Hospital of the ICRC of Novye Atagi

This hospital had been created in September 1996 by the International committee of the Red Cross (ICRC) to Novye Atagi in Chetchnia, Fédération of Russia. It was evacuated in December of the same year after 6 members of the expatriate team were assassinated of night by an armed commando. This event to date constitutes the greatest tragedy of the history of the ICRC.

Context

The decision to create this hospital was made at the end of the First war of Chetchnia in a context of great insecurity. Indeed, during the battle of Grozny from August 6th to 15th 1996, of many hospitals had been destroyed.

The choice of Novye atagi

A mission of evaluation of the ICRC started from Geneva arrived in the town of Naltchik in Kabardino-Balkarie on August 18th Three assumptions of localization were emitted at this stage: the border enters Ingouchie and Chetchnia, Grozny, the villages in the South of Grozny.

The mission left on the ground the following day August 19th In Ingouchie it was seen proposing a room to establish the hospital by the local authorities. The mission left then on Chetchnia and returned in Nazran on August 21st by proposing the site of Novye Atagi, village located as Chetchnia, with approximately 20 kilometers in the South of Grozny.

She explained the neutral character of the village, sits of the negotiations between the Russian freedom fighters and authorities. The representatives of the village had also guaranteed the safety of the ICRC. They had also explained the local tradition of protection of the guests. That Ci wants that a host loses the face if its guest undergoes some aggression that it is under its roof.

The chief of the mission of evaluation managed to rejoin the delegation with his proposal. That Ci was then subjected to the seat of Geneva which, reticent at the beginning ends up agreeing.

The option " Ingouche" was thus abandoned with the explanation which the combatants tchetchenes would not be in safety on a Russian territory. It been necessary to excuse itself near the Ingouches authorities not to adopt their proposal.

This decision seemed hasty with certain members of the delegation. It appeared to them that the possibility of obtaining security guarantees on behalf of the Russian authorities for the transport and the treatment of wounded in Ingouchie had not been sufficiently explored. They pointed out the Afghan context or of wounded the moudjahidin was transported to Kabul to the hospital of the ICRC under protection of that Ci. It appeared strange to them to want to install a hospital in an area as volatile as Chetchnia on mainly local criteria of safety. They stressed that a hospital is a structure heavy, difficult to evacuate quickly and discreetly in the event of danger. Upon the departure, the hospital was presented like fulfilling two roles: beyond its only function of care, it was to show an example of what is medical neutrality in this context or the hospitals are more often a target than a protected place.

The number of expatriates present as Chetchnia until there was very limited. Continuation with the opening of the hospital and the extension of other projects, this number exploded literally. The security policy was now based on a maximum visibility making it possible to make known itself.

Opening and first difficulties

As soon as the decision taken, an international medical team gathered by the ICRC left Geneva. She found in Nazran the material intended to assemble a hospital of countryside provided by the Norwegian Red Cross with the Norwegian technicians accompanying it. The team and her material joined Novye Atagi while forwarding by Nazran. The hospital was assembled very quickly and opened as of on September 2nd.

The personnel expatriates was immediately submitted to very intense pressures of the local authorities to recruit always more personnel among the inhabitants of the village.

September 18th, the war leader Islamiste Ibn Al-Khattab penetrated in the enclosure of the hospital with several armed men, demanding that the ICRC immediately withdraws all the flags carrying the Red Cross which announced the hospital. A compromise was finally found and the simply decreased number of flags.

September 21st was announced during a meeting that impacts of balls had been raised on the wall external of the residence of the expatriates. The commander of the village promised to make supervise the neighborhoods.

The pressures to recruit led on September 26th to the removal of the chief of under delegation and the administrator expatriate by the same commander who was supposed to protect the team. They were however released the very same day and the commander was replaced.

The problem of the framing

In the first weeks, the " cadres" expatriates were the administrator of Grozny and the surgeon chief, this last very occupied assembling the hospital and treating the first patients.

As regards the head clerk, the first came in the neighborhoods of on September 15th. Tested but on mission temporary of 1 month, it was replaced for a few days by a delegate then for approximately three weeks by le" deputy" from Moscow. Finally was named the final person having several years of experiment ICRC as an administrator. It was its first station as a head clerk.

The administrator came a few days afterwards, it was his second mission after a few months in Bosnia. He was then assisted by a first mission, almost in training.

All these people made absolutely of their better, working without slackening, but they always missed them either time or the experiment.

There was a delegate safety for Chetchnia, generally in Grozny.

The decision to increase the hospital

The provided site was an old unused school made up of several buildings distributed in a vast enclosure.

The principal building became a hospital with 2 operating rooms, the ancillary services (room of sterilization, admission, urgently, banks of blood, room of radiotherapy, physiotherapy and classroom, a treatment room intensive for a maximum of 7 patients and six treatment rooms making it possible to receive a little more than 60 patients.

