{"id":1734,"date":"2026-03-17T08:00:00","date_gmt":"2026-03-17T05:00:00","guid":{"rendered":"https:\/\/tatd.org.tr\/afet\/?p=1734"},"modified":"2026-03-17T11:05:50","modified_gmt":"2026-03-17T08:05:50","slug":"savas-ve-silahli-catisma-ortamlarinda-sivil-saglik-hizmetlerinin-surekliligi-ve-etik","status":"publish","type":"post","link":"https:\/\/tatd.org.tr\/afet\/afet-yazi-dizisi\/savas-ve-silahli-catisma-ortamlarinda-sivil-saglik-hizmetlerinin-surekliligi-ve-etik\/","title":{"rendered":"Sava\u015f ve Silahl\u0131 \u00c7at\u0131\u015fma Ortamlar\u0131nda Sivil Sa\u011fl\u0131k Hizmetlerinin S\u00fcreklili\u011fi ve Etik"},"content":{"rendered":"\n

Giri\u015f<\/strong><\/h2>\n\n\n\n

Sava\u015f, tarih boyunca ekonomik, dini, siyasi \u00e7\u0131karlar gibi nedenlerden dolay\u0131 ba\u015flayan ve sonu\u00e7lar\u0131n\u0131 ise \u00e7o\u011funlukla sivillerin ya\u015fad\u0131\u011f\u0131 insan eliyle ortaya \u00e7\u0131kar\u0131lm\u0131\u015f bir afettir(1). T\u00fcm afet durumlar\u0131nda oldu\u011fu gibi sava\u015f ve silahl\u0131 \u00e7at\u0131\u015fma ortam\u0131nda da sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131 insan ya\u015fam\u0131n\u0131 korumaya ve sa\u011fl\u0131k hizmetlerini kesintisiz s\u00fcrd\u00fcrmeyi ama\u00e7lamaktad\u0131r. Bu durum \u00f6zellikle sa\u011fl\u0131k hizmetlerinin s\u00fcreklili\u011fi, sa\u011fl\u0131k personelinin ve hastalar\u0131n korunmas\u0131 a\u00e7\u0131s\u0131ndan etik ve hukuki sorunlar\u0131 beraberinde getirmektedir (2). Sava\u015f ve \u00e7at\u0131\u015fma ortam\u0131nda sa\u011fl\u0131k hizmetlerinin s\u00fcreklili\u011fi bir\u00e7ok \u015fekilde kesintiye u\u011frayabilir: Hastanelerin veya nakil ara\u00e7lar\u0131n\u0131n bombalanmas\u0131; sa\u011fl\u0131k personelinin ka\u00e7\u0131r\u0131lmas\u0131, \u00f6ld\u00fcr\u00fclmesi, tutuklanmas\u0131; ila\u00e7, kan \u00fcr\u00fcnlerinin stoklar\u0131n\u0131n t\u00fckenmesi\u2026 gibi nedenler say\u0131labilir (3). Afetlerde yaralanma sonras\u0131nda yaral\u0131lar\u0131n tedavisi \u00f6ncelik olmas\u0131na ra\u011fmen, do\u011fum, kronik hastal\u0131klar\u0131n alevlenmesi, a\u015f\u0131lama programlar\u0131, hasta takipleri bir yandan devam etmektedir (4). Bu y\u00fczden afetler \u00f6ncesindeki haz\u0131rl\u0131k planlar\u0131 ortaya \u00e7\u0131kan afetin sa\u011fl\u0131k hizmetlerinin kesintiye u\u011fratmamas\u0131 temelleri ve hedefleri ile olu\u015fturulur (5). Bir\u00e7ok afette uluslararas\u0131 bile\u015fenler bir araya gelerek afetin etkiledi\u011fi toplum \u00fczerindeki etkisini azaltmaya \u00e7al\u0131\u015f\u0131rken; sava\u015flar ve \u00e7at\u0131\u015fmalarda bu durum biraz daha farkl\u0131 olabilmektedir.<\/p>\n\n\n\n

