International Committee of the Red Cross

The ICRC treats the wounded when war conditions prevent public medical facilities from doing so.

The ICRC’s first aid and emergency transport activities provide treatment for casualties from the point of injury until their transfer to appropriate medical facilities. It then helps with subsequent care by supporting existing health facilities with medicines, equipment, training and capacity building in most aspects of hospital management. This ranges from provision of quality patient care to human resources, infrastructure maintenance, finance, logistics and administration. When the situation demands, the ICRC deploys its own specialist teams to work alongside local hospital staff.

Operating in the midst of armed conflict – where regular medical services may be limited or lacking entirely – is often dangerous and imposes many limitations. The pathology of high-energy penetrating missile wounds is unfamiliar to most non-military surgeons – treatment of civilian gunshot wounds in a normal hospital does not readily compare. The ICRC therefore runs seminars on war surgery that enable dialogue between medical personnel from the national health system and ICRC specialists. Based on this experience, it has established basic protocols and procedures for war surgery techniques and for patient management in dangerous and limiting environments.

ICRC support to hospitals can include:

• surgery and medical services
• gynecology and obstetrics
• pediatrics
• nursing
• mental health
• hospital management and administration
• provision of consumables, equipment and expertise

The normal functioning of local health systems is often disrupted by conflict. In the worst cases, parts or all of the system may cease to exist. The risk of epidemics increases and support for civilian casualties and those suffering psychological trauma is limited or non-existent. The ICRC intervenes to maintain essential health care services for the affected population, as far as possible by supporting local structures and enabling them to continue functioning. Where needed, the ICRC will send its own specialists and will focus support on areas where official agencies are unable to work.

In cases of serious emergency when vital needs are not covered by existing health services, the ICRC takes emergency measures to limit mortality through basic medical treatment, communicable-disease control and immunization campaigns. It supplies medical equipment and drugs, and provides organizational support for capacity building, skills training and supervision.

The ICRC’s primary health-care initiatives to combat infant mortality include extended immunization programmes against measles, tuberculosis, tetanus, diphtheria, poliomyelitis and whooping cough. The ICRC is also involved in specific campaigns to counter certain diseases, such as polio. It helps ensure access to children living in areas where governments and United Nations organizations are unable to work.

The ICRC also pays special attention to the needs of expectant and nursing mothers. It encourages good practices for safe delivery, often with traditional birth attendants and offers counselling on HIV/AIDS.

The wounds of war are not only physical: proximity to combat, forced evacuation, separation from relatives, rape and other violence leave deep psychological scars and vulnerability which the ICRC seeks to address through psychological support and mental health activities.

The ICRC’s water and habitat activities ensure that people in conflict zones have access to water and create or maintain a sustainable living environment. Ultimately, this work reduces death and suffering due to habitat damage or disruption to water supplies.

In acute crisis situations where water supplies are interrupted (sometimes deliberately) and lives are at risk as people seek alternative sources in a hostile environment, the ICRC aims to ensure emergency access to water and health care and to maintain whatever local facilities remain. In emerging, chronic and post-crisis situations, the ICRC’s priority is to ensure continuity of basic services by supporting and strengthening existing resources.

Water
The ICRC assists in the repair or construction of all types of water supply system, regardless of size and technology. This work covers water intake from sources, treatment, storage and distribution. In rural areas, work includes improving hand-dug wells and installing motorized pumps at boreholes.

Sanitation and hygiene
Overcrowding, such as in camps for the displaced, quickly leads to the spread of disease. Providing proper sanitation is essential to the prevention of disease, and is therefore a high priority for the ICRC. This may involve building latrines or repairing sewage plants. The organization also runs-hygiene promotion programmes to encourage behaviour that will help prevent water- and sanitation-related diseases.

Habitat/shelter
The immediate response may be to provide plastic sheeting or tents. But the response can also take the form of temporary accommodation in schools, mosques, churches, private homes and other facilities. The ICRC also undertakes the post-crisis repair or reconstruction of health facilities and schools, the construction of camps for displaced people and the provision of material assistance (housing, heating and cooling systems, water and electricity, etc.) to families returning to their communities.

