Practice Relating to Rule 110. Treatment and Care of the Wounded, Sick and Shipwrecked

Note: For practice concerning non-discrimination between the wounded and the sick in general, see Rule 88, Section C.
Geneva Convention I
Article 12, third paragraph, of the 1949 Geneva Convention I provides: “Only urgent medical reasons will authorize priority in the order of treatment to be administered.” 
Convention (I) for the Amelioration of the Condition of the Wounded and Sick in Armed Forces in the Field, Geneva, 12 August 1949, Article 12, third para.
Geneva Convention II
Article 12, third paragraph, of the 1949 Geneva Convention II provides: “Only urgent medical reasons will authorize priority in the order of treatment to be administered.” 
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 12, third para.
Additional Protocol I
Article 10(2) of the 1977 Additional Protocol I provides: “There shall be no distinction among [the wounded, sick and shipwrecked] founded on any grounds other than medical ones.” 
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 10(2). Article 10 was adopted by consensus. CDDH, Official Records, Vol. VI, CDDH/SR. 37, 24 May 1977, p. 69.
Additional Protocol I
Article 15(3) of the 1977 Additional Protocol I provides: “The Occupying Power may not require that, in the performance of [humanitarian] functions, [civilian medical] personnel shall give priority to the treatment of any person except on medical grounds.” 
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(3). Article 15 was adopted by consensus. CDDH, Official Records, Vol. VI, CDDH/SR. 37, 24 May 1977, p. 70.
Additional Protocol II
Article 7(2) of the 1977 Additional Protocol II provides: “There shall be no distinction among [the wounded, sick and shipwrecked] founded on any grounds other than medical ones.” 
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 7(2). Article 7 was adopted by consensus. CDDH, Official Records, Vol. VII, CDDH/SR.51, 3 June 1977, p. 109.
Additional Protocol II
Article 9(2) of the 1977 Additional Protocol II provides: “In the performance of their duties, medical personnel may not be required to give priority to any person except on medical grounds.” 
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(2). Article 9 was adopted by consensus. CDDH, Official Records, Vol. VII, CDDH/SR.51, 3 June 1977, p. 112.
Convention on Cluster Munitions
Article 5(2)(e) of the 2008 Convention on Cluster Munitions states that each State Party shall “[n]ot discriminate against and among cluster munition victims, or between cluster munition victims and those who have suffered injuries and disabilities from other causes; differences in treatment should be based only on medical, rehabilitative, psychological or socio-economic needs”. 
Convention on Cluster Munitions (CCM), Dublin, 30 May 2008, Article 5(2)(e).
Oxford Manual
Article 10 of the 1880 Oxford Manual provides: “Wounded or sick soldiers shall be brought in and cared for, to whatever nation they belong.” 
The Laws of War on Land, adopted by the Institute of International Law, Oxford, 9 September 1880, Article 10.
(emphasis added)
Memorandum of Understanding on the Application of IHL between Croatia and the Socialist Federal Republic of Yugoslavia
Paragraph 1 of the 1991 Memorandum of Understanding on the Application of IHL between Croatia and the Socialist Federal Republic of Yugoslavia provides: “All wounded and sick on land shall be treated in accordance with the provisions of the First Geneva Convention.” 
Memorandum of Understanding on the Application of International Humanitarian Law between Croatia and the Socialist Federal Republic of Yugoslavia, Geneva, 27 November 1991, § 1.
Agreement on the Application of IHL between the Parties to the Conflict in Bosnia and Herzegovina
Paragraph 2.1 of the 1992 Agreement on the Application of IHL between the Parties to the Conflict in Bosnia and Herzegovina provides: “There shall be no distinction among [the wounded, sick and shipwrecked] founded on any grounds other than medical ones.” 
Agreement between Representatives of Mr. Alija Izetbegović (President of the Republic of Bosnia and Herzegovina and President of the Party of Democratic Action), Representatives of Mr. Radovan Karadžić (President of the Serbian Democratic Party), and Representative of Mr. Miljenko Brkić (President of the Croatian Democratic Community), Geneva, 22 May 1992, § 2.1.
UN Secretary-General’s Bulletin
Section 9.1 of the 1999 UN Secretary-General’s Bulletin specifies: “Only urgent medical reasons will authorize priority in the order of treatment to be administered.” 
Observance by United Nations Forces of International Humanitarian Law, Secretary-General’s Bulletin, UN Secretariat, UN Doc. ST/SGB/1999/13, 6 August 1999, § 9.1.
(emphasis added)
N’Djamena Protocol on the Establishment of Humanitarian Assistance
Article 2 of the 2004 N’Djamena Protocol on the Establishment of Humanitarian Assistance states: “Humanitarian assistance is provided regardless of ethnic origin, gender, nationality, opinions, race or religion. Assistance to victims will be guided only by urgent distress cases.” 
Protocol on the Establishment of Humanitarian Assistance in Darfur, signed by the Government of Sudan, the Sudan Liberation Movement/Army, the Sudanese Justice and Equality Movement, the African Union and the Chadian Mediation, N’Djamena, 8 April 2004, annexed to the N’Djamena Humanitarian Ceasefire Agreement, signed by the Government of Sudan, the Sudan Liberation Movement/Army, the Sudanese Justice and Equality Movement, the African Union and the Chadian Mediation, N’Djamena, 8 April 2004, Article 2.
Argentina
Argentina’s Law of War Manual (1969) provides: “Only urgent medical reasons will authorize priority in the order of treatment to be administered.”  
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, § 3.001.
(emphasis added)
Argentina
Argentina’s Law of War Manual (1989) refers to Article 10 of the 1977 Additional Protocol I and Article 7 of the 1977 Additional Protocol II and states:
In all circumstances, the wounded, sick and shipwrecked, to whichever party they belong, must be respected and protected … There shall be no distinction based on any grounds other than medical ones. 
