Abstract
The ICRC was founded in 1863 and, in 1864, the first Geneva convention was created. It states that wounded and sick in armed conflict should receive assistance. They and the medical staff caring for them are protected by the emblem of the Red Cross, meaning that they must not be attacked.
War surgery is a major activity of the ICRC. From 1979, independent hospitals have been set up by the ICRC for wounded from conflict areas such as Afghanistan, Cambodia, and Sudan, and more than 100 000 wounded have received treatment. Treatment is always free of charge and medical needs are the only reasons for admission, so both soldiers and fighters from different groups are treated.
Expatriate doctors and nurses are civilians, doing missions as volunteers and usually staying between three months and a year. Most come from Europe, but many are from Canada, Australia, and New Zealand. Many have no previous experience of treating weapon wounds. Basic equipment is provided, but based on the long experience of ICRC, guidelines and treatment protocols have been created with the aim of saving life and limbs and rehabilitating the wounded. Even with these limited resources, hospital mortality is only 2.2–6.4%.
It all started with the battle of Solferino. In the north of Italy, a fierce battle between the Austrian and French armies took place on June 24, 1859. At least 40 000 dead and wounded were lying around by the end of the day. A Swiss merchant, Henry Dunant, passed by and saw all the suffering and tried to help by tending to the victims. Back home in Geneva, he put his impressions and thoughts to paper in a book called A Memory of Solferino[1]. He proposed that volunteers should be trained to take care of the wounded in wartime and that they should be recognized and protected through an international agreement.
The Founding of the International Committee of the Red Cross and the Geneva Conventions
In 1863, Henry Dunant, together with a group of Swiss doctors and lawyers, founded the International Committee of the Red Cross (ICRC). They organized an international conference in Geneva, where it was decided that a distinctive emblem – the red cross on a white background – the reverse of the national Swiss flag, was adopted. The following year, another conference was convened, and the result was the first Geneva convention (GC) of 1864. It states that medical services in armed conflict on land should be protected, and the emblem of the Red Cross should be used as a clearly visible sign on hospitals and ambulances. Wounded and sick should be cared for. These ideas were quickly spread and accepted over the world, and national societies of the Red Cross were created in many countries. It was followed by the second GC, which states the same for victims at sea, the third about protection and assistance to prisoners of war, and the fourth about protection of civilians. They were updated in 1949. Today, 196 countries have signed the first GC.
The ICRC is an impartial, neutral, and independent organization, whose exclusively humanitarian mission is to protect the lives and dignity of victims of armed conflict and other situations of violence, and to provide them with assistance. The ICRC is the guardian of the GCs, which means it has a role in informing about the conventions and promoting respect for them.
Several examples of the work of a medical doctor as a neutral observer for the ICRC are given in the book by Marcel Junod: Warrior Without Weapons (Le Troisième Combattant)[2]. He went to Abyssinia in the 1930s and tried to document the attacks by the Italian forces on a Swedish ambulance (a field hospital), which was marked with the Red Cross. Medical staff and patients were killed and wounded, a clear violation of the first GC. He also went to Hiroshima after the atomic bomb and described how most of the civilian population had been wiped out and the incredible suffering of the survivors.
Hospitals Under the Red Cross Emblem
If a country does not have the means to cope with a situation itself, it can ask for help from its sister national societies. This was the case during the Korean War, in which the Swedish Red Cross set up a field hospital to treat the wounded and sick. It existed from 1950 to 1957, even after the cease-fire in 1953. During its first three months, the hospital treated more than 3200 patients, of whom 50% were Americans, 36% North Koreans, and 14% from other nations. Over the years, more than 1000 Swedish doctors and nurses worked there under the flag of the Red Cross, respecting the basic principles of humanity and neutrality[3].
Early Assistance of ICRC
In the 1960s, 1970s, and 1980s, the ICRC sent out single doctors or teams to work in areas of armed conflict where the country itself did not have the means to give proper care. They worked in local hospitals and provided necessary basic equipment and drugs. The team members often came from one national society and were sent to places such as Cambodia and Angola. These could be purely surgical teams, but often also included a general practitioner and obstetrician or midwife. Focus was on weapon wounded, but other emergencies such as car accidents, malaria, and pregnant women needing cesarean sections were sometimes treated.
The ICRC Hospitals
Background
The 1970s and 1980s saw an escalation of armed conflicts in many countries, with limited resources to take care of weapon wounded. To provide better care, the idea of independent hospitals led to the creation of the first ICRC hospital in Thailand on the border to Cambodia in 1979. It existed until 1992, by which time it had treated more than 20 000 wounded from over the border.
Similar hospitals were created in the 1980s in Pakistan for wounded from the conflict in Afghanistan, and in north Kenya for wounded from Sudan and later in Ruanda, Democratic Republic of the Congo, Sierra Leone, Chechnya, and other places. More than 100 000 wounded have been treated in ICRC hospitals.
Related posts:
Chapter 6 – Training and Accreditation
Chapter 3 – Definitions, Needs, Scenarios, Functional Concept, and Modes of Deployment
Chapter 7 – Personnel
Chapter 15 – Pediatrics in a Field Hospital
Chapter 18 – Orthopedics in a Field Hospital
Chapter 25 – Infectious Diseases and Public Health in a Field Hospital
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