Power supply
The ICRC restores or maintains power supplies to essential installations such as hospitals, water treatment plants and water distribution networks, by repairing power distribution networks, generators, and hydroelectric plants.

Physical rehabilitation is a way of helping restore dignity to people with disabilities. It seeks to eliminate – or at least minimize – restrictions on their movement and activities, so that they may become more independent and enjoy the highest possible quality of life.

People with disabilities might need mobility devices such as prostheses, orthoses, walking aids and wheelchairs; they also need therapy to learn to make the fullest use of their devices. Restoring mobility is the first step in ensuring access to food, shelter, education, a job, an income and, more generally, the same opportunities as other members of society.

In the conflict-racked countries where the ICRC works, physical rehabilitation is needed not only by people whose disabilities are the direct result of the fighting (landmines, bombs, etc.) but also by people who become physically disabled because normal health care breaks down and they fail to receive treatment or vaccinations. The vast majority of these people will require access to physical rehabilitation follow-up for the rest of their lives…

The ICRC has acquired a leadership position in the field of physical rehabilitation on account of the scope of its activities, the development of its high-quality, low-cost, polypropylene technology, its acknowledged expertise and its long-term commitment to assisted projects. In most countries where the ICRC has launched rehabilitation projects, services had previously been almost nonexistent, and, in many cases, the ICRC project has formed the basis for establishing a national service.

Every year, armed conflicts, natural disasters and migration split up countless families. When fleeing a conflict or natural disaster, children can lose their way in the chaos. Elderly or sick people may not have the will or ability to leave. Injured people are taken to hospital without being able to let their loved ones know what has happened to them. People are sometimes detained without their families being informed of their whereabouts. Families suffer terribly from not having contact with, or any news from, their loved ones. It is scarcely surprising that their well-being and ability to cope with a crisis depends to a large extent on their ability to stay in touch with relatives.

The ICRC and the National Red Cross and Red Crescent Societies work together all over the world to assist people separated from loved ones both in emergencies and in other situations. Staff and volunteers strive to ensure that they are treated with dignity, respect and compassion. Their work involves in particular:

• forwarding family news (through various means, such as Red Cross messages, radio broadcasts, the telephone and the Internet) via the worldwide network of National Red Cross and Red Crescent Societies and ICRC delegations
• tracing people separated from their families, in particular unaccompanied and separated children, including demobilized child soldiers
• collecting information on detentions, disappearances and deaths, collecting tracing requests from the families of missing people and submitting them to the relevant authorities for clarification
• organizing repatriations and family reunifications
• facilitating family visits to detainees or across front lines
• issuing ICRC travel documents for people who, owing to a conflict, do not or no longer have identity papers and are about to be repatriated or resettled in a third country

Activities for missing persons are intended to shed light on the fate and/or whereabouts of people who are unaccounted for as a consequence of an armed conflict, other situation of violence or migration, and thereby respond to the suffering caused to their relatives by the uncertainty surrounding their fate.

The ICRC pursues a strictly humanitarian approach to the issue, which involves promoting and supporting mechanisms to help clarify the fate of missing persons, including the collection and management of information and the recovery and identification of human remains; facilitating dialogue between the authorities and the families of missing people; assessing and responding to the latter’s needs in a holistic manner; and promoting measures to prevent people from becoming unaccounted for.

The ICRC aim to promote the universal ratification of international humanitarian law (IHL) treaties and the adoption by States of legislative, administrative and practical measures and mechanisms to give effect to these instruments at national level. It is also important to ensure that proposals to develop domestic laws do not undermine existing IHL norms.

