"The
guerrillas blew up the hospital."
I still vividly remember the scorching hot day in November 1989
when I heard those words and instantly recognized that there might
be a story behind them. I was working as Central America correspondent
for Newsweek. El Salvador was in the middle of a ferocious
nationwide offensive by a Marxist guerrilla group known as the Farabundo
Marti National Liberation Front (FMLN). The FMLN had surprised the
Salvadoran Army with large-scale coordinated attacks on the capital,
San Salvador, and all the major provincial towns across the tiny,
Massachusetts-size country. One of the towns they hit was Zacatecoluca,
a provincial capital near the country's international airport. Amid
the ensuing chaos, both sides charged each other with horrific human
rights violations. It was in that atmosphere that I heard the first
report of a guerrilla assault on the hospital in Zacatecoluca.
Hospitals, of course, enjoy a special protected status under international
humanitarian law. It is a war crime deliberately to attack a hospital
or other medical unit, whether civilian or military. It is also
unlawful to use a hospital in direct support of a military operationto
convert one wing of the hospital into an ammo dump, for example.
(Indeed, hospitals that are misused in this manner lose their legal
protection.) Medical personnel in general may not be attacked; but
at the same time it is unlawful to use medical facilities, or related
equipment such as ambulances, as camouflage or protection for military
personnel, or as a shield for military forces.
International humanitarian law is not, however, completely inflexible
in how it evaluates collateral
damage to hospitals that may result from attacks on legitimate
military targets nearby. The rule of thumb is that if the damage
to the hospital is not excessive in view of the direct and concrete
military advantages to be gained from attacking the nearby target,
then the damage may be considered lawful.
To go back to that hot day in El Salvador nine years ago. I clambered
into my beat-up Mitsubishi Montero Jeep and took off down the road
for Zacatecoluca. I will never forget the shock I felt when, without
warning, a huge explosion erupted from what seemed like only two
inches from my right ear. Temporarily deafened, I recovered my other
senses enough to realize that an army artillery piece had just been
fired from about twenty-five yards away; the Salvadoran military
was pouring shells into the hills around Zacatecoluca, in a desultory
attempt to deal with the retreating guerrillas.
When I reached the town, I made immediately for the large, modern
public hospital not far from the main square. Once inside, I did
indeed find that the pediatric ward had been blown to smithereens.
Windows were broken, the elevator destroyed, bits of bedding lay
strewn about on the floor. And the hospital personnel confirmed
to us that the damage had been caused when a guerrilla unit detonated
a large bomb in the ward.
End of story? Not quite. The destruction was heavy, but not entirely
wanton. There had been heavy fighting that day between the army
and the guerrillas. Neither side occupied the hospital or attempted
to do so, but as the fighting raged among the narrow cobblestoned
streets of the town, a few Salvadoran Army soldiers had become separated
from their unit and attempted to flee onto the roof of the hospital.
The FMLN forces cornered the government soldiers, and, in an attempt
to flush them out, decided to detonate an explosive charge in the
pediatric ward, the spot nearest to the soldiers' rooftop hideout.
Hence, two crucial legal questions arise: First, were the soldiers
a legitimate target for the FMLN? Almost certainly yes. (It could
even be argued that the hospital lost its protected status because
the soldiers chose to hide themselves there, but their flight onto
the hospital roof seemed less calculated than a decision made amid
the heat and panic of battle, with no cooperation from the hospital
staff, and it would seem perverse to make the hospital pay for that.)
Second, were the FMLN troops within their rights to use an explosive
to attack the soldiers, knowing that to detonate it would cause
substantial damage to the wing of the hospital where civilian children
were treated? I think that in this instance, the answer is also
yesespecially in view of the fact that hospital personnel
told us that the guerrillas gave them ample warning and permitted
them to evacuate all the patients and medical personnel before they
set off their bomb.
But it is a qualified yes. The answer, under international law,
would ultimately hinge on the question of whether killing or capturing
a handful of already fleeing enemy troops really warranted the eminently
foreseeable damage to a hospital facility. And that damage was extensive;
not total destruction of the entire building, to be sure, but serious
enough to force dozens of sick and injured people into a makeshift
outdoor clinic. It might reasonably be argued that this level of
damage was unwarranted, notwithstanding the FMLN's laudable effort
to evacuate the building first. In fact, the FMLN never did capture
or kill the soldiers. If humanitarian law was violated, the FMLN
theoretically might be required to pay reparations for the damage
caused. But there was no evidence of willfulness
in the legal sense required to constitute individually culpable
war crimes.
So I went back to San Salvador and incorporated the Zacatecoluca
hospital incident into that week's article. It was true, as I initially
heard, that the guerrillas had blown up the hospital. But a close
investigation of all the factors that led them to take that action,
and of the manner in which they took it, showed that, tragic as
it was, the assault may well have fallen into the category of a
questionable but lawful military action, rather than that of a major
violation of human rights or an individually culpable war crime.

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