conflits armés et droit international humanitaire, Manuel de l’instructeur en vigueur dans les forces de défense, Ministère de la Défense, Présidence de la République, Etat-major des Armées, 2006, pp. 92–93, §§ 352.2–352.21; see also pp. 134–135, §§ 412.2–412.21.
The manual also states:
Protection of Non-Combatants in Combat Zones
Medical and religious personnel must fulfil their tasks under the special protection of the belligerents; amongst other things, they must provide assistance in the various combat zones and when circumstances require.
1. Medical Personnel
Medical personnel must be respected and protected in order to be able to act in favour of the wounded. Since they exercise their medical activities in the interest of the wounded, they must be able to do so without any doubt or constraint. 
Cameroon, Droit des conflits armés et droit international humanitaire, Manuel de l’instructeur en vigueur dans les forces de défense, Ministère de la Défense, Présidence de la République, Etat-major des Armées, 2006, p. 229, § 541.
The manual further states under the heading “Protection of Persons and Objects”:
3. Enemy Military Medical Personnel
Medical personnel of captured units and medical transports must be free to pursue their tasks in situations when the capturing force is not yet able to provide for the care for the wounded and sick in these units or transports. 
Cameroon, Droit des conflits armés et droit international humanitaire, Manuel de l’instructeur en vigueur dans les forces de défense, Ministère de la Défense, Présidence de la République, Etat-major des Armées, 2006, p. 122, § 403; see also p. 164, § 463.
The manual also provides under the heading “Protection in Case of Evacuation”:
d) Enemy Medical Military Personnel
The evacuation of enemy medical military personnel is to be carried out via a medical channel and only when those personnel are no longer needed by the wounded and shipwrecked. They may be called upon to carry out medical tasks during the evacuation. 
Cameroon, Droit des conflits armés et droit international humanitaire, Manuel de l’instructeur en vigueur dans les forces de défense, Ministère de la Défense, Présidence de la République, Etat-major des Armées, 2006, p. 124, § 404; see also p. 166, § 463.
The manual further provides under the heading “Enemy Medical Military Personnel”:
These personnel are not prisoners of war, but they benefit from all provisions of the Third Geneva Convention [1949 Geneva Convention III] regarding the treatment of prisoners of war.
But the temporary medical military personnel, being deployed to their missions, will be prisoners of war. 
Cameroon, Droit des conflits armés et droit international humanitaire, Manuel de l’instructeur en vigueur dans les forces de défense, Ministère de la Défense, Présidence de la République, Etat-major des Armées, 2006 . p. 122, § 403.
Cameroon
Cameroon’s Disciplinary Regulations (2007) states:
Article 31: Humanitarian rules
Every soldier must:
respect medical units, establishments and transports, hospital zones and localities, places where the wounded and sick, civilian or military, are collected, the emblems of the Red Cross, the Red Crescent and national Red Cross and Red Crescent societies, which are protective signs as such, as well as medical personnel;
For the application of the rules addressed in the two preceding paragraphs,
the medical and religious personnel, apart from their distinctive emblem, must carry the special identity card defined by the Geneva Conventions.
These rules apply to the extent possible to operations undertaken by airplanes and navy ships against targets on land or at sea. 
Cameroon, Règlement de discipline générale dans les forces de défense, Décret N° 2007/199, Président de la République, 7 July 2007, Article 31.
Canada
Canada’s LOAC Manual (1999) defines medical personnel as follows:
“Medical personnel” are those persons, military or civilian, assigned exclusively to medical purposes or to the administration of medical units, or the operation or administration of medical transports. Such assignment may be permanent or temporary. In addition to doctors, dentists, nurses, medical orderlies, and hospital administrators, “medical personnel” includes personnel of national Red Cross and other voluntary aid societies recognized and authorized by a party to the conflict. The term also includes medical personnel attached to civil defence units, any persons made available for humanitarian purposes by a neutral state, a recognized and authorized aid society of such a state, or an impartial international humanitarian organization. 
Canada, The Law of Armed Conflict at the Operational and Tactical Level, Office of the Judge Advocate General, 1999, p. 9-3, § 27.
The manual states: “Medical … personnel, both military and civilian, have protected status and thus shall not be attacked. 
Canada, The Law of Armed Conflict at the Operational and Tactical Level, Office of the Judge Advocate General, 1999, p. 4-5, § 41.
The manual further states: “Humanitarian aid societies, such as the Red Cross or Red Crescent Societies, who on their own initiative, collect and care for the wounded, sick and shipwrecked, even in invaded or occupied areas, shall not be made the object of attack.” 
Canada, The Law of Armed Conflict at the Operational and Tactical Level, Office of the Judge Advocate General, 1999, p. 4-6, § 53.
With respect to non-international armed conflicts in particular, the manual states: “Medical … personnel are to be respected and protected at all times [and] receive all available aid to enable them to fulfil their duties.” 
Canada, The Law of Armed Conflict at the Operational and Tactical Level, Office of the Judge Advocate General, 1999, p. 17-4, § 34.
Canada
Rule 10 of Canada’s Code of Conduct (2001) states:
There are two categories of medical personnel: permanent and temporary. Permanent medical personnel include doctors, nurses and medical assistants who are engaged exclusively in the collection, transport or treatment of the sick or wounded, or in the prevention of disease; staff exclusively engaged in the administration of medical units and establishments; and chaplains attached to the armed forces. These people shall be respected and protected. They must not be attacked. … If captured, permanent medical personnel and chaplains, although detained, will continue to care for their sick and wounded. If there is no such medical requirement, they are to be released and returned to their own forces. Temporary medical personnel may be employed on a part-time basis as hospital orderlies or temporary stretcher bearers in the search for and collection, transport and treatment of the sick and wounded. Part-time medical personnel are protected when they are carrying out those duties and shall not be the object of attack … Captured temporary medical personnel who are detained may be employed on medical duties. Unlike permanent medical personnel, temporary medical personnel do not have to be released to their side even if there is no medical requirement for their services.
Under the Law of Armed Conflict, the International Committee of the Red Cross (ICRC) has a special role and status. The ICRC may undertake to care for the wounded and sick. The ICRC is an independent humanitarian institution. As a neutral intermediary in the event of armed conflict it endeavours, on its own initiative or on the basis of the Geneva Conventions, to bring protection and assistance to the victims of armed conflict. Members of the ICRC wear the distinctive emblem. As such, they must be protected at all times.
NGOs such as CARE and Médecins Sans Frontières (Doctors Without Borders) might wear other recognizable symbols. The symbols used by CARE, MSF and other NGOs do not benefit from international legal protection, although their work in favour of the victims of armed conflict must be respected. Upon recognition that they are providing care to the sick and wounded, NGOs are also to be respected. 
Canada, Code of Conduct for CF Personnel, Office of the Judge Advocate General, 4 June 2001, Rule 10, §§ 2–3, 7 and 9.
Canada
Canada’s LOAC Manual (2001) states in its chapter entitled “Combatant Status”:
1. Personnel of the armed forces permanently assigned to medical activities, to the administration of medical units and to medical transport (“medical duties”) are non-combatants. They may not be attacked. If captured, permanent medical personnel will be returned to their own armed forces unless they are retained by the detaining power to assist PWs [prisoners of war].
2. Personnel of the armed forces temporarily assigned to medical duties during a limited period of time, such as stretcher-bearers, are non-combatants when engaged in such duties. They may not be attacked while engaged in medical duties. If captured, temporary medical personnel become PWs. 
Canada, The Law of Armed Conflict at the Operational and Tactical Levels, Office of the Judge Advocate General, 13 August 2001, § 311.
In its chapter on targeting, the manual states:
Medical and religious personnel, both military and civilian, have protected status and thus shall not be attacked. These persons wear the Red Cross or Red Crescent … and carry identity cards which identify them as protected persons. 
Canada, The Law of Armed Conflict at the Operational and Tactical Levels, Office of the Judge Advocate General, 13 August 2001, § 432.
The manual further states:
Humanitarian aid societies, such as the Red Cross or Red Crescent Societies, who on their own initiative, collect and care for the wounded, sick and shipwrecked, even in invaded or occupied areas, shall not be made the object of attack. 
Canada, The Law of Armed Conflict at the Operational and Tactical Levels, Office of the Judge Advocate General, 13 August 2001, § 438.
In its chapter on the treatment of the wounded, sick and shipwrecked, the manual states:
“Medical personnel” are those persons, military or civilian, assigned exclusively to medical purposes or to the administration of medical units, or the operation or administration of medical transports. Such assignment may be permanent or temporary. In addition to doctors, dentists, nurses, medical orderlies, and hospital administrators, “medical personnel” includes personnel of national Red Cross and other voluntary aid societies recognized and authorized by a party to the conflict. The term also includes medical personnel attached to civil defence units, any persons made available for humanitarian purposes by a neutral state, a recognized and authorized aid society of such a state, or an impartial international humanitarian organization. 
Canada, The Law of Armed Conflict at the Operational and Tactical Levels, Office of the Judge Advocate General, 13 August 2001, § 914.1.
In its chapter entitled “Treatment of civilians in the hands of a party to the conflict or an occupying power”, the manual states:
3. Protection and respect must be extended to persons regularly and solely engaged in the operation and administration of civilian hospitals. Included in this category are persons engaged in the search for, removal, transport and care of wounded and sick civilians. In occupied territory and in zones of military operations such personnel must carry an identity card certifying their status, bearing the photograph of the holder and stamped by the responsible authority. The belligerents must also issue to them special armlets (bearing the Red Cross or equivalent emblem), to be worn while they are carrying out their duties.
4. Other persons, engaged in the operation and administration of civilian hospitals, are entitled to protection, and to wear the armlet while employed on their duties. Their identity cards must state what those duties are. The management of each hospital must hold at the disposal of the competent national or occupying authorities an up-to-date list of the personnel employed in the hospital. 
Canada, The Law of Armed Conflict at the Operational and Tactical Levels, Office of the Judge Advocate General, 13 August 2001, § 1111.3–4.
In its chapter on non-international armed conflicts, the manual states: “Medical and religious personnel are to be respected and protected at all times [and to] receive all available aid to enable them to fulfil their duties.” 
Canada, The Law of Armed Conflict at the Operational and Tactical Levels, Office of the Judge Advocate General, 13 August 2001, § 1719.2.
In its glossary, the manual notes the following as “medical duties”:
a. the search for the wounded, sick and shipwrecked;
b. the collection, transportation, diagnosis or treatment (including first aid treatment) of the wounded, sick and shipwrecked; and
c. medical activities for the prevention of disease. 
Canada, The Law of Armed Conflict at the Operational and Tactical Levels, Office of the Judge Advocate General, 13 August 2001, Glossary, p. GL-11.
Canada
Rule 10 of Canada’s Code of Conduct (2005) states:
Medical and Protected Personnel
2. There are two categories of medical personnel: permanent and temporary. Permanent medical personnel include doctors, nurses and medical assistants who are engaged exclusively in the collection, transport or treatment of the sick or wounded, or in the prevention of disease; staff exclusively engaged in the administration of medical units and establishments; and chaplains attached to the armed forces. These people shall be respected and protected. They must not be attacked … If captured permanent medical personnel and chaplains although detained, will continue to care for their sick and wounded. If there is no such medical requirement, they are to be released and returned to their own forces.
3. Temporary medical personnel may be employed on a part-time basis as hospital orderlies or temporary stretcher bearers in the search for and collection, transport and treatment of the sick and wounded. Part-time medical personnel are protected when they are carrying out those duties and shall not be the object of attack … Captured temporary medical personnel who are detained may be employed on medical duties. Unlike permanent medical personnel, temporary medical personnel do not have to be released to their side even if there is no medical requirement for their services.
International Committee of the Red Cross
7. Under the Law of Armed Conflict, the International Committee of the Red Cross (ICRC) has a special role and status. The ICRC may undertake to care for the wounded and sick. The ICRC is an independent humanitarian institution. As a neutral intermediary in the event of armed conflict it endeavours, on its own initiative or on the basis of the Geneva Conventions, to bring protection and assistance to the victims of armed conflict. Members of the ICRC wear the distinctive emblem. As such, they must be protected at all times.
Non-Governmental Organizations
9. NGOs such as CARE and Médecins Sans Frontières (Doctors Without Borders) might wear other recognizable symbols. The symbols used by CARE, MSF and other NGOs do not benefit from international legal protection, although their work in favour of the victims of armed conflict must be respected. Upon recognition that they are providing care to the sick and wounded, NGOs are also to be respected. 
Canada, Code of Conduct for CF Personnel, Office of the Judge Advocate General, 2005, Rule 10, §§ 2–3, 7 and 9.
Central African Republic
The Central African Republic’s Instructor’s Manual (1999) states in Volume 1 (Basic and team leader instruction): “The military and civilian medical services … enjoy special protection.” 
Central African Republic, Le Droit de la Guerre, Fascicule No. 1: Formation élémentaire toutes armés (FETA), formation commune de base (FCB), certificat d’aptitude technique No. 1 (Chef d’équipe), Ministère de la Défense, Forces Armées Centrafricaines, 1999, Chapter II, Section II, § 1; see also Le Droit de la Guerre, Fascicule No. 2: Formation pour l’obtention du certificat technique No. 2 (Chef de Groupe), du certificat Inter-Armé (CIA), du certificat d’aptitude de Chef de Patrouille (CACP), Ministère de la Défense, Forces Armées Centrafricaines, 1999, Chapter I, Fundamental Rules, § 3.
In Volume 2 (Instruction for group and patrol leaders), the manual states:
Specially protected personnel [military and civilian medical services, as identified in Volume 1 of this manual] are authorized to carry out their tasks unless the tactical situation does not allow it. The mission and actual activities of such personnel may be checked. 
Central African Republic, Le Droit de la Guerre, Fascicule No. 2: Formation pour l’obtention du certificat technique No. 2 (Chef de Groupe), du certificat Inter-Armé (CIA), du certificat d’aptitude de Chef de Patrouille (CACP), Ministère de la Défense, Forces Armées Centrafricaines, 1999, Chapter II, Section II, § 2.1.
Also in Volume 2, the manual states: “Military medical personnel and their equipment identified by the distinctive symbols and by distinctive radio signals must be respected.” 
Central African Republic, Le Droit de la Guerre, Fascicule No. 2: Formation pour l’obtention du certificat technique No. 2 (Chef de Groupe), du certificat Inter-Armé (CIA), du certificat d’aptitude de Chef de Patrouille (CACP), Ministère de la Défense, Forces Armées Centrafricaines, 1999, Chapter IV, Section IV.
Central African Republic
The Central African Republic’s Disciplinary Regulations (2009) states: “In accordance with the international conventions signed or approved by the Central African Government, it is stipulated that during combat servicemen must: … respect … medical personnel”. 
Central African Republic, Décret 09.411 portant règlement de discipline générale dans les Armées, Ministre de la Défense Nationale, des Anciens Combattants, des Victimes de Guerre, du Désarmement et de la Restructuration de l’Armée, 10 December 2009, Article 12(10).
Chad
Chad’s Instructor’s Manual (2006) states that medical personnel are protected: “[They] may not take part in hostilities and may not be attacked” but “may lose their protection if they take part in the fighting”. 
Chad, Droit international humanitaire, Manuel de l’instructeur en vigueur dans les forces armées et de sécurité, Ministère de la Défense, Présidence de la République, Etat-major des Armées, 2006, p. 16; see also pp. 34, 36 and 88.
The manual also states: “An enemy nurse or doctor who is taken captive may continue to treat the wounded who were under his or her care in the field.” 
Chad, Droit international humanitaire, Manuel de l’instructeur en vigueur dans les forces armées et de sécurité, Ministère de la Défense, Présidence de la République, Etat-major des Armées, 2006, p. 88.
The manual further states that attacking medical personnel is a war crime. 
Chad, Droit international humanitaire, Manuel de l’instructeur en vigueur dans les forces armées et de sécurité, Ministère de la Défense, Présidence de la République, Etat-major des Armées, 2006, p. 78.
Colombia
Colombia’s Circular on Fundamental Rules of IHL (1992) states that the protection due to the wounded and sick “also covers, as such, medical personnel”. 
Colombia, Transcripción Normas Fundamentales del Derecho Humanitario Aplicables en los Conflictos Armados, Circular No. 033/DIPL-SERPO-526, Policía Nacional, Dirección General, Santafé de Bogotá, 14 May 1992, § 3.
Colombia
Colombia’s Basic Military Manual (1995) states that it is prohibited “to attack … medical and aid personnel”. 
Colombia, Derecho Internacional Humanitario – Manual Básico para las Personerías y las Fuerzas Armadas de Colombia, Ministerio de Defensa Nacional, 1995, p. 29, § 2.a.
Congo
Congo’s Disciplinary Regulations (1986) provides that medical personnel must be respected. 
Congo, Décret No. 86/057 du 14 janvier 1986 portant Règlement du Service dans l’Armée Populaire Nationale, 1986, Article 32.
Côte d’Ivoire
Côte d’Ivoire’s Teaching Manual (2007) provides in Book I (Basic instruction):
Lesson 1. Basic notions of IHL
The principle of distinction specifies who and what can be attacked and who and what cannot be attacked.
- Who and what must be protected?
- medical personnel …
Lesson 2. Identification
II.2 Persons and objects under special protection
- medical personnel …
Lesson 3. Rules of behaviour in combat
15. Respect medical personnel, material and establishments. 
Côte d’Ivoire, Droit de la guerre, Manuel d’instruction, Livre I: Instruction de base, Ministère de la Défense, Forces Armées Nationales, November 2007, pp. 14–15, 17, 19, 21 and 26.
In Book III, Volume 2 (Instruction of second-year trainee officers), the Teaching Manual provides:
I.3. Protection of military medical and religious personnel
The law gives civilian medical and religious personnel the same status as military medical and religious personnel. Both must be respected and protected. It is appropriate to do everything to allow them to carry out their activities.
Combatants, temporarily used as nursing auxiliaries, from the legal point of view remain combatants. In fact, it can, for example, be urgently necessary to have stretcher-bearers to take the wounded from the frontline. They are therefore clearly combatants entrusted with a temporary mission, and not medical personnel in the sense described above. Nevertheless, they must be respected and protected while they fulfil their medical functions. If they are captured, they are prisoners of war. 
Côte d’Ivoire, Droit de la guerre, Manuel d’instruction, Livre III, Tome 2: Instruction de l’élève officier d’active de 2ème année, Manuel de l’instructeur, Ministère de la Défense, Forces Armées Nationales, November 2007, pp. 26–27; see also Droit de la guerre, Manuel d’instruction, Livre IV: Instruction du chef de section et du commandant de compagnie, Manuel de l’élève, Ministère de la Défense, Forces Armées Nationales, November 2007, p. 33.
Croatia
Croatia’s Commanders’ Manual (1992) states: “Specifically protected persons may not participate directly in hostilities and may not be attacked. They shall be allowed to perform their tasks, when the tactical situation permits.” Such persons include military and civilian medical personnel. 
Croatia, Basic Rules of the Law of Armed Conflicts – Commanders’ Manual, Republic of Croatia, Ministry of Defence, 1992, §§ 7 and 12.
Croatia
Croatia’s Soldiers’ Manual (1992) instructs soldiers to respect medical personnel. 
Croatia, Rules of Conduct for Soldiers, Republic of Croatia, Ministry of Defence, 1992, pp. 2 and 3
Dominican Republic
The Dominican Republic’s Military Manual (1980) instructs soldiers not to attack medical personnel, but to protect them.  
Dominican Republic, La Conducta en Combate según las Leyes de la Guerra, Escuela Superior de las FF. AA. “General de Brigada Pablo Duarte”, Secretaría de Estado de las Fuerzas Armadas, May 1980, p. 4.
Ecuador
Ecuador’s Naval Manual (1989) states that “medical personnel, including medical and dental officers, technicians and corpsmen, nurses, and medical service personnel, have special protected status when engaged exclusively in medical duties and may not be attacked”. 
Ecuador, Aspectos Importantes del Derecho Internacional Marítimo que Deben Tener Presente los Comandantes de los Buques, Academia de Guerra Naval, 1989, § 11.5.
The manual qualifies “deliberate attack upon … medical personnel” as a war crime. 
Ecuador, Aspectos Importantes del Derecho Internacional Marítimo que Deben Tener Presente los Comandantes de los Buques, Academia de Guerra Naval, 1989, § 6.2.5.
El Salvador
El Salvador’s Soldiers’ Manual provides:
Doctors, nurses and other medical … personnel who serve in hospitals or work for the Red Cross … shall be specially protected because they relieve, aid and comfort all victims without distinction between friend and foe. 
El Salvador, Manual del Combatiente, undated, p. 12.
France
France’s Disciplinary Regulations (1975), as amended, provides that soldiers in combat must respect and protect medical personnel. 
France, Règlement de Discipline Générale dans les Armées, Decree No. 75-675 of 28 July 1975, replacing Decree No. 66-749, completed by Decree of 11 October 1978, implemented by Instruction No. 52000/DEF/C/5 of 10 December 1979, and modified by Decree of 12 July 1982, Ministère de la Défense, Etat-Major de l’Armée de Terre, Bureau Emploi, Article 9 bis.