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, § 2.03.
(emphasis added)
Australia
Australia’s Commanders’ Guide (1994) states: “If medical supplies, personnel or facilities are inadequate to treat all the sick and wounded then medical assistance is to be provided strictly on the basis of medical triage.” It adds: “The most in need of medical treatment are to be given priority.” 
Australia, Law of Armed Conflict, Commanders’ Guide, Australian Defence Force Publication, Operations Series, ADFP 37 Supplement 1 – Interim Edition, 7 March 1994, § 622.
(emphasis added)
Australia
Australia’s Defence Force Manual (1994) states: “Priority in medical treatment can only be determined on the basis of medical need.” 
Australia, Manual on Law of Armed Conflict, Australian Defence Force Publication, Operations Series, ADFP 37 – Interim Edition, 1994, § 992.
(emphasis added) The manual also states: “While there is no absolute obligation to accept civilian wounded and sick, once civilian patients have been accepted, discrimination against them, on any grounds other than medical, is not permissible.” 
Australia, Manual on Law of Armed Conflict, Australian Defence Force Publication, Operations Series, ADFP 37 – Interim Edition, 1994, § 987.
Australia
Australia’s LOAC Manual (2006) states: “Priority in medical treatment can only be determined on the basis of medical need, although women are to be treated with all consideration due to their sex.” 
Australia, The Manual of the Law of Armed Conflict, Australian Defence Doctrine Publication 06.4, Australian Defence Headquarters, 11 May 2006, §§ 9.92 and 9.97.
The LOAC Manual (2006) replaces both the Defence Force Manual (1994) and the Commanders’ Guide (1994).
Belgium
Belgium’s Teaching Manual for Soldiers states: “During search and rescue operations, priority shall be given to a wounded enemy in the event that he/she is more seriously affected.” 
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. 32.
Benin
Benin’s Military Manual (1995) instructs soldiers to “care for the wounded and sick, whether friend or foe”. 
Benin, Le Droit de la Guerre, III fascicules, Forces Armées du Bénin, Ministère de la Défense nationale, 1995, Fascicule II, p. 18.
(emphasis added)
Cameroon
Cameroon’s Instructor’s Manual (2006) states: “In the domain of medical activities, only reasons of medical urgency authorize a priority in the order of care.” 
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. 93, § 352.20.
Canada
Canada’s LOAC Manual (1999) states: “Only urgent medical requirements will justify any priority in treatment among those who are sick and wounded.” 
Canada, The Law of Armed Conflict at the Operational and Tactical Level, Office of the Judge Advocate General, 1999, p. 9-2, §§ 19–20.
(emphasis added)
Canada
Canada’s Code of Conduct (2001) states: “There shall be no distinction among [the wounded, sick and shipwrecked] based on any grounds other than medical ones … Only medical reasons will determine the priority of treatment.” 
Canada, Code of Conduct for CF Personnel, Office of the Judge Advocate General, 4 June 2001, Rule 7, §§ 1 and 4.
(emphasis added)
Canada
Canada’s LOAC Manual (2001) states in its chapter on the treatment of the wounded, sick and shipwrecked:
907. Treatment of the wounded, sick and shipwrecked
1. The wounded, sick and shipwrecked are to be protected, respected, treated humanely and cared for by the Detaining Power without any adverse discrimination.
2. … The term “wounded, sick and shipwrecked”, includes civilians.
908. Priority of treatment
1. Only urgent medical requirements will justify any priority in treatment among those who are sick and wounded.
2. Regardless of the party to which they belong, or whether they are combatants or non-combatants, the wounded, sick and shipwrecked are to be respected and protected without any adverse discrimination. 
Canada, The Law of Armed Conflict at the Operational and Tactical Levels, Office of the Judge Advocate General, 13 August 2001, §§ 907–908.
Canada
Canada’s Prisoner of War Handling and Detainees Manual (2004) states:
As a matter of law, wounded PW [prisoners of war] are to receive the same medical treatment as Canadian casualties with priorities for treatment and evacuation being allocated solely according to medical criteria. 
Canada, Prisoner of War Handling, Detainees, Interrogation and Tactical Questioning in International Operations, B-GJ-005-110/FP-020, National Defence Headquarters, 1 August 2004, p. 3B-1, § B001.1.
Canada
Canada’s Code of Conduct (2005) states: “There shall be no distinction among [the wounded and sick] based on any grounds other than medical ones.” 
Canada, Code of Conduct for CF Personnel, Office of the Judge Advocate General, 2005, Rule 7, § 1.
The Code of Conduct further states: “Only medical reasons will determine the priority of treatment.” 
Canada, Code of Conduct for CF Personnel, Office of the Judge Advocate General, 2005, Rule 7, § 4.
Chad
Chad’s Instructor’s Manual (2006) requires soldiers to “treat the wounded and sick, regardless of whether they are friend or foe”. 
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. 26; see also p. 47.
Colombia
Colombia’s Soldiers’ Manual (1999) states: “The most seriously wounded enemy combatants must be cared for first.” 
Colombia, Derechos Humanos & Derecho Internacional Humanitario – Guía de Conducta para el Soldado e Infante de Marina, Ministerio de Defensa Nacional, Oficina de Derechos Humanos, Fuerzas Militares de Colombia, Santafé de Bogotá, 1999, p. 20.
Côte d’Ivoire
Côte d’Ivoire’s Teaching Manual (2007) provides in Book I (Basic instruction):
Persons who do not directly participate in hostilities and those rendered hors de combat because they are sick, wounded, shipwrecked, captured or for other reasons, must be respected and protected against the consequences of the war. All victims must be assisted without discrimination. 