G\u00fcn\u00fcm\u00fczde y\u00fcr\u00fcrl\u00fckte olan Cenevre S\u00f6zle\u015fmeleri ve bunlara ek protokoller kapsam\u0131nda, sava\u015f ve silahl\u0131 \u00e7at\u0131\u015fma ortamlar\u0131nda sa\u011fl\u0131k hizmeti sunan ki\u015fi ve kurulu\u015flar\u0131n korunmas\u0131 uluslararas\u0131 insanc\u0131l hukukun temel ilkelerinden biri olarak kabul edilmektedir (6). Bu \u00e7er\u00e7evede; sivil hekimler, asker\u00ee tabipler, sa\u011fl\u0131k personeli, insani yard\u0131m faaliyetlerinde bulunan sivil toplum kurulu\u015flar\u0131 ile yaral\u0131 ve hastalara yard\u0131m ula\u015ft\u0131ran sa\u011fl\u0131k birimleri<\/em><\/strong> \u00f6zel olarak korunmaktad\u0131r. S\u00f6z konusu d\u00fczenlemelere g\u00f6re, bu ki\u015fi ve kurulu\u015flar \u00e7at\u0131\u015fman\u0131n taraf\u0131 olarak kabul edilmez; g\u00f6revlerini yerine getirirken hedef al\u0131nmamalar\u0131, engellenmemeleri ve zarar g\u00f6rmemeleri<\/em><\/strong> uluslararas\u0131 hukuk taraf\u0131ndan g\u00fcvence alt\u0131na al\u0131nm\u0131\u015ft\u0131r. Ayr\u0131ca sa\u011fl\u0131k personelinin yaral\u0131 ve hastalara taraf g\u00f6zetmeksizin t\u0131bbi yard\u0131m sunabilmesi, t\u0131bbi tesislerin ve ambulanslar\u0131n korunmas\u0131 ve sa\u011fl\u0131k hizmetlerinin s\u00fcreklili\u011finin sa\u011flanmas\u0131 da bu s\u00f6zle\u015fmelerin temel h\u00fck\u00fcmleri aras\u0131nda yer almaktad\u0131r. Fakat bu s\u00f6zle\u015fmelere uyumu, korumay\u0131 ve hesap verebilirli\u011fi art\u0131rmaya y\u00f6nelik stratejiler eksiktir ve ihlallerin d\u00fczenli olarak raporlanmas\u0131 s\u00f6z konusu de\u011fildir (7).<\/p>\n\n\n\n