France
France’s LOAC Summary Note (1992) provides: “The specific immunity granted to certain persons and objects by the law of war [including the personnel of military and civilian medical services] must be strictly observed … They may not be attacked.” 
France, Fiche de Synthèse sur les Règles Applicables dans les Conflits Armés, Note No. 432/DEF/EMA/OL.2/NP, Général de Corps d’Armée Voinot (pour l’Amiral Lanxade, Chef d’Etat-major des Armées), 1992, §§ 2.2 and 2.3.
France
France’s LOAC Manual (2001) states: “The law of armed conflicts provides special protection for the following persons: … medical personnel attached to armed forces [and] civilian medical personnel.” 
France, Manuel de droit des conflits armés, Ministère de la Défense, Direction des Affaires Juridiques, Sous-Direction du droit international humanitaire et du droit européen, Bureau du droit des conflits armés, 2001, pp. 95–96.
Under the heading “Red Cross and Red Crescent (rules of protection)”, the manual also provides: “The protection is linked to the medical purposes of the actions undertaken and finds its expression in the limitation of detention, [and] in the granting of facilities when that personnel carries out its activity”. 
France, Manuel de droit des conflits armés, Ministère de la Défense, Direction des Affaires Juridiques, Sous-Direction du droit international humanitaire et du droit européen, Bureau du droit des conflits armés, 2001, p. 46.
Germany
Germany’s Military Manual (1992) defines military medical personnel with reference to the relevant provisions of the 1949 Geneva Conventions and of the 1977 Additional Protocol I. 
Germany, Humanitarian Law in Armed Conflicts – Manual, DSK VV207320067, edited by The Federal Ministry of Defence of the Federal Republic of Germany, VR II 3, August 1992, English translation of ZDv 15/2, Humanitäres Völkerrecht in bewaffneten Konflikten – Handbuch, August 1992, § 625.
The manual provides: “Civilian and military medical personnel are entitled to special protection. They shall neither be made the object of attack nor prevented from exercising their functions.” 
Germany, Humanitarian Law in Armed Conflicts – Manual, DSK VV207320067, edited by The Federal Ministry of Defence of the Federal Republic of Germany, VR II 3, August 1992, English translation of ZDv 15/2, Humanitäres Völkerrecht in bewaffneten Konflikten – Handbuch, August 1992, § 624.
The manual considers offences such as “wilful killing, mutilation, torture or inhumane treatment, including biological experiments, wilfully causing great suffering, serious injury to body or health” committed against medical personnel, to be grave breaches of IHL. 
Germany, Humanitarian Law in Armed Conflicts – Manual, DSK VV207320067, edited by The Federal Ministry of Defence of the Federal Republic of Germany, VR II 3, August 1992, English translation of ZDv 15/2, Humanitäres Völkerrecht in bewaffneten Konflikten – Handbuch, August 1992, § 1209.
Germany
Germany’s Soldiers’ Manual (2006) states: “Medical personnel exclusively assigned to medical purposes are under the special protection of international humanitarian law.” 
Germany, Druckschrift Einsatz Nr. 03, Humanitäres Völkerrecht in bewaffneten Konflikten - Grundsätze, Erarbeitet nach ZDv 15/2, Humanitäres Völkerrecht in bewaffneten Konflikten - Handbuch, DSK SF009320187, Bundesministerium der Verteidigung, R II 3, August 2006, p. 5.
Greece
The Hellenic Territorial Army’s Internal Service Code (1984), as amended, provides that members of the armed forces should respect the personnel of hospitals and places where wounded and sick are gathered. 
Greece, Hellenic Territorial Army Regulation of Internal Service Code, Presidential Decree 130/1984 (Military Regulation 20-1), as amended, Article 14(d).
Guinea
Guinea’s Soldier’s Manual (2010), under the heading “Distinctive signs” displays an image of a person bearing a red cross on a white ground and states: “Let these persons complete their task.” 
Guinea, Soldier’s Manual, Ministry of National Defence, 2010, p. 12.
Under same the heading and in a section on “Medical services (military and civilian)”, the manual lists the red cross, red crescent and red crystal on a white ground and states: “Respect those bearing … these signs.” 
Guinea, Soldier’s Manual, Ministry of National Defence, 2010, p. 11.
Hungary
Hungary’s Military Manual (1992) instructs soldiers to respect and protect permanent medical personnel. 
Hungary, A Hadijog, Jegyzet a Katonai, Föiskolák Hallgatói Részére, Magyar Honvédség Szolnoki Repülötiszti Föiskola, 1992, p. 19.
Indonesia
Indonesia’s Field Manual (1979) restates the rules on medical personnel found in Articles 24–26 of the 1949 Geneva Convention I. 
Indonesia, Field Manual concerning the Treatment of Prisoners of War, Department of Defence, 1979, §§ 6–8.
Indonesia
Indonesia’s Air Force Manual (1990) provides: “A non-combatant is not a lawful military target in warfare. They consist of: a. members of the armed forces with special status such as … medical personnel.” 
Indonesia, The Basics of International Humanitarian Law in Air Warfare, Indonesian Air Force, 1990, § 24(a).
Ireland
Ireland’s Basic LOAC Guide (2005) states: “Prohibited targets include … medical personnel”. 
Ireland, Basic Guide to the Law of Armed Conflict, TP/TRG/01-2005, Director of Defence Forces Training, Department of Defence, July 2005, p. 4.
The manual also states:
Medical personnel engaged in the search for, or the collection, transport, or treatment of the wounded or sick must be respected and protected in all circumstances. …
Medical … personnel include:
- personnel (doctors, orderlies, nurses, stretcher-bearers) assigned, whether permanently or temporarily, exclusively to medical purposes (search for, collection, transportation, diagnosis and treatment of the wounded and sick, and for the prevention of disease);
- personnel (administrators, drivers, cooks, etc.) assigned, whether permanent or temporary, to the administration or operation of medical units or medical transport;
If medical … personnel fall into “enemy” hands, they shall be allowed to continue their duties towards the wounded and sick. 
Ireland, Basic Guide to the Law of Armed Conflict, TP/TRG/01-2005, Director of Defence Forces Training, Department of Defence, July 2005, pp. 6–7.
Israel
Israel’s Manual on the Laws of War (1998) states:
It is prohibited to interfere with the administration of medical aid … In fact, this prohibition also covers the attack on medical personnel, paramedics and doctors in the battlefield itself. According to the Geneva Convention, medical teams are not part of the armed conflict. They are marked with distinctive identification signs, they do not carry arms, they do not cause injury and it is forbidden to harm them. It is prohibited to shoot a paramedic in the battlefield or to take him prisoner. The medical team is also restricted in that it does not take part in the hostilities, does not carry any weapons and is committed to administering medical aid also to the enemy’s wounded. In actuality, this provision is not observed in the wars and confrontations waged in the Middle East, at least not in regard to medical teams in the field. They are not immune to harm, they are not identified by special identification symbols, they bear arms and take part in the fighting. This situation also exists in many other armies around the world, including the American army. 
Israel, Laws of War in the Battlefield, Manual, Military Advocate General Headquarters, Military School, 1998, pp. 32–33.
Israel
Israel’s Manual on the Rules of Warfare (2006) states:
It is absolutely forbidden to attack the medical facilities of the enemy including military medical facilities and it is forbidden to attack the enemy’s wounded. This ban also applies to attacks on medical personnel, paramedics and doctors in the battlefield. According to the Geneva Convention medical teams are not part of the fighting force, they are marked with recognised insignia and do not carry arms. They do not attack and it is forbidden to attack them. It is forbidden to open fire on a medic on the battlefield and he/she must not be taken into captivity, providing the medical team is not participating directly in the war and does not carry arms. … In wars and confrontations in the Middle East, the medical teams have not worn special insignia; they participate in the fighting, consequently they are not protected from being attacked. 
Israel, Rules of Warfare on the Battlefield, Military Advocate-General’s Corps Command, IDF School of Military Law, Second Edition, 2006, p. 24.
The Manual on the Rules of Warfare (2006) is a second edition of the Manual on the Laws of War (1998).
Italy
Italy’s LOAC Elementary Rules Manual (1991) states: “Specifically protected persons may not participate directly in hostilities and may not be attacked.” Such persons include military and civilian medical personnel. 
Italy, Regole elementari di diritto di guerra, SMD-G-012, Stato Maggiore della Difesa, I Reparto, Ufficio Addestramento e Regolamenti, Rome, 1991, §§ 7 and 12.
Kenya
Kenya’s LOAC Manual (1997) states:
Medical personnel are those exclusively assigned to medical units and engaged in the search for, or the collection, transport or treatment of the wounded and sick, or in the prevention of disease. They are to be respected, protected and not attacked. Military medical personnel who are captured during an international armed conflict are not prisoners of war. They may be “retained” for the sole purpose of providing medical care for POWs [prisoners of war] of their own forces … Military medical personnel who may have medical duties to perform on a temporary basis, e.g. stretcher bearers, may not be attacked while performing medical duties. On capture, they become POWs but are to be employed on medical duties if the need arises. 
Kenya, Law of Armed Conflict, Military Basic Course (ORS), 4 Précis, The School of Military Police, 1997, Précis No. 3, p. 9.
Lebanon
Lebanon’s Teaching Manual (1997) provides for respect for medical personnel, without distinguishing between military and civilian personnel. 
Lebanon, Manuel de l’Instruction Nationale dans l’Armée Libanaise, 1997, p. 77.
Madagascar
Madagascar’s Military Manual (1994) defines medical personnel as “those exclusively assigned to medical units and medical transports” whether military or civilian. Their tasks consist in “the search for, collection, transportation, diagnosis or treatment of the wounded, sick, and shipwrecked, or the prevention of disease”. 
Madagascar, Le Droit des Conflits Armés, Ministère des Forces Armées, August 1994, Fiche No. 3-SO, §§ B and C.
The manual states: “Specifically protected persons may not participate directly in hostilities and may not be attacked. They shall be allowed to perform their tasks, when the tactical situation permits.” Such persons include military and civilian medical personnel. 
Madagascar, Le Droit des Conflits Armés, Ministère des Forces Armées, August 1994, Fiche No. 2-O, § 7 and Fiche No. 3-O, § 12.
Mali
Mali’s Army Regulations (1979) provides that, according to the laws and customs of war, soldiers in combat must respect medical personnel. 
Mali, Règlement du Service dans l’Armée, 1ère Partie: Discipline Générale, Ministère de la Défense Nationale, 1979, Article 36.
Mexico
Mexico’s Army and Air Force Manual (2009), in a section on the 1949 Geneva Conventions, states: “Medical personnel engaged in searching for, collecting, transporting and caring for the sick and wounded, preventing illness and disease and managing health facilities and institutions … must be respected and protected in all circumstances.” 
Mexico, Manual de Derecho Internacional Humanitario para el Ejército y la Fuerza Área Mexicanos, Ministry of National Defence, June 2009, § 74.
Mexico
Mexico’s IHL Guidelines (2009), in a section entitled “Basic rules of conduct in armed conflict”, states: “Do not attack medical … personnel. Ensure their protection.” 
Mexico, Cartilla de Derecho Internacional Humanitario, Ministry of National Defence, 2009, § 14(i); see also § 14(f).
Morocco
Morocco’s Disciplinary Regulations (1974) provides that, according to the laws and customs of war, soldiers in combat must respect medical personnel. 
Morocco, Règlement de Discipline Général dans les Forces Armées Royales, Dahir No. 1-74-383 du 15 rejeb 1394, 5 August 1974, Article 25(1).
Netherlands
The Military Manual (1993) of the Netherlands defines medical personnel with reference to Article 25 of the 1949 Geneva Convention I and Article 8 of the 1977 Additional Protocol I. 
Netherlands, Toepassing Humanitair Oorlogsrecht, Voorschift No. 27-412/1, Koninklijke Landmacht, Ministerie van Defensie, 1993, p. VI-4.
The manual states: “Medical personnel … must be respected and protected.” 
Netherlands, Toepassing Humanitair Oorlogsrecht, Voorschift No. 27-412/1, Koninklijke Landmacht, Ministerie van Defensie, 1993, p. VI-4.
With respect to non-international armed conflicts in particular, the manual states: “Medical personnel … must be respected and protected and must receive aid to fulfil their tasks.” 
Netherlands, Toepassing Humanitair Oorlogsrecht, Voorschift No. 27-412/1, Koninklijke Landmacht, Ministerie van Defensie, 1993, pp. XI-5 and XI-6.
Netherlands
The Military Handbook (1995) of the Netherlands states:
Medical personnel engaged temporarily or permanently in the care of the wounded and the sick must be able to fulfil their humanitarian tasks under all circumstances. Persons in charge of the administration and operation of medical units and material (for example administrative personnel, cooks and drivers) belong to the medical personnel. This personnel may not be attacked. 
Netherlands, Handboek Militair, Ministerie van Defensie, 1995, p. 7-40.
Netherlands
The Military Manual (2005) of the Netherlands states: “Medical (and religious) personnel must be respected and protected.” 
Netherlands, Humanitair Oorlogsrecht: Handleiding, Voorschift No. 27-412, Koninklijke Landmacht, Militair Juridische Dienst, 2005, § 0617.
The manual further states:
Rendering humanitarian assistance never means involvement in the conflict.
Examples:
- The immunity granted to medical personnel is coupled with the obligation of such personnel to refrain from any hostile action.
- No one may be harassed or condemned for helping the wounded or sick. 
Netherlands, Humanitair Oorlogsrecht: Handleiding, Voorschift No. 27-412, Koninklijke Landmacht, Militair Juridische Dienst, 2005, § 0224(a).
In its chapter on combatants, the manual states: “The term ‘non-combatant’ is used for anyone who is not a combatant. This includes all civilians … It also includes medical personnel”. 
Netherlands, Humanitair Oorlogsrecht: Handleiding, Voorschift No. 27-412, Koninklijke Landmacht, Militair Juridische Dienst, 2005, § 0305.
The manual further states:
[Medical and religious personnel] may be held by the adversary only as long as the state of health, spiritual needs and numbers of prisoners of war require. During the time of detention of medical personnel by the adversary, they must at least enjoy the benefits of the Prisoner of War Convention [1949 Geneva Convention III]. They must be returned if the medical or religious activities are not necessary and military circumstances make a return possible. The exception is that medical auxiliaries are treated as prisoners of war. 
Netherlands, Humanitair Oorlogsrecht: Handleiding, Voorschift No. 27-412, Koninklijke Landmacht, Militair Juridische Dienst, 2005, § 0618.
In addition, the manual provides: “Military members of the medical and religious personnel are not treated as prisoners of war. The detaining power may require them to lend support and assistance to prisoners of war.” 
Netherlands, Humanitair Oorlogsrecht: Handleiding, Voorschift No. 27-412, Koninklijke Landmacht, Militair Juridische Dienst, 2005, § 0704.
In its chapter on non-international armed conflict, the manual states:
Medical and religious personnel must be respected, protected and helped in fulfilling their duties. They may not be forced to carry out tasks incompatible with their humanitarian mission. 
Netherlands, Humanitair Oorlogsrecht: Handleiding, Voorschift No. 27-412, Koninklijke Landmacht, Militair Juridische Dienst, 2005, § 1057.
New Zealand
New Zealand’s Military Manual (1992) provides:
Medical personnel are those persons, military or civilian, assigned exclusively to medical purposes or to the administration of medical units or the operation or administration of medical transports, and such assignment may be permanent or temporary. In addition to doctors, dentists, nurses, medical orderlies, hospital administrators and the like, attached to the forces or military and civilian establishments, there are included the personnel of national Red Cross and other voluntary aid societies recognised and authorized by a Party to the conflict, medical personnel attached to civil defence units, and any persons made available for humanitarian purposes by a neutral State, a recognised and authorised aid society of such State, or an impartial international humanitarian organisation.
Protection and respect must be extended to persons regularly and solely engaged in the operation and administration of civilian hospitals. Included in this category are persons engaged in the search for, removal, transport and care of wounded and sick civilians, the infirm, and maternity cases.
Other persons engaged in the operation and administration of civilian hospitals are entitled to protection … while employed on their duties. 
New Zealand, Interim Law of Armed Conflict Manual, DM 112, New Zealand Defence Force, Headquarters, Directorate of Legal Services, Wellington, November 1992, §§ 1005(1) and 1109(3) and (4).
With respect to non-international armed conflict in particular, the manual states: “Medical … personnel are to be respected and protected at all times, receiving all available aid to enable them to fulfil their duties.” 
New Zealand, Interim Law of Armed Conflict Manual, DM 112, New Zealand Defence Force, Headquarters, Directorate of Legal Services, Wellington, November 1992, § 1818(2).
Nicaragua
Nicaragua’s Military Manual (1996) states, with respect to international armed conflicts, that assistance to the wounded, sick and shipwrecked includes a requirement of “protection of permanent [medical] personnel assigned to the search, collection, transportation or treatment of the wounded and sick, the prevention of disease or the administration of [medical] units and establishments”, as well as “respect for and protection of temporary [medical] personnel” and “respect for and protection of regular personnel of civilian hospitals”. 
Nicaragua, Military Manual (1996), Article 14(4), (6) and (37).
Nigeria
Nigeria’s Operational Code of Conduct (1967) states: “Hospital staff and patients should not be tampered with or molested.” 
Nigeria, Operational Code of Conduct for Nigerian Armed Forces, Federal Military Government of Nigeria, July 1967, § 4(d).
Nigeria
Nigeria’s Manual on the Laws of War states:
Medical personnel engaged exclusively in the search and collection of the wounded and sick and the prevention of disease, the staff engaged in the administration of hospitals and medical units … are also entitled to protection. 
Nigeria, The Laws of War, by Lt. Col. L. Ode PSC, Nigerian Army, Lagos, undated, § 33.
Nigeria
Nigeria’s Military Manual (1994) provides: “Specifically protected persons … recognised as such must be respected. Specifically protected persons are to be allowed to fulfil their activity unless the tactical situation does not permit.” 
Nigeria, International Humanitarian Law (IHL), Directorate of Legal Services, Nigerian Army, 1994, p. 45, § (f).
Nigeria
Nigeria’s Soldiers’ Code of Conduct states: “Medical personnel must be respected.” 
Nigeria, Code of Conduct for Combatants, “The Soldier’s Rules”, Nigerian Army, undated, § 7.
Peru
Peru’s IHL Manual (2004) states:
[A]ll medical personnel performing their duties in armed conflicts must be respected and protected. This means that they must not be attacked and must be defended, assisted and supported when necessary. This right applies in all circumstances, and the obligation that it entails is binding on everyone, particularly combatants, regardless of which side they belong to. 
Peru, Manual de Derecho Internacional Humanitario para las Fuerzas Armadas, Resolución Ministerial Nº 1394-2004-DE/CCFFAA/CDIH-FFAA, Lima, 1 December 2004, § 92.a; see also § 100.
The manual also states:
b. The protection to which medical personnel are entitled is not an individual privilege granted to them, but rather a natural corollary to the requirement to respect and protect the victims of armed conflict.
c. Medical personnel must refrain from any act of hostility. They are protected because they must remain neutral towards the armed conflict in which they are performing their duties. If they cease to be neutral, they lose this protection.
“Neutrality”, in respect of medical personnel, is the obligation to refrain from any hostile act or, in general, any involvement in military operations. If they meet this requirement, they are granted special protection. 
Peru, Manual de Derecho Internacional Humanitario para las Fuerzas Armadas, Resolución Ministerial Nº 1394-2004-DE/CCFFAA/CDIH-FFAA, Lima, 1 December 2004, § 83.b and c.
The manual further states:
(1) When permanent military medical personnel fall into the hands of the enemy, they do not become prisoners of war, although they can be retained to provide assistance to wounded and sick members of their own armed forces who have been captured.
(2) Captured military medical personnel can only be retained for as long as there are medical duties for them to perform. When this is not the case, they must be repatriated.
(3) Civilian medical personnel who fall into the hands of the enemy cannot be detained and must be allowed to continue performing their medical duties. If security measures have to be taken, civilian medical personnel are entitled to all the protection granted to protected persons. 
Peru, Manual de Derecho Internacional Humanitario para las Fuerzas Armadas, Resolución Ministerial Nº 1394-2004-DE/CCFFAA/CDIH-FFAA, Lima, 1 December 2004, § 31.d.(1)–(3); see also § 156.d.
The manual also states: “Members of the crews of hospital ships may not be captured during the time they are in the service of these vessels.” 
Peru, Manual de Derecho Internacional Humanitario para las Fuerzas Armadas, Resolución Ministerial Nº 1394-2004-DE/CCFFAA/CDIH-FFAA, Lima, 1 December 2004, § 31.d.(1)–(3); see also § 156.b.