Côte d’Ivoire, Droit de la guerre, Manuel d’instruction, Livre I: Instruction de base, Ministère de la Défense, Forces Armées Nationales, November 2007, p. 5; see also Droit de la guerre, Manuel d’instruction, Livre II: Instruction du gradé et du cadre, Manuel de l’instructeur, Ministère de la Défense, Forces Armées Nationales, November 2007, p. 4; Droit de la guerre, Manuel d’instruction, Livre III, Tome 1: Instruction de l’élève officier d’active de 1ère année, Manuel de l’élève, Ministère de la Défense, Forces Armées Nationales, November 2007, p. 7; 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, p. 5; 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. 5.
In Book III, Volume 1 (Instruction of first-year trainee officers), the Teaching Manual provides:
Prisoners of war can be sick, traumatized or wounded. In such cases, they must be evacuated and cared for by the friendly or enemy medical service at the front. Medical urgency must be the only factor which determines the priority of care. There must be no discrimination in favour of friendly troops. 
Côte d’Ivoire, Droit de la guerre, Manuel d’instruction, Livre III, Tome 1: Instruction de l’élève officier d’active de 1ère année, Manuel de l’élève, Ministère de la Défense, Forces Armées Nationales, November 2007, p. 46.
Ecuador
Ecuador’s Naval Manual (1989) states: “Priority in order of treatment may only be justified by urgent medical considerations.” 
Ecuador, Aspectos Importantes del Derecho Internacional Marítimo que Deben Tener Presente los Comandantes de los Buques, Academia de Guerra Naval, 1989, § 11.4.
France
France’s LOAC Manual (2001) states with regard to the wounded and sick: “The law of armed conflicts does not allow any distinction other than that based on medical needs.” 
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. 32.
Germany
Germany’s Soldiers’ Manual (1991) states with regard to the treatment of the wounded, sick and shipwrecked: “There shall be no distinction other than on medical grounds.” 
Germany, Taschenkarte, Humanitäres Völkerrecht in bewaffneten Konflikten – Grundsätze, Bearbeitet nach ZDv 15/2, Humanitäres Völkerrecht in bewaffneten Konflikten – Handbuch, Zentrum Innere Führung, June 1991, p. 5.
Germany
Germany’s Soldiers’ Manual (2006) states:
The wounded, sick and shipwrecked shall be respected and protected in all circumstances … They shall be treated humanely and cared for …
There shall be no distinction among them other than on medical grounds. 
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.
Hungary
Hungary’s Military Manual (1992) makes an explicit reference to the 1949 Geneva Convention I as being the regime applicable to the wounded and sick. 
Hungary, A Hadijog, Jegyzet a Katonai, Föiskolák Hallgatói Részére, Magyar Honvédség Szolnoki Repülötiszti Föiskola, 1992, p. 86.
Kenya
Kenya’s LOAC Manual (1997) instructs soldiers to “care for the wounded and sick, be they friend or foe”. 
Kenya, Law of Armed Conflict, Military Basic Course (ORS), 4 Précis, The School of Military Police, 1997, Précis No. 3, p. 14.
(emphasis added)
Madagascar
Madagascar’s Military Manual (1994) provides that the wounded and sick shall receive the medical care required by their state of health. It specifies that this obligation also applies in the case of wounded, sick and shipwrecked enemies. 
Madagascar, Le Droit des Conflits Armés, Ministère des Forces Armées, August 1994, Fiche No. 3-O, § 16 and Fiche No. 2-T, § 2.
Mexico
Mexico’s Army and Air Force Manual (2009), in a section on the 1977 Additional Protocol I, states: “Doctors and all other people engaged in medical activities have the right to provide medical attention without making any distinction.” 
Mexico, Manual de Derecho Internacional Humanitario para el Ejército y la Fuerza Área Mexicanos, Ministry of National Defence, June 2009, § 273.
Netherlands
The Military Manual (1993) of the Netherlands states: “Only urgent medical reasons will determine priority of treatment among the wounded and sick”. 
Netherlands, Toepassing Humanitair Oorlogsrecht, Voorschift No. 27-412/1, Koninklijke Landmacht, Ministerie van Defensie, 1993, p. VI-1.
(emphasis added)
With respect to non-international armed conflicts, the manual states that the wounded, sick and shipwrecked shall receive medical care without discrimination”. 
Netherlands, Toepassing Humanitair Oorlogsrecht, Voorschift No. 27-412/1, Koninklijke Landmacht, Ministerie van Defensie, 1993, p. XI-5.
Netherlands
The Military Handbook (1995) of the Netherlands states: “All wounded and sick must be cared for, also those from the enemies. Priority in treatment may only be based on medical grounds.” 
Netherlands, Handboek Militair, Ministerie van Defensie, 1995, p. 7-37.
Netherlands
The Military Manual (2005) of the Netherlands states: “No distinction must be made … between members of friendly and hostile forces. Priority in treatment must be assigned solely on grounds of medical necessity.” 
Netherlands, Humanitair Oorlogsrecht: Handleiding, Voorschift No. 27-412, Koninklijke Landmacht, Militair Juridische Dienst, 2005, § 0604.
In its chapter on non-international armed conflict, the manual states: “Medical personnel may not be required to give priority to a person, save on medical grounds, while carrying out their duties.” 
Netherlands, Humanitair Oorlogsrecht: Handleiding, Voorschift No. 27-412, Koninklijke Landmacht, Militair Juridische Dienst, 2005, § 1057.
New Zealand
New Zealand’s Military Manual (1992) states: “Only urgent medical requirements will justify any priority in treatment among those who are sick and wounded.” 
