tradition of the ICRC5 have increasingly been present in conflict zones, primarily to fill gaps in local health care services, but also occasionally as direct providers of care to the war-wounded. Thirdly, classical battlefield engagements tend to disappear, replaced by protracted or sporadic combats often taking place in populated areas. From a military perspective, theories of ‘irregular’ or ‘asymmetr ic’ warfare propounded as deviations from classical warfare, have had a particular resonance since the 9/11 attacks against the USA6. In addition to direct casualties, current contexts of warfare in mid- or lowdevelopment countries typically feature additional mortality, due to population displacements, food insecurity, epidemics and the collapse of health systems. From the viewpoint of relief agencies, such situations have been described as ‘complex emergencies’, and they are familiar to both humanitarian and military medical personnel deployed abroad. In peacetimes, and following a long-established tradition in some countries, military medical services have classically contributed to medical and public health activities overseas, owing to the habitual expertise of military doctors in tropical medicine or disaster medicine. After the post-colonial era, this kind of expertise has also been acquired by non-military physicians working for humanitarian organizations. During recent conflicts, the participation of the military to civilian relief operations (for example as part of peacekeeping operations, or during low-intensity warfare) has further blurred the lines between military and humanitar ian medicine7, not as much as a matter of professional disciplines, but more profoundly in terms of neutrality and independence. This situation has been a source of ideological controversies, with humanitarian NGOs expressing concerns over the co-optation of humanitarian endeavors and the risks of misperceptions from local populations. Yet, the distinction between military medicine and humanitarian medicine remains clear, at least on two accounts. Firstly, military personnel operate under the protection of their own troops, whereas humanitarian volunteers rarely rely on military protection. Secondly, military medical personnel face unique ethical challenges due to their dual professional identities, for example when confronted to situations of battlefield triage 8.
of International Humanitarian Law (IHL), whereby it is clearly specified that properly identified hospitals should never become military targets10. The US-led coalition gave variable accounts of the events in Kunduz, ultimately blaming faulty aircraft communication equipment for the tragic course of events. Whatever the result of further investigations (being independent or not), this paper will not entertain any consideration over who is to blame, or the philosophical question of intentionality of actions11. The outcry following the Kunduz attacks has been relayed by many organisations, including a number of prominent national and international medical associations. The President of the USA offered a personal apology to MSF12, but fell short of supporting an independent investigation. On May 3rd 2016, the UN Security Council adopted Resolution 2286, condemning attacks against medical facilities and personnel in conflict situations13. On October 3rd, 2016, the US Secretary of Defense issued a statement, reminding the ‘legal principles related to the protection of the wounded and sick and of impartial humanitarian organizations during armed conflicts’14. Whether the attacks were triggered by omission or commission, or whether the victims were properly compensated15 does not really matter here. Regardless of what actually happened in Kunduz, the case reveals at the very least a systemic failure, and it casts doubts about political commitments by belligerents to guarantee the respect of the IHL. Kunduz is a case in point for in depth analysis, but it should certainly not overshadow other incidents of similar proportions that deserve equal outcry and accou