Silahl\u0131 \u00e7at\u0131\u015fmalarda sa\u011fl\u0131k hizmetlerine y\u00f6nelik sald\u0131r\u0131lar, insan haklar\u0131n\u0131n ve Uluslararas\u0131 \u0130nsani Hukukun temel ilkelerini ihlal etmektedir (8).Fakat yak\u0131n tarihli sava\u015flarda tan\u0131k olundu\u011fu gibi, \u00f6zellikle co\u011frafyam\u0131za yak\u0131n b\u00f6lgelerde ger\u00e7ekle\u015fenler olmak \u00fczere d\u00fcnya genelindeki sava\u015flarda, hastanelerin bombaland\u0131\u011f\u0131, insani yard\u0131mlar\u0131n engellendi\u011fi, sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131n\u0131n hayat\u0131n\u0131 kaybetti\u011fi y\u00f6n\u00fcndeki olaylar\u0131n uluslararas\u0131 raporlar ve medya arac\u0131l\u0131\u011f\u0131yla s\u0131kl\u0131kla g\u00fcndeme geldi\u011fi g\u00f6r\u00fclmektedir (9). \u00c7at\u0131\u015fma Ortam\u0131nda Sa\u011fl\u0131\u011f\u0131 Koruma Koalisyonu taraf\u0131ndan olu\u015fturulan \u015eiddet Salg\u0131n\u0131: \u00c7at\u0131\u015fmalarda Sa\u011fl\u0131k Personeline Y\u00f6nelik \u015eiddet | 2024 raporuna g\u00f6re:<\/em><\/strong> 2024 y\u0131l\u0131nda sa\u011fl\u0131k hizmetlerine y\u00f6nelik \u015fiddet ve sa\u011fl\u0131k hizmetlerini engelleme ama\u00e7l\u0131 3623 olay tespit edilmi\u015ftir; Sa\u011fl\u0131k tesislerine y\u00f6nelik hasar verici ya da y\u0131k\u0131c\u0131 olay say\u0131s\u0131 1100 olarak bildirilmi\u015ftir ve \u00e7o\u011funlukla L\u00fcbnan, Myanmar, Filistin, Sudan, Suriye ve Ukrayna\u2019da ger\u00e7ekle\u015fmi\u015ftir (10). Bu rapora g\u00f6re: 2024 y\u0131l\u0131 kay\u0131tl\u0131 olarak sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131n\u0131n en fazla \u00f6ld\u00fc\u011f\u00fc y\u0131l olmu\u015f, En \u00e7ok \u00f6l\u00fcm vakas\u0131 642 sa\u011fl\u0131k \u00e7al\u0131\u015fan\u0131 ile Filistin\u2019de ger\u00e7ekle\u015f; Nijerya ve Myanmar a\u011f\u0131rl\u0131kl\u0131 olmak \u00fczere toplam 140 sa\u011fl\u0131k \u00e7al\u0131\u015fan\u0131n\u0131n ka\u00e7\u0131r\u0131ld\u0131\u011f\u0131 rapor edilmi\u015f; 470\u2019ten fazla sa\u011fl\u0131k \u00e7al\u0131\u015fan\u0131n\u0131n tutukland\u0131\u011f\u0131 bildirilmektedir ve \u00e7o\u011funlu\u011fu Filistin\u2019de ya\u015fanm\u0131\u015ft\u0131r. \u0130ngiliz T\u0131p Birli\u011fi\u2019nin, T\u0131bb\u0131n Hedef Al\u0131nmas\u0131: \u00c7at\u0131\u015fma b\u00f6lgelerinde sa\u011fl\u0131k hizmetlerine y\u00f6nelik artan sald\u0131r\u0131lar <\/em><\/strong>raporu da bu verileri destekler niteliktedir (11). Lancet\u2019te 2010 y\u0131l\u0131nda yap\u0131lan bir derlemede (7): \u00c7at\u0131\u015fmalarda sa\u011fl\u0131k sistemine yap\u0131lan sald\u0131r\u0131larda \u00fc\u00e7 ana e\u011filim tespit etmi\u015ftir: 1) T\u0131bbi i\u015flevlere y\u00f6nelik sald\u0131r\u0131lar, sivillere y\u00f6nelik geni\u015f bir sald\u0131r\u0131n\u0131n par\u00e7as\u0131 gibi g\u00f6r\u00fcnmektedir; 2)T\u0131bbi i\u015flevlere y\u00f6nelik sald\u0131r\u0131lar askeri avantaj elde etmek i\u00e7in kullan\u0131l\u0131yor; 3)Sava\u015f\u00e7\u0131lar, sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131n\u0131n mensubiyetlerine bak\u0131lmaks\u0131z\u0131n hastalara bak\u0131m sa\u011flama y\u00f6n\u00fcndeki etik g\u00f6revine sayg\u0131 g\u00f6stermemektedir. Derleme bu sonu\u00e7lar\u0131 ile DS\u00d6\u2019n\u00fc bu ihlallerin sa\u011flam ve sistematik bir \u015fekilde belgelenmesine \u00f6nc\u00fcl\u00fck etmeye ve \u00fclkelerin ve t\u0131p camias\u0131n\u0131n uyumluluk, koruma ve hesap verebilirli\u011fi geli\u015ftirmek i\u00e7in ad\u0131mlar atmas\u0131n\u0131 \u00f6nermektedir.<\/p>\n\n\n\n

Silahl\u0131 \u00c7at\u0131\u015fmalar\u0131n Sa\u011fl\u0131k Sistemine Olan Etkisi<\/strong><\/h2>\n\n\n\n
    \n
  1. <\/li>\n<\/ol>\n\n\n\n