A second building been used of refectory and pharmacy, the third of room of rest for the expatriates, the fourth was the residence of the expatriates, the fifth became the workshop. A sixth in bad condition was rehabilitated to become the administration. The restoration of all these buildings was programmed and quickly started for some.

The active combat had ceased since August 15th and the peace agreement between the Russian representatives and tchetchenes had been signed on August 31st with Khasaviourt in Daghestan, the number of patients of the hospital was in constant fall and did not seem to have to go up.

Moreover, the team had arrived with a hospital of countryside made up of tents. One could thus think that in the event of surge of wounded beyond the capacity of the provided buildings, the ICRC metterait the least reached of them in tents.

Thus in another mission of the ICRC with Quetta in Pakistan, the hospital included/understood 120 beds in the buildings into hard, the capacity being able to go up to 280 by using tents. The winter was quite as cold there as as Chetchnia.

One however quickly spoke to increase the hospital by new construction S into hard. The head clerk of Novye atagi of the moment and the manufacturer were against this idea. A meeting took place finally on September 24th. The project of extension was tiny room of two rooms. Remained all the same the construction of a new wing of the hospital comprising several rooms to carry the capacity to 150 beds as well as building allowing to increase pharmacy and the workshop. The option “tent” was isolated by explaining why one cannot provide same comfort in a country developed like Russia and in Pakistan.

Once this started building work, the problêmes of recruitment and monitoring became very other extensive. There be quickly more than one hundred people working with construction on the site or it became almost impossible to control the movements. In addition the importance of the contracts to be entrusted caused many covetousnesses and jealousy between the local contractors, increasing the tension further.

Threats

From November, the incidents of safety as Chetchnia believed of number and in gravity at one time or the date of the elections started to be fixed.

November 20th, a delegate was removed during a few hours by an armed group which apparently sought to make release some of their friends held by the Russians. He was slackening on pressure of the more high ranking authorities tchétchénes.

One night of the armed individuals entrérent in the radio room of Novi Atagi which was at the ground floor of the residence of the expatriates in the intention to steal the apparatuses present. Hearing noise, the head clerk went down, was made coil blows and threaten of a revolver on the temple. They laissérent a small note whose translation said to little pré>s: " Here for all the evil that you faites."

At the same time, two local employees of the SOEC were kidnapped in Grozny to be slackenings later a few hours. With their " debriefing" , they expliquérent that their kidnappers sought expatriates of the SOEC or ICRC and that if that had been their case, the business would have been much more serious, being able to go until the murder. To a meeting of CICRà Grozny, one put the question to know why the " petites" organizations still present (an expatriate of Merlin and two of MSF France) were not named. Analysis was that a blow on the two most visible organizations would be much more media.

Security measures were taken consequently. For the delegation of Grozny, they primarily consistérent to decrease in an important way the number of expatriates, to reduce and reinforce the safety of displacements. Request was also made with the local authorities place check-points around the delegation.

Concerning Novi Atagi, the delegate safety became much more present. He reinforced the number and the distribution of the guards, controlled their work better. But the ICRC, according to its principles, refused to provide them weapons. Check-points were also requested from the authorities which promised but did not make large thing. The personnel expatriate was slightly reduced: removal of the post of teaching male nurse, period of longer compensations.

Feelings of the team

Little before the massacre, the number of patients had fallen in the neighborhoods from 35. Many chronic cases (standard of osseous infection or revision of stub), little case " frais" , little urgently. A first " fournée" local nurses had been put of availability for this reason. Certain nurses expatriates started to be bored, others occupied themselves by making teaching. The team of the hospital had acted in concert to ask not to replace two of them which finished their mission. The remplaçantes however arrived, they died one week afterwards! The medical team knew by the deleguation of Grozny that the hospitals started with there refonctionner.

Some started to construct the gap between the unceasingly decreasing importance of the medical role of the hospital and the increase in the courrus risks. But it is difficult to still speak about closing for a hospital in construction!

Others spoke more and more about the second role of the hospital: the example of medical neutrality. It had to be shown that a hospital must remain an protected area, without weapons. It was also heard that even if this hospital did not have so many patients, it so media and was so well financed that it made it possible to make turn the action of the ICRC. And the ICRC was almost the last organization present as Chetchnia.

The massacre

In neighborhoods the 3 hour old 30 of the morning the 17 décezmbre, a group of five to ten men masked and armed with silencer guns pénétrérent in the enclosure of the hospital. They entrérent in the building of rest of the personnel expatriate. It was a building of two stages having two entries. They rentrérent in the rooms whose doors were not closed with key and killed their occupant almost with bearing end. They tentérent to smash the doors of the other rooms. Six people trouvérent death thus. The head clerk was wounded with the shoulder and did it dead and was thus saved.

