Evacuation

Evacuation is the act of transferring populations or individuals. In situations of armed conflict, humanitarian law prohibits the forced displacement of populations. Military or medical evacuations are permitted, but only in exceptional circumstances and respecting strict and precise conditions.

Military Evacuations

Military forces may -under strictly limited conditions- impose certain kinds of evacuations on non-combatants. These conditions must -however- be interpreted restrictively as the evacuation of populations may never be used as a combat strategy and may never be carried out simply because of its practical efficiency in attaining a military objective. It may only be used when no military alternative to evacuation exists. Evacuations are only permitted under the following circumstances:
  • The evacuation of a given area is possible if the safety of the population or imperative military reasons require it;
  • Such evacuations must be temporary. Persons thus evacuated must be transferred back to their homes as soon as hostilities in the area in question have ceased;
  • Such evacuations may not involve the displacement of protected persons outside the bounds of the occupied territory, except when it is impossible to avoid such displacement for material reasons;
  • Such evacuations must be carried out with respect for the interests of the civilian population. They may not be evacuated to a region that is exposed to the dangers of war; the authorities undertaking these evacuations must ensure that the individuals are received in proper accommodation and are transported in satisfactory conditions of hygiene, health, safety, and nutrition; and family members must not be separated;
  • The protecting power or its substitute, the ICRC, must be informed of any evacuations as soon as they have taken place.
In non-international armed conflicts, the provisions prohibiting forced population displacements, or regulating the exceptions, use parallel -yet distinct- language.

Medical Evacuations

Medical evacuations concern wounded, sick, and shipwrecked individuals who need medical attention. Such evacuations may also concern children and other vulnerable persons who, in certain circumstances, are covered by the same protection offered to the sick and wounded under humanitarian law.
In encircled or besieged areas, the parties to the conflict must “endeavor to conclude local agreements for the removal of wounded, sick, infirm, and aged persons, children and maternity cases, and for the passage of ministers of all religions, medical personnel and medical equipment on their way to such areas.” Such persons are usually evacuated toward hospitals or appropriate medical structures.

If there is no such written agreement, humanitarian law establishes that, as far as military considerations allow, each party to the conflict shall facilitate measures undertaken to search for the dead, sick, and wounded and to evacuate them to a location where they can be cared for (GCIV Arts. 16 and 17).
All of these operations, carried out by medical personnel, units, and transport, must be accomplished under the protective emblem of the Red Cross (or Red Crescent) and with the same guarantees as those provided for military evacuations (GCIV Art. 49). ▸

To better protect the medical installations to which the persons are being evacuated, the parties to the conflict may set up hospital and safety zones, at the onset of hostilities, as well as neutralized zones in which to shelter the vulnerable persons (GCIV Arts. 14 and 15).
The persons concerned by these medical zones and localities are wounded, sick, infirm, and aged persons; children under fifteen; expectant mothers; and mothers of children under seven. The establishment and functioning of these zones are dependent on the authorities and relief organizations concluding special agreements that allow the appropriate entities to search for the individuals in danger and transport them to the hospital zones.

Medical evacuations have been recognized in customary international humanitarian law. Rule 109 of the customary IHL study published by the ICRC in 2005 provides that “whenever circumstances permit, and particularly after an engagement, each party to the conflict must, without delay, take all possible measures to search for, collect and evacuate the wounded, sick and shipwrecked without adverse distinction.” This rule applies in international and non-international armed conflicts. This duty is also applicable to the search, collection, and evacuation of the dead (Rule 112).
Humanitarian organizations have an important role to play in the case of an evacuation, especially in negotiating the establishment of hospital and safety zones. In particular, they must draw up nominative lists of all evacuated persons and ascertain that their medical responsibilities prevail over any police or military decisions, so as to ensure the protection of these persons during the evacuation.
Given the risks incurred by individuals who are evacuated and then gathered together in hospital zones, the parties to the conflict must sign written agreements to regulate the operation of these zones (GCIV Arts. 14 and 15). In particular, these agreements must define the different responsibilities in terms of protecting the populations in these zones.
The massacres committed in the past years in security zones set up under the aegis of the UN should make each actor realize the importance of establishing clear responsibilities.
Evacuations must take place in a way that does not prevent the return home of the evacuees and does not hinder family reunification. Special measures must be taken for the identification of each person. These measures are particularly strict with regard to children.

Specific Medical Evacuations

Evacuation of Children

If necessary, measures must be taken to “remove children temporarily from the area in which hostilities are taking place to a safer area within the country, and ensure that they are accompanied by persons responsible for their safety and well-being,” in both international and internal conflicts (APII Art. 4.3.e, API Art. 78). Whenever possible, this must be done with the consent of their parents or persons responsible for their care.
In case of an international conflict, children may not be evacuated to a foreign country unless they are being evacuated by the party to the conflict of which they are nationals.
When children are evacuated, humanitarian law establishes many restrictions. The aim of such regulations is to protect the interests of the children, particularly to facilitate their return to their families and to prevent the development of practices such as illegal adoptions (API Art. 78).
The authorities arranging for the evacuation of children, or those of the country receiving them, must establish a card for each child and send it to the Central Tracing Agency of the Red Cross.
Each card must bear, whenever possible and whenever it involves no risk to the child, the following information: last and first name; gender; place and date of birth; father’s and mother’s first and last names; next of kin; nationality; the child’s native language and any other languages he or she speaks; family’s address; any identification number that might have been given to the child; state of health and blood type; any distinguishing features; the date and place where the child was found; the date and place from which the child left the country; the child’s religion, if any; and the child’s address in the receiving country. If the child should die before his or her return, the date, place, and circumstances of death and place of burial must also be noted (API Art. 78).

Evacuation of Wounded Combatants

Humanitarian law prohibits any distinction being made between wounded civilians and wounded military personnel. They have the same rights to be collected, evacuated, and cared for.
However, wounded and sick members of a belligerent party who fall into enemy hands are considered prisoners of war (GCI Art. 14). As such, they benefit from the rights established by the Third Geneva Convention and must be evacuated from the combat zone to an internment camp for prisoners of war situated away from the danger zones (GCIII Art. 19). The evacuation must be carried out humanely and in conditions similar to those for the forces of the detaining power in their changes of station. In particular, they must be given food, drinking water, clothing, and any necessary medical attention (GCIII Art. 20).
Prisoners of war who suffer from certain illnesses or wounds may not be kept in captivity or be cared for in the territory of the detaining power. Humanitarian law establishes that they should be transferred to the hospitals of neutral States or repatriated directly to their own country. The kinds of wounds and diseases to which these conditions apply are enumerated in Article 110 of the Third Geneva Convention and are further detailed in the entry on ▸ Prisoners of war . Annex I of the Third Geneva Convention provides a model agreement concerning the direct repatriation or hospitalization in neutral countries of wounded and sick prisoners of war.