    Sa\u011fl\u0131k hizmetlerinin kesintisiz bi\u00e7imde s\u00fcrd\u00fcr\u00fclebilmesi, g\u00fcvenli sa\u011fl\u0131k tesislerinin varl\u0131\u011f\u0131 kadar bu tesislerde g\u00fcvenli ko\u015fullar alt\u0131nda g\u00f6rev yapabilen nitelikli sa\u011fl\u0131k personelinin bulunmas\u0131na da ba\u011fl\u0131d\u0131r. Uluslararas\u0131 insanc\u0131l hukuk \u00e7er\u00e7evesinde sa\u011fl\u0131k tesisleri; hastaneler, klinikler, laboratuvarlar, acil servisler, kan transf\u00fczyon merkezleri ile t\u0131bbi ve farmas\u00f6tik malzemelerin depoland\u0131\u011f\u0131 lojistik birimleri kapsamaktad\u0131r (12). Bunun yan\u0131 s\u0131ra, uluslararas\u0131 insanc\u0131l hukuk kapsam\u0131nda koruma i\u015fareti olarak kabul edilen ve sa\u011fl\u0131k hizmetleri ile insani yard\u0131m faaliyetlerini tan\u0131mlamak amac\u0131yla kullan\u0131lan baz\u0131 amblemler bulunmaktad\u0131r. Bu ba\u011flamda Red Cross emblem, Red Crescent emblem ve Red Crystal emblem<\/em><\/strong> amblemlerini ta\u015f\u0131yan ve insani yard\u0131m faaliyetleri kapsam\u0131nda g\u00f6rev yapan t\u0131bbi birimler de sa\u011fl\u0131k tesisleri kapsam\u0131nda de\u011ferlendirilmektedir. Beyaz zemin \u00fczerine k\u0131rm\u0131z\u0131 ha\u00e7tan olu\u015fan K\u0131z\u0131lha\u00e7 amblemi, \u00e7at\u0131\u015fma ortamlar\u0131nda t\u0131bbi hizmetlerin, yaral\u0131 ve hastalar\u0131n bak\u0131m\u0131n\u0131 \u00fcstlenen sa\u011fl\u0131k personelinin ve tarafs\u0131z insani yard\u0131m faaliyetlerinin ay\u0131rt edilmesini sa\u011flayan ve uluslararas\u0131 d\u00fczeyde tan\u0131nan bir koruma sembol\u00fcd\u00fcr (13). Benzer \u015fekilde K\u0131z\u0131l Hilal amblemi de uluslararas\u0131 insanc\u0131l hukuk taraf\u0131ndan korunan bir i\u015faret olup \u00f6zellikle M\u00fcsl\u00fcman \u00fclkelerde K\u0131z\u0131lha\u00e7 ambleminin k\u00fclt\u00fcrel olarak kabul edilebilir e\u015fde\u011feri olarak kullan\u0131lmaktad\u0131r. Bununla birlikte, 2005 y\u0131l\u0131nda kabul edilen \u00dc\u00e7\u00fcnc\u00fc Ek Protokol ile uluslararas\u0131 insanc\u0131l hukuka d\u00e2hil edilen K\u0131z\u0131l Kristal amblemi ise din\u00ee veya k\u00fclt\u00fcrel \u00e7a\u011fr\u0131\u015f\u0131mlardan ar\u0131nd\u0131r\u0131lm\u0131\u015f, tarafs\u0131z bir alternatif koruma sembol\u00fc olarak kabul edilmi\u015ftir (14). Bu amblemler, silahl\u0131 \u00e7at\u0131\u015fma ve afet durumlar\u0131nda sa\u011fl\u0131k hizmeti sunan birimlerin tarafs\u0131zl\u0131\u011f\u0131n\u0131 ve korunmas\u0131n\u0131 g\u00f6stermek amac\u0131yla kullan\u0131lmakta olup, bu i\u015faretleri ta\u015f\u0131yan t\u0131bbi tesisler ve sa\u011fl\u0131k hizmeti sa\u011flay\u0131c\u0131lar\u0131 uluslararas\u0131 hukuk \u00e7er\u00e7evesinde \u00f6zel koruma stat\u00fcs\u00fcne sahiptir. Bu yap\u0131lar\u0131n temel amac\u0131, silahl\u0131 \u00e7at\u0131\u015fma veya ola\u011fan\u00fcst\u00fc durumlar s\u0131ras\u0131nda yaral\u0131 ve hastalara ayr\u0131m g\u00f6zetmeksizin t\u0131bbi bak\u0131m sa\u011flanmas\u0131n\u0131 m\u00fcmk\u00fcn k\u0131lmak ve sa\u011fl\u0131k hizmetlerinin s\u00fcreklili\u011fini g\u00fcvence alt\u0131na almakt\u0131r<\/em><\/strong>.<\/p>\n\n\n\n

    Bu konuda yay\u0131nlanm\u0131\u015f en g\u00fcncel ve kapsaml\u0131 raporlardan birisi Uluslararas\u0131 K\u0131z\u0131lha\u00e7 Komitesi (International Committee of the Red Cross) taraf\u0131ndan yay\u0131mlanan, sa\u011fl\u0131k hizmetlerine y\u00f6nelik \u015fiddet ve sald\u0131r\u0131lar silahl\u0131 \u00e7at\u0131\u015fma ve di\u011fer acil durumlarda ciddi bir sorun olarak \u00f6ne \u00e7\u0131karan Health Care in Danger<\/em><\/strong>\u2019d\u0131r (15). Tehlike Alt\u0131ndaki Sa\u011fl\u0131k Hizmetleri, 2012 y\u0131l\u0131nda ba\u015flat\u0131lan K\u0131z\u0131lha\u00e7 ve K\u0131z\u0131lay Hareketi’nin Uluslararas\u0131 K\u0131z\u0131lha\u00e7 Komitesi liderli\u011findeki bir projesidir. Silahl\u0131 \u00e7at\u0131\u015fma ve di\u011fer acil durumlarda etkili ve tarafs\u0131z sa\u011fl\u0131k hizmetlerinin verimlili\u011fini ve sunumunu geli\u015ftirmeyi ama\u00e7lamaktad\u0131r (16). Bu raporlar detayl\u0131 olarak incelendi\u011finde a\u015fa\u011f\u0131daki tan\u0131m ve olgular \u00f6ne \u00e7\u0131kmaktad\u0131r:<\/p>\n\n\n\n

