In the early 1980s, when I served as medical officer for a minesweeping squadron, we were called upon to sweep* the shipping channel in the Sacramento River–someone had called in a mine threat because a Russian grain ship was to pass through. I wanted to ride the ‘sweeper to observe the sweeping operations, but my Commodore said “I want you on the beach with me, doctor; if people get hurt out there on the water, I want you here safe to be able to take care of them.” The prudent commander protects his medical assets.
Medical personnel have long accompanied their comrades in times of war, and they were traditionally protected from intentional attack by gentlemen’s agreement between the armies’ generals. This all changed in the mid nineteenth century when the killing power of modern armies was markedly increased, and the fluidity of battleground movement made it increasingly difficult to protect–or even to identify–the medical personnel of the opposing side. The appreciation of this was a major impetus for the development of modern humanitarian law which sets out protections for medical personnel in fields of armed conflict. As part of their Geneva Convention protection, medical personnel were to wear the Swiss red cross to make them easily identifiable both to friend needing aid and to foe so he could shift his fire. As a result, for a time, most wartime deaths and injuries of medical personnel were caused by disease or accident.
Nevertheless, Navy medical personnel go in harm’s way to accompany their Marine and sailor comrades, and they often pay the ultimate price. 18 American enlisted and officer medical men died in service of the U S Marines in World War I, and 165 were wounded or gassed. Medical personnel were among those who died in the Pearl harbor attack, and in total 1170 Navy Corpsmen died during World War II, most in service with the Marines in the Pacific, including 132 who succumbed to the privations and maltreatment they received in Japanese prisoner of war camps. Navy nurses also served and suffered–21 languished in Japanese POW camps and several died from injuiries suffered from a kamikazi attack on hospital ship USS Comfort. In Korea, 108 hospital corpsmen serving with Marines were killed in action, and in Vietnam, 638 died, a rate 120% greater than that of their non-medical comrades. I could not find data for medical casualties in Gulf War I and succeeding conflicts, but we can expect to see those sad statistics, especially in view of the fact that medical personnel now serve very far forward in the field of battle.
One deplorable trend has become apparent since the Vietnam conflict: the deliberate targeting of forward deployed medical personnel. Because they wore the Geneva Convention-specified Red Cross, Navy and Army corpsmen were often specifically targeted by the enemy in Vietnam. As a result they no longer wear the distinctive mark of their medical calling. Even so, corpsmen tending to wounded Marines and soldiers often come under specifically aimed fire from enemy fighters. We need to teach the lesson of history here: in the nineteenth century, army generals, and later the international community, saw significant value in protecting the medical people who take care of the wounded–of both “sides”–in combat. The result was the Geneva Conventions. Those Conventions call for the arrest, extradition and prosecution of people responsible for intentionally attacking medical workers in the field of battle. It’s time for the international community to take seriously this treaty obligation and to vigorously pursue, arrest and prosecute those responsible for the atrocity of intentional attacks on battlefield care givers.
* We found no mines during that sweeping operation–just a bunch of junk like old refrigerators and even the carcass of a car–and the Russian grain carrier transited safely to the San Francisco Bay.