Implementation activities also aim to foster compliance with IHL during armed conflicts and to ensure that national authorities, international organizations, the armed forces and other bearers of weapons correctly understand the law applicable in such situations. This involves in particular:

• promoting IHL treaties among the relevant authorities by making representations to governments, providing training in IHL and drafting technical documents and guidelines to further national implementation
• providing technical advice and support for the implementation of IHL, undertaking studies and carrying out technical assessments of the compatibility of national legislation with this body of law
• promoting the creation of national committees to steer IHL implementation and supporting existing ones
• encouraging and helping authorities to integrate IHL into the doctrine, education and training of national armed forces (international human rights law in the case of police and security forces), and into the training and education programmes for future leaders and opinion-makers in universities and schools
• developing and implementing approaches for influencing the attitudes and actions of political authorities and weapon bearers
• reinforcing links with academic circles to consolidate a network of IHL experts and developing partnerships with institutes and research centres specializing in IHL
• engaging with the media and the greater public to inform, influence and mobilize key stakeholders on priority humanitarian issues and to promote greater understanding of and support for IHL and the work of the ICRC.

The ICRC pays particular attention to promoting measures to prohibit the use of weapons that have indiscriminate effects or cause superfluous injury or unnecessary suffering. This includes promoting the application of existing international humanitarian law (IHL) norms on the use of weapons and the development, when appropriate, of additional norms in response to the field realities witnessed by the ICRC or the emergence of new technology.

The ICRC, working closely with National Red Cross and Red Crescent Societies, also conducts preventive mine-risk education in situations where mines, cluster munitions and explosive remnants of war represent a danger to the population.

ICRC mine-action activities involve:

• making representations to governments and weapon bearers where a problem exists
• holding meetings of military, legal, technical and foreign affairs experts to consider, inter alia, issues relating to emerging weapons technology and the impact in humanitarian terms of the use of certain weapons
• promoting the full and faithful implementation of treaties such as the Anti-Personnel Mine Ban Convention, the Convention on Certain Conventional Weapons and the Convention on Cluster Munitions, and providing IHL perspectives in meetings on relevant arms treaties
• attending meetings with key mine-action organizations that contribute to the development of mine-action policy, methodologies and systems
• planning and conducting preventive mine action, often in cooperation with National Red Cross and Crescent Societies, to limit the physical, social and economic impact of mines, cluster munitions and explosive remnants of war
• in emergency response situations where weapon contamination impacts the population and/or ICRC staff and activities, and in situations where others are unable to act or where it is not possible to mobilize other actors, deploying a rapid response team to survey and/or clear contaminated areas for a limited time; while not engaging in long-term clearance projects, providing training, mentoring and capacity building to enable States to do so

The objective of the ICRC’s activities for people deprived of their freedom is purely humanitarian, namely to ensure that their physical and mental integrity is fully respected and that their conditions of detention are in line with international humanitarian law (IHL) and/or internationally recognized standards. As circumstances dictate, the ICRC strives to prevent forced disappearances or extrajudicial executions, ill-treatment and failure to respect fundamental judicial guarantees, and, whenever necessary, takes action to improve conditions of detention. This involves in particular:

• negotiating with the authorities to obtain access to people deprived of their freedom wherever they may be held, in accordance with procedures that guarantee the effectiveness and consistency of ICRC action
• visiting all detainees, assessing their conditions of detention and identifying any shortcomings and humanitarian needs
• monitoring individual detainees (for specific protection, medical or other purposes)
• maintaining family links (such as facilitating family visits or forwarding Red Cross messages)
• under specific conditions, providing material and medical relief supplies to detainees or engaging in cooperation on specific projects with the detaining authorities
• fostering a confidential and meaningful dialogue with the authorities at all levels regarding any problems of a humanitarian nature that may arise

Visits to places of detention are carried out by the ICRC in accordance with strict conditions:

• delegates must be provided with full and unimpeded access to all detainees falling within the ICRC’s mandate and to all places where they are held
• delegates must be able to hold private interviews with the detainees of their choice
• delegates must be able to repeat their visits
• detainees falling within the ICRC’s mandate must be notified individually to the ICRC, and the ICRC must be able to draw up lists of their names