      \n
    • Raporlarda sa\u011fl\u0131k personeli kavram\u0131;<\/strong> doktorlar, hem\u015fireler, paramedikler, fizyoterapistler, eczac\u0131lar, ambulans s\u00fcr\u00fcc\u00fcleri, silahl\u0131 kuvvetlere ba\u011fl\u0131 sa\u011fl\u0131k personeli ile sa\u011fl\u0131k hizmeti sunan uluslararas\u0131 kurulu\u015flar ve sivil toplum \u00f6rg\u00fctlerinde g\u00f6rev yapan sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131n\u0131 kapsamaktad\u0131r. Bunun yan\u0131nda hastanelerde g\u00f6rev yapan idari ve destek personeli de sa\u011fl\u0131k hizmetlerinin s\u00fcreklili\u011finde kritik rol oynayan sa\u011fl\u0131k personeli kapsam\u0131nda de\u011ferlendirilmektedir.<\/li>\n\n\n\n
    • T\u0131bbi ula\u015f\u0131m ara\u00e7lar\u0131<\/strong> ise sivil ya da asker\u00ee nitelikte olmas\u0131na bak\u0131lmaks\u0131z\u0131n yaral\u0131 ve hastalar\u0131n ta\u015f\u0131nmas\u0131 amac\u0131yla kullan\u0131lan ambulanslar, hastane gemileri ve t\u0131bbi ama\u00e7l\u0131 u\u00e7aklar\u0131 i\u00e7ermektedir. Ayr\u0131ca hasta, sa\u011fl\u0131k personeli, t\u0131bbi malzeme veya ekipman ta\u015f\u0131nmas\u0131 amac\u0131yla kullan\u0131lan \u00f6zel ula\u015f\u0131m ara\u00e7lar\u0131 da uluslararas\u0131 insanc\u0131l hukuk kapsam\u0131nda t\u0131bbi ula\u015f\u0131m arac\u0131 olarak tan\u0131mlanmaktad\u0131r.<\/li>\n\n\n\n
    • Sa\u011fl\u0131k hizmetlerine y\u00f6nelik sald\u0131r\u0131larda,<\/strong> Ocak 2012 ile Aral\u0131k 2014 tarihleri aras\u0131nda toplam 2398 \u015fiddet olay\u0131 rapor edilmi\u015ftir. Bu olaylar\u0131n 728\u2019i t\u0131bbi ula\u015f\u0131m ara\u00e7lar\u0131n\u0131 etkilemi\u015f, 1222\u2019si ise do\u011frudan sa\u011fl\u0131k tesislerini veya \u00e7evresini hedef alm\u0131\u015ft\u0131r<\/li>\n\n\n\n
    • Bu sald\u0131r\u0131lar\u0131n sonu\u00e7lar\u0131 yaln\u0131zca sa\u011fl\u0131k altyap\u0131s\u0131na verilen fiziksel zararlarla s\u0131n\u0131rl\u0131 kalmam\u0131\u015f; hasta ve hasta yak\u0131nlar\u0131n\u0131n yaralanmas\u0131, darp edilmesi veya hayat\u0131n\u0131 kaybetmesi gibi ciddi insani sonu\u00e7lara da yol a\u00e7m\u0131\u015ft\u0131r. Sa\u011fl\u0131k personeli tehdit edilmi\u015f, t\u0131bbi etik ilkelerine ayk\u0131r\u0131 davranmaya zorlanm\u0131\u015f ve baz\u0131 durumlarda hastalara \u00fccretsiz tedavi uygulamalar\u0131 i\u00e7in bask\u0131 g\u00f6rm\u00fc\u015flerdir. Ayr\u0131ca sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131n\u0131n hasta veya hasta yak\u0131nlar\u0131 taraf\u0131ndan fiziksel sald\u0131r\u0131ya u\u011frad\u0131\u011f\u0131 vakalar da rapor edilmi\u015ftir.<\/li>\n\n\n\n
    • Sa\u011fl\u0131k tesisleri<\/strong> baz\u0131 durumlarda do\u011frudan hedef al\u0131narak kur\u015funlanm\u0131\u015f, bombalanm\u0131\u015f veya yak\u0131lm\u0131\u015f; baz\u0131 durumlarda ise devam eden \u00e7at\u0131\u015fmalar nedeniyle dolayl\u0131 olarak zarar g\u00f6rm\u00fc\u015ft\u00fcr. Bunun yan\u0131nda sa\u011fl\u0131k tesislerine silah kullan\u0131larak zorla girilmesi, hastanelerin askeri ama\u00e7larla i\u015fgal edilmesi, silah depolama alan\u0131 veya bar\u0131nak olarak kullan\u0131lmas\u0131 gibi vakalar da bildirilmi\u015ftir. Bu s\u00fcre\u00e7te bir\u00e7ok sa\u011fl\u0131k tesisinde t\u0131bbi malzeme ve ekipmanlar\u0131n ya\u011fmaland\u0131\u011f\u0131, bunun sonucunda sa\u011fl\u0131k hizmetlerinin ciddi bi\u00e7imde aksad\u0131\u011f\u0131 rapor edilmi\u015ftir.<\/li>\n\n\n\n
    • Ambulans ekiplerinin<\/strong> sa\u011fl\u0131k tesislerine ula\u015f\u0131m\u0131n\u0131n engellenmesi veya geciktirilmesi, yaral\u0131 ve hastalar\u0131n zaman\u0131nda sa\u011fl\u0131k hizmetine eri\u015fimini zorla\u015ft\u0131ran \u00f6nemli bir di\u011fer sorun olarak \u00f6ne \u00e7\u0131kmaktad\u0131r. Baz\u0131 olaylarda ise sa\u011fl\u0131k tesislerine y\u00f6nelik sald\u0131r\u0131lar\u0131n ard\u0131ndan yard\u0131m amac\u0131yla olay yerine gelen ekiplerin hedef al\u0131nd\u0131\u011f\u0131 ikincil sald\u0131r\u0131lar<\/strong> da g\u00f6zlemlenmi\u015ftir.<\/li>\n<\/ul>\n\n\n\n