New Zealand, Interim Law of Armed Conflict Manual, DM 112, New Zealand Defence Force, Headquarters, Directorate of Legal Services, Wellington, November 1992, § 1004(2).
(emphasis added)
With regard to civilian sick and wounded, the manual states:
There is no absolute obligation to accept civilian wounded and sick only so far as it is practicable to do so. For example, if military medical facilities are not being used but might be used in the immediate future because of an impending battle, there is no obligation to treat civilians. Once a civilian patient has been accepted, however, discrimination against him/her on other than medical grounds is not permissible. 
New Zealand, Interim Law of Armed Conflict Manual, DM 112, New Zealand Defence Force, Headquarters, Directorate of Legal Services, Wellington, November 1992, § 1003(2).
Nigeria
Nigeria’s Military Manual (1994) states: “Only urgent medical reasons will authorise priority in the order of treatment to be administered.” 
Nigeria, International Humanitarian Law (IHL), Directorate of Legal Services, Nigerian Army, 1994, p. 13, § 4.
(emphasis added)
Nigeria
Nigeria’s Manual on the Laws of War states: “Priority in treatment should be granted to the most gravely wounded.” 
Nigeria, The Laws of War, by Lt. Col. L. Ode PSC, Nigerian Army, Lagos, undated, § 35.
Peru
Peru’s IHL Manual (2004) states: “There must be no discrimination in the treatment of the wounded, sick and shipwrecked except on medical grounds.” 
Peru, Manual de Derecho Internacional Humanitario para las Fuerzas Armadas, Resolución Ministerial Nº 1394-2004-DE/CCFFAA/CDIH-FFAA, Lima, 1 December 2004, § 32.l.
The manual also states:
[a.] Medical ethics in armed conflict are the same as in peacetime, taking into account that:
(3) in emergency situations, medical assistance must be provided without discrimination, the only relevant criterion for determining priority of treatment being the degree of medical urgency.
c. Assistance must be provided without making any distinction based on criteria other than medical grounds.
Priority of treatment must always be dictated by the degree of medical urgency. 
Peru, Manual de Derecho Internacional Humanitario para las Fuerzas Armadas, Resolución Ministerial Nº 1394-2004-DE/CCFFAA/CDIH-FFAA, Lima, 1 December 2004, § 84.a and c.
Peru
Peru’s IHL and Human Rights Manual (2010) states: “There must be no discrimination in the treatment of the wounded, sick and shipwrecked except on medical grounds.” 
Peru, Manual de Derecho Internacional Humanitario y Derechos Humanos para las Fuerzas Armadas, Resolución Ministerial No. 049-2010/DE/VPD, Lima, 21 May 2010, § 33(l), p. 251.
The manual also states:
[a.] Medical ethics in armed conflict are the same as in peacetime, taking into account that:
(3) in emergency situations, medical assistance must be provided without discrimination, the only relevant criterion for determining priority of treatment being the degree of medical urgency.
c. Assistance must be provided without making any distinction based on criteria other than medical grounds.
Priority of treatment must always be dictated by the degree of medical urgency. 
Peru, Manual de Derecho Internacional Humanitario y Derechos Humanos para las Fuerzas Armadas, Resolución Ministerial No. 049-2010/DE/VPD, Lima, 21 May 2010, § 75(a)(3) and (c), pp. 273–274.
Philippines
The Soldier’s Rules (1989) of the Philippines requires soldiers to “care for the wounded and sick, be they friend or foe”. 
Philippines, Soldier’s Rules, in Handbook on Discipline, Annex C(I), General Headquarters, Armed Forces of the Philippines, Camp General Emilio Aguinaldo, Quezon City, 1989, § 5.
(emphasis added)
Romania
Romania’s Soldiers’ Manual (1991) tells soldiers: “Nobody will punish you for rendering first aid to a wounded, not even to an enemy one.” 
Romania, Manualul Soldatului, Ghid de comportare în luptă, Asociaţia Română de Drept Umanitar (ARDU), 1991, p. 22, § 3.
Russian Federation
The Russian Federation’s Military Manual (1990) provides:
Military commanders may appeal to the charity of the local population to voluntarily collect and care for the wounded and sick. The military authorities must permit the inhabitants and relief societies, even in invaded or occupied areas, spontaneously to collect and care for wounded or sick of whatever nationality. 
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, § 15.
[emphasis added]
Russian Federation
The Russian Federation’s Regulations on the Application of IHL (2001) states: “There shall be no distinction among [the wounded, sick and shipwrecked] founded on any grounds other than medical ones.” 
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, § 47; see also § 13 (responsibilities of military medical personnel).
With regard to internal armed conflict, the Regulations states: “In performance of their duties, medical personnel may not be required to give priority to any person except on medical grounds.” 
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 IHL Manual (1999) states that one of the fundamental guarantees common to IHL and the 1948 Universal Declaration of Human Rights is that no distinction other than that based on medical grounds shall be made in the treatment of the wounded and sick. 
Senegal, Le DIH adapté au contexte des opérations de maintien de l’ordre, République du Sénégal, Ministère des Forces Armées, Haut Commandement de la Gendarmerie et Direction de la Justice Militaire, Cabinet, 1999, pp. 3 and 24.
Sierra Leone
Sierra Leone’s Instructor Manual (2007) states: “Priority of treatment should be dictated by medical reasons only.” 
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. 38.
South Africa
South Africa’s LOAC Manual (1996) states: “Medical personnel must provide care without any distinction based on non-medical criteria. Only reasons of medical urgency may justify priorities in the order of treating people.” 
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, § 50.
South Africa
South Africa’s Revised Civic Education Manual (2004) states: “Medical personnel must provide care without any distinction based on non-medical criteria. Only reasons of medical urgency may justify priorities in the order of treating people.” 