Peru
Peru’s IHL and Human Rights Manual (2010) states:
The norms of international humanitarian law provide that medical personnel performing their duties in armed conflict must be respected and protected. This means that they must not be attacked and must be defended, assisted and supported when necessary. This right applies in all circumstances, and the obligation that it entails is binding on everyone, particularly soldiers, regardless of which side they belong to. 
Peru, Manual de Derecho Internacional Humanitario y Derechos Humanos para las Fuerzas Armadas, Resolución Ministerial No. 049-2010/DE/VPD, Lima, 21 May 2010, § 83(a), p. 285.
The manual also states:
b. The protection of medical personnel is not an individual privilege granted to them, but rather a natural corollary to the requirement to respect and protect the victims of armed conflict.
c. Medical personnel must refrain from any act of hostility. Members of the medical personnel are protected because they must remain neutral towards the armed conflict in which they are performing their duties. If they cease to be neutral, they lose this protection.
“Neutrality”, in respect of medical personnel, is the obligation to refrain from any hostile act or, in general, any involvement in military operations. If they meet this requirement, they are granted special protection. 
Peru, Manual de Derecho Internacional Humanitario y Derechos Humanos para las Fuerzas Armadas, Resolución Ministerial No. 049-2010/DE/VPD, Lima, 21 May 2010, § 74(b)–(c), p. 272.
The manual further states:
(1) When permanent military medical personnel fall into the hands of the enemy … they can be retained to provide assistance to wounded and sick members of their own armed forces who have been captured.
(2) Captured military medical personnel can only be retained for as long as there are medical duties for them to perform. When this is not the case, they must be repatriated.
(3) Civilian medical personnel who fall into the hands of the enemy cannot be detained and must be allowed to continue performing their medical duties. If security measures have to be taken, civilian medical personnel are entitled to all the protection granted to protected persons. 
Peru, Manual de Derecho Internacional Humanitario y Derechos Humanos para las Fuerzas Armadas, Resolución Ministerial No. 049-2010/DE/VPD, Lima, 21 May 2010, § 32(10)(d), p. 250.
The manual also states: “Members of the crews of hospital ships may not be captured during the time they are in the service of these vessels.” 
Peru, Manual de Derecho Internacional Humanitario y Derechos Humanos para las Fuerzas Armadas, Resolución Ministerial No. 049-2010/DE/VPD, Lima, 21 May 2010, § 147(b), p. 333.
In its Glossary of Terms, the manual defines “relief society” as: “A society recognized by the respective government, whose members search, rescue, transport, and attend to the wounded and sick and provide assistance to prisoners of war. Their personnel are analogous to military medical personnel.” 
Peru, Manual de Derecho Internacional Humanitario y Derechos Humanos para las Fuerzas Armadas, Resolución Ministerial No. 049-2010/DE/VPD, Lima, 21 May 2010, p. 415.
Philippines
The Philippines’ Air Power Manual (2000) provides:
1-6.3. The 1949 Geneva Convention includes the doctrine of proportionality – a concept which provides foundation for LOAC … It also embodies the protection of the various classes of people affected by the hostilities.
1-6.5. In addition to the conventions, Additional Protocols are incorporated which deal with people and their claim to protection under defined circumstances, such as medical and religious personnel. Additional Protocol One includes international conflicts and wars of national liberation. In effect, it defines the protection of the civilian population in times of international conflict.
1-6.6. Additional Protocol Two defines two things: limitations in the conduct of operations and principles relating to the protection of civilians in a non-international conflict. Thus, every combatant should understand the consequences of this Protocol. 
Philippines, Air Power Manual, Philippine Air Force, Headquarters, Office of Special Studies, May 2000, §§ 1-6.3 and 1-6.5–1-6.6.
Republic of Korea
The Republic of Korea’s Operational Law Manual (1996) states that military medical personnel must be protected. 
Republic of Korea, Operational Law Manual, 1996, p. 133.
Romania
Romania’s Soldiers’ Manual (1991) provides for respect for medical personnel. 
Romania, Manualul Soldatului, Ghid de comportare în luptă, Asociaţia Română de Drept Umanitar (ARDU), 1991, p. 32.
Russian Federation
The Russian Federation’s Military Manual (1990) states that attacks against medical personnel are a prohibited method of warfare. 
Russian Federation, Instructions on the Application of the Rules of International Humanitarian Law by the Armed Forces of the USSR, Appendix to Order of the USSR Defence Minister No. 75, 1990, § 5(g).
Russian Federation
The Russian Federation’s Regulations on the Application of IHL (2001) states: “[P]ersons protected by international humanitarian law include … medical and religious personnel … Attacks against such persons are prohibited.” 
Russian Federation, Regulations on the Application of International Humanitarian Law by the Armed Forces of the Russian Federation, Ministry of Defence of the Russian Federation, Moscow, 8 August 2001, § 1.
The Regulations further specifies:
Enemy medical and religious personnel shall be respected and protected and shall not be made the object of attack, unless such personnel, when checked, have committed acts which go beyond their professional (medical or religious) duties and if they refrain from taking part in hostilities; if the said persons observe the established identification rules … Protection may cease only after a warning has been given setting, whenever appropriate, a reasonable time-limit and after such warning has remained unheeded. 
Russian Federation, Regulations on the Application of International Humanitarian Law by the Armed Forces of the Russian Federation, Ministry of Defence of the Russian Federation, Moscow, 8 August 2001, § 58.
With regard to internal armed conflict, the Regulations states: “Medical and religious personnel shall be respected and protected and shall be granted all available help for the performance of their duties.” 
Russian Federation, Regulations on the Application of International Humanitarian Law by the Armed Forces of the Russian Federation, Ministry of Defence of the Russian Federation, Moscow, 8 August 2001, § 83.
Senegal
Senegal’s Disciplinary Regulations (1990) provides that soldiers in combat must respect and protect medical personnel. 
Senegal, Règlement de Discipline dans les Forces Armées, Décret 90-1159, 12 October 1990, Article 34(1).
Sierra Leone
Sierra Leone’s Instructor Manual (2007) lists “civilian and military medical personnel and facilities” among “persons under special protection”. 
Sierra Leone, The Law of Armed Conflict. Instructor Manual for the Republic of Sierra Leone Armed Forces (RSLAF), Armed Forces Education Centre, September 2007, p. 29.
The manual further states: “All medical personnel are protected from attack while carrying out their medical duties and they should not participate in combat activity. If they do, they will lose their protection.” 
Sierra Leone, The Law of Armed Conflict. Instructor Manual for the Republic of Sierra Leone Armed Forces (RSLAF), Armed Forces Education Centre, September 2007, p. 56.
South Africa
South Africa’s LOAC Manual (1996) provides:
Medical … personnel of the parties to a conflict, whether military or civilian, are to be respected and protected. This protection is not a personal privilege but rather a natural consequence of the rules designed to ensure respect and protection for the victims of armed conflict. Protection is accorded to medical personnel to facilitate the humanitarian tasks assigned to them; the protection is therefore limited to those circumstances in which they are carrying out these tasks exclusively.
The manual points to the distinction between permanent and auxiliary medical personnel and restates Articles 24–25 of the 1949 Geneva Convention I. 
South Africa, Presentation on the South African Approach to International Humanitarian Law, Appendix A, Chapter 4: International Humanitarian Law (The Law of Armed Conflict), National Defence Force, 1996, §§ 46–47.
South Africa
South Africa’s Revised Civic Education Manual (2004) states:
62. Medical … Personnel. Medical … personnel of the parties to a conflict, whether military or civilian, are to be respected and protected. This protection is not a personal privilege but rather a natural consequence of the rules designed to ensure respect and protection for the victims of armed conflict. Protection is accorded to medical personnel to facilitate the humanitarian tasks assigned to them; the protection is therefore limited to those circumstances in which they are carrying out these tasks exclusively.
63. Two types of medical personnel are involved in military operations. They can be categorised as follows:
a. Those exclusively engaged in the search for, or the collection, transport or treatment of, wounded and sick, or employed in the prevention of disease. Staff engaged exclusively in the administration of medical units and establishments … shall be respected and protected in all circumstances.
b. Auxiliary medical personnel, specifically trained for employment, should the need arise, as hospital orderlies, nurses or auxiliary stretcher bearers, or in the search for or collection, transport or treatment of the wounded and sick, shall likewise be protected if they are carrying out these duties at the time when they come into contact with the enemy or fall into enemy hands. Auxiliary medical personnel are not protected when carrying out their normal military functions. 
South Africa, Revised Civic Education Manual, South African National Defence Force, 2004, Chapter 4, §§ 62–63.
Spain
Spain’s LOAC Manual (1996) defines medical personnel with reference to Article 8 of the 1977 Additional Protocol I. 
Spain, Orientaciones. El Derecho de los Conflictos Armados, Publicación OR7-004, 2 Tomos, aprobado por el Estado Mayor del Ejército, División de Operaciones, 18 March 1996, Vol. I, § 9.2.a.(1).
The manual states, with reference to the relevant provisions of the Geneva Conventions and both Additional Protocols, that “respect and protection” of medical personnel include the duty not to attack medical personnel, and the duty to defend, assist and support such personnel when needed. The manual further explains:
It must be underlined that the protection of medical personnel is not a personal privilege but rather a corollary of the respect and protection due to the wounded and sick, who must be treated humanely in all circumstances. This means that the protection of medical personnel is not permanent but is only granted when such personnel are carrying out their humanitarian tasks. Medical personnel lose the special protection to which they are entitled if they commit acts of hostility. Such behaviour might even constitute perfidy if in so doing they take advantage of their medical position and the distinctive emblems. 
Spain, Orientaciones. El Derecho de los Conflictos Armados, Publicación OR7-004, 2 Tomos, aprobado por el Estado Mayor del Ejército, División de Operaciones, 18 March 1996, Vol. I, § 9.2.a.(2).
Spain
Spain’s LOAC Manual (2007) defines medical personnel with reference to Article 8 of the 1977 Additional Protocol I. 
Spain, Orientaciones. El Derecho de los Conflictos Armados, Tomo 1, Publicación OR7–004, (Edición Segunda), Mando de Adiestramiento y Doctrina, Dirección de Doctrina, Orgánica y Materiales, 2 November 2007, § 9.2.a.(1).
The manual also states that medical personnel of the armed forces and civilian medical personnel are protected persons and cannot therefore be attacked. 
Spain, Orientaciones. El Derecho de los Conflictos Armados, Tomo 1, Publicación OR7–004, (Edición Segunda), Mando de Adiestramiento y Doctrina, Dirección de Doctrina, Orgánica y Materiales, 2 November 2007, § 4.5.b.(1).(b); see also §§ 5.2.a.(2).(c), 7.3.a.(10) and 9.2.a.2.(c).
The manual further explains:
It should be emphasized that the protection to which medical personnel are entitled is not an individual privilege granted to them, but rather a natural corollary to the obligations to respect and protect the wounded and sick, who must be treated humanely in all circumstances.
This means that such protection is not permanent; it is granted when and for as long as medical personnel are performing humanitarian duties. If medical personnel commit acts of hostility, they lose this special protection, and their conduct could be considered an act of perfidy if they take advantage of their medical status or the protective emblems to commit such acts. 
Spain, Orientaciones. El Derecho de los Conflictos Armados, Tomo 1, Publicación OR7–004, (Edición Segunda), Mando de Adiestramiento y Doctrina, Dirección de Doctrina, Orgánica y Materiales, 2 November 2007, § 9.2.a.(2).(a).
The manual further states that “medical personnel … who take a direct part in hostilities” are military objectives and can therefore be attacked. 
Spain, Orientaciones. El Derecho de los Conflictos Armados, Tomo 1, Publicación OR7–004, (Edición Segunda), Mando de Adiestramiento y Doctrina, Dirección de Doctrina, Orgánica y Materiales, 2 November 2007, § 4.5.b.(1).(a).
Sweden
Sweden’s IHL Manual (1991) considers that Article 15 of the 1977 Additional Protocol I on the protection of medical personnel has the status of customary law. 
Sweden, International Humanitarian Law in Armed Conflict, with reference to the Swedish Total Defence System, Swedish Ministry of Defence, January 1991, Section 2.2.3, p. 18.
Switzerland
Switzerland’s Basic Military Manual (1987) states: “Medical … personnel must be respected and protected in all circumstances. They may not be attacked or prevented from carrying out their duties.” It defines medical personnel as including persons specially and exclusively assigned to the care of the wounded and sick, such as doctors, nurses and stretcher-bearers; administrative staff of medical units and establishments such as hospital administrators, drivers and cooks; chaplains and temporary medical personnel. 
Switzerland, Lois et coutumes de la guerre (Extrait et commentaire), Règlement 51.7/II f, Armée Suisse, 1987, Article 78(1) and commentary.
Switzerland
Switzerland’s Aide-Memoire on the Ten Basic Rules of the Law of Armed Conflict (2005) states: “I spare and respect personnel and installations as well as equipment and means of transport of the medical services … without discrimination unless they open fire on my comrades or me.” 
Switzerland, The Ten Basic Rules of the Law of Armed Conflict, Aide-memoire 51.007/IIIe, Swiss Army, issued based on Article 10 of the Ordinance for Organization of the Federal Department for Defence, Civil Protection and Sports dated 7 March 2003, entry into force on 1 July 2005, Rule 7.
The Aide-Memoire further states with regard to the protective signs of the red cross and red crescent:
Correct behaviour
- Personnel, installations, material and means of transport of the medical services as well as carriers
of signs or objects marked with distinctive signs must be respected and spared;
 
Switzerland, The Ten Basic Rules of the Law of Armed Conflict, Aide-memoire 51.007/IIIe, Swiss Army, issued based on Article 10 of the Ordinance for Organization of the Federal Department for Defence, Civil Protection and Sports dated 7 March 2003, entry into force on 1 July 2005, Chart of Protective Signs.
Switzerland
Switzerland’s Regulation on Legal Bases for Conduct during an Engagement (2005) states:
12. The principle of distinction
159 Hostilities must be directed exclusively against combatants and military objectives. …
3 Protected persons are persons who are not or no longer taking part in combat or enjoy specially protected status, such as medical and religious personnel, civil protection or cultural property protection personnel, as well as wounded persons and prisoners of war.
13 Protected persons
13.1 Behaviour with regard to the wounded, sick and shipwrecked and medical and religious personnel
176 Medical personnel, equipment and means of transport as well as localities used by the military service must be spared and must not be hindered in the fulfilment of their mission.
177 The red cross and the red crescent on a white ground represent a distinctive emblem. Civilian and military medical personnel must be enabled to carry out their duties at all times. Civilian and military medical personnel who do not participate in hostilities must be protected at all times, even when wearing no distinctive emblem or no distinctive emblem that has been officially recognized by the Conventions.
178 For their own protection, medical personnel may be armed with a personal weapon (e.g. assault rifle, submachine gun, pistol). Explosive weapons and collective weapons are prohibited. Medical personnel do not participate in hostilities, except for their own protection or for the protection of the patients in their care. Nor must they be engaged in other harmful acts (e.g. intelligence services).
179 Enemy medical personnel may be retained for as long as they are needed for the care of patients. Superiors make the necessary arrangements.
15 Methods of warfare
15.2 Prohibited methods of warfare
225 Indiscriminate attacks, i.e. attacks which cannot distinguish between protected persons/objects and military objectives, as well as attacks directed against protected persons/objects or acts of revenge are prohibited in any place and at any time.
17 Sanctions for violations of the international law of armed conflict
17.1 General provisions
237 The following in particular are criminal offences: … harmful acts against internationally protected persons and objects[.] 
Switzerland, Bases légales du comportement à l’engagement (BCE), Règlement 51.007/IVf, Swiss Army, issued based on Article 10 of the Ordinance on the Organization of the Federal Department for Defence, Civil Protection and Sports of 7 March 2003, entry into force on 1 July 2005, §§ 159(3), 176–179, 225 and 237.
Togo
Togo’s Military Manual (1996) lists military and civilian medical personnel as specially protected persons. 
Togo, Le Droit de la Guerre, III fascicules, Etat-major Général des Forces Armées Togolaises, Ministère de la Défense nationale, 1996, Fascicule I, p. 14.
The manual states: “Specially protected persons may not take a direct part in hostilities and must not be attacked. They shall be allowed to carry out their tasks as long as the tactical situation permits”. 
Togo, Le Droit de la Guerre, III fascicules, Etat-major Général des Forces Armées Togolaises, Ministère de la Défense nationale, 1996, Fascicule III, p. 5; see also Fascicule II, p. 8.
The manual further states that military medical personnel must be respected. 
Togo, Le Droit de la Guerre, III fascicules, Etat-major Général des Forces Armées Togolaises, Ministère de la Défense nationale, 1996, Fascicule II, p. 16
Ukraine
Ukraine’s IHL Manual (2004) states that medical personnel are “protected under international humanitarian law” and that directing attacks against such persons constitutes “a serious violation of international humanitarian law”. 
Ukraine, Manual on the Application of IHL Rules, Ministry of Defence, 11 September 2004, §§ 1.2.33 and 1.8.5.
The manual further states:
1.2.24. Non-combatants (those who do not fight) are members of the armed forces who provide assistance to them but take no direct part in hostilities. These [include] medical personnel … Weapons shall not be employed against such persons while they are engaged in the performance of their direct duties.
Such persons become combatants in case of their direct participation in hostilities.
1.2.34. “Medical personnel” (both military and civilian) means members of medical units assigned (permanently or temporarily):
- for performing exclusively medical purposes – namely the search for, collection, transportation, diagnosis or treatment – including first-aid treatment – of the wounded, sick and shipwrecked, or for the prevention of disease or for maintenance of medical units and work on medical transport. 
Ukraine, Manual on the Application of IHL Rules, Ministry of Defence, 11 September 2004, §§ 1.2.24 and 1.2.34.
United Kingdom of Great Britain and Northern Ireland
The UK Military Manual (1958) restates Articles 24–26 of the 1949 Geneva Convention I. 
United Kingdom, The Law of War on Land being Part III of the Manual of Military Law, The War Office, HMSO, 1958, §§ 346–347 and 350.
The manual specifies that the duty to respect and protect means that medical personnel
must not knowingly be attacked, fired upon, or unnecessarily prevented from discharging their proper functions. The pure accidental killing or wounding of protected personnel when in or near the area of combat is not a legitimate cause for complaint. 
United Kingdom, The Law of War on Land being Part III of the Manual of Military Law, The War Office, HMSO, 1958, § 346, footnote 1.
The manual also restates Article 20 of the 1949 Geneva Convention IV. 
United Kingdom, The Law of War on Land being Part III of the Manual of Military Law, The War Office, HMSO, 1958, § 32.
United Kingdom of Great Britain and Northern Ireland
The UK LOAC Pamphlet (1981) states: “Medical personnel are those exclusively assigned to medical units. They are to be respected, protected and not attacked.” 
United Kingdom, The Law of Armed Conflict, D/DAT/13/35/66, Army Code 71130 (Revised 1981), Ministry of Defence, prepared under the Direction of The Chief of the General Staff, 1981, Section 6, p. 23, § 9(a).
United Kingdom of Great Britain and Northern Ireland
The UK LOAC Manual (2004) states:
7.11. “Medical personnel” means “those persons assigned, by a Party to the conflict, exclusively to the medical purposes enumerated in paragraph 7.10 [relating to medical units] or to the administration of medical units or to the operation or administration of medical transports. Such assignments may be either permanent or temporary’.
7.11.1. The term embraces not only doctors and nurses but also a wide range of specialists, technicians, maintenance staff, drivers, cooks and administrators. It expressly includes military and civilian personnel and those assigned to civil defence organizations as well as medical personnel of national Red Cross or Red Crescent or other duly authorized and recognized national voluntary aid societies. Personnel of medical units and transports of neutral and other states not parties to the conflict, national aid societies of such states and impartial international humanitarian organizations are also included within the definition if made available to a party to the conflict for humanitarian purposes. While the expression includes dental personnel and chaplains in medical units and part-time medical personnel while engaged on medical duties, it excludes qualified medical and dental practitioners who are not assigned exclusively to medical purposes.
Identification of service medical personnel
7.26. Service medical personnel must be clearly identifiable as such so that they receive the protection and respect due to them. To achieve this, all service medical personnel must, in addition to normal service identity discs, wear on the left arm a water-resistant armlet (brassard) bearing the appropriate distinctive emblem. The armlet should be issued and stamped by the military authority. Service medical personnel must also carry a special identity card bearing the distinctive emblem. This card is embossed with the stamp of the military authority. These service identity cards must be uniform throughout the same armed forces and, as far as possible, of a similar type in the armed forces of all parties to Geneva Conventions I and II. Parties to a conflict must inform each other at the outbreak of hostilities which model identity card they are using. Identity cards should be made out, if possible, at least in duplicate, one copy being kept by the home country. In no circumstances may service medical personnel be deprived of their armlets (or the right to wear them) or of their identity cards. In the case of loss they are entitled to receive duplicates of the cards and to have the insignia replaced.
