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Friday 27 March 2020

Urgent call for medical evacuations from Rukban camp


Four women with high-risk pregnancies in Rukban camp need caesarean sections imminently. Rukban camp has no access to health services bar a small mud-hut clinic run by a few nurses.

US and UK Coalition forces control the area around Rukban camp and have a legal duty to civilians under Geneva Convention IV. Below is our letter to the UK Government.

PLEASE HELP by alerting your MP.

You can email your MP via www.writetothem.com.

UPDATE 30 March 2020: Response by Minister of State for Middle East and North Africa added below.

UPDATE 2 April 2020: Two women have now had caesarean sections in Tanf base, Richard Spencer reports in the Times:

The second woman, whose two previous children were born by caesarean section which meant giving birth naturally would have been dangerous, arrived at the camp yesterday, but again the US refused to help. Dr Abdulkareem said the US commander eventually agreed to repeat the operation so long as campaigners did not ask for help for anybody else. The second woman also gave birth to a daughter.

“They did it as a one-off and don’t want it to be repeated,” Dr Abdulkareem said. “The US and the UK, which is a senior partner as well there, are evading responsibility.”



Urgent evacuation of four women with high-risk pregnancies

27.03.2020

[PDF version]

To:
The Rt Hon James Cleverly, Minister of State for Middle East and Africa
David Ashley, Head of Syria Unit, Foreign and Commonwealth Office

We are writing to you to express our grave concern over the dire situation of four women with high-risk pregnancies, in Rukban camp, these women need caesarean sections imminently. Rukban camp has no access to health services bar a small mud-hut clinic run by a few nurses. They have been barred from access to the UNICEF clinic since Jordan closed its border. Two of these women have lost children due to lack of access to healthcare, one of them precisely due to the inability to have a caesarean section last pregnancy.

Yesterday, one of the women went into labour and after an extremely difficult and risky labour, her baby needed resuscitation due to respiratory distress and is still in a critical condition. Another mother is 12 days overdue today, this poses a very high risk to both the mother and baby. It is medically established that there’s a sharp increase in risk of fetal death at day 14 after the due date due to the inability of the placenta to sustain the fetus any longer, hence all obstetric guidelines dictate that women must be delivered at day 14 after their due date at the latest to avoid sudden fetal death. Day 14 for this woman is this Sunday after which there’s an exponential increase of risk of death to the unborn baby.

Rukban camp is inside a 55-kilometre radius zone around Tanf base controlled by Coalition forces, including the Royal Air Force.
This military occupation is part of a Coalition operation in Syria which claims legal justification under Article 51 of the UN Charter as collective self-defence of Iraq, as set out in a letter to the UN Secretary General on 23 September 2014 from then US Ambassador to the UN Samantha Power.

Under Article 55 of the Geneva Convention IV the UK is under legal obligation to ensure residents of Rukban have access to food and healthcare services.

Article 55 of the Geneva Convention IV states that: To the fullest extent of the means available to it, the Occupying Power has the duty of ensuring the food and medical supplies of the population; it should, in particular, bring in the necessary foodstuffs, medical stores and other articles if the resources of the occupied territory are inadequate.

We therefore ask as a matter of urgency to:

  • Evacuate these women within the next 48 hours from Tanf to hospitals in a safe location to be treated and to deliver their babies safely.

Multiple human rights and humanitarian aid organisations have condemned the situation in Rukban camps; 1 woman and 3 children have died in the past 18 months due to lack of access to medical care.

We call on you to evacuate these women within the next 48 hours, otherwise their lives and their unborn babies lives are at risk.

Dr Batool Abdulkareem, Syria Solidarity UK
Bronwen Griffiths, Syria Solidarity UK
Hamish de Bretton-Gordon, Doctors Under Fire



MINISTERIAL RESPONSE:

30 March 2020

Dr Batool Abdulkareem, Syria Solidarity UK Bronwen Griffiths, Syria Solidarity UK

Hamish de Bretton-Gordon, Doctors Under Fire


Dear Dr Batool Abdulkareem, Bronwen Griffiths and Hamish de Bretton-Gordon,

Thank you for your letter of 27 March about evacuating women from Rukban camp for Internally Displaced Persons in southern Syria.

I am sorry to hear about the women you describe with high risk pregnancies; of course I appreciate the severity of this situation. The UK is in regular communications with the UN and has continued to express concern, including in multilateral fora such as the UN Security Council and bilaterally with Russian counterparts, at the conditions in Rukban, where some 12,000 people still shelter and reports continue of a regime-imposed seige. We have pressed for the Assad regime to allow humanitarian aid access from Damascus which, although allowed only intermittently, remains the most appropriate route.

We do not accept that the UK has legal responsibility for Rukban. The UK is not an occupying power in Syria and Al-Tanf is a US military base. We have passed your urgent request to the US military to see if there is any way they can assist, but as you will be aware, the Covid-19 situation has complicated what was already a very difficult humanitarian situation in Rukban. The global strain on healthcare and newly introduced limits on travel will only add to the challenge.

On 25 March, I echoed UN Special Envoy for Syria, Geir Pedersen’s call for a nationwide ceasefire in Syria, in response to this new threat. Ultimately, a UN-led political solution is the only way to resolve the conflict. In the immediate term, however, I hope these women and their children, along with all those in Rukban, are able to access the support they need.

The Rt Hon. James Cleverly MP
Minister of State for the Middle East and North Africa



BACKGROUND ON RUKBAN CAMP

Rukban camp: A case study in reviewing the UK’s protection of civilians strategy
By Dr Kate Ferguson, Protection Approaches, June 2019.

The UK is complicit in a crime against humanity at Rukban camp
Syria Solidarity UK report, April 2019.