A Heavy Price to Pay: Attacks on Healthcare Systems in Syria 2015-2021 (May 2022)



Since the start of the conflict in Syria, the world has witnessed the distressing reality of how perpetrators of violence have systematically targeted healthcare systems in Syria,1 a now well-documented and substantial reality of the conflict. Alongside immediate destruction that this causes on people and healthcare systems, this also means that healthcare systems have all too often been prevented from offering treatment to patients and their communities.

The Syrian American Medical Society (SAMS)2 - a global medical relief organization working on the front lines of crisis relief in Syria - has always called for accountability for any perpetrator who carried out any attacks in violation of their international legal obligations.3 They have also gathered years of data on attacks on healthcare systems. A Heavy Price to Pay presents this data collected by SAMS on attacks on healthcare systems in Syria in an attempt to support any future mechanism for accountability on this issue. The data it has collected includes incidents impacting its own facilities and data SAMS has gathered on other incidents that impacted non-SAMS systems.In 2021, SAMS built a unified database of these incidents which included verifying credibility, expanding on details where needed, correcting and coding information, reviewing coordinates for the attacked facilities, and matching media files with their respective incident reports. After the process of cleaning, the data was then analyzed through a legal lens.

What this report has done is explored this data in the context of international humanitarian law, and, by utilizing the data SAMS has collected, this report shows that there is an urgent need for investigators to explore further were crimes against humanity or war crimes have taken place.