South Africa, Revised Civic Education Manual, South African National Defence Force, 2004, Chapter 4, § 66.
South Africa
South Africa’s LOAC Teaching Manual (2008) states:
2.3 Specifically Protected Persons and Objects …
a. Civilian Medical Services
Conclusion
Civilian medical personnel shall be respected and protected. … Occupying Powers must assist them with the performance of their functions and may not require from them to give priority to the treatment of any person, except on medical grounds.
d. Wounded, sick, shipwrecked, the dead and missing.
General Treatment of Wounded and Sick ([1949] Geneva convention I Article 12)
- Wounded and sick may not be adversely discriminated against on grounds of sex, race, nationality, religion, political convictions or any other similar criteria. Only urgent medical reasons will determine the order of treatment. 
South Africa, Advanced Law of Armed Conflict Teaching Manual, School of Military Justice, 1 April 2008, as amended to 25 October 2013, Learning Unit 2, pp. 72, 76, 102 and 104–105.
[emphasis in original]
Spain
Spain’s LOAC Manual (1996) states that medical personnel shall provide the wounded and sick with the medical care required by their condition. It states that only urgent medical reasons may justify priority in the order of medical treatment. 
Spain, Orientaciones. El Derecho de los Conflictos Armados, Publicación OR7-004, 2 Tomos, aprobado por el Estado Mayor del Ejército, Division de Operaciones, 18 March 1996, Vol. I, § 9.2.(a).2.
Spain
Spain’s LOAC Manual (2007) states: “Enemy wounded and sick must … receive the medical care and attention required by their condition, with no distinction being made between enemy wounded and sick and the party’s own wounded and sick.” 
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, § 5.2.d.(5).
The manual also states that “the duties of medical personnel, as established by the law of armed conflict” include: “provide assistance in accordance with purely medical criteria; priorities in treating people can only be established on medical grounds”. 
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).(b).
Switzerland
Switzerland’s Basic Military Manual (1987) states: “At all times, and especially following an engagement, all means should be taken to search for and collect the wounded … whether friend or foe.” 
Switzerland, Lois et coutumes de la guerre (Extrait et commentaire), Règlement 51.7/II f, Armée Suisse, 1987, Article 71.
(emphasis added)
The manual further states: “Only emergency medical reasons shall establish the priority in the treatment of friendly or enemy wounded.” 
Switzerland, Lois et coutumes de la guerre (Extrait et commentaire), Règlement 51.7/II f, Armée Suisse, 1987, Article 74.
(emphasis added)
Switzerland
Switzerland’s Regulation on Legal Bases for Conduct during an Engagement (2005) states:
In combat, the disarmament, rescue of and the provision of first aid to the wounded, sick and shipwrecked begins as soon as the situation allows. … No distinction may be made between friend and enemy or between civilian and military personnel. Purely medical criteria determine the priority in medical treatment. No one may be punished for having cared for the wounded or sick. 
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, § 174.
Togo
Togo’s Military Manual (1996) instructs soldiers to “care for the wounded and sick, whether friend or foe”. 
Togo, Le Droit de la Guerre, III fascicules, Etat-major Général des Forces Armées Togolaises, Ministère de la Défense nationale, 1996, Fascicule II, p. 18.
(emphasis added)
Ukraine
Ukraine’s IHL Manual (2004) states:
While performing their military duty, military medical personnel shall be guided by the generally recognized rules of international humanitarian law that oblige them … to render medical assistance during armed conflicts as necessary without any discrimination save for medical reasons. 
Ukraine, Manual on the Application of IHL Rules, Ministry of Defence, 11 September 2004, § 1.7.1.
United Kingdom of Great Britain and Northern Ireland
The UK LOAC Pamphlet (1981) states: “Priority in the order of medical treatment is decided only for urgent medical reasons.” 
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. 22, § 2.
(emphasis added)
United Kingdom of Great Britain and Northern Ireland
The UK LOAC Manual (2004) states:
7.3. The wounded and sick are to be protected and respected. They may not be attacked. They must be treated humanely. They must be provided with medical care. They may not wilfully be left without medical assistance nor exposed to contagious diseases or infection. Priority of treatment is dictated by medical reasons only …
7.3.2. Paragraph 7.3 applies to all wounded and sick, whether United Kingdom, allied or enemy, military or civilian. They are entitled to respect and protection, humane treatment and, to the fullest extent practicable and with the least possible delay, the medical care and attention required by their condition. It is forbidden, for example, to give the treatment of United Kingdom and allied wounded priority over the treatment of wounded enemy personnel. The only distinction which is permitted in dealing with the wounded or sick is that founded on real medical need. There is no absolute obligation on the part of the military medical services to accept civilian wounded and sick – that is to be done only so far as it is practicable to do so. For example, the commander of a field hospital placed to deal with casualties from an impending battle would be entitled to refer non-urgent cases elsewhere, even if the hospital had the capacity to treat them at the time. Once the treatment of a civilian patient has commenced, however, discrimination against him on other than medical grounds is not permissible. 
United Kingdom, The Manual of the Law of Armed Conflict, Ministry of Defence, 1 July 2004, §§ 7.3 and 7.3.2.
With regard to priority of treatment, the manual states:
There must be no discrimination on grounds of sex, race, nationality, religion, political belief or any other similar test. Spies, saboteurs, partisans and illegal combatants who are wounded or sick are entitled to the same treatment. 
United Kingdom, The Manual of the Law of Armed Conflict, Ministry of Defence, 1 July 2004, § 7.3, footnote 4.
In its chapter on maritime warfare, the manual further states: “The wounded, sick and shipwrecked … must be provided with medical care … Priority of treatment is dictated by medical reasons only.” 
United Kingdom, The Manual of the Law of Armed Conflict, Ministry of Defence, 1 July 2004, § 13.129.