Status on capture of service medical personnel
7.27. In the event of capture, medical personnel do not become prisoners of war but are “retained personnel”.
Auxiliary medical personnel
7.28. Auxiliary medical personnel are members of the armed forces who are specifically trained for employment, when the need arises, as hospital orderlies, nurses or auxiliary stretcher-bearers in the search for or the collection, transport or treatment of the wounded and sick. Auxiliary medical personnel are issued with a special identity card. Auxiliary medical personnel become prisoners of war on capture. They may be required to exercise their medical functions in the interests of prisoners of war of their own state. In that case, they are exempt from any other work.
Civilian medical personnel
7.29. Civilian medical personnel are to be accorded the same protection as service medical personnel and, in occupied territory and areas where fighting is taking place or is likely to take place, they should be recognizable by the distinctive emblem and carry an identity card certifying their status. This card differs from that issued to service medical personnel. Civilian medical personnel who fall into the hands of the enemy should not be detained and should be allowed to continue their medical duties. If any security measures have to be taken, civilian medical personnel have all the protection of protected persons. 
United Kingdom, The Manual of the Law of Armed Conflict, Ministry of Defence, 1 July 2004, §§ 7.11–7.11.1, 7.26, 7.27–7.28 and 7.29.
Furthermore, the manual prohibits attacks on medical and religious personnel in non-international armed conflict. 
United Kingdom, The Manual of the Law of Armed Conflict, Ministry of Defence, 1 July 2004, § 15.29.
United States of America
The US Field Manual (1956) grants respect and protection to both permanent and temporary medical personnel as provided for in Articles 24–25 of the 1949 Geneva Convention I. The manual states:
The respect and protection accorded personnel by Articles 19, 24, and 25 [of the 1949 Geneva Convention I] mean that they must not knowingly be attacked, fired upon, or unnecessarily prevented from discharging their proper functions. The accidental killing or wounding of such personnel, due to their presence among or in proximity to combatant elements actually engaged, by fire directed at the latter, gives no just cause for complaint. 
United States, Field Manual 27-10, The Law of Land Warfare, US Department of the Army, 18 July 1956, as modified by Change No. 1, 15 July 1976, §§ 225–226.
Protection is also granted to the personnel of aid societies by reference to Article 26 of the 1949 Geneva Convention I. 
United States, Field Manual 27-10, The Law of Land Warfare, US Department of the Army, 18 July 1956, as modified by Change No. 1, 15 July 1976, § 227.
United States of America
The US Air Force Pamphlet (1976) refers to the protection of medical personnel as set out in the 1949 Geneva Convention I. 
United States, Air Force Pamphlet 110-31, International Law – The Conduct of Armed Conflict and Air Operations, US Department of the Air Force, 1976, § 12-2(b).
The Pamphlet further states: “In addition to grave breaches of the Geneva Conventions of 1949, the following acts are representative of situations involving individual criminal responsibility: (1) deliberate attack on … medical … personnel”. 
United States, Air Force Pamphlet 110-31, International Law – The Conduct of Armed Conflict and Air Operations, US Department of the Air Force, 1976, § 15-3(c)(1).
United States of America
The US Air Force Commander’s Handbook (1980) provides that medical personnel, civilian or military, “should not be deliberately attacked, fired upon, or unnecessarily prevented from performing their medical duties. The same protection should also be given to any civilian or group of civilians trying to aid the sick and wounded after combat”. 
United States, Air Force Pamphlet 110-34, Commander’s Handbook on the Law of Armed Conflict, Judge Advocate General, US Department of the Air Force, 25 July 1980, § 3-2.
United States of America
The US Naval Handbook (1995) states:
Medical personnel, including medical and dental officers, technicians and corpsmen, nurses, and medical service personnel, have special protected status when engaged exclusively in medical duties and may not be attacked. 
United States, The Commander’s Handbook on the Law of Naval Operations, NWP 1-14M/MCWP 5-2.1/COMDTPUB P5800.7, issued by the Department of the Navy, Office of the Chief of Naval Operations and Headquarters, US Marine Corps, and Department of Transportation, US Coast Guard, October 1995 (formerly NWP 9 (Rev. A)/FMFM 1-10, October 1989), § 11.5.
The manual qualifies “deliberate attack upon … medical personnel” as a war crime. 
United States, The Commander’s Handbook on the Law of Naval Operations, NWP 1-14M/MCWP 5-2.1/COMDTPUB P5800.7, issued by the Department of the Navy, Office of the Chief of Naval Operations and Headquarters, US Marine Corps, and Department of Transportation, US Coast Guard, October 1995 (formerly NWP 9 (Rev. A)/FMFM 1-10, October 1989), § 6.2.5.
United States of America
The Annotated Supplement to the US Naval Handbook (1997) notes: “The United States supports the principle in [Article 15 of the 1977 Additional Protocol I] that civilian medical … personnel be respected and protected and not be made the objects of attack”. 
United States, Annotated Supplement to the Commander’s Handbook on the Law of Naval Operations, prepared by the Oceans Law and Policy Department, Center for Naval Warfare Studies, Naval War College, Newport, Rhode Island, November 1997, § 11.5, footnote 31.
United States of America
The US Naval Handbook (2007) states:
Medical personnel of the armed forces, including medical and dental officers, technicians and corpsmen, nurses, and medical service personnel, have special protected status when engaged exclusively in medical duties. In exchange for this protection, medical personnel must not commit acts harmful to the enemy. If they do, they risk losing their protection as noncombatants and could be attacked. 
United States, The Commander’s Handbook on the Law of Naval Operations, NWP 1-14M/MCWP 5-12.1/COMDTPUB P5800.7, issued by the Department of the Navy, Office of the Chief of Naval Operations and Headquarters, US Marine Corps, and Department of Homeland Security, US Coast Guard, July 2007, § 8.2.4.1.
The Handbook also states:
Noncombatants [§ 5.4.2. – “Noncombatants are those members of the armed forces who do not take direct part in hostilities because of their status as medical personnel and chaplains”] may not be deliberately or indiscriminately attacked, unless they forgo their protection by taking a direct part in hostilities. 
United States, The Commander’s Handbook on the Law of Naval Operations, NWP 1-14M/MCWP 5-12.1/COMDTPUB P5800.7, issued by the Department of the Navy, Office of the Chief of Naval Operations and Headquarters, US Marine Corps, and Department of Homeland Security, US Coast Guard, July 2007, § 6.2.6.
The Handbook further states that examples of war crimes that could be considered as grave breaches of the 1949 Geneva Conventions include: “Deliberate attacks upon … medical personnel.” 
United States, The Commander’s Handbook on the Law of Naval Operations, NWP 1-14M/MCWP 5-12.1/COMDTPUB P5800.7, issued by the Department of the Navy, Office of the Chief of Naval Operations and Headquarters, US Marine Corps, and Department of Homeland Security, US Coast Guard, July 2007, § 6.2.6(7).
The Handbook also states:
Medical personnel … falling into enemy hands … unless their retention by the enemy is required to provide for the medical … needs of prisoners of war, … must be repatriated at the earliest opportunity. 
United States, The Commander’s Handbook on the Law of Naval Operations, NWP 1-14M/MCWP 5-12.1/COMDTPUB P5800.7, issued by the Department of the Navy, Office of the Chief of Naval Operations and Headquarters, US Marine Corps, and Department of Homeland Security, US Coast Guard, July 2007, § 11.4.
United States of America
The US Manual for Military Commissions (2010), Part IV, Crimes and Elements, states: “The term ‘protected person’ means any person entitled to protection under one or more of the [1949] Geneva Conventions, including … military medical … personnel.” 
United States, Manual for Military Commissions, published in implementation of Chapter 47A of Title 10, United States Code, as amended by the Military Commissions Act of 2009, 10 U.S.C, §§ 948a, et seq., 27 April 2010, § 1(a)(2)(C), p. IV-1.
Yugoslavia, Socialist Federal Republic of
The Socialist Federal Republic of Yugoslavia’s Military Manual (1988) restates Articles 24–26 of the 1949 Geneva Convention I and extends the protection of military medical personnel to civilian medical personnel. 
Yugoslavia, Socialist Federal Republic of, Propisi o Primeri Pravila Medjunarodnog Ratnog Prava u Oruzanim Snagama SFRJ, PrU-2, Savezni Sekretarijat za Narodnu Odbranu (Pravna Uprava), 1988, §§ 175–178 and 195; see also § 82 (conduct of hostilities).
Zimbabwe
Zimbabwe’s Code of Conduct for Combatants (1993) states: “Respect medical personnel”. 
Zimbabwe, Code of Conduct for Combatants, Joint publication of the Zimbabwe Defence Forces and the International Committee of the Red Cross Regional Delegation in Harare, 1993, p. 5.
The Code of Conduct adds: “Special protection is to be given to medical personnel”. 
Zimbabwe, Code of Conduct for Combatants, Joint publication of the Zimbabwe Defence Forces and the International Committee of the Red Cross Regional Delegation in Harare, 1993, p. 5.
Bangladesh
Bangladesh’s International Crimes (Tribunal) Act (1973) states that the “violation of any humanitarian rules applicable in armed conflicts laid down in the Geneva Conventions of 1949” is a crime. 
Bangladesh, International Crimes (Tribunal) Act, 1973, Section 3(2)(e).
Belgium
Belgium’s Penal Code (1867), as amended in 2003, provides:
War crimes envisaged in the 1949 [Geneva] Conventions … and in the [1977 Additional Protocols I and II] … , as well as in Article 8(2)(f) of the [1998 ICC Statute], and listed below, … constitute crimes under international law and shall be punished in accordance with the provisions of the present title … :
15. intentionally directing attacks against … medical … personnel using the distinctive emblems of international humanitarian law, in conformity with international law. 
Belgium, Penal Code, 1867, as amended on 5 August 2003, Chapter III, Title I bis, Article 136 quater, § 1(15).
Belgium
Belgium’s Law relating to the Repression of Grave Breaches of International Humanitarian Law (1993), as amended in 2003, provides:
War crimes envisaged in the 1949 [Geneva] Conventions … and in the [1977 Additional Protocols I and II] … , as well as in Article 8(2)(f) of the [1998 ICC Statute], and listed below, … constitute crimes under international law and shall be punished in accordance with the provisions of the present title … :
8 ter intentionally directing attacks against … medical … personnel using the distinctive emblems of international humanitarian law, in conformity with international law. 
Belgium, Law relating to the Repression of Grave Breaches of International Humanitarian Law, 1993, as amended on 23 April 2003, Article 1 ter, § 1(8 ter).
Bosnia and Herzegovina
Under the Federation of Bosnia and Herzegovina’s Criminal Code (1998), “murder, torture [or] inhuman treatment” of medical personnel is considered to be a war crime. 
Bosnia and Herzegovina, Federation, Criminal Code, 1998, Article 155.
The Republika Srpska’s Criminal Code (2000) contains the same provision. 
Bosnia and Herzegovina, Republika Srpska, Criminal Code, 2000, Article 434.
Bosnia and Herzegovina
Bosnia and Herzegovina’s Criminal Code (2003) contains the following war crimes provision:
Whoever, in violation of the rules of international law in time of war or armed conflict, orders or perpetrates in regard to … medical personnel … any of the following acts:
(a) Depriving another person of their life (murder), intentional infliction of severe physical or mental pain or suffering upon a person (torture), inhuman treatment, including therein biological, medical or other scientific experiments, taking of tissue or organs for the purpose of transplantation;
(b) Causing of great suffering or serious injury to bodily integrity or health;
shall be punished by imprisonment for a term of not less than ten years or long-term imprisonment. 
Bosnia and Herzegovina, Criminal Code, 2003, Article 174(a) and (b).
Colombia
Colombia’s Emblem Decree (1998) lists as persons who must be protected:
medical, paramedical and aid society personnel, members of the International Red Cross and Red Crescent Movement and persons who, permanently or temporarily, provide humanitarian services and transports of medicine, food and humanitarian aid in situations of armed conflict or natural disaster. 
Colombia, Emblem Decree, 1998, Article 10.
Colombia
Under Colombia’s Penal Code (2000), it is a punishable act to “hinder or prevent, at the occasion of and during armed conflict, medical, health and aid personnel … from carrying out the medical and humanitarian tasks assigned to them by the norms of International Humanitarian Law”. 
Colombia, Penal Code, 2000, Article 153.
Colombia
Colombia’s Decree No. 138 (2005), which implements the Emblem Law (2004), states:
All authorities and persons in Colombia must protect the medical … personnel of the public forces [i.e. the armed forces and the police], the civilian medical personnel [as well as] the medical, paramedical and relief personnel who permanently or temporarily carry out humanitarian tasks in situations of armed conflict. 
Colombia, Decree No. 138, 2005, Article 16.
Croatia
Under Croatia’s Criminal Code (1997), “the killing, torture or inhuman treatment” of medical personnel is a war crime. 
Croatia, Criminal Code, 1997, Article 159.
Denmark
Denmark’s Military Criminal Code (1973), as amended in 1978, provides:
Any person who uses war instruments or procedures the application of which violates an international agreement entered into by Denmark or the general rules of international law, shall be liable to the same penalty [i.e. a fine, lenient imprisonment or up to 12 years’ imprisonment]. 
Denmark, Military Criminal Code, 1973, as amended in 1978, § 25(1).
Denmark’s Military Criminal Code (2005) provides:
Any person who deliberately uses war means [“krigsmiddel”] or procedures the application of which violates an international agreement entered into by Denmark or international customary law, shall be liable to the same penalty [i.e. imprisonment up to life imprisonment]. 
Denmark, Military Criminal Code, 2005, § 36(2).
El Salvador
Under El Salvador’s Code of Military Justice (1934), medical personnel must be respected. 
El Salvador, Code of Military Justice, 1934, Article 69.
Estonia
Under Estonia’s Penal Code (2001), “a person who kills, tortures, causes health damage to or takes hostage a member of a medical unit properly identified, or any other person attending to the sick or wounded persons” commits a war crime. 
Estonia, Penal Code, 2001, § 102.
Ethiopia
Under Ethiopia’s Penal Code (1957), “the killing, torture or inhuman treatment or other acts entailing direct suffering or physical or mental injury to … members of the medical or first-aid services” is punishable as a war crime. 
Ethiopia, Penal Code, 1957, Article 283(a).
Ethiopia’s Criminal Code (2004) states:
Article 271.- War Crimes against Wounded, Sick or Shipwrecked Persons or Medical Services.
(1) Whoever, in the circumstances defined above [in time of war, armed conflict or occupation] organizes, orders or engages in:
(a) killings, torture, withholding medical care and attention required by their condition or inhuman treatment or other acts entailing direct suffering or physical or mental injury to wounded, sick or shipwrecked persons, or to members of the medical or first aid service …
is punishable in accordance with Article 270 [with rigorous imprisonment from five years to twenty-five years, or, in more serious cases, with life imprisonment or death]. 
Ethiopia, Criminal Code, 2004, Article 271(1)(a).
Ethiopia’s Criminal Code of 2004 replaced the Penal Code of 1957.
France
France’s Code of Defence (2004), as amended in 2008, states:
Combatants must respect and treat with humanity all persons protected by the applicable international conventions, as well as their objects.
… [M]edical … personnel are protected persons …
Protected persons are protected as long as they abstain from taking a direct part in hostilities.
It is prohibited for combatants to deliberately target protected persons. 
France, Code of Defence, 2004, as amended in 2008, Article D4122-8.
France
France’s Penal Code (1994), as amended in 2010, states in its section on war crimes common to both international and non-international armed conflicts:
Intentionally launching attacks against medical personnel … displaying, in accordance with international law, the distinctive emblems provided for in the [1949 Geneva Conventions] or their [1977] Additional Protocols is punishable by 20 years’ imprisonment. 
France, Penal Code, 1994, as amended in 2010, Article 461-12.
Georgia
Georgia’s Criminal Code (1999) provides for the punishment of “wilful breaches of norms of international humanitarian law committed in an international or internal armed conflict … against medical … personnel”. 
Georgia, Criminal Code, 1999, Article 411(2).
Ireland
Ireland’s Geneva Conventions Act (1962), as amended in 1998, provides that any “minor breach” of the 1949 Geneva Conventions, including violations of Articles 24–26 of the Geneva Convention I, Article 36 of the Geneva Convention II and Article 20 of the Geneva Convention IV, and of the 1977 Additional Protocol I, including violations of Article 15(1), as well as any “contravention” of the 1977 Additional Protocol II, including violations of Article 9(1), are punishable offences. 
Ireland, Geneva Conventions Act, 1962, as amended in 1998, Section 4(1) and (4).
Italy
Italy’s Law of War Decree (1938), as amended in 1992, states that military medical personnel must be respected and protected “provided they are not committing acts of hostility”. 
Italy, Law of War Decree, 1938, as amended in 1992, Article 95.
Lithuania
Lithuania’s Criminal Code (1961), as amended in 1998, prohibits attacks against medical and civilian defence personnel, military or civilian hospitals, health centres, vehicles transporting the wounded and sick, and personnel of the ICRC or National Red Cross and Red Crescent Societies if protected by the distinctive emblems. 
Lithuania, Criminal Code, 1961, as amended in 1998, Article 337.
Nicaragua
Nicaragua’s Military Penal Code (1996) provides for the punishment of any soldier who “exercises violence against the personnel of medical … services, be they enemy or neutral, members of aid organizations and personnel affected to the services of [medical establishments]”, provided that the protection due is not misused for hostile purposes. 
Nicaragua, Military Penal Code, 1996, Article 57(2).
Norway
Norway’s Military Penal Code (1902), as amended in 1981, provides:
Anyone who contravenes or is accessory to the contravention of provisions relating to the protection of persons or property laid down in … the Geneva Conventions of 12 August 1949 … [and in] the two additional protocols to these Conventions … is liable to imprisonment. 
Norway, Military Penal Code, 1902, as amended in 1981, § 108.
Peru
Peru’s Military and Police Criminal Code (2010), in a chapter entitled “Crimes against humanitarian operations and emblems”, states:
A member of the military or the police shall be punished with deprivation of liberty of not less than six years and not more than twenty-five years if, in a state of emergency and when the Armed Forces assume control of the internal order, he or she:
2. Attacks medical … personnel … who are identified with the protective signs of the [1949] Geneva Conventions in accordance with International Humanitarian Law. 
Peru, Military and Police Criminal Code, 2010, Article 95(2).
Poland
Poland’s Penal Code (1997) provides for the protection of medical personnel, including the medical personnel of authorized aid societies. 
Poland, Penal Code, 1997, Article 123(1)(2).
Romania
Romania’s Penal Code (1968) provides for the punishment of anyone who “subjects to inhuman treatment … members of civil medical personnel … or subjects such persons to medical or scientific experiments”. 
Romania, Penal Code, 1968, Article 358.
Serbia
Serbia’s Criminal Code (2005) states that, in time of war, armed conflict or occupation, ordering or committing an attack “against … medical staff” constitutes a war crime. 
Serbia, Criminal Code, 2005, Article 373.
Slovenia
Under Slovenia’s Penal Code (1994), “slaughter, torture [or] inhuman treatment” of medical personnel is a war crime. 
Slovenia, Penal Code, 1994, Article 375.
Somalia
Somalia’s Military Criminal Code (1963) states:
375. Use of weapons against … medical … personnel. – Anyone who uses weapons … against the personnel responsible for [the sick and wounded] … when, in accordance with the law and international agreements, they must be regarded as respected and protected, shall, unless the act constitutes a more serious offence, be punished by military confinement for not less than 10 years.
378. Violence against medical personnel … – 1. … [A]nyone who uses violence against any of the persons regularly assigned to the medical service, when, in accordance with the law and international agreements, the said personnel must be respected and protected, shall be punished by imprisonment for 5 to 15 years.
3. If the violence consists of homicide, including attempted murder or manslaughter, or severe personal injury, the corresponding penalties prescribed in the criminal code shall be applied. The penalty of short-term imprisonment shall, however, be increased.
379. Failure to release medical personnel — Anyone who, in violation of the laws and international agreements, fails to hand over or release or otherwise detains any of the persons referred to in the preceding article when they have ceased to carry out their work in the hospitals, ambulances or other places where they were providing services, shall be punished by military confinement for one to five years. 
Somalia, Military Criminal Code, 1963, Articles 375, 378(1) and (3) and 379.
Spain
Spain’s Military Criminal Code (1985) provides for the punishment of any soldier who “exercises violence against the personnel of medical … services, be they enemy or neutral, members of aid organizations and personnel affected to the services of [medical establishments]”, provided that the protection due is not misused for hostile purposes. 
Spain, Military Criminal Code, 1985, Article 77(4).
Spain
Spain’s Penal Code (1995) provides for the punishment of “anyone who should … exercise violence on health … personnel, or members of medical missions or rescue teams”. 
Spain, Penal Code, 1995, Article 612(2).
Spain
Spain’s Penal Code (1995), as amended in 2003, states:
Anyone who [commits any of the following acts] during armed conflict shall be punished with three to seven years’ imprisonment:
2. Exercising violence against medical … personnel or against a member of medical missions. 
Spain, Penal Code, 1995, as amended on 25 November 2003, Article 612(2).