      Sald\u0131r\u0131larda sa\u011fl\u0131k tesislerinin do\u011frudan veya dolayl\u0131 olarak zarar g\u00f6rmesi, sa\u011fl\u0131k sisteminin i\u015fleyi\u015fini ciddi \u015fekilde sekteye u\u011fratmaktad\u0131r. Bu t\u00fcr durumlarda \u00f6ncelikle sa\u011fl\u0131k tesislerinin fiziksel altyap\u0131s\u0131 zarar g\u00f6rmekte; telekom\u00fcnikasyon, ula\u015f\u0131m yollar\u0131, su, elektrik ve gaz gibi temel hizmetlerin kesintiye u\u011framas\u0131 sa\u011fl\u0131k hizmetlerinin sunumunu g\u00fc\u00e7le\u015ftirmektedir. Bunun yan\u0131 s\u0131ra sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131n\u0131n ya\u015fam g\u00fcvenli\u011finin tehdit alt\u0131nda olmas\u0131, yo\u011fun stres ve t\u00fckenmi\u015flik ile m\u00fccadele etmek zorunda kalmalar\u0131 ve sterilizasyon ko\u015fullar\u0131n\u0131n bozulmas\u0131 gibi fakt\u00f6rler bula\u015f\u0131c\u0131 hastal\u0131klar\u0131n yay\u0131lma riskini art\u0131rarak sa\u011fl\u0131k hizmetlerinin s\u00fcreklili\u011fini olumsuz etkilemektedir. Bu durum ayn\u0131 zamanda hastalar\u0131n tedavilerinin eksik veya yetersiz kalmas\u0131na, hayatta kalan sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131n\u0131n personel yetersizli\u011fi nedeniyle birden fazla rol \u00fcstlenmek zorunda kalmas\u0131na ve baz\u0131 hastalar\u0131n g\u00fcvenlik kayg\u0131lar\u0131 nedeniyle sa\u011fl\u0131k kurulu\u015flar\u0131na ba\u015fvurmaktan ka\u00e7\u0131nmas\u0131na neden olmaktad\u0131r.<\/p>\n\n\n\n

