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(Benghazi) - Attacks by Libyan government forces in the western city of Misrata have endangered civilians and targeted a medical clinic in violation of international law, Human Rights Watch said today. The assessment is based on interviews with two doctors still in Misrata and 17 wounded civilians recently evacuated from the city, which is largely cut off from the outside world by Libyan government forces.

Human Rights Watch called on the Libyan government to allow regular access of humanitarian aid to the city by sea and land, and to permit safe passage for all civilians who wish to leave.

"The Libyan government's near siege of Misrata has not prevented reports of serious abuses getting out," said Sarah Leah Whitson, Middle East and North Africa director at Human Rights Watch. "We've heard disturbing accounts of shelling and shooting at a clinic and in populated areas, killing civilians where no battle was raging."

According to Dr. Muhammad el-Fortia, who works at Misrata Hospital, medical facilities have recorded 257 people killed and 949 wounded and hospitalized since February 19, 2011. The wounded include 22 women and eight children, he said.

A second doctor, interviewed separately, said that hospitals in the city had documented about 250 dead over the past month, most of them civilians. He believed the actual number was higher because many people could not reach medical facilities.

"The fighters know how to protect themselves, but the civilians are getting hurt," he said.

Human Rights Watch could not verify the doctors' figures or determine to what extent government forces or rebel fighters were responsible for civilian casualties.

On April 3 and 4, Human Rights Watch interviewed 17 civilians wounded by gunfire and tank or artillery rounds in Benghazi after they had been evacuated from Misrata by boat. Some described deliberate and indiscriminate attacks on civilians, and showed the wounds they had suffered, though their accounts could not be confirmed.

Information on the fighting in Misrata, Libya's third-largest city with more than 300,000 residents, remains limited because the government has blocked access to the city by land for more than a month and had blocked it by sea until late March, Human Rights Watch said.

Under international humanitarian law applicable in Libya, all sides to the conflict are prohibited from targeting civilians and civilian objects or conducting attacks that do not discriminate between civilians and combatants. Forces must take all feasible precautions to minimize the harm to the civilian population, including avoiding deploying in populated areas and ensuring all targets are military.

Government forces have fired mortar rounds and aimed sniper fire that struck the Misrata Polyclinic, forcing its evacuation, said el-Fortia, who was present on March 23 at one of two attacks on the clinic, an account corroborated by the other doctor and two members of the Misrata city council. El-Fortia told Human Rights Watch:

It started that day with snipers who randomly shot people coming into the Polyclinic. Some people were wounded but none died. Then two mortars came from the Libyan Insurance Company building. This attack did not hit the Polyclinic itself; one hit just outside the clinic, 20 meters from the mosque, and one hit right behind the clinic. A fragment from the second mortar killed Noureddin Elgally, who was bringing food by car to the clinic. So we evacuated the patients from the Polyclinic to a place far from the center of Misrata.

On April 7, another two mortars hit the Polyclinic, but this time one of them landed on the building itself. The first hit the parking area, and the fragments destroyed the emergency entrance where people were standing around. The second hit the Polyclinic building, and the fragments damaged the mobile operating theater. A hospital cafeteria worker, Mohamed el-Mugasabi, who was working as a guard of the evacuated clinic at the time, was killed in the attack.

Approximately 15 other workers were injured in the April 7 attack, another doctor told Human Rights Watch. Medical centers are protected objects under the laws of war and a deliberate attack on them is a war crime, Human Rights Watch said. Even if they are being used for offensive military operations, medical centers cannot be targeted without advance warning.

The main hospital in Misrata has been under construction for about two years, the two doctors said, so the Polyclinic and other private facilities have been treating the wounded.

The 17 wounded civilians told Human Rights Watch how they were injured. Abdullah Abushofer, 26, said that on March 16, Libyan government tanks fired shells into his neighborhood in the Zwabi district of Misrata, although he did not know of any rebel forces nearby. He said he saw shells and high-caliber bullets strike behind his house. When he stepped outside his house to see what was going on, shrapnel struck him in the eye.

Muhammad Bashir, 42, told Human Rights Watch that he was standing outside his home in Misrata's Al Jazeera district on March 25 when a mortar shell struck nearby, he believed fired by government forces, wounding him badly in the leg. He said that there had been no fighting in the area. Bashir, a police officer who said he was not taking part in the fighting, had the lower part of his left leg amputated before being evacuated by ship.

Khalid Ali, 32, said that on March 29 he was walking down the street in the Gzeer neighborhood, where no fighting was taking place at the time, when two gunshots hit him in the leg.

"The people who took me to the clinic said that the sniper was positioned in the Thanuwayat El-Yarmuk school near where I was walking," he said.

Jamal Muhammad Suaib, 35, described an attack by government soldiers that caused the deaths of three family members. On March 17, uniformed soldiers broke into his family's home, stole their valuables, and threatened to return. Shortly after the soldiers departed, Suaib's family decided to flee for a safer part of town. They loaded three cars and drove away, until they came across soldiers blocking a street in their neighborhood. Without warning, the soldiers opened fire on the three vehicles, killing Jamal's 4-year-old niece, Aisha Misbah Suaib; his brother Hamza Muhammad Suaib, 22; and his father, Muhammad Suaib, 63.