In its chapter on internal armed conflict, the manual states: “The wounded, sick and shipwrecked must be … given the medical treatment they need without discrimination for non-medical reasons.” 
United Kingdom, The Manual of the Law of Armed Conflict, Ministry of Defence, 1 July 2004, § 15.29.1.
United States of America
The US Field Manual (1956) states: “Only urgent medical reasons will authorize priority in the order of treatment to be administered.” 
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, § 215.
(emphasis added)
United States of America
The US Air Force Pamphlet (1976) states: “Priority in order of treatment is justified only by urgent medical reasons.” 
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.
(emphasis added)
United States of America
The US Naval Handbook (1995) states: “Priority in order of treatment may only be justified by urgent medical considerations.” 
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), § 11.4.
(emphasis added)
United States of America
The US Naval Handbook (2007) states:
Wounded and sick personnel falling into enemy hands must be treated humanely and cared for without adverse distinction along with the enemy’s own casualties. Priority in order of treatment may only be justified by urgent medical considerations. 
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, § 11.6.
Yugoslavia, Socialist Federal Republic of
The Socialist Federal Republic of Yugoslavia’s Military Manual (1988) states: “Only urgent medical reasons shall determine priority of treatment among the wounded and sick.” 
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, Article 162.
(emphasis added)
Afghanistan
Afghanistan’s Public Health Law (2009) states:
Article 18. Provision of Emergency Medical Aid.
Health services shall be provided by the nearest health facility to … those whose health condition requires emergency aid, without any discrimination, and by taking into consideration the prioritized status of patients. 
Afghanistan, Public Health Law, 2009, Article 18.
Azerbaijan
Azerbaijan’s Law concerning the Protection of Civilian Persons and the Rights of Prisoners of War (1995) provides that, in international and non-international armed conflicts:
the Armed Forces of the Azerbaijan Republic and appropriate authorities and governmental bodies shall ensure [in all circumstances and with the least possible delay] medical assistance and care, needed for the wounded and sick irrespective of their status. 
Azerbaijan, Law concerning the Protection of Civilian Persons and the Rights of Prisoners of War, 1995, Article 25.
[emphasis added]
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).
Ethiopia
Ethiopia’s Red Cross Legal Notice (1947) refers to one of the objectives of the Red Cross, notably “caring for the sick and wounded among troops and civilians without national discretion”. 
Ethiopia, Red Cross Legal Notice, 1947, Article 4(a).
France
France’s Code of Defence (2004), as amended in 2008, states: “Combatants must … protect and care for the wounded, sick and shipwrecked without any discrimination on the grounds of race, gender, religion, nationality, ideology or ethnic group.” 
France, Code of Defence, 2004, as amended in 2008, Article D4122-8.
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 12 of the 1949 Geneva Convention I and Article 12 of the 1949 Geneva Convention II, and of the 1977 Additional Protocol I, including violations of Articles 10(2) and 15(3), as well as any “contravention” of the 1977 Additional Protocol II, including violations of Articles 7(2) and 9(2), 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.
Somalia
Somalia’s Military Criminal Code (1963) states:
A commander who causes serious harm … to the sick, wounded or shipwrecked, by not according them the treatment prescribed by law or by international agreements … shall be punished, unless the act constitutes a more serious offence, by military confinement for not less than three years. 
Somalia, Military Criminal Code, 1963, Article 382.
South Africa
In 1987, in the Petane case, the Cape Provincial Division of South Africa’s Supreme Court dismissed the accused’s claim that the 1977 Additional Protocol I reflected customary international law. The Court stated:
The accused has been indicted before this Court on three counts of terrorism, that is to say, contraventions of s 54(1) of the Internal Security Act 74 of 1982. He has also been indicted on three counts of attempted murder.
The accused’s position is stated to be that this Court has no jurisdiction to try him.
… The point in its early formulation was this. By the terms of [the 1977 Additional] Protocol I to the [1949] Geneva Conventions the accused was entitled to be treated as a prisoner-of-war. A prisoner-of-war is entitled to have notice of an impending prosecution for an alleged offence given to the so-called “protecting power” appointed to watch over prisoners-of-war. Since, if such a notice were necessary, the trial could not proceed without it, Mr Donen suggested that the necessity or otherwise for giving such a notice should be determined before evidence was led. …
On 12 August 1949 there were concluded at Geneva in Switzerland four treaties known as the Geneva Conventions. …
South Africa was among the nations which concluded the treaties. … Except for the common art 3, which binds parties to observe a limited number of fundamental humanitarian principles in armed conflicts not of an international character, they apply to wars between States.
After the Second World War many conflicts arose which could not be characterised as international. It was therefore considered desirable by some States to extend and augment the provisions of the Geneva Conventions, so as to afford protection to victims of and combatants in conflicts which fell outside the ambit of these Conventions. The result of these endeavours was Protocol I and Protocol II to the Geneva Conventions, both of which came into force on 7 December 1978.
Protocol II relates to the protection of victims of non-international armed conflicts. Since the State of affairs which exists in South Africa has by Protocol I been characterised as an international armed conflict, Protocol II does not concern me at all.
The extension of the scope of art 2 of the Geneva Conventions was, at the time of its adoption, controversial. …
The article has remained controversial. More debate has raged about its field of operation than about any other articles in Protocol I. …
South Africa is one of the countries which has not acceded to Protocol I. Nevertheless, I am asked to decide, as I indicated earlier, as a preliminary point, whether Protocol I has become part of customary international law. If so, it is argued that it would have been incorporated into South African law. If it has been so incorporated it would have to be proved by one or other of the parties that the turmoil which existed at the time when the accused is alleged to have committed his offences was such that it could properly be described as an “armed conflict” conducted by “peoples” against a “ra[c]ist regime” in the exercise of their “right of self-determination”. Once all this has been shown it would have to be demonstrated to the Court that the accused conducted himself in such a manner as to become entitled to the benefits conferred by Protocol I on combatants, for example that, broadly speaking, he had, while he was launching an attack, distinguished himself from civilians and had not attacked civilian targets. …
… I am prepared to accept that where a rule of customary international law is recognised as such by international law it will be so recognised by our law.