Sudan
Sudan’s Armed Forces Act (2007) provides:
Subject to the provisions of the Criminal Act of 1991, shall be punished with imprisonment for a term not exceeding twenty years, or with any lighter penalty, whoever treats inhumanly any of the persons hereinafter mentioned, during wartime, by killing him/her or causing physical or moral injury or grievous suffering thereto …:
(c) personnel of the medical … service of the enemy, unless they turn into combatants. 
Sudan, Armed Forces Act, 2007, Article 152.
Switzerland
Switzerland’s Ordinance on the Red Cross Service (2006) states:
Article 1 Object and scope of application
1 The present ordinance regulates:
a. the attribution of the members of the Red Cross Service (RCS) to the army;
c. the rights and duties of the RCS that depart from military law;
2 For the rest, the members of the RCS have the same rights and the same duties as the military.
Article 2 Attribution and tasks
1 Members of the RCS are assigned to the army as specialists. They carry out their tasks within the framework of the army’s medical service.
2 Within the framework of the instruction, peace support and assistance services and within the framework of the active service, they support:
a. the nursing services;
b. the medical, dental and pharmaceutical services;
c. the medico-technical and medico-therapeutic services.
3 They are responsible for promoting the fundamental rules of international humanitarian law and the principles of the Red Cross. 
Switzerland, Ordinance on the Red Cross Service, 2006, Articles 1–2.
Tajikistan
Tajikistan’s Criminal Code (1998), in the section on “Serious violations of international humanitarian law”, provides for the punishment of “wilful breaches of norms of international humanitarian law committed in an international or non-international armed conflict, against … medical … personnel”. 
Tajikistan, Criminal Code, 1998, Article 403(2).
Ukraine
Ukraine’s Criminal Code (2001) stipulates that medical personnel are to be respected. 
Ukraine, Criminal Code, 2001, Article 414.
United States of America
The US Military Commissions Act (2006), passed by Congress following the Supreme Court’s decision in Hamdan v. Rumsfeld in 2006, amends Title 10 of the United States Code as follows:
§ 950v. Crimes triable by military commissions
(a) DEFINITIONS AND CONSTRUCTION. – In this section:
(2) PROTECTED PERSON. – The term “protected person” means any person entitled to protection under one or more of the Geneva Conventions, including –
(C) military medical or religious personnel. 
United States, Military Commissions Act, 2006, Public Law 109-366, Chapter 47A of Title 10 of the United States Code, 17 October 2006, p. 120 Stat. 2625, § 950v(a)(2)(C).
United States of America
The US Military Commissions Act (2009) amends Chapter 47A of Title 10 of the United States Code as follows:
§ 950p. Definitions; construction of certain offenses; common circumstances
“(a) DEFINITIONS.—In this subchapter:
“ …
“(2) The term “protected person” means any person entitled to protection under one or more of the [1949] Geneva Conventions, including … military medical … personnel. 
United States, Military Commissions Act, 2009, § 950p(a)(2).
Venezuela
Venezuela’s Code of Military Justice (1998), as amended, prohibits attacks on Red Cross and medical personnel and provides for the punishment of “those who carry out serious attacks against members of … medical services, be they enemy or neutral”. 
Venezuela, Code of Military Justice, 1998, as amended, Article 474.
Yugoslavia, Socialist Federal Republic of
Under the Socialist Federal Republic of Yugoslavia’s Penal Code (1976), as amended in 2001, “murder, torture [or] inhuman treatment” of medical personnel is a war crime. 
Yugoslavia, Socialist Federal Republic of, Penal Code, 1976, as amended in 2001, Article 143.
Colombia
In 2007, in the Constitutional Case No. C-291/07, the Plenary Chamber of Colombia’s Constitutional Court stated that the obligation in the 1977 Additional Protocol II to respect and protect medical personnel “has attained customary status, mainly due to its impact on State practice and on conflicts in the last decades”. 
Colombia, Constitutional Court, Constitutional Case No. C-291/07, Judgment of 25 April 2007, p. 69; see also p. 119.
Israel
In its judgment in Physicians for Human Rights v. IDF Commander in the West Bank in 2002, the Supreme Court of Israel stated:
[I]nternational law provides protection for medical stations and personnel against attack by combat forces. Article 19 of the Geneva Convention for the Amelioration of the Condition of the Wounded and Sick in Armed Forces in the Field, of Aug. 12, 1949 … forbids, under all circumstances, attack of stations and mobile medical units of the “Medical Service,” that is to say, hospitals, medical warehouses, evacuation points for the wounded and sick, and ambulances. 
Israel, Supreme Court, Physicians for Human Rights v. IDF Commander in the West Bank, 28 April 2002, § 1.
Israel
In its judgment in Physicians for Human Rights v. Prime Minister of Israel in 2009, concerning the humanitarian situation in the Gaza Strip consequent to the start of Israeli military operations (“Cast Lead”) there in December 2008, Israel’s High Court of Justice stated:
17. … Everyone agrees that the rules of customary international law – which grant protection to medical personnel … – apply to the combat operations that are being carried out in the “Cast Lead” operation and bind the actions of the IDF [Israel Defense Forces].
18. The provisions of international humanitarian law grant protection to medical … personnel from being attacked. Thus … arts. 24–25 of the First Geneva Convention for the Amelioration of the Condition of the Wounded and Sick in Armed Forces in the Field, 1949, prohibit any attack upon medical personnel, if they are exclusively or currently engaged in medical activities; art. 26 of the Fourth Geneva Convention extends this protection to members of the Red Cross or other international organizations that fulfil similar functions (see also art. 20 of the Fourth Geneva Convention). A detailed definition of what constitutes protected medical personnel is laid down in art. 8(c) of the First Protocol [1977 Additional Protocol I] and detailed provisions with regard to the protections that are given to medical personnel are laid down in arts. 12–16 of the First Protocol. 
Israel, High Court of Justice, Physicians for Human Rights v. Prime Minister of Israel, Judgment, 19 January 2009, §§ 17–18.
United Kingdom of Great Britain and Northern Ireland
In 2009, in the MH and DS case, the England and Wales Court of Appeal (Civil Division) was called upon to decide an appeal by MH, a Syrian Kurd, against a decision to exclude her from refugee protection on the basis of Article 1F of the 1951 Refugee Convention. The appellant had been affiliated with the Kurdistan Workers’ Party (PKK) and had inter alia worked as an assistant nurse in a refugee camp set up for Turkish Kurds in Syria. Lord Justice Richards stated: “It is not in dispute that nurses and other medical personnel enjoy a special status and protection under international humanitarian law.” 
United Kingdom, England and Wales Court of Appeal (Civil Division), MH and DS case, Judgment, 24 March 2003, § 31.
United States of America
David Hicks, an Australian citizen, was captured in Afghanistan in December 2001 and afterwards detained at Guantanamo Bay Naval Base, Cuba. In March 2007, in the Hicks case, the accused became the first person to be tried and convicted under the US Military Commissions Act of 2006. Following a pre-trial agreement struck with the Convening Authority, the accused pleaded guilty to the charge of “providing material support for terrorism”. In April 2007, Hicks returned to Australia to serve the remaining nine months of a suspended seven-year sentence. In the case’s record of trial for the 30 March 2007 hearing, the military judge defined various terms contained in the charge to which the accused had pleaded guilty:
“Protected person” means any person entitled to protection under one or more of the Geneva Conventions, including: (a) civilians not taking part in hostilities; (b) military personnel placed hors de combat by sickness, wounds, or detention; and (c) military medical or religious personnel. 
United States, Office of Military Commissions, Hicks case, Record of Trial, 26 and 30 March 2007.
Algeria
The Report on the Practice of Algeria notes that no instances of attacks against medical personnel or objects by the Armée de Libération Nationale (ALN) were reported during Algeria’s war of independence. 
Report on the Practice of Algeria, 1997, Chapter 2.7.
Canada
In 2011, in a statement before the UN Security Council during an open debate in connection with the agenda item “Children and Armed Conflict”, the deputy permanent representative of Canada stated on behalf of the Group of Friends of Children and Armed Conflict:
The Friends Group is pleased with the work undertaken by the Security Council, in the last few years, in progressively strengthening the protection framework for children affected by armed conflict. …
Members of the Friends Group have reliably called on the Security Council to strengthen its protection framework even more and consistently called for all six grave violations committed against children in armed conflict to be included amongst the Security Council Resolution 1612 [of 2005] listing criteria. The Friends Group has supported a progressive approach in this regard and therefore commends the Security Council in filling an important gap in the child protection framework by including attacks against schools and hospitals as the latest trigger through the resolution it will adopt today [Resolution 1998(2011)].
For the Friends Group, a new trigger such as this not only includes in the annexes to the Secretary General’s reports on children and armed conflict those parties to armed conflict that, in contravention of applicable international law, engage in attacks against schools and hospitals, but also those who engage in threats or attacks against schoolchildren, patients, educational or medical personnel. 
Canada, Statement by the deputy permanent representative of Canada before the UN Security Council during an open debate in connection with the agenda item “Children and Armed Conflict”, made on behalf of the Group of Friends of Children and Armed Conflict, 12 July 2011.
Canada
In 2012, in a statement before the UN Security Council during an open debate on the protection of civilians in armed conflict, the permanent representative of Canada stated:
The Secretary General and the International Committee of the Red Cross highlight the fact that health care providers and facilities continue to come under attack in situations of conflict and violence. … Humanitarian workers, including medical volunteers, have lost their lives in the performance of their duties. 
Canada, Statement by the permanent representative of Canada before the UN Security Council during an open debate on the protection of civilians in armed conflict, 25 June 2012.
Canada
In 2013, in a statement before the UN Security Council during an open debate on the protection of civilians in armed conflict, the permanent representative of Canada stated:
The brutal conflict in Syria represents a stark example of how much work remains to be achieved to better protect civilians who are routinely victims of deliberate and targeted attacks, as are hospitals, medical facilities and health care workers. The result is that people in desperate need are denied lifesaving humanitarian assistance. … Canada calls on all parties to the conflict in Syria to refrain from attacking civilians and other protected persons and facilities in conformity with their obligations under international law.  
Canada, Statement by the permanent representative of Canada before the UN Security Council during an open debate on the protection of civilians in armed conflict, 19 August 2013, p. 1.
Chile
According to the Report on the Practice of Chile, it is Chile’s opinio juris that the prohibition of attacks on medical personnel and objects is part of customary international law. 
Report on the Practice of Chile, 1997, Chapter 2.7.
China
In 1972, in a statement before the General Conference of UNESCO concerning US attacks in Viet Nam, China criticized the United States because it allegedly had “wantonly bombarded Vietnamese cities and villages, seriously destroyed many schools and cultural and sanitary facilities [and] killed a large number of teachers, students, patients and medical personnel”. 
China, Statement before the General Conference of UNESCO, 25 October 1972, Selected Documents of the Chinese Delegation to the United Nations, The People’s Press, Beijing, 1972, p. 239.
China
According to the Report on the Practice of China, it is China’s opinio juris that medical personnel shall be respected and protected. 
Report on the Practice of China, 1997, Chapter 2.7.
Djibouti
In 2010, in the History and Geography Textbook for 8th Grade, Djibouti’s Ministry of National Education and Higher Education, under the heading “Basic rules of IHL” and in a section on “Specific protection”, stated: “Medical … personnel … shall be respected and protected.ˮ 
Djibouti, Ministry of National Education and Higher Education, History and Geography Textbook for 8th Grade, 2010, p. 194.
France
Under the instructions given to the French armed forces for the conduct of Opération Mistral, simulating a military operation under the right of self-defence or a mandate of the UN Security Council, medical personnel shall be protected. 
France, État-major de la Force d’Action Rapide, Ordres pour l’Opération Mistral, 1995, Section 6, § 62.
Germany, Federal Republic of
At the CDDH, the Federal Republic of Germany stated that it could not agree that “the definitions of Article 8 [of the 1977 Additional Protocol I] could apply to the Geneva Conventions, but they should apply to the whole of [the 1977 Additional Protocol I], and not only to part II”. 
Germany, Federal Republic, Statement at the CDDH, Official Records, Vol. XI, CDDH/II/SR.4, 12 March 1974, p. 26, § 10.
The Federal Republic of Germany also explained that the distinction between local and foreign non-Red Cross relief organizations was “to avoid the situation of an obscure private group from outside the country establishing itself as an aid society within the territory and then being recognized by the rebels”. 
Germany, Federal Republic of, Statement at the CDDH, Official Records, Vol. XII, CDDH/II/SR.80, 4 June 1976, p. 270, § 16.
Germany
In a declaration in 1993, the German Federal Minister of Foreign Affairs condemned the killing of a German soldier belonging to UNTAC’s medical personnel in Cambodia as a “cruel act of violence”. 
Germany, Declaration by the Federal Minister of Foreign Affairs, Süddeutsche Zeitung, 15 October 1993.
Germany
The Report on the Practice of Germany notes that the German Federal Armed Forces may incorporate medical staff into combat units, if they are needed, especially for special missions. 
Report on the Practice of Germany, 1997, Answers to additional questions on Chapter 2.7.
Iraq
The Report on the Practice of Iraq refers to the protection afforded to medical personnel by the 1949 Geneva Conventions. 
Report on the Practice of Iraq, 1998, Chapter 2.7.
On the basis of the reply by Iraq’s Ministry of Defence to a questionnaire, the report also states that the protection of relief personnel is “an absolute principle, without any restriction”. 
Report on the Practice of Iraq, 1998, Chapter 4.2.
Islamic Republic of Iran
According to the Report on the Practice of the Islamic Republic of Iran, the Islamic Republic of Iran accused Iraq on several occasions of attacking Iranian Red Crescent personnel during the Iran–Iraq war. Islamic Republic of Iran claimed that Iraq had violated IHL by committing these acts. 
Report on the Practice of the Islamic Republic of Iran, 1997, Chapter 2.7.
Israel
According to the Report on the Practice of Israel, the Israel Defense Forces (IDF) do not have a policy of targeting the medical personnel of its adversaries. The report adds that the implementation of this policy is subject to such personnel being clearly recognizable and not participating in hostile activities. It further states:
The IDF … has chosen to incorporate its front-line medical staff in its combat units. As a result, when participating in combat missions, front-line Israeli military medical personnel would not carry distinguishing marks and do not expect to be granted protected status in combat situations. 
Report on the Practice of Israel, 1997, Chapter 2.7, referring to Conduct in the Battlefield in Accordance with the Law of War, Israel Defence Forces, 1986, p. 7.
Israel
In 2009, in a report on Israeli operations in Gaza between 27 December 2008 and 18 January 2009 (the “Gaza Operation”, also known as “Operation Cast Lead”), Israel’s Ministry of Foreign Affairs stated: “[The] IDF [Israel Defense Forces] trains forces at all levels to exercise extra caution to avoid harming medical crews … In the Gaza Operation, the IDF reinforced those instructions. In many cases IDF forces suspended their operations against legitimate military objectives when … medical staff were in the vicinity.” 
Israel, Ministry of Foreign Affairs, The Operation in Gaza 27 December 2008–18 January 2009: Factual and Legal Aspects, 29 July 2009, § 371.
Kuwait
During the Iraqi occupation of Kuwait in 1990, Kuwait stated in a letter to the UN Secretary-General: “On the pretext that the staff had been lax in attending to the injured Iraqis, a number of the hospital staff were arrested, tortured and then executed.” These acts were described as violations of “the most basic of human rights” and of the 1949 Geneva Convention IV. 
Kuwait, Letter dated 16 September 1990 to the UN Secretary-General, UN Doc. S/21777, 17 September 1990, p. 1.
Kuwait
At the International Conference for the Protection of War Victims in 1993, Kuwait stated: “Persons committing acts against [medical personnel] must be considered as war criminals.” 
Kuwait, Statement at the International Conference for the Protection of War Victims, Geneva, 30 August–1 September 1993.
Kuwait
According to the Report on the Practice of Kuwait, attacks against medical personnel are an offence under Kuwaiti law. 
Report on the Practice of Kuwait, 1997, Chapter 2.7.
New Zealand
At the CDDH, New Zealand, supported by Austria, stated that the definitions provided by the 1977 Additional Protocol I could not be applied to the 1949 Geneva Conventions and considered that Committee II of the CDDH “was not competent to take a decision affecting the 1949 Geneva conventions”. 
New Zealand, Statement at the CDDH, Official Records, Vol. XI, CDDH/II/SR.4, 12 March 1974, p. 25, § 5.
Nigeria
According to the Report on the Practice of Nigeria, it is Nigeria’s opinio juris that the prohibition of attacks on medical personnel and objects is part of customary international law. 
Report on the Practice of Nigeria, 1997, Chapter 2.7.
Philippines
An agreement, concluded in 1990 between several Philippine governmental departments, the National Police, and a group of NGOs involved in the delivery of medical services, provides for the protection of health workers from harassment and human rights violations. The preamble to the agreement states that the parties are adhering to generally accepted principles of IHL and human rights law. 
Philippines, Memorandum of Agreement on the Delivery of Health Services between the Departments of Foreign Affairs, Justice, Local Government, National Defense and Health and the Philippines Alliance of Human Rights Advocates (PAHRA), the Free Legal Assistance Group (FLAG) and the Medical Action Group (MAG), 10 December 1990, preamble.
Philippines
The Report on the Practice of the Philippines notes that medical personnel are given protection when they are delivering health services. 
Report on the Practice of the Philippines, 1997, Chapter 2.7.
Rwanda
On the basis of replies by army officers to a questionnaire, the Report on the Practice of Rwanda states: “Military medical personnel must be protected.” 
Report on the Practice of Rwanda, 1997, Replies by army officers to a questionnaire, Chapter 2.7.
Medical personnel of aid societies were not specifically mentioned, but in reply to the question regarding the improper use of uniforms, an officer stated that the use of the “uniforms” of humanitarian organizations was prohibited since it endangered their staff. 
Report on the Practice of Rwanda, 1997, Replies by army officers to a questionnaire, Chapter 2.7.
Switzerland
Switzerland’s ABC of International Humanitarian Law (2009) states:
Emblems (distinctive sign)
In Armed conflicts recognisable emblems serve above all to protect military and civilian medical installations as well as the buildings of national relief organisations and their personnel from attack (protective function). This protection is guaranteed not by the emblems themselves but is based directly in international law.
Prisoners of war
The medical and religious personnel who administer to prisoners must not be considered prisoners of war, although they have the right to the same treatment. 
Switzerland, Federal Department of Foreign Affairs, ABC of International Humanitarian Law, 2009, pp. 18 and 34–35.
Switzerland
In 2009, in a statement before the UN Security Council during an open debate on the protection of civilians in armed conflict, the permanent representative of Switzerland stated:
The current situation in Gaza cries out to us the importance of the issue we are discussing today. …
… Switzerland also wishes to recall that all the parties to the conflict are under the obligation to protect medical personnel, hospitals and other sanitary facilities. 
Switzerland, Statement by the permanent representative of Switzerland before the UN Security Council on the protection of civilians in armed conflict, 14 January 2009, pp. 5–6.
Switzerland
In 2009, in its Report on Foreign Policy, Switzerland’s Federal Council stated:
One of the primary concerns of humanitarian law and policy is to guarantee access to victims and to provide assistance to them. However, it frequently occurs … that it is impossible to ensure the security of humanitarian actors. This was once more clearly evident in the Gaza Strip at the end of 2008 and at the beginning of 2009. Switzerland called upon all the parties to the conflict … to protect medical personnel, hospitals and other medical units. 
Switzerland, Federal Council, Report on Foreign Policy 2009, 2 September 2009, Section 3.3.7.3, p. 5811.
Switzerland
In 2011, in a statement before the UN Security Council during an open debate on children and armed conflict, made on behalf of the Group of Friends of Children and Armed Conflict, including Switzerland, the deputy permanent representative of Canada stated:
Members of the Friends Group have reliably called on the [UN] Security Council to strengthen its protection framework even more and consistently called for all six grave violations committed against children in armed conflict to be included amongst the Security Council Resolution 1612 [of 2005] listing criteria. The Friends Group has supported a progressive approach in this regard and therefore commends the Security Council in filling an important gap in the child protection framework by including attacks against schools and hospitals as the latest trigger through the resolution it will adopt today [Resolution 1998(2011)].
For the Friends Group, a new trigger such as this not only includes in the annexes to the Secretary General’s reports on children and armed conflict those parties to armed conflict that, in contravention of applicable international law, engage in attacks against schools and hospitals, but also those who engage in threats or attacks against schoolchildren, patients, educational or medical personnel. 
Canada, Statement by the deputy permanent representative of Canada before the UN Security Council during an open debate in connection with the agenda item “Children and Armed Conflict”, made on behalf of the Group of Friends of Children and Armed Conflict, 12 July 2011.
Switzerland
In 2013 in a statement before the UN Human Rights Council during an interactive dialogue with the Commission of Inquiry on Syria and the UN Special Rapporteur on the human rights of internally displaced persons, the representative of Switzerland stated: “Switzerland condemns in the strongest terms deliberate attacks against medical and humanitarian personnel as well as medical installations, which, let us recall, are protected under international humanitarian law.” 