Human Rights Watch observed the wounds to the surviving family members. Jamal was wounded in the leg; his wife, Hanan Omar Suaib, 21, was wounded in the arm; and their 8-month-old son Muhammad had a dislodged jaw that required a metal structural support.

"My wife was holding my son," he told Human Rights Watch. "The bullet hit her in the arm and ricocheted into my son's face. None of us had a weapon. We were just families looking for safe place to stay."

Government forces in Misrata have also committed violations of international human rights law, which remains applicable during armed conflict, Human Rights Watch said.

Hazma Muhammad Kariat, 32, told Human Rights Watch that on March 19 he attended a protest against the presence of government tanks and soldiers in Misrata. A crowd of civilians gathered in the city center chanting, "We don't want Muammar!" a reference to Libyan leader Muammar Gaddafi. Kariat said he watched government tanks advance towards the protesters on Tripoli Street. Then the tanks and soldiers opened fire.

"It was a slaughterhouse," he said. "I was hit by a sniper in the back, and there were five other injured people in the ambulance with me." Kariat was paralyzed from the waist down.

Alnoman el-Fezzani, 33, described taking part in a protest on March 21 at the public hall in downtown Misrata. "When Gaddafi forces arrived downtown and hoisted the [Libyan government] green flag, everyone said ‘No!'" said el-Fezzani. "When one guy raised the independence flag in the public hall, a sniper immediately shot him." Shortly after, el-Fezzani said, he himself was shot in the leg.

Individuals interviewed by Human Rights Watch also described family members who were missing, some of whom are believed to be in government custody. Two Misrata council members interviewed in Benghazi told Human Rights Watch that government forces had detained many city residents, whose whereabouts were unknown. They said the council had recorded the names of approximately 1,000 missing people over the past month, many of them youth. Human Rights Watch could not confirm that number or what had happened to them.

Muhammad el-Montaser, a council member, said that government forces around March 15 arrested Dr. Hussein Sherkisi, one of Misrata's most prominent doctors. Sherkisi has not been heard from since, he said.

Muhammad Bashir, whose leg had been partially amputated, told Human Rights Watch that two of his cousins, Hani Muhammad and Khairy Muftah, have been missing since March 13. According to Bashir, Muhammad had called his mother on March 16, before the government shut off Misrata's phone service, to say that government forces had detained him, but he did not know where he was. The family has received no more information on his whereabouts.

Khalid Ali, who was shot in the leg, told Human Rights Watch that three of his brothers, Abdusalam, Jabar, and a third brother whose name is unknown, have been missing since March 24. They left home together that afternoon at 1 p.m. and had not been heard from since.

Individuals from other parts of Libya have told Human Rights Watch they had been in government detention in the town of Sirte alongside men from Misrata. A rebel fighter who had been held in Sirte told Human Rights Watch that a government committee had released him from 11 days in detention on March 21 along with 13 men from Misrata.

Human Rights Watch also expressed concern about the humanitarian situation in Misrata because of the extremely limited aid reaching the city. Relief has been sharply restricted since shortly after protesters overcame the internal security forces in Misrata in the third week of February, when government armed forces launched an attack to seize control of the city from rebels.

The government has blocked all humanitarian aid via land routes. Following international coalition airstrikes in late March on Libyan government naval vessels blockading the port, limited humanitarian relief has arrived by sea. A ship chartered by the World Food Program arrived on April 7 with 800 tons of humanitarian aid. A boat with supplies from the International Committee of the Red Cross arrived in Misrata on April 9.

Under international humanitarian law, parties to the conflict must allow and facilitate rapid and unimpeded passage of humanitarian aid by impartial humanitarian organizations to civilians in need.

Wounded civilians and others in need of medical assistance have not been able to leave the city by land, either due to the fighting or because of widespread reports that government forces are arresting people who leave the city center. A few hundred medical emergency cases have been evacuated on boats organized by Medecins sans Frontieres and the Turkish organization IHH.

In addition to Libyan civilians trapped in Misrata, an estimated 6,000 Egyptian and sub-Saharan migrant workers have been stranded since early March on the coast east of Misrata because of the fighting, according to the Misrata Council members. The migrants have some tents but no sanitation or running water and are in desperate need of evacuation.

"The Libyan government should allow safe passage for civilians who wish to leave Misrata, including migrants," said Whitson. "It is crucial that regular humanitarian aid be delivered by land and sea to a population in dire need."

Correction

This 10 April 2011 press release was updated to correct the name of a victim's family, a doctor's place of employment, and minor details. Dr. El-Fortia works at the Misrata Hospital, not the Polyclinic. The original press release stated that Dr. El-Fortia told Human Rights Watch about the 15 injured people, but the information came from another doctor. Additionally, the family name Suaib was misspelled as Sueib.

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