      Sa\u011fl\u0131k Tesisleri ve Sa\u011fl\u0131k \u00c7al\u0131\u015fanlar\u0131n\u0131n Hedef Al\u0131nmas\u0131 ve Nedenleri<\/strong><\/h2>\n\n\n\n

      Cenevre S\u00f6zle\u015fmesi 3 Numara Madde 19\u2019da \u2018\u2019Sa\u011fl\u0131k servisine ba\u011fl\u0131 sabit m\u00fcesseseler ve seyyar s\u0131hhiye birlikleri hi\u00e7bir suretle tecav\u00fcze maruz b\u0131rak\u0131lmayarak muharipler taraf\u0131ndan h\u00fcrmet g\u00f6recek ve himaye olunacaklard\u0131r. Bu m\u00fcessese ve birlikler muhas\u0131m taraf\u0131n eline d\u00fc\u015ferlerse hasta ve yaral\u0131lar\u0131 i\u00e7in gereken ihtimam ve tedavi esir eden devlet taraf\u0131ndan sa\u011flanmad\u0131k\u00e7a i\u015flerine devam edeceklerdir. Yetkili makamlar; yukar\u0131da mezk\u00fbr s\u0131hhi birlik ve m\u00fcesseselerinin, m\u00fcmk\u00fcn mertebe, askeri hedeflere yap\u0131lmas\u0131 muhtemel taarruzlardan tehlikeye d\u00fc\u015fmeyecek yerlerde bulundurulmalar\u0131na dikkat edeceklerdir.<\/em><\/strong>\u2019\u2019 \u015feklinde sa\u011fl\u0131k tesislerinin korundu\u011fu a\u00e7\u0131k\u00e7a belirtilmi\u015ftir (17,18). Yine 4 Numara Madde 24\u2019te \u2018\u2019M\u00fcnhas\u0131ran hasta ve yaral\u0131lar\u0131n ara\u015ft\u0131r\u0131lmas\u0131, kald\u0131r\u0131lmas\u0131, nakli, tedavisi veya hastal\u0131klar\u0131n \u00f6nlenmesi ile vazifelendirilen personel, s\u0131hhiye birlik ve m\u00fcesseseleri idaresi, personeli, silahl\u0131 kuvvetlere ba\u011fl\u0131 imam ve rahipler her zaman ve yerde himaye edilecek ve sayg\u0131 g\u00f6receklerdir.\u2019\u2019 \u015feklindedir (5). Sa\u011fl\u0131k personelinin de sava\u015f esnas\u0131nda korundu\u011fu net bir \u015fekilde anla\u015f\u0131lmaktad\u0131r. Buna ra\u011fmen sa\u011fl\u0131k tesisleri do\u011frudan ya da dolayl\u0131 bir \u015fekilde sald\u0131r\u0131lara hedef olmaktad\u0131r.  Ge\u00e7mi\u015f sava\u015flar incelendi\u011finde sa\u011fl\u0131k tesislerinin yanl\u0131\u015fl\u0131kla hedef al\u0131nd\u0131\u011f\u0131, tarafs\u0131zl\u0131k ihlaline kar\u015f\u0131 tepki olarak misilleme yap\u0131ld\u0131\u011f\u0131, d\u00fc\u015fman\u0131n moralini bozmak i\u00e7in hastane gibi savunmas\u0131z yerlerin hedef g\u00f6sterilmesi, k\u00fclt\u00fcrel k\u00fc\u00e7\u00fcmseme, \u0131rksal \u015fartlanma sonucunda sald\u0131r\u0131 yap\u0131lmas\u0131, farkl\u0131 \u00fclkelerin h\u00fck\u00fcmet \u00e7\u0131karlar\u0131 do\u011frultusunda medyada hastane sald\u0131r\u0131lar\u0131n\u0131 haber yapma \u00f6zg\u00fcrl\u00fcklerinin derecesine g\u00f6re kamuoyu tepkilerinin de farkl\u0131 olmas\u0131, uluslararas\u0131 hukukun galip gelen devlete farkl\u0131 davranmas\u0131 gibi nedenler sa\u011fl\u0131k tesisi ve sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131n\u0131 hedef haline getirme sebepleri olarak belirtilmi\u015ftir (19).<\/p>\n\n\n\n