Switzerland, Statement by the representative of Switzerland before the UN Human Rights Council during an interactive dialogue with the UN Commission of Inquiry on Syria and the UN Special Rapporteur on the human rights of internally displaced persons, 16 September 2013.
Switzerland
In 2013, in a statement at the 64th Session of the Executive Committee of the Programme of the UN High Commissioner for Refugees, the ambassador of Switzerland stated: “Switzerland condemns in the strongest terms deliberate attacks against medical and humanitarian personnel as well as medical infrastructure and material. Such attacks constitute a war crime, a flagrant violation of international humanitarian law and an attack on human dignity.” 
Switzerland, Statement by the ambassador of Switzerland at the 64th Session of the Executive Committee of the Programme of the UN High Commissioner for Refugees, 1 October 2013.
Switzerland
In 2013, in a statement before the UN General Assembly during an interactive dialogue with the UN Special Rapporteur on the human rights of internally displaced persons, the representative of Switzerland stated: “Switzerland condemns in the strongest terms deliberate attacks against the civilian population, including medical and humanitarian personnel, as well as against civilian, and especially medical, infrastructure. Such attacks constitute serious violations of international humanitarian law.” 
Switzerland, Statement by the representative of Switzerland before the UN General Assembly during an interactive dialogue with the UN Special Rapporteur on the human rights of internally displaced persons, 24 October 2013.
United Kingdom of Great Britain and Northern Ireland
A training video on IHL produced by the UK Ministry of Defence emphasizes the duty to respect, and not to attack, medical personnel. 
United Kingdom, Ministry of Defence, Training Video: The Geneva Conventions, 1986, Report on UK Practice, 1997, Chapter 2.7.
United Kingdom of Great Britain and Northern Ireland
According to the Report on UK Practice, there is no practice of incorporating medical staff in combat units in the UK armed forces. 
Report on UK Practice, 1997, Chapter 2.7.
United States of America
At the CDDH, the United States stated that Committee II of the CDDH “was not competent to take a decision to apply to the 1949 Geneva Conventions the terms defined in Article 8”. 
United States, Statement at the CDDH, Official Records, Vol. XI, CDDH/II/SR.4, 12 March 1974, p. 25, § 4.
United States of America
Upon signature of the 1977 Additional Protocols I and II, the United States declared:
It is the understanding of the United States of America that the terms used in Part III of [the 1977 Additional Protocol II] which are the same as the terms defined in Article 8 [of the 1977 Additional Protocol I] shall so far as relevant be construed in the same sense as those definitions. 
United States, Declaration made upon signature of the 1977 Additional Protocol I and the 1977 Additional Protocol II, 12 December 1977, § B.
United States of America
In 1987, in submitting the 1977 Additional Protocol II to the US Senate for advice and consent to ratification, the US President expressed the view that
the obligations in Additional Protocol II are no more than a restatement of the rules of conduct with which US military forces would almost certainly comply as a matter of national policy, constitutional and legal protections, and common decency. 
United States, Message from the US President transmitting the 1977 Additional Protocol II to the US Senate for advice and consent to ratification, Treaty Doc. 100-2, 29 January 1987, Comment on Article 10.
United States of America
In 1987, the Deputy Legal Adviser of the US Department of State affirmed that “we support the principle that medical and religious personnel must be respected and protected” as provided in Article 15 of the 1977 Additional Protocol I. 
United States, Remarks of Michael J. Matheson, Deputy Legal Adviser, US Department of State, The Sixth Annual American Red Cross-Washington College of Law Conference on International Humanitarian Law: A Workshop on Customary International Law and the 1977 Protocols Additional to the 1949 Geneva Conventions, American University Journal of International Law and Policy, Vol. 2, 1987, pp. 423–424.
United States of America
In 1991, in a diplomatic note to Iraq concerning operations in the Gulf War, the United States stated that medical personnel must be respected and protected at all times. 
United States, Department of State, Diplomatic Note to Iraq, Washington, 19 January 1991, annexed to Letter dated 21 January 1991 to the President of the UN Security Council, UN Doc. S/22122, 21 January 1991, Annex I, p. 2.
United States of America
In 1996, the US Department of State qualified the killing of six ICRC medical aid workers in Chechnya as a “barbaric act” and condemned it “in the strongest possible terms”. 
United States, Department of State, Daily Press Briefing, 17 December 1996.
United States of America
In 1998, the Office of General Counsel of the US Department of Defence issued a memorandum on the subject of whether radio operators assigned to an air force medical unit could be issued with identification cards bearing the red cross and documenting their status as personnel “exclusively engaged in supporting a medical unit or establishment in performance of its medical mission” under Article 24 of the 1949 Geneva Convention I. The memorandum concluded that “the administrative staff category would appear to be broad enough to cover radio operators, so long as they are exclusively engaged in supporting a medical unit or establishment in the performance of its medical mission”. 
United States, Department of Defence, Office of General Counsel, Memorandum for Defence Resources Activity, Subject: Geneva Convention Cards for Medical Personnel, 4 August 1998, Yearbook of International Humanitarian Law, Vol. 2, 1999, p. 422.
United States of America
According to the Report on US Practice, it is the opinio juris of the United States that medical personnel are not to be knowingly attacked or unnecessarily prevented from performing their duties in either international or non-international armed conflicts. It adds: “Customary practice has proceeded little beyond the specific rules of the Geneva Conventions, with a few exceptions.” The report notes that there is no practice of incorporating medical staff in combat units in the armed forces. 
Report on US Practice, 1997, Chapter 2.7.
Venezuela
In 1993, during a debate in the UN Security Council on the situation in the former Yugoslavia, Venezuela stated that those who had committed war crimes and crimes against humanity, including “attacks upon … medical personnel”, had to be brought to justice. 
Venezuela, Statement before the UN Security Council, UN Doc. S/PV.3269, 24 August 1993, p. 44.
Yugoslavia
Order No. 579 issued in 1991 by the Chief of Staff of the Yugoslav People’s Army (YPA) instructs YPA units to “apply all means to prevent any attempt of … mistreatment of … religious and medical personnel”. 
Yugoslavia, Chief of General Staff of the Yugoslav People’s Army, Political Department, Order No. 579, 14 October 1991, § 2.
Yugoslavia, Socialist Federal Republic of
In 1991, in a document entitled “Examples of violations of the rules of international law committed by the so-called armed forces of Slovenia”, the Ministry of Defence of the Socialist Federal Republic of Yugoslavia included as an example the arrest of medical teams even though they were wearing the red cross emblem. 
Yugoslavia, Socialist Federal Republic of, Ministry of Defence, Examples of violations of the rules of international law committed by the so-called armed forces of Slovenia, 10 July 1991, § 1(iii).
Zimbabwe
The Report on the Practice of Zimbabwe states that the rule on the protection of medical personnel from attack is part of customary international law. In particular, it points out the customary status of Articles 15 and 16 of the 1977 Additional Protocol I. 
Report on the Practice of Zimbabwe, 1998, Chapter 2.7.
UN General Assembly
In a resolution adopted in 1984 on the situation of human rights in El Salvador, the UN General Assembly urged the government and the insurgent forces “to agree as early as possible to respect the medical personnel … as required by the Geneva Conventions”. 
UN General Assembly, Res. 39/119, 14 December 1984, § 9, voting record: 93-11-40-15.
UN General Assembly
In a resolution adopted in 1985 on the situation of human rights and fundamental freedoms in El Salvador, the UN General Assembly:
Expresses its deep concern at the fact that serious and numerous violations of human rights continue to take place in El Salvador owing above all to non-fulfilment of the humanitarian rules of war and therefore … recommends that the UN Special Representative [for El Salvador] should, for the duration of the armed conflict, continue to observe and to inform the General Assembly and the Commission on Human Rights of the extent to which the contending parties are respecting those rules, particularly as regards humanitarian treatment and respect for … health personnel … of either party. 
UN General Assembly, Res. 40/139, 13 December 1985, § 3, voting record: 100-2-42-15.
This recommendation was reiterated in a subsequent resolution adopted in 1986. 
UN General Assembly, Res. 41/157, 4 December 1986, § 4, voting record: 110-0-40-9.
UN Commission on Human Rights
In a resolution adopted in 1987 on the situation of human rights in El Salvador, the UN Commission on Human Rights requested that the UN Special Representative for El Salvador “continue to observe and inform the General Assembly and the Commission of the extent to which the contending parties are respecting the humanitarian rules of war, particularly as regards respect for … health personnel”. 
UN Commission on Human Rights, Res. 1987/51, 11 March 1987, § 5, voting record: 36-0-7.
UN Commission on Human Rights
In a resolution adopted in 2003 on the question of the violation of human rights in the occupied Arab territories, including Palestine, the UN Commission on Human Rights:
Also strongly condemns again the opening of fire by the Israeli army of occupation on ambulances and paramedical personnel and the practice of preventing ambulances and vehicles of the International Committee of the Red Cross from reaching the wounded and the dead in order to transport them to hospital, thus leaving the wounded bleeding to death in the streets. 
UN Commission on Human Rights, Res. 2003/6, 15 April 2003, § 10, voting record: 33-5-15.
UN Commission on Human Rights
In a resolution adopted in 2004 on the question of the violation of human rights in the occupied Arab territories, including Palestine, the UN Commission on Human Rights:
Also strongly condemns once more the Israeli army of occupation’s practices of opening fire on ambulances and paramedical personnel and preventing ambulances and vehicles of the International Committee of the Red Cross from reaching the wounded and the dead in order to transport them to hospital, thus leaving the wounded bleeding to death in the streets. 
UN Commission on Human Rights, Res. 2004/10, 15 April 2004, § 10, voting record: 31-7-15.
UN Human Rights Council
In a resolution adopted in 2006 on the question of human rights violations emanating from Israeli military incursions in the Occupied Palestinian Territory, the UN Human Rights Council:
Affirming that, under international humanitarian law, the medical personnel and means of transport of the Palestine Red Crescent Society must be protected and respected in all circumstances,
1. Condemns the Israeli killing of Palestinian civilians, including women and children, as well as of medics in Beit Hanoun and other Palestinian towns and villages, and calls for bringing the perpetrators thereof to justice. 
UN Human Rights Council, Res. S-3/1, 15 November 2006, preamble and § 1, voting record: 32-8-6.
UN Sub-Commission on Human Rights
In a resolution adopted in 1985 on the situation in El Salvador, the UN Sub-Commission on Human Rights:
Recommends that the UN Special Representative for El Salvador inform the Commission on whether both parties accept their obligation to respect the Geneva Conventions and to what extent they are truly observing them, specially in those aspects which refer to the protection of … the medical personnel of both parties. 
UN Sub-Commission on Human Rights, Res. 1985/18, 29 August 1985, § 4.
UN Commission of Experts Established pursuant to Security Council Resolution 780 (1992)
In 1994, in its final report on grave breaches of the Geneva Conventions and other violations of IHL committed in the former Yugoslavia, the UN Commission of Experts Established pursuant to Security Council Resolution 780 (1992) linked attacks on medical personnel to “ethnic cleansing”, regarding them as a coercive means to remove the population from certain areas.  
UN Commission of Experts Established pursuant to Security Council Resolution 780 (1992), Final report, UN Doc. S/1994/674, 27 May 1994, §§ 133–134.
UN Commission of Experts Established pursuant to Security Council Resolution 935 (1994)
In 1994, in its final report on grave violations of IHL in Rwanda, the UN Commission of Experts Established pursuant to Security Council Resolution 935 (1994) treated the cases of attacks on medical personnel no differently from attacks on civilians. It mostly referred to common Article 3 of the 1949 Geneva Conventions (acknowledging its customary status) and of the 1977 Additional Protocol II. 
UN Commission of Experts Established pursuant to Security Council Resolution 935 (1994), Final report, UN Doc. S/1994/1405, 9 December 1994, §§ 73–92.
UN Verification Mission in Guatemala
In 1995, in a report on the conflict in Guatemala, the Director of MINUGUA recommended to the Unidad Revolucionaria Nacional Guatemalteca (URNG) that it “should issue precise instructions to its combatants to refrain from … endangering ambulances and duly identified health workers who assist such wounded persons”. 
MINUGUA, Director, First report, UN Doc. A/49/856, 1 March 1995, Annex, § 194.
UN Commission on the Truth for El Salvador
In its report in 1993, the UN Commission on the Truth for El Salvador held that the summary execution of a Spanish doctor who had entered El Salvador to work as a doctor for the Farabundo Martí para la Liberación Nacional (FMLN) was a flagrant violation of IHL and human rights law. No indication was given as to what were the doctor’s activities, and the Commission made no mention of the special protected status of medical personnel. 
UN Commission on the Truth for El Salvador, Report, UN Doc. S/25500, 1 April 1993, Annex, pp. 89–92.
The Commission described the summary execution of a French nurse working in an FMLN hospital by a unit of the Salvadoran Air Force as a deliberate attack on medical personnel in violation of IHL. 
UN Commission on the Truth for El Salvador, Report, UN Doc. S/25500, 1 April 1993, Annex, pp. 87–89.
Council of Europe Parliamentary Assembly
In a resolution adopted in 1988 on the protection of humanitarian medical missions, the Council of Europe Parliamentary Assembly called on all States to respect “the right of medical personnel to be protected during their missions”. It recalled that the 1977 Additional Protocols afforded protection to medical personnel intervening in conflicts of a non-international nature. The Parliamentary Assembly further emphasized that the protected status applied only to medical personnel working under the aegis of the ICRC or to personnel employed by a State and that the application of these texts did not always cover cases of internal conflicts not recognized by the legal government. 
Council of Europe, Parliamentary Assembly, Res. 904 (1988), 30 June 1988, § 14 and Annex, § 1.
Organization for Security and Co-operation in Europe
Following the killing of six ICRC medical aid workers in Chechnya in December 1996, the OSCE Chairman stated that he was “horrified to learn of the atrocious crime which claimed the lives of six International Red Cross aid workers as they were sleeping” and strongly condemned “this act of violence … and terrorism”. 
OSCE, Chairman in Office, Press Release 86/96, 17 December 1996.
Diplomatic Conference on the Reaffirmation and Development of International Humanitarian Law Applicable in Armed Conflicts
At the CDDH, the Working Group on the Protection of Medical Personnel considered in its report that the term “medical personnel” as used in the 1977 Additional Protocol II should include all the categories of personnel listed in Article 8(c) of the 1977 Additional Protocol I. 
CDDH, Official Records, Vol. XIII, CDDH/II/269, 3 February–18 April 1975, p. 217.
However, the definition developed for the 1977 Additional Protocol II by Committee II, which took into account the specific aspects of non-international armed conflicts, provided that medical personnel included, inter alia, “medical personnel of other aid societies [other than Red Cross or Red Crescent organizations] recognised and authorised by a Party to the conflict and located within the territory of the High Contracting Party in whose territory an armed conflict is taking place”. 
CDDH, Official Records, Vol. XIII, CDDH/235/Rev.1, Report of Committee II, 21 April–11 June 1976, p. 304.
In this respect, the Drafting Committee stated:
It had been necessary to specify that aid societies other than Red Cross organizations must be located within the territory of the High Contracting Party in whose territory the armed conflict was taking place in order to avoid the situation of an obscure private group from outside the country establishing itself as an aid society within the territory and being recognized by the rebels. 
CDDH, Official Records, Vol. XII, CDDH/II/SR.80, 4 June 1976, p. 270, § 16.
International Conference for the Protection of War Victims
The Final Declaration adopted by the International Conference for the Protection of War Victims in 1993 urged all States to “make every effort” to protect medical personnel. 
International Conference for the Protection of War Victims, Geneva, 30 August–1 September 1993, Final Declaration, § II (9), ILM, Vol. 33, 1994, p. 301.
Conference of African Ministers of Health
In a resolution on health and war adopted in 1995, the Conference of African Ministers of Health invited OAU Member States “to do everything possible to protect medical personnel against pressure, threats and attempts on their lives”. 
Conference of African Ministers of Health, Cairo, 26–28 April 1995, Res. 14 (V), § 5(c).
No data.
ICRC
The ICRC Commentary on the Additional Protocols, in the light of the fact that the 1977 Additional Protocol II provides no definition of medical personnel, states: “We should therefore refer, both for medical personnel and for religious personnel, to the definitions of these terms given in Article 8 (Terminology) of Protocol I.” 
Yves Sandoz et al. (eds.), Commentary on the Additional Protocols, ICRC, Geneva, 1987, § 4663.
The Commentary further specifies that:
4666. The term “Red Cross organizations” was used in order to cover not only the assistance available on the government side, but also groups or sections of the Red Cross on the other side which already existed, and even improvised organizations which might be set up during the conflict.
4667. Such was the intention of the negotiators, and this interpretation remains in the absence of definitions in the Protocol. It is supported not only by the above-mentioned work of the Conference, but also by Article 18 (Relief societies and relief actions), paragraph 1, which uses the term “Red Cross organizations” in this sense. As regards relief societies, it was considered necessary to specify that relief societies other than Red Cross organizations should be located within the territory of the Contracting Party where the armed conflict was taking place, to avoid private groups from outside the country establishing themselves by claiming the status of a relief society and then being recognized by the insurgents.
4668. In the absence of a precise definition, the term “medical personnel” covers both permanent and temporary categories. The term “permanent medical personnel” means medical personnel exclusively assigned to medical purposes for an unspecified length of time, while “temporary medical personnel” are personnel exclusively assigned to medical purposes for limited periods.
4669. In both cases such assignment must be exclusive. It should be noted that such status is based on the functions carried out, and not on qualifications. 
Yves Sandoz et al. (eds.), Commentary on the Additional Protocols, ICRC, Geneva, 1987, §§ 4666–4669.
ICRC
To fulfil its task of disseminating IHL, the ICRC has delegates around the world teaching armed and security forces that:
64. “Medical personnel” means personnel assigned exclusively to medical activities, to the administration of medical establishments and to medical transportation.
78. The law of war grants the same status to civilian and military medical services … The provisions governing military medical personnel … apply equally to the corresponding categories of the civilian medical service. 
Frédéric de Mulinen, Handbook on the Law of War for Armed Forces, ICRC, Geneva, 1987, §§ 64 and 78.
Delegates also teach that:
474. Specifically protected personnel … recognized as such must be respected.
475. Specifically protected personnel shall be allowed to fulfil their activity, unless the tactical situation does not permit … Their mission and genuine activity may be verified. Armed enemy personnel may be disarmed. 
Frédéric de Mulinen, Handbook on the Law of War for Armed Forces, ICRC, Geneva, 1987, §§ 474–475.
ICRC
In a press release issued in 1978, the ICRC urgently appealed to the belligerents in Lebanon “to take measures immediately to ensure that hospitals and medical personnel may continue their work unimpeded and in safety”. 
ICRC, Press Release No. 1341, Lebanon: ICRC appeals for truce, 2 October 1978.
ICRC
In a press release issued in 1991 in the context of the Gulf War, the ICRC reminded the parties to respect and protect medical personnel at all times. 
ICRC, Press Release No. 1658, Gulf War: ICRC reminds States of their obligations, 17 January 1991.
National Society (Croatia)
In 1991, the Croatian Red Cross denounced attacks against medical personnel by the Yugoslav army. 
Croatian Red Cross, Protest against repeated violations of the Geneva Conventions and Humanitarian Law in Vukovar, 22 November 1991.
ICRC
In a press release issued in 1992, the ICRC urged the parties to the conflict in Nagorno-Karabakh to ensure that medical personnel were respected and protected. 
ICRC, Press Release No. 1670, Nagorno-Karabakh: ICRC calls for respect for humanitarian law, 12 March 1992.
ICRC
In a press release issued in 1992, the ICRC enjoined the parties to the conflict in Afghanistan “to respect medical personnel”. 
ICRC, Press Release No. 1712, Afghanistan: ICRC appeals for compliance with humanitarian rules, 5 May 1992; see also Press Release No. 1726, Afghanistan: New ICRC appeal for compliance with humanitarian rules, 14 August 1992 and Press Release No. 1764, Afghanistan: ICRC calls for respect for the civilian population, 8 February 1994.
ICRC
In a press release issued in 1992, the ICRC urged the parties to the conflict in Tajikistan “to make certain that medical personnel … are respected and protected”. 
ICRC, Press Release, Tajikistan: ICRC urges respect for humanitarian rules, ICRC Dushanbe, 23 November 1992.
ICRC
In a communication to the press issued in 1993, the ICRC appealed to the belligerents in the conflict in Georgia “to respect hospitals and medical personnel in all circumstances”. 
ICRC, Communication to the Press No. 93/32, Conflict in Georgia: ICRC action, 22 September 1993.
National Society (Mexico)
In a declaration issued in 1994 in the context of the conflict between the Mexican Government and the Ejército Zapatista de Liberación Nacional (EZLN), the Mexican Red Cross stated:
Protection must be extended to health personnel in general and, in particular, to Mexican Red Cross personnel … Health personnel as well as Mexican Red Cross personnel must be deemed to be neutral and must therefore not be attacked. 
