Hospitals have become military targets in Syria, making it difficult to provide aid to victims of the country’s civil war, according to leaders of NGO and human rights groups working in the region.

More than 300 healthcare facilities in Syria have been attacked and at least 768 medical professionals killed in the conflict, according to Physicians for Human Rights.

Syrian President Bashar al-Assad’s regime and its ally Russia have been responsible for the vast majority of aerial attacks on Syria’s medical infrastructure, while opposition forces and the Islamic State have also been linked to attacks on healthcare workers, according to a documentary produced by the Center for Strategic and International Studies.

The documentary, entitled “The New Barbarianism,” depicts a “crisis facing the norms of international humanitarian law contained in the Geneva Conventions” in the conflicts in Syria and Yemen.

“Hospitals have become part of the battlefield. It has become, in the eyes of some combatants, a legitimate target,” said Jason Cone of Doctors Without Borders in the documentary, “an incredibly important facet of where we define some sense of humanity amidst all this chaos is really getting eroded away.”

On April 7, more than 70 people were killed in Syria in a chemical attack by the Assad regime just outside of Damascus, according to medics and rescue workers. “Attacking innocent civilians in Syria with chemical weapons is a gross violation of humanity and utterly immoral,” responded Philippe Nassif, the executive director of In Defence of Christians in a press release on April 12. Following the chemical attack, Catholic Maronite Patriarch Beshara Rai in Lebanon called on the international community to “work to end the war and to achieve a just, comprehensive and lasting peace through political and diplomatic means.”

“No one has behaved in the way that the Russians/Syrians have in intentional infliction of human rights violations, killing, manslaughter, gas, in the case of Bashar al Assad,” said Senator John McCain in the CSIS documentary, calling the Assad regime’s actions unprecedented in the post-Cold War era. The Geneva Conventions declared that medical establishments, including mobile medical units, may in no circumstance be attacked, but must be protected by all involved in armed conflict.

The United Nations Security Council passed a 2016 resolution condemning attacks on medical facilities and personnel in conflict zones, however, the attacks on hospitals in Syria have persisted.

“The NGO logo that used to be a protection has became a target. It attracts attacks,” said Rabih Torbay, the president of Project Hope.

Doctors have started to operate underground in Syria and surgeons have made covert trips into the country to treat those in need of medical aid. “Doctors started to establish their hospitals in secret places, in chicken farms, in factories, deserted buildings,  in the basements of churches and mosques,” remembered Dr. Zaher Salhoul in a documentary interview. Salhoul is founder and executive director of American Relief Coalition for Syria. 

At an April 13 screening of the documentary at the Embassy of Sweden to the United States, retired General John Allen explained that the U.S. military seeks to act in accordance with international law in these types of conflicts.

“All of us in the U.S. military, and I can say by extension in NATO and NATO-led coalitions, go through extensive training with respect to the use of force and combat,” said Allen.

The retired general explained the three decisions required in U.S. military use-of-force decision-making. First, a judgment must be made regarding whether it is necessary to employ force at that particular moment against that particular target. Second, it is required to prove a capacity to discriminate between combatants and noncombatants. And, finally, “when you decide that you must employ force, do it with a proportionality that applies the least amount of force necessary to accomplish the necessity for which you have chosen to apply force at that moment.”

Since the onset of the Syrian conflict in 2011, 400,000 people have been killed and many more wounded. According to the UN more than 11 million Syrians have fled their homes.

Dioceses and Catholic aid agencies, have contributed over $100 million in humanitarian aid to Syria, according to the Secretary for the Holy See’s Relations with States.

The Knights of Columbus sent $300,000 to the Syriac Catholic Patriarchate to support families from Syria and Iraq with food, clothing, shelter, and medical care as part of $1 million in aid given by the Knights of Columbus for persecuted Christians in the Middle East during Holy Week this year.