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(Beirut) – Unidentified militia fired on a hospital in southern Yemen that pro-Houthi soldiers had endangered, in violation of the laws of war. All parties to Yemen’s conflict should take necessary measures to ensure that medical facilities and personnel do not come under attack so that patients can be treated.

Yemeni army forces fighting on behalf of the Houthis endangered the hospital, in the city of Lahej, by shutting off the hospital lights and deploying snipers nearby on April 13, 2015, and two days later stationing a tank at the hospital entrance. Opposing gunmen carried out attacks beginning on April 13 that repeatedly struck the hospital and put medical personnel at grave risk. As of April 16, fighting was continuing in the vicinity, with both groups using rocket-propelled grenades and other military weaponry.

“Fighters on both sides in Lahej have unlawfully put a hospital in the middle of a battle,” said Joe Stork, deputy Middle East and North Africa director. “For the safety of doctors and patients it’s crucial for all sides to stay away from medical facilities and allow them to function.”

Ibn Khaldun Hospital is on the outskirts of Lahej, just north of Aden in southern Yemen. When fighting escalated in the area after March 26, the hospital staff evacuated all patients except those receiving emergency assistance. Three doctors working at the hospital told Human Rights Watch that on the evening of April 13 they heard gunfire and saw militia of unknown affiliation attack a military checkpoint about 500 meters from the hospital.

The army deployed snipers in buildings near the hospital, increasing the likelihood it would be damaged by fighting, Human Rights Watch said. Dr. Jaem al-Hilali said that on the night of April 13, four soldiers forcibly entered the house where his family and five other families live, across the street from the hospital. “My father tried to stop them from entering, but one of the soldiers threatened him, pointing a gun to his head,” he said. “We decided it was best to let them in. They proceeded to the roof where they set up snipers. I moved my family out the next day.”

Several hours into the fighting on April 13, two soldiers entered the hospital and ordered the doctors to turn off the hospital’s external lights so that they could hide along the walls of the building. By this time the hospital was no longer housing any patients, but 20 staff remained, the doctors said. Dr. Hussein al-Yazidi told Human Rights Watch that some rockets and other projectiles then hit the hospital, breaking a window and damaging some walls. Bullets also hit a spare tank of diesel fuel for the hospital generator, causing it to leak. The use of such direct fire weapons suggests that the attackers knew they were hitting a hospital, Human Rights Watch said.

The doctors said fighting subsided on the morning of April 14 and people were able to leave and enter the hospital, including new patients. At about 10 a.m., several army officers entered the hospital, saying that they were there to investigate what the doctors were doing. They left shortly thereafter. Dr. Abd al-Majeed Atif told Human Rights Watch that on the following day, April 15, the army stationed a tank 10 to 20 meters from the gate of the main entrance to the hospital. The tank has since fired on targets and received fire with various levels of intensity. “We had to force all the remaining patients to leave and cancel a Caesarian operation we had planned for that day,” Dr. Atif said. “We cannot use the front door of the hospital and need to leave through the back door – we are all in extreme danger.” The doctors said that soldiers were stationed at the back door, though the use of armed guards at a medical facility is permissible. No civilian casualties were reported at the hospital.

In addition to the damage from the fighting, Ibn Khaldun Hospital faced increasing shortages. The doctors told Human Rights Watch that the hospital was running low on diesel fuel, needed for running its generator. They said food stocks in the area were also running low and that vehicles with supplies were not coming in because of the ongoing fighting and lack of fuel.

Under the laws of war applicable to the armed conflict in Yemen, all hospitals and other medical facilities, whether civilian or military, have special protection. They may not be targeted, even if being used to treat enemy fighters. Medical facilities remain protected unless they are used to commit hostile acts that are outside their humanitarian function. Even then, they are only subject to attack after a warning has been given setting a reasonable time limit, and after such warning has gone unheeded. Armed forces or groups should not occupy medical facilities.

As of April 14, the fighting in Yemen, including airstrikes by the Saudi Arabia-led coalition, had killed at least 364 civilians, including at least 84 children, according to the United Nations Office of the High Commissioner for Human Rights. Human Rights Watch has documented strikes that may have been indiscriminate or disproportionate in violation of the laws of war.

“All warring sides in Yemen need to get the message out that hospitals have special protections,” Stork said. “Ensuring their safety benefits everyone.”

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