To my way of thinking, the trouble with the first Protocol giving rise to State practice is that its terms have not been capable of being observed by all that many States. At the end of 1977 when the treaty first lay open for ratification there were few States which were involved in colonial domination or the occupation of other States and there were only two, South Africa and Israel, which were considered to fall within the third category of ra[c]ist regimes. Accordingly, the situation sought to be regulated by the first Protocol was one faced by few countries; too few countries in my view, to permit any general usage in dealing with armed conflicts of the kind envisaged by the Protocol to develop.
Mr Donen contended that the provisions of multilateral treaties can become customary international law under certain circumstances. I accept that this is so. There seems in principle to be no reason why treaty rules cannot acquire wider application than among the parties to the treaty.
Brownlie Principles of International Law 3rd ed at 13 agrees that non-parties to a treaty may by their conduct accept the provisions of a multilateral convention as representing general international law. …
I incline to the view that non-ratification of a treaty is strong evidence of non-acceptance.
It is interesting to note that the first Protocol makes extensive provision for the protection of civilians in armed conflict. …
In this sense, Protocol I may be described as an enlightened humanitarian document. If the strife in South Africa should deteriorate into an armed conflict we may all one day find it a cause for regret that the ideologically provocative tone of s 1(4) has made it impossible for the Government to accept its terms.
To my mind it can hardly be said that Protocol I has been greeted with acclaim by the States of the world. Their lack of enthusiasm must be due to the bizarre mixture of political and humanitarian objects sought to be realised by the Protocol. …
According to the International Review of the Red Cross (January/February 1987) No 256, as at December 1986, 66 States were parties to Protocol I and 60 to Protocol II, which, it will be remembered, deals with internal non-international armed conflicts. With the exception of France, which acceded only to Protocol II, not one of the world’s major powers has acceded to or ratified either of the Protocols. This position should be compared to the 165 States which are parties to the Geneva Conventions.
This approach of the world community to Protocol I is, on principle, far too half-hearted to justify an inference that its principles have been so widely accepted as to qualify them as rules of customary international law. The reasons for this are, I imagine, not far to seek. For those States which are contending with “peoples[’]” struggles for self-determination, adoption of the Protocol may prove awkward. For liberation movements who rely on strategies of urban terror for achieving their aims the terms of the Protocol, with its emphasis on the protection of civilians, may prove disastrously restrictive. I therefore do not find it altogether surprising that Mr Donen was unable to refer me to any statement in the published literature that Protocol I has attained the status o[f] customary international [law].
I have not been persuaded by the arguments which I have heard on behalf of the accused that the assessment of Professor Dugard, writing in the Annual Survey of South African Law (1983) at 66, that “it is argued with growing conviction that under contemporary international law members of SWAPO [South-West Africa People’s Organisation] and the ANC [African National Congress] are members of liberation movements entitled to prisoner-of-war status, in terms of a new customary rule spawned by the 1977 Protocols”, is correct. On what I have heard in argument I disagree with his assessment that there is growing support for the view that the Protocols reflect a new rule of customary international law. No writer has been cited who supports this proposition. Here and there someone says that it may one day come about. I am not sure that the provisions relating to the field of application of Protocol I are capable of ever becoming a rule of customary international law, but I need not decide that point today.
For the reasons which I have given I have concluded that the provisions of Protocol I have not been accepted in customary international law. They accordingly form no part of South African law.
This conclusion has made it unnecessary for me to give a decision on the question of whether rules of customary international law which conflict with the statutory or common law of this country will be enforced by its courts.
In the result, the preliminary point is dismissed. The trial must proceed. 
South Africa, Supreme Court, Petane case, Judgment, 3 November 1987, pp. 2–8.
South Africa
In 2010, in the Boeremag case, South Africa’s North Gauteng High Court stated:
In Petane, … Conradie J found that the provisions of [the 1977 Additional] Protocol I are not part of customary international law, and therefore are also not part of South African law.
Referring to the fact that in December 1986 only 66 of the 165 States party to the Geneva Conventions had ratified Protocol I, the Court [in Petane] stated:
This approach of the world community to Protocol I is, on principle, far too half-hearted to justify an inference that its principles have been so widely accepted as to qualify them as rules of customary international law. The reasons for this are, I imagine, not far to seek. For those States which are contending with “peoples[’]” struggles for self-determination, adoption of the Protocol may prove awkward. For liberation movements who rely on strategies of urban terror for achieving their aims the terms of the Protocol, with its emphasis on the protection of civilians, may prove disastrously restrictive. I therefore do not find it altogether surprising that Mr Donen was unable to refer me to any statement in the published literature that Protocol I has attained the status of customary international law.
Important changes with respect to certain aspects applicable at the time of Petane have taken place. The ANC [African National Congress] has become South Africa’s ruling party and in 1995 ratified Protocol I. The total number of States that have ratified it, is now … 162.
This last aspect forms the basis on which the First Respondent [the State] and the applicants agree that Protocol I forms part of customary international law as well as of South African law. As requested, this position is accepted for the purposes of the decision, without deciding on the matter.
Despite these changes, it remains debatable whether the provisions of Protocol I have become a part of South African law in this way.