Mexican Red Cross, Declaración de Cruz Roja Mexicana en torno a los acontecimientos que se han presentado en el Chiapas a partir del 1o. enero de 1994, 3 January 1994, § 2(C).
ICRC
In a press release issued in 1994, the ICRC appealed to the parties to the internal armed conflict in Yemen to respect and facilitate the work of first-aiders from the Yemen Red Crescent Society and of ICRC delegates. 
ICRC, Press Release No. 1773, Fighting in Yemen, 9 May 1994.
ICRC
In 1994, in a Memorandum on Respect for International Humanitarian Law in Angola, the ICRC stated that medical personnel “shall be protected and respected”. 
ICRC, Memorandum on Respect for International Humanitarian Law in Angola, 8 June 1994, § III, IRRC, No. 320, 1997, p. 504
ICRC
In a press release issued in 1994, the ICRC urged the parties to the conflict in Chechnya “to ensure that medical personnel … are respected and protected”. 
ICRC, Press Release No. 1793, Chechnya: ICRC urges respect for humanitarian rules, 28 November 1994; see also Communication to the Press No. 96/10, Chechen conflict: ICRC appeal, 8 March 1996 and Communication to the Press No. 96/27, Russian Federation/Chechnya: ICRC calls on Federal Authorities to extend ultimatum, 21 August 1996.
ICRC
In a press release issued in 1995, the ICRC expressed concern about an attack on a hospital in Burundi, which it regarded as a grave breach of IHL, and reminded the belligerents that all medical personnel must be respected. 
ICRC, Press Release No. 50, Burundi: Grenade lands in hospital room, 13 December 1995.
ICRC
In a press release issued in 2000, following allegations that the Palestine Red Crescent Society had been targeted in shooting incidents, the ICRC stated: “Any attacks … on those medical personnel … indeed constitute a grave violation of International Humanitarian Law.” 
ICRC, Press Release, Israel and the Occupied Territories: Respect for medical personnel, ICRC Tel Aviv, 1 November 2000.
ICRC
In a communication to the press issued in 2000 in connection with the hostilities in the Near East, the ICRC stated:
Members of the medical services must be respected and protected. They must be allowed to circulate unharmed so that they can discharge their humanitarian duties. All those who take part in the confrontations must respect the medical services, whether deployed by the armed forces, civilian facilities, the Palestine Red Crescent Society or the Magen David Adom in Israel. 
ICRC, Communication to the Press No. 00/42, ICRC appeal to all involved in the violence in the Near East, 21 November 2000.
ICRC
In a communication to the press issued in 2001, the ICRC, deeply concerned by the situation in Afghanistan, urged the warring parties to “ensure the safety of medical personnel”. 
ICRC, Communication to the Press No. 01/47, Afghanistan: ICRC calls on all parties to conflict to respect international humanitarian law, 24 October 2001.
Americas Watch
In several reports on violations of the laws of war and on human rights in Nicaragua between 1985 and 1988, Americas Watch noted attacks against medical personnel by the armed opposition. 
Americas Watch, Violations of the Laws of War by Both Sides in Nicaragua: 1981–1985, New York, March 1985, pp. 81–83; Human Rights in Nicaragua: 1985–1986, New York, March 1986, p. 105; Human Rights in Nicaragua: August 1987–August 1988, New York, August 1988, pp. 94–95.
In one such report, it mentioned an incident in which civilian medical personnel were kidnapped by the contras. Two of them were taken over to Honduras and held and maltreated for several days. Miskito Indians were tried and convicted as accomplices in the kidnapping. They were later granted an amnesty. In the same report, Americas Watch also stated that doctors who worked in the countryside had been targeted for abduction and that several foreign physicians had been murdered. 
Americas Watch, Violations of the Laws of War by Both Sides in Nicaragua: 1981–1985, New York, March 1985, pp. 74 and 80–82.
União Nacional para Independência Total de Angola (UNITA)
In 1988, in the context of the conflict in Angola, UNITA expressed concern about the premeditated targeting of medical personnel by government forces. It deplored the fact that the 1949 Geneva Conventions had no validity in guerrilla warfare. 
“Comments of a UNITA official”, Allgemeine Zeitung, 21 March 1988.
Africa Watch
In 1989, in a report on violations of the laws of war in Angola, Africa Watch stated that the targeting of medical personnel was unlawful. 
Africa Watch, Angola: Violations of the Laws of War by Both Sides, New York, April 1989, pp. 147–148.
Medical Action Group (MAG)
In a report in 1989, MAG, a Philippine NGO, reported threats, harassment and physical abuse of health workers. 
Aurora A. Parong, Total War: A Threat to People’s Health and Lives, Medical Action Group (MAG), Philippines, 1989, p. 4, § 5.
Turku Declaration of Minimum Humanitarian Standards
The Turku Declaration of Minimum Humanitarian Standards, adopted by an expert meeting convened by the Institute for Human Rights of Åbo Akademi University in Turku/Åbo, Finland in 1990, states: “Medical … personnel shall be respected and protected and shall be granted all available help for the performance of their duties.” 
Turku Declaration of Minimum Humanitarian Standards, adopted by an expert meeting convened by the Institute for Human Rights, Åbo Akademi University, Turku/Åbo, 30 November–2 December 1990, Article 14(1), IRRC, No. 282, 1991, p. 335.
International Institute of Humanitarian Law
The Rules of International Humanitarian Law Governing the Conduct of Hostilities in Non-international Armed Conflicts, adopted in 1990 by the Council of the International Institute of Humanitarian Law, provide: “The obligation to respect and protect medical … personnel … in the conduct of military operations is a general rule applicable in non-international armed conflicts.” 
International Institute of Humanitarian Law, Rules of International Humanitarian Law Governing the Conduct of Hostilities in Non-international Armed Conflicts, Rule A5, IRRC, No. 278, 1990, p. 391.
Geneva Convention (1906)
Article 8(1) of the 1906 Geneva Convention lists among the conditions not depriving mobile sanitary formations and fixed establishments of the protection guaranteed by Article 6 of the Convention the fact “that the personnel of a formation or establishment is armed and uses its arms in self defense or in defense of its sick and wounded”. 
Convention for the Amelioration of the Condition of the Wounded and Sick in Armies in the Field, Geneva, 6 July 1906, Article 8(1).
Geneva Convention (1929)
Article 8(1) of the 1929 Geneva Convention lists among the conditions not depriving mobile medical formations and fixed establishments of the protection guaranteed by Article 6 of the Convention the fact “that the personnel of the formation or establishment is armed, and that they use the arms in their own defence or in that of the sick and wounded in charge”. 
Convention for the Amelioration of the Condition of the Wounded and Sick in Armies in the Field, Geneva, 27 July 1929, Article 8(1)
Geneva Convention I
Article 22(1) of the 1949 Geneva Convention I lists among the conditions not depriving fixed establishments and mobile medical units of the protection guaranteed by Article 19 of the 1949 Geneva Convention I the fact “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”. 
Convention (I) for the Amelioration of the Condition of the Wounded and Sick in Armed Forces in the Field, Geneva, 12 August 1949, Article 22(1).
Additional Protocol I
Under Article 13(2)(a) of the 1977 Additional Protocol I, the fact that “the personnel of the unit are equipped with light individual weapons for their own defence or for that of the wounded and sick in their charge” shall not be considered as an act harmful to the enemy, depriving a medical unit of its protected status. 
Protocol Additional to the Geneva Conventions of 12 August 1949, and relating to the Protection of Victims of International Armed Conflicts (Protocol I), Geneva, 8 June 1977, Article 13(2)(a). Article 13 was adopted by consensus. CDDH, Official Records, Vol. VI, CDDH/SR. 37, 24 May 1977, p. 70.
Additional Protocol II (draft)
Article 17(2) and (3)(a) of the draft Additional Protocol II, adopted by consensus in Committee II of the CDDH, provided:
2.The protection to which medical units and transports are entitled shall not cease unless they are used to commit, outside their humanitarian function, acts harmful to the adverse Party.
3.The following shall not be considered as harmful acts:
(a) that the personnel of the unit or the transport are equipped with light individual weapons for their own defence or for that of the wounded and sick for whom they are responsible. 
CDDH, Official Records, Vol. XIII, CDDH/221/Rev.1, 3 February–18 April 1975, p. 130, § 170 and p. 197.
Eventually, however, subparagraph (3) was deleted from Article 17 of the draft Additional Protocol II, which was then adopted by consensus in the plenary meeting of the CDDH. 
CDDH, Official Records, Vol. VII, CDDH/SR.51, 3 June 1977, p. 113.
No data.
Argentina
Argentina’s Law of War Manual (1969) lists among the conditions not depriving fixed establishments and mobile medical units of their protection “the fact that the personnel of the unit or establishment are armed and use their arms in their own defence or in that of the wounded and sick in their charge”. 
Argentina, Leyes de Guerra, RC-46-1, Público, II Edición 1969, Ejército Argentino, Edición original aprobado por el Comandante en Jefe del Ejército, 9 May 1967, § 3.007.
Australia
Australia’s Commanders’ Guide (1994) provides that military medical personnel lose their protection “if they engage in acts harmful to the enemy … Protection will not be lost if medical members act in self-defence. Defensive weapons such as side-arms may be carried.” 
Australia, Law of Armed Conflict, Commanders’ Guide, Australian Defence Force Publication, Operations Series, ADFP 37 Supplement 1 – Interim Edition, 7 March 1994, § 615.
Australia
Australia’s Defence Force Manual (1994) states that medical personnel “are protected so long as they do not participate in hostilities. The carriage of light individual weapons for self-defence or for defence of wounded or sick in their care is not considered participation.” 
Australia, Manual on Law of Armed Conflict, Australian Defence Force Publication, Operations Series, ADFP 37 – Interim Edition, 1994, § 521; see also §§ 911 and 964.
Australia
Australia’s LOAC Manual (2006) states that medical personnel “are protected so long as they do not participate in hostilities. The carriage of light individual weapons for self-defence or for defence of wounded or sick in their care is not considered participation.” 
Australia, The Manual of the Law of Armed Conflict, Australian Defence Doctrine Publication 06.4, Australian Defence Headquarters, 11 May 2006, § 5.23; see also §§ 9.11 and 9.69.
The LOAC Manual (2006) replaces both the Defence Force Manual (1994) and the Commanders’ Guide (1994).
Belgium
Belgium’s Law of War Manual (1983) states: “Medical personnel may carry arms but only to defend themselves or the patients in their charge.” 
Belgium, Droit Pénal et Disciplinaire Militaire et Droit de la Guerre, Deuxième Partie, Droit de la Guerre, Ecole Royale Militaire, par J. Maes, Chargé de cours, Avocat-général près la Cour Militaire, D/1983/1187/029, 1983, p. 48.
Belgium
Belgium’s Teaching Manual for Soldiers provides: “The prohibition to attack hospitals remains applicable even if … its personnel carry light individual weapons for their own defence or for the defence of the wounded in their charge, the establishment or material.” 
Belgium, Droit de la Guerre, Dossier d’Instruction pour Soldat, à l’attention des officiers instructeurs, JS3, Etat-Major Général, Forces Armées belges, undated, pp. 18–19.
Benin
Benin’s Military Manual (1995) states: “The use of weapons by medical personnel and by sentries of military medical establishments and transports is subject to regulation (e.g. in case of self-defence).” 
Benin, Le Droit de la Guerre, III fascicules, Forces Armées du Bénin, Ministère de la Défense nationale, 1995, Fascicule II, p. 16.
Burundi
Burundi’s Regulations on International Humanitarian Law (2007) states: “Medical personnel … may carry light individual weapons for their own defence or for the defence of the wounded and sick.” 
Burundi, Règlement n° 98 sur le droit international humanitaire, Ministère de la Défense Nationale et des Anciens Combattants, Projet “Moralisation” (BDI/B-05), August 2007, Part I, p. 15; see also Part I bis, pp. 11, 25 and 57.
The Regulations also states: “The prohibition of attack remains valid even if the hospital is guarded by sentries or if the nurses carry light individual weapons for their own protection and the protection of the wounded, installations and material.” 
Burundi, Règlement n° 98 sur le droit international humanitaire, Ministère de la Défense Nationale et des Anciens Combattants, Projet “Moralisation” (BDI/B-05), August 2007, Part I bis, p. 84.
Cameroon
Cameroon’s Instructor’s Manual (1992) states: “The weapons carried by medical personnel must be of such a nature as to avoid any confusion with combatants.” 
Cameroon, Droit international humanitaire et droit de la guerre, Manuel de l’instructeur en vigueur dans les Forces Armées, Présidence de la République, Ministère de la Défense, Etat-major des Armées, Troisième Division, Edition 1992, p. 87, § 142.
Cameroon
Cameroon’s Instructor’s Manual (2006), under the heading “Command Responsibility”, states: “The weapons of the medical personnel must be of a nature and proportion so as to avoid any confusion with the status of a combatant.” 
Cameroon, Droit des conflits armés et droit international humanitaire, Manuel de l’instructeur en vigueur dans les forces de défense, Ministère de la Défense, Présidence de la République, Etat-major des Armées, 2006, p. 220, § 142.
Canada
Canada’s LOAC Manual (1999) lists among the conditions not depriving medical units of their protection the fact “that the personnel of the medical unit are armed for their own defence or that of the wounded and sick in their charge”. 
Canada, The Law of Armed Conflict at the Operational and Tactical Level, Office of the Judge Advocate General, 1999, p. 4-9, § 91(a).
Canada
Canada’s Code of Conduct (2001) provides: “Personnel of a medical unit or establishment may be armed with small arms and may use those arms in defence of themselves or of the wounded and sick under their charge.” 
Canada, Code of Conduct for CF Personnel, Office of the Judge Advocate General, 4 June 2001, Rule 10, § 6.
Canada
Canada’s LOAC Manual (2001) states in its chapter on targeting:
447. Medical units and establishments
3. The protection to which medical units are entitled shall not cease unless they are used to commit, outside their humanitarian function, acts harmful to the enemy …
4. The following are not considered “acts harmful to the enemy” and do not deprive medical units of protection:
a. that the personnel of the medical unit are armed for their own defence or that of the wounded and sick in their charge;
448. Medical transports
2. Medical transports should not be armed (i.e., crew-served weapons) because of the danger that they may be mistaken as fighting vehicles. Medical personnel in the medical transports can, however, retain their personal weapons. 
Canada, The Law of Armed Conflict at the Operational and Tactical Levels, Office of the Judge Advocate General, 13 August 2001, §§ 447.3, 4.a and 448.2.
Canada
Canada’s Code of Conduct (2005) provides:
Personnel of a medical unit or establishment may be armed with small arms and may use those arms in defence of themselves or of the wounded and sick under their charge. Pickets or sentries equipped with small arms consisting of non-medical personnel, can be used without adversely affecting the protected status of the medical establishment or unit. As a general rule medical transports should not have any weapons “mounted” on them to avoid being mistaken for fighting vehicles. 
Canada, Code of Conduct for CF Personnel, Office of the Judge Advocate General, 2005, Rule 10, § 6.
Central African Republic
The Central African Republic’s Instructor’s Manual (1999) states in Volume 2 (Instruction for group and patrol leaders): “The use of arms by medical personnel and sentries guarding military medical establishments and transports are subject to regulation (for example, legitimate defence).” 
Central African Republic, Le Droit de la Guerre, Fascicule No. 2: Formation pour l’obtention du certificat technique No. 2 (Chef de Groupe), du certificat Inter-Armé (CIA), du certificat d’aptitude de Chef de Patrouille (CACP), Ministère de la Défense, Forces Armées Centrafricaines, 1999, Chapter IV, Section IV.
Chad
Chad’s Instructor’s Manual (2006) states:
Medical personnel may carry light weapons for their own personal protection. Medical establishments and means of transport may be guarded by a person on guard duty, sentries or an escort, who are not, however, entitled to oppose the capture of the medical establishment or means of transport. They must bear distinctive signs. 
Chad, Droit international humanitaire, Manuel de l’instructeur en vigueur dans les forces armées et de sécurité, Ministère de la Défense, Présidence de la République, Etat-major des Armées, 2006, p. 56.
Ecuador
Ecuador’s Naval Manual (1989) provides:
Possession of small arms for self-protection, for the protection of the wounded and sick, and for protection from marauders and others violating the law of armed conflict does not disqualify medical personnel from protected status. Medical personnel may not use such arms against enemy forces acting in conformity with the law of armed conflict. 
Ecuador, Aspectos Importantes del Derecho Internacional Marítimo que Deben Tener Presente los Comandantes de los Buques, Academia de Guerra Naval, 1989, § 11.5.
France
France’s LOAC Summary Note (1992) provides that personnel of military and civilian medical services “may not take a direct part in hostilities [and] they may only be equipped with individual arms for their own protection”. 
France, Fiche de Synthèse sur les Règles Applicables dans les Conflits Armés, Note No. 432/DEF/EMA/OL.2/NP, Général de Corps d’Armée Voinot (pour l’Amiral Lanxade, Chef d’Etat-major des Armées), 1992, § 2.3.
Germany
Germany’s Military Manual (1992) provides:
Medical personnel may be equipped with individual weapons for the protection of the wounded, sick and shipwrecked in their charge as well as for their own protection. Individual weapons are pistols, submachine guns and rifles. 
Germany, Humanitarian Law in Armed Conflicts – Manual, DSK VV207320067, edited by The Federal Ministry of Defence of the Federal Republic of Germany, VR II 3, August 1992, English translation of ZDv 15/2, Humanitäres Völkerrecht in bewaffneten Konflikten – Handbuch, August 1992, § 631; see also §§ 315 and 619.
Ireland
Ireland’s Basic LOAC Guide (2005) states: “Medical personnel may be armed with light individual weapons for their own protection and the protection of persons under their care.” 
Ireland, Basic Guide to the Law of Armed Conflict, TP/TRG/01-2005, Director of Defence Forces Training, Department of Defence, July 2005, p. 4.
Kenya
Kenya’s LOAC Manual (1997) states: “Medical personnel may carry and use small arms for their self-defence and for the defence of the wounded and sick in their care.” 
Kenya, Law of Armed Conflict, Military Basic Course (ORS), 4 Précis, The School of Military Police, 1997, Précis No. 3, p. 9.
Netherlands
The Military Manual (1993) of the Netherlands provides:
Medical personnel may be armed with pistols, sub-machine guns and rifles, but not with machine guns or other weapons that have to be handled by more than one person, or with weapons that are meant for use against material objects, such as missile launchers and other anti-tank weapons, nor with fragmentation hand grenades and the like. 
Netherlands, Toepassing Humanitair Oorlogsrecht, Voorschift No. 27-412/1, Koninklijke Landmacht, Ministerie van Defensie, 1993, p. VI-5.
Netherlands
The Military Handbook (1995) of the Netherlands states:
Medical personnel may not in any way take part in hostilities, but they may be armed. They may, however, only use these weapons to defend themselves or the wounded and sick in their care and not, for example, to prevent being captured by the enemy. 
Netherlands, Handboek Militair, Ministerie van Defensie, 1995, pp. 7-40/7-41.
Netherlands
The Military Manual (2005) of the Netherlands states:
0618. Medical and religious personnel are non-combatants. They may not take part in hostilities. However, medical personnel may bear arms – see point 0621. If they fall into enemy hands, medical personnel are not considered as prisoners of war.
0621. In relation to medical personnel bearing arms, the rule is that they may carry a personal firearm such as a pistol, automatic pistol or rifle. Medical personnel may not be armed with machine guns or other support weapons. They must not bear weapons designed for use against materiel targets, such as rocket launchers and other anti-tank weapons, or fragmentation hand grenades, etc. They may fire their weapons in self-defence, for the defence of the wounded and sick in their care, and to preserve order and calm within the medical institution. 
Netherlands, Humanitair Oorlogsrecht: Handleiding, Voorschift No. 27-412, Koninklijke Landmacht, Militair Juridische Dienst, 2005, §§ 0618 and 0621.
Nigeria
Nigeria’s Manual on the Laws of War states that the protection of medical establishments is not forfeited “merely because medical personnel are armed for self-defence”. 
Nigeria, The Laws of War, by Lt. Col. L. Ode PSC, Nigerian Army, Lagos, undated, § 36.
Norway
Norway’s Medical Services Directive (2009) states:
(1) Medical personnel can be issued with and use personal weapons, which include pistol, machine gun, gun and rifle. These types of weapons should only be used in self-defence purposes.
(2) Medical personnel do not lose the protection they are entitled to if they are in a self-defence situation, using the weapon that are otherwise available to achieve a genuine self-defence, even if these weapons would be other weapons than personal weapons as defined in the first paragraph. 
Norway, Directive on Compliance with Certain International Law Obligations Concerning the Medical Services, Chief of Defence, Defence Staff Norway, 1 May 2009, § 5(1)–(2).