The group of attacker, which was expressed in Tchétchène, met two members of the local personnel but left them the safe life, their goal was clearly to assassinate the personnel expatriate.

There be a gust of automatic weapon, undoubtedly drawn by a guard which had gone to seek a weapon. The attackers quittérent the hospital then. The attack had not lasted more than ten minutes.

The guards rapportérent the accident with the military commander of the village which arrived accompanied men-at-arms at the neighborhoods of four hour by the morning.

The survivors discovered deaths, soignérent the casualty and rassemblérent themselves while waiting for the paddle. A crowd of inhabitant piled up to comfort them and protect them.

Evacuation, debriefing, ceremony

A convoy left Novye atagi at the end of the morning bound for Nalchik transporting the survivors and deaths. Forwarding by Grozny, they reached Nalchik around 10 p.m. after having rolled 8 hours under snow. The casualty was evacuated after one hour to be hospitalized on Geneva.

The following day December 18th, the doctor responsible for the assumption of responsibility of the stress to the ICRC proceeds then to the emotional debriefing of the 13 survivors of the hospital. That makes it possible each person to make the account of “its night” and to share its emotions with the group.

The afternoon, the team finds itself with the mortuary of Naltchik for the beer setting of the bodies. In end-of-day, a long convoy made up of a truck transporting the six coffins and of about fifteen vehicles, shakes in direction of the airport of Mineralnyje-Vody, located at hundred kilometers; from there in the evening the skins, the guides and the survivors will leave. Aupararavant, a ceremony takes place in a hangar of the airport, vis-a-vis the coffins covered with the flag of the ICRC. A hundred people are present: the survivors of the drama, others deputy which will regain Geneva, but also all those which remain. By a freezing cold and in the din of the planes which land and take off, a last homage, sober and moving, is paid to the six victims, then each one, in a slow procession, ravels in front of the coffins. The plane takes off and a similar ceremony is organized in the night of December 19th on the tarmac of the airport of Cointrin, in Geneva, in the presence of the local authorities, members of the Committee, executives of the direction of the ICRC and representatives of the National companies.

The following day, we precipitated on an aircraft allowing to join our surviving colleagues with airport Vada the Mineral before their return on Geneva. A first ceremony took place with the bodies of the victims in a hangar. Speeches with half drowned in the noise of the engines. We get into the plane for Geneva. The first stories start to leave.

Deaths: That which slept, probably the killed first. Those dead beside their beds. That fallen meadows from its door. That which tried to barricade with its cupboard a door which did not close. That which still breathed.

The alive ones: That which, wounded, made it died. That which will be made pendentive with the key which saved the life to him. That which had not closed its door, which had time to turn the key (the key was on the door). That which was apprétait to open not to irritate them, believer with a " simple" taking of hostage. Having included/understood, he then believed that its door was going to release under the blows. That which awaited them close fighting with naked hands. Others. The following night, I frankly badly slept.

The continuation of the action of the ICRC in Caucasus north

The shortly after the drama, certain frameworks of the ICRC spoke to take again the activities as Chetchnia as soon as the culprits would have been identified. However the whole of the personnel expatriate was durably evacuated of Chetchnia. A small team remained in Nalchik of or it remotely controlled the action of the local employees of the ICRC remained as Chetchnia.

The hospital of Novye atagi was given to the local authorities without particular difficulties.

The interpretation of the ICRC

In the days which followed their repatriation, of the delegates submitted very critical reports/ratios on the action of the ICRC as Chetchnia. The report/ratio of the executives, justifying their action, arrived a little later. The seat followed the conclusions of the latter. The official line was thus that no error major had been made.

assumption

Here to come time from the " si" , of the equations with multiple variables.

Let us take for probable the assumption that this assassination was perpetrated to aim at the government places from there before the elections by proving its incapacity to ensure the safety in the country.

If the hospital could have been open in Ingushie

An action at the hospital would not have had a direction any more. Remained obviously the delegation of Grozny.

If the hospital had not been increased

It would have been a little less visible but it is difficult to think that would have been determining. The decision to close it would have on the other hand been easier.

If the hospital had been closed front

The delegation of Grozny became again the target. Provided that it does not have summer also closed. SOEC and its armored cars was more " coriace" that deadened nurses.

attempt at analysis

A catastrophe can sometimes result from a succession of small errors.

In this particular case, one can think that certain hasty decisions have summer taken with the initial phase of the project. These decisions were made by excellent technicians in the urgency but less good in anticipation and listening. The hierarchy of the delegation followed, making confidence with the enthusiasm of its specialists. The seat ratified in its turn trusting to him even its delegation. The " base" did not have great a deal to say.

These initial decisions then trapped us in an escape ahead until the end.

Bonds

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