The consensus of both parties to the conflict is required. See Petane … and Article 96 of Protocol I. …
Parliament’s failure to incorporate Protocol I into legislation in accordance with Article 231(4) of the Constitution in fact points to the contrary, and is indicative that the requirements of usus and/or opinio juris have not been met. See Petane. 
South Africa, North Gauteng High Court, Boeremag case, Judgment, 26 August 2010, pp. 21–22.
[footnotes in original omitted]
The Court also held:
If the [1977 Additional Protocol I] applies in South Africa as customary international law, the two requirements that form the basis of customary law must be met. It is arguable that the requirement of usus has been met by the vast number of States that have acceded or ratified it. By ratifying Protocol I the Republic of South Africa has indicated its intention to apply the Protocol, thereby fulfilling the requirement of opinio juris. 
South Africa, North Gauteng High Court, Boeremag case, Judgment, 26 August 2010, p. 66.
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 “Treatment”, stated: “No preferential treatment [among wounded, sick and shipwrecked enemy combatants] shall apply, except for [distinction on] medical grounds.ˮ 
Djibouti, Ministry of National Education and Higher Education, History and Geography Textbook for 8th Grade, 2010, p. 194.
Switzerland
Switzerland’s ABC of International Humanitarian Law (2009) states:
Wounded, sick and shipwrecked
International humanitarian law calls on all parties to a conflict to treat the wounded and sick in a humane way, i.e. to shelter, rescue and protect them and to provide medical care. No distinction is to be made, except of a medical nature, and Women are given special consideration. The same rules apply to shipwrecked persons, i.e. to all members of the armed forces and civilians in danger at sea or in any other body of water. 
Switzerland, Federal Department of Foreign Affairs, ABC of International Humanitarian Law, 2009, p. 42.
United States of America
In 1987, the Deputy Legal Adviser of the US Department of State affirmed: “We support the principle that when [the wounded, sick and shipwrecked] are given medical treatment, no distinction among them be based on any grounds other than medical ones.” 
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, p. 423.
United States of America
According to the Report on US Practice, it is the opinio juris of the United States that there should be no distinction among the wounded and sick on any but medical grounds. 
Report on US Practice, 1997, Chapter 5.1.
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ICRC
To fulfil its task of disseminating IHL, the ICRC has delegates around the world teaching armed and security forces that “there shall be no distinction among wounded, sick and shipwrecked founded on any grounds other than medical ones” and that “only urgent medical reasons shall authorize priority in the order of treatment to be administered. Criteria based on nationality or rank are excluded.” 
Frédéric de Mulinen, Handbook on the Law of War for Armed Forces, ICRC, Geneva, 1987, §§ 200 and 215.
ICRC
In a Memorandum on the Applicability of International Humanitarian Law sent in 1990 to all States party to the 1949 Geneva Conventions in the context of the Gulf War, the ICRC stated: “The wounded, the sick and the shipwrecked must be collected and cared for regardless of the party to which they belong.” 
ICRC, Memorandum on the Applicability of International Humanitarian Law, 14 December 1990, § I, IRRC, No. 280, 1991, p. 24.
(emphasis added)
ICRC
In a press release in 1992, the ICRC urged all parties to the conflict in Nagorno-Karabakh “to ensure that the wounded and sick are cared of in all circumstances, regardless of the side to which they belong”. 
ICRC, Press Release No. 1700, Nagorno-Karabakh: ICRC calls for respect for humanitarian law, 12 March 1992.
ICRC
In 1994, in a Memorandum on Respect for International Humanitarian Law in Angola, the ICRC stated: “All the wounded and sick, both civilian and military, must be collected and cared for, without distinction.” 
ICRC, Memorandum on Respect for International Humanitarian Law in Angola, 8 June 1994, § I, IRRC, No. 320, 1997, p. 503.
(emphasis added)
ICRC
In 1994, in a Memorandum on Compliance with International Humanitarian Law by the Forces Participating in Opération Turquoise in the Great Lakes region, the ICRC emphasized: “All the wounded and sick must be collected and cared for without distinction, in accordance with the provisions laid down primarily in the First and Fourth Geneva Conventions.” 
ICRC, Memorandum on Compliance with International Humanitarian Law by the Forces Participating in Opération Turquoise, 23 June 1994, § I, reprinted in Marco Sassòli and Antoine A. Bouvier, How Does Law Protect in War?, ICRC, Geneva, 1999, p. 1308.
(emphasis added)
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, provides: “In every circumstance, the wounded and sick, whether or not they have taken part in acts of violence, … shall receive … medical care … There shall be no distinction among them on any grounds other than their medical condition.” 
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, Articles 12 and 14, IRRC, No. 282, 1991, p. 335.
Médecins Sans Frontières (MSF)
In 1993, in a communication on violations of IHL in Somalia during UNOSOM operations, MSF denounced “obstruction of civilian access to hospitals and medical care” in the following terms:
The access of the only two civilian hospitals which have surgical units, Benadir and Digfer, was blocked on July 17, 1993 by the deployment of United Nations’ tanks.
The military hospitals were reserved exclusively for the treatment of United Nations’ troops, thus setting up an unacceptable discrimination between the wounded.
Only the Moroccan hospital remained open to the wounded Somalis. This building was inaccessible to the residents west of the K6/Digfer axis. Moreover, as the Moroccan troops were involved in front line military operations, the civilian population could expect little help from them.
MSF urged the UN military commander and the commanders of the various national contingents to respect humanitarian law, including “the right of the injured to treatment, anytime, anywhere, civilian and military alike (article 3 of the four Geneva Conventions)” and requested that “access to treatment be always guaranteed, with no discrimination”. 
MSF, Communication on the violations of humanitarian law in Somalia during UNOSOM operations, 20 July 1993, Part I, § 3(a), Part II and Part III, § 2(b).