Peru
Peru’s IHL Manual (2004) states:
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 weapons carried by medical personnel are limited to light, individual firearms, which can only be used for the purposes mentioned above. 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. 
Peru, Manual de Derecho Internacional Humanitario para las Fuerzas Armadas, Resolución Ministerial Nº 1394-2004-DE/CCFFAA/CDIH-FFAA, Lima, 1 December 2004, § 83.d.
The manual also states: “Regulations must be established governing the use of weapons by medical personnel, sentries guarding establishments and military medical transports to ensure that they are not confused with people taking a direct part in the hostilities.” 
Peru, Manual de Derecho Internacional Humanitario para las Fuerzas Armadas, Resolución Ministerial Nº 1394-2004-DE/CCFFAA/CDIH-FFAA, Lima, 1 December 2004, § 24.d.(2).(c).
Peru
Peru’s IHL and Human Rights Manual (2010) states:
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 weapons carried by medical personnel are limited to light, individual firearms, which can only be used for the purposes mentioned above. 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. 
Peru, Manual de Derecho Internacional Humanitario y Derechos Humanos para las Fuerzas Armadas, Resolución Ministerial No. 049-2010/DE/VPD, Lima, 21 May 2010, § 74(d), p. 227; see also § 79(b)(1), p. 280.
The manual also states: “Regulations must be established governing the use of weapons by medical personnel, sentries guarding establishments and military medical transports to ensure that they are not confused with people taking a direct part in the hostilities.” 
Peru, Manual de Derecho Internacional Humanitario y Derechos Humanos para las Fuerzas Armadas, Resolución Ministerial No. 049-2010/DE/VPD, Lima, 21 May 2010, § 25(d)(2)(c), p. 229.
Russian Federation
The Russian Federation’s Regulations on the Application of IHL (2001) states: “Military medical personnel may have individual small arms for their own defence and protection of the wounded and sick in their charge.” 
Russian Federation, Regulations on the Application of International Humanitarian Law by the Armed Forces of the Russian Federation, Ministry of Defence of the Russian Federation, Moscow, 8 August 2001, § 1.
The Regulations further states:
Medical transports are allowed to carry individual small arms and ammunition taken from the transported wounded (sick) and shipwrecked as well as individual small arms of the transported military medical personnel. 
Russian Federation, Regulations on the Application of International Humanitarian Law by the Armed Forces of the Russian Federation, Ministry of Defence of the Russian Federation, Moscow, 8 August 2001, § 152.
Sierra Leone
Sierra Leone’s Instructor Manual (2007) states:
[M]edical personnel may carry a Light Individual Weapon (LIW) for self-defence and for the protection of patients under their care from unlawful attack.
Authorized Use of Arms
… medical personnel may use their arms:
- When they or a patient under their care are attacked by marauders, bandits or other persons violating the law of war.
- Medical personnel would be allowed to use his weapon without losing their special protection, if, for example, an enemy soldier enters a medical facility and start killing medical staff or patients.
- Medical personnel may also use his light individual weapon when serving on special duties. For example, when serving on sentry, or guard duty. Such use should however be limited to protecting medical installations, personnel, wounded and sick.
- The Light Individual Weapon may also be used by medical personnel in self-defence; if, for example, the enemy has fired upon him, his medical unit or those under its care.
Unauthorized Use of Arms
Medical personnel should not use their weapon against enemy forces acting in accordance with the law of war … Medical personnel will forfeit their protected status and may be attacked if they unlawfully use their weapon. 
Sierra Leone, The Law of Armed Conflict. Instructor Manual for the Republic of Sierra Leone Armed Forces (RSLAF), Armed Forces Education Centre, September 2007, pp. 57–58.
[emphasis in original]
South Africa
South Africa’s LOAC Manual (1996) provides:
Medical personnel must abstain from all acts of hostility or they lose their protection. They are authorised to carry only light arms and have the right to use them only for their own defence or for that of the wounded or sick for whom they are responsible. 
South Africa, Presentation on the South African Approach to International Humanitarian Law, Appendix A, Chapter 4: International Humanitarian Law (The Law of Armed Conflict), National Defence Force, 1996, § 48. This manual is also included in Chapter 4 of the Draft Civic Education Manual of 1997.
South Africa
South Africa’s Revised Civic Education Manual (2004) states:
Medical … personnel must abstain from all acts of hostility or they lose their protection. They are authorised to carry only light arms and have the right to use them only for their own defence or for that of the wounded and sick for whom they are responsible. 
South Africa, Revised Civic Education Manual, South African National Defence Force, 2004, Chapter 4, § 64.
Spain
Spain’s LOAC Manual (1996) states that military medical personnel
may carry arms for self-defence and for the defence of the wounded, sick and shipwrecked. They may not use them to avoid being taken prisoner. Using these arms in combat will terminate the protection to which they are entitled. 
Spain, Orientaciones. El Derecho de los Conflictos Armados, Publicación OR7-004, 2 Tomos, aprobado por el Estado Mayor del Ejército, División de Operaciones, 18 March 1996, Vol. I, § 4.5.b.(1)(b); see also § 9.6.b.(2).
Spain
Spain’s LOAC Manual (2007) states with regard to medical personnel of the armed forces:
Medical personnel can carry weapons to defend themselves and the wounded, sick and shipwrecked in their charge. They must not use these weapons to avoid being captured or taken prisoner. If they use these weapons in acts of war, they will lose their entitlement to protection. 
Spain, Orientaciones. El Derecho de los Conflictos Armados, Tomo 1, Publicación OR7–004, (Edición Segunda), Mando de Adiestramiento y Doctrina, Dirección de Doctrina, Orgánica y Materiales, 2 November 2007, § 4.5.b.(1).(b); see also §§ 3.2.a and 9.6.b.(2).
The manual also states:
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; medical units guarded by pickets, sentries or escorts … 
Spain, Orientaciones. El Derecho de los Conflictos Armados, Tomo 1, Publicación OR7–004, (Edición Segunda), Mando de Adiestramiento y Doctrina, Dirección de Doctrina, Orgánica y Materiales, 2 November 2007, § 7.3.a.(10).
Switzerland
Switzerland’s Basic Military Manual (1987) states: “Medical personnel may be armed with light weapons for its own defence.” 
Switzerland, Lois et coutumes de la guerre (Extrait et commentaire), Règlement 51.7/II f, Armée Suisse, 1987, Article 78(2); see also Article 83, commentary.
Switzerland
Switzerland’s Regulation on Legal Bases for Conduct during an Engagement (2005) states:
178 For their own protection, medical personnel may be armed with a personal weapon (e.g. assault rifle, submachine gun, pistol). Explosive weapons and collective weapons are prohibited. Medical personnel do not participate in hostilities, except for their own protection or for the protection of the patients in their care. Nor must they be engaged in other harmful acts (e.g. intelligence services). 
Switzerland, Bases légales du comportement à l’engagement (BCE), Règlement 51.007/IVf, Swiss Army, issued based on Article 10 of the Ordinance on the Organization of the Federal Department for Defence, Civil Protection and Sports of 7 March 2003, entry into force on 1 July 2005, § 179.
Togo
Togo’s Military Manual (1996) states: “The use of weapons by medical personnel and by sentries of military medical establishments and transports is subject to regulation (e.g. in case of self-defence).” 
Togo, Le Droit de la Guerre, III fascicules, Etat-major Général des Forces Armées Togolaises, Ministère de la Défense nationale, 1996, Fascicule II, p. 16.
Ukraine
Ukraine’s IHL Manual (2004) states: “Medical personnel of the armed forces may carry light individual weapons for self-defence and to defend wounded and sick”. 
Ukraine, Manual on the Application of IHL Rules, Ministry of Defence, 11 September 2004, § 1.2.34.
United Kingdom of Great Britain and Northern Ireland
The UK Military Manual (1958) lists among the conditions not depriving hospitals and mobile medical units of their protection the fact that “the personnel are armed, and use their arms for their own defence or for the defence of the wounded and sick”. 
United Kingdom, The Law of War on Land being Part III of the Manual of Military Law, The War Office, HMSO, 1958, § 352.
United Kingdom of Great Britain and Northern Ireland
The UK LOAC Pamphlet (1981) provides: “Medical personnel may carry and use small arms for their self-defence and for the defence of the wounded and sick in their care.” 
United Kingdom, The Law of Armed Conflict, D/DAT/13/35/66, Army Code 71130 (Revised 1981), Ministry of Defence, prepared under the Direction of The Chief of the General Staff, 1981, Section 6, p. 23, § 9(b).
United Kingdom of Great Britain and Northern Ireland
The UK LOAC Manual (2004) states:
7.15. Medical personnel may be equipped with “light individual weapons for their own defence or for that of the wounded and sick in their charge.”
7.15.1. 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. It should be stressed that the provision and use of these arms must be merely for defensive purposes as outlined above. Medical personnel (and chaplains) are non-combatants so they are not otherwise entitled to take part in hostilities. Medical personnel may use their weapons only if they, or those in their care, are attacked. 
United Kingdom, The Manual of the Law of Armed Conflict, Ministry of Defence, 1 July 2004, §§ 7.15–7.15.1.
United Kingdom of Great Britain and Northern Ireland
The UK LOAC Manual (2004), as amended in 2010, states: “Medical personnel do not forfeit their protection under Geneva Convention I 1949 by being armed with light individual weapons and by using those arms in their own defence or in the defence of the wounded and sick in their charge.” 
United Kingdom, The Manual of the Law of Armed Conflict, Ministry of Defence, 1 July 2004, as amended by Amendment 3, Ministry of Defence, September 2010, § 4.2.3.
United States of America
The US Field Manual (1956) states:
Although medical personnel may carry arms for self-defense, they may not employ such arms against enemy forces acting in conformity with the law of war. These arms are for their personal defense and for the protection of the wounded and sick under their charge against marauders and other persons violating the law of war. 
United States, Field Manual 27-10, The Law of Land Warfare, US Department of the Army, 18 July 1956, as modified by Change No. 1, 15 July 1976, § 223(b).
United States of America
The US Air Force Commander’s Handbook (1980) states: “Medical personnel are permitted to carry arms solely to protect themselves and their patients against unlawful attack.” 
United States, Air Force Pamphlet 110-34, Commander’s Handbook on the Law of Armed Conflict, Judge Advocate General, US Department of the Air Force, 25 July 1980, § 3-2(d).
United States of America
The US Naval Handbook (1995) states:
Possession of small arms for self-protection, for the protection of the wounded and sick, and for protection from marauders and others violating the law of armed conflict does not disqualify medical personnel from protected status. Medical personnel may not use such arms against enemy forces acting in conformity with the law of armed conflict. 
United States, The Commander’s Handbook on the Law of Naval Operations, NWP 1-14M/MCWP 5-2.1/COMDTPUB P5800.7, issued by the Department of the Navy, Office of the Chief of Naval Operations and Headquarters, US Marine Corps, and Department of Transportation, US Coast Guard, October 1995 (formerly NWP 9 (Rev. A)/FMFM 1-10, October 1989), § 11.5.
United States of America
The Annotated Supplement to the US Naval Handbook (1997) notes that “there was no agreement at the [CDDH] as to what “light individual weapons” for self-defence and for the defence of patients meant, although a number of military experts agreed with the British proposal (see infra). 
United States, Annotated Supplement to the Commander’s Handbook on the Law of Naval Operations, prepared by the Oceans Law and Policy Department, Center for Naval Warfare Studies, Naval War College, Newport, Rhode Island, November 1997, § 11.5, footnote 32.
United States of America
The US Naval Handbook (2007) states:
Medical personnel may possess small arms for self-protection or for the protection of the wounded and sick in their care against marauders and others violating the law of armed conflict. Medical personnel may not use such arms against enemy forces acting in conformity with the law of armed conflict. 
United States, The Commander’s Handbook on the Law of Naval Operations, NWP 1-14M/MCWP 5-12.1/COMDTPUB P5800.7, issued by the Department of the Navy, Office of the Chief of Naval Operations and Headquarters, US Marine Corps, and Department of Homeland Security, US Coast Guard, July 2007, § 8.2.4.1.
Yugoslavia, Socialist Federal Republic of
The Socialist Federal Republic of Yugoslavia’s Military Manual (1988) provides that military medical personnel may carry light weapons for their self-defence. Such personnel is authorized to engage in armed resistance against enemy armed forces directly and deliberately attacking, in spite of warning, and against marauders. 
Yugoslavia, Socialist Federal Republic of, Propisi o Primeri Pravila Medjunarodnog Ratnog Prava u Oruzanim Snagama SFRJ, PrU-2, Savezni Sekretarijat za Narodnu Odbranu (Pravna Uprava), 1988, §§ 171–172.
Bangladesh
Bangladesh’s International Crimes (Tribunal) Act (1973) states that the “violation of any humanitarian rules applicable in armed conflicts laid down in the Geneva Conventions of 1949” is a crime. 
Bangladesh, International Crimes (Tribunal) Act, 1973, Section 3(2)(e).
Denmark
Denmark’s Military Criminal Code (1973), as amended in 1978, provides:
Any person who uses war instruments or procedures the application of which violates an international agreement entered into by Denmark or the general rules of international law, shall be liable to the same penalty [i.e. a fine, lenient imprisonment or up to 12 years’ imprisonment]. 
Denmark, Military Criminal Code, 1973, as amended in 1978, § 25(1).
Denmark’s Military Criminal Code (2005) provides:
Any person who deliberately uses war means [“krigsmiddel”] or procedures the application of which violates an international agreement entered into by Denmark or international customary law, shall be liable to the same penalty [i.e. imprisonment up to life imprisonment]. 
Denmark, Military Criminal Code, 2005, § 36(2).
Ireland
Ireland’s Geneva Conventions Act (1962), as amended in 1998, provides that any “minor breach” of the 1949 Geneva Conventions, including violations of Article 19 of the Geneva Convention I and Article 22 of the Geneva Convention II, and of the 1977 Additional Protocol I, including violations of Article 13(2)(a), are punishable offences. 
Ireland, Geneva Conventions Act, 1962, as amended in 1998, Section 4(1) and (4).
Norway
Norway’s Military Penal Code (1902), as amended in 1981, provides:
Anyone who contravenes or is accessory to the contravention of provisions relating to the protection of persons or property laid down in … the Geneva Conventions of 12 August 1949 … [and in] the two additional protocols to these Conventions … is liable to imprisonment. 
Norway, Military Penal Code, 1902, as amended in 1981, § 108.
Sweden
Sweden’s Total Defence Ordinance relating to IHL (1990) provides: “Those assigned in war time to the armed forces health and medical services may only carry light personal arms.” 
Sweden, Total Defence Ordinance relating to IHL, 1990, Section 10, p. 181.
Switzerland
Switzerland’s Ordinance on the Red Cross Service (2006) states:
Article 1 Object and scope of application
1 The present ordinance regulates:
a. the attribution of the members of the Red Cross Service (RCS) to the army;
Article 9 Arming
1 In principle, members of the RCS carry out their tasks unarmed.
2 On request, the army can equip them with a pistol as an individual weapon and instruct them about their use. 
Switzerland, Ordinance on the Red Cross Service, 2006, Articles 1(1)(a) and 9(1)–(2).
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Germany
In 2005, in reply to a written question by a Member of the Bundestag (Lower House of Parliament), Germany’s Parliamentary State Secretary, Ministry of Defence, wrote:
Male and female members of the medical service currently do service involving the use of arms only in the context of the ISAF [International Security Assistance Force] mission, namely in the form of guard duty. Currently, about 300 male and female members of the medical service are employed in Kabul. Overall, they do 20 guard duty shifts per week.
The use of male and female members of the medical service for guard duty in this context does not give cause to legal concerns. Federal law contains no provision according to which members of the medical service of the Federal Armed Forces would not be allowed to do guard duty.
The peace missions of the Federal Armed Forces and the right of the contingents to defend themselves by means of the guard duty are to be judged under international law mainly against the UN mandates which are at the basis of the deployments as well as against status of forces agreements, which do not exclude guard duty by male and female members of the medical service.
Special features of international law apply to members of the medical service not in peace time, but in times of armed conflicts. According to Article 24 of Geneva Convention I for the Amelioration of the Condition of the Wounded and Sick in Armed Forces in the Field of 12 August 1949, medical personnel exclusively engaged in the search for, or the collection, transport or treatment of the wounded or sick, or in the prevention of disease, as well as staff exclusively engaged in the administration of medical units and establishments shall be respected and protected in all circumstances. Article 22 further shows that in international armed conflicts the male and female members of the medical service may protect themselves and the wounded and sick also with arms, without losing their special protection under international law. The ISAF mission, however, does not take place in the context of an international armed conflict.
As regards the ISAF mission, international law provisions do not limit the use of members of the medical service for guard duty, during which they need to abstain from wearing the armlet with the protective emblem. The right of male and female members of the medical service to wear an armlet with the protective emblem (red cross on a white ground) is regulated by international law. On the basis of a special provision also applicable in times of peace (Article 44 of Geneva Convention I for the Amelioration of the Condition of the Wounded and Sick in Armed Forces in the Field of 12 August 1949) the distinctive emblem must not be worn when fulfilling duties other than medical service duties. 
Germany, Bundestag, Written questions with the replies by the Federal Government received from 18 October to 5 November 2005, Reply by Parliamentary State Secretary, Ministry of Defence, 26 October 2005, BT-Drs. 16/48, 4 November 2005, pp. 16–17.
Hungary
At the CDDH, Hungary stated: “The proposal that civilian medical units should be armed was a new one which his delegation was not prepared to endorse fully at that stage, although it did not wish to exclude it completely.” 
Hungary, Statement at the CDDH, Official Records, Vol. XI, CDDH/SR.14, 7 March 1974, p. 128, § 67.
India
The Report on the Practice of India states: “Medical and religious personnel are also authorised to wear their personal arms for their individual safety.” 
Report on the Practice of India, 1997, Answers to additional questions on Chapter 2.7.
Kuwait
The Report on the Practice of Kuwait states that medical personnel are authorized to defend themselves. 
Report on the Practice of Kuwait, 1997, Chapter 2.7.
Philippines
On the basis of an interview with an officer of the armed forces, the Report on the Practice of the Philippines states that members of the medical corps are not allowed to carry arms, except when in garrison, “because they become the target of the enemy”.  
Report on the Practice of the Philippines, 1997, Interview with an officer of the armed forces, Chapter 2.7.
Union of Soviet Socialist Republics
In a plenary meeting of the CDDH, the representative of the USSR stated that he:
thought the deletion of paragraph 3 [of Article 17 of the draft Additional Protocol II] would enormously complicate matters for medical personnel in actual combat conditions. If, for instance, an army doctor disarmed a wounded soldier and failed to throw away the weapon, would he thereby forfeit his right to protection? He appealed to the representative of Pakistan to restore paragraph 3. 
USSR, Statement at the CDDH, Official Records, Vol. VII, CDDH/SR.51, 3 June 1977, p. 113, § 45.
United Kingdom of Great Britain and Northern Ireland
The Report on UK Practice refers to a letter from an army lawyer who, after consultation with the medical-legal department, confirmed that medical personnel may carry a weapon for the purposes of self-defence and defence of their patients only. He also noted that, during the Gulf War, a certain commander of a field hospital would not allow any weapons at all within the hospital confines, even for self-defence. 
Report on UK Practice, 1997, Letter from an army lawyer, 3 March 1998, Chapter 2.7.
United States of America
At the CDDH, the United States “agreed that the carrying of arms by civilian medical personnel … should not be considered as harmful, but in occupied territories or in areas in which fighting was taking place, the right of the party in control of the area to disarm such personnel should be reserved”. 
United States, Statement at the CDDH, Official Records, Vol. XI, CDDH/SR.14, 7 March 1974, p. 128, § 66.
United States of America
According to the Report on US Practice, it is the opinio juris of the United States that
[medical] personnel and medical vehicles may be armed, but in international armed conflicts, they may use their weapons only in self-defence and in defence of their patients against marauders and against those enemy forces that do not respect their protected status. 
Report on US Practice, 1997, Chapter 2.7.
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ICRC
The ICRC’s Commentary on the Additional Protocols, on the interpretation of the expression “light individual weapons”, states:
This expression was not defined, but it appears from the discussions in Committee II … that it refers to weapons which are generally carried and used by a single individual. Thus not only hand weapons such as pistols are permitted, but also rifles or even sub-machine guns. On the other hand, machine guns and any other heavy arms which cannot easily be transported by an individual and which have to be operated by a number of people are prohibited. Thus it is evident that the level of acceptance is quite high. However, this is the case above all to prevent the unit’s right to protection from being suppressed too easily. 
Yves Sandoz et al. (eds.), Commentary on the Additional Protocols, ICRC, Geneva, 1987, § 563.
ICRC
To fulfil its task of disseminating IHL, the ICRC has delegates around the world teaching armed and security forces that: “Medical personnel may be armed with light individual weapons for their own protection or for that of the wounded and sick in their charge.” 
Frédéric de Mulinen, Handbook on the Law of War for Armed Forces, ICRC, Geneva, 1987, § 76.
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