      Sa\u011fl\u0131k tesislerine ili\u015fkin koruman\u0131n sona ermesi Cenevre S\u00f6zle\u015fmesi Numara 1 Madde 21\u2019de \u201cSa\u011fl\u0131k hizmetlerine ba\u011fl\u0131 seyyar sa\u011fl\u0131k birlikleri ve sa\u011fl\u0131k kurulu\u015flar\u0131, insani g\u00f6revleri d\u0131\u015f\u0131nda d\u00fc\u015fmana zarar vermek amac\u0131yla kullan\u0131lmad\u0131klar\u0131 s\u00fcrece uluslararas\u0131 insanc\u0131l hukuk kapsam\u0131nda korunmaktad\u0131r. Bununla birlikte, bu birimlerin insani g\u00f6revleri d\u0131\u015f\u0131nda askeri ama\u00e7larla kullan\u0131ld\u0131\u011f\u0131n\u0131n tespit edilmesi durumunda, \u00f6ncelikle makul bir s\u00fcre tan\u0131yan bir uyar\u0131 yap\u0131lmas\u0131 gerekmektedir. Yap\u0131lan uyar\u0131ya ra\u011fmen s\u00f6z konusu faaliyetlerin devam etmesi halinde, bu koruma stat\u00fcs\u00fc kald\u0131r\u0131labilmektedir.<\/em><\/strong>\u2019\u2019<\/em> Belirtilmi\u015ftir (18,20).<\/p>\n\n\n\n

      Etik Kurallar<\/strong><\/h2>\n\n\n\n

      Sava\u015f\u0131n y\u0131k\u0131mlar\u0131n\u0131n a\u015f\u0131r\u0131ya ka\u00e7mamas\u0131 sava\u015f\u0131n da s\u0131n\u0131rlar\u0131 olmas\u0131 gereklili\u011fi sava\u015f hukukuna dair ilk yaz\u0131l\u0131 belge, M.\u00d6 1740 Hammurabi Kanunlar\u0131d\u0131r (20,21). G\u00fcn\u00fcm\u00fczde Cenevre S\u00f6zle\u015fmesi ile sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131, hastaneler ve siviller koruma alt\u0131na al\u0131nm\u0131\u015ft\u0131r (22). Ayr\u0131ca 2016 y\u0131l\u0131nda 2286 say\u0131l\u0131 Birle\u015fmi\u015f Milletler G\u00fcvenlik Konseyi karar\u0131nda Cenevre S\u00f6zle\u015fmesi ve 2005 ek protokollerinin maddeleri vurgulanm\u0131\u015ft\u0131r (23).<\/p>\n\n\n\n

      Bu maddeler incelendi\u011finde: Hastalar, yaral\u0131lar, t\u0131bbi bak\u0131m veren personeller, insani yard\u0131m kurulu\u015flar\u0131, t\u0131bbi birimler ve t\u0131bbi nakil ara\u00e7lar\u0131na olan sald\u0131r\u0131lar\u0131 k\u0131nama ve koruma ile ilgili maddeler belirtilmi\u015ftir. Cenevre S\u00f6zle\u015fmesi d\u00fcnya \u00e7ap\u0131nda kurallar belirtmi\u015f olsa da uygulamas\u0131nda birtak\u0131m sorunlar ortaya \u00e7\u0131kmaktad\u0131r. Bunlarda ilki \u00f6zellikle ABD, Rusya, \u00c7in gibi g\u00fc\u00e7l\u00fc devletler i\u015f birli\u011fi yapmamalar\u0131 durumunda bu devletleri yarg\u0131layabilecek bir \u00fcst kurul\/g\u00fc\u00e7 bulunmamaktad\u0131r.<\/p>\n\n\n\n

      Her zaman \u00fclkeler veya devletler \u00e7at\u0131\u015fmamaktad\u0131r. Uluslararas\u0131 stat\u00fcs\u00fc olmayan devlet d\u0131\u015f\u0131 silahl\u0131 gruplar da bu \u00e7at\u0131\u015fmaya kat\u0131lmaktad\u0131r. Bu silahl\u0131 gruplar da sava\u015f hukukuna uymak zorundad\u0131r (3). Cenevre S\u00f6zle\u015fmesi Numara 1 Madde 3\u2019te belirtilmi\u015ftir (20).<\/p>\n\n\n\n

      Sonu\u00e7<\/strong><\/h2>\n\n\n\n

      \u0130ngiliz t\u0131p cemiyeti taraf\u0131ndan 2025 y\u0131l\u0131nda uluslararas\u0131 hukukun a\u00e7\u0131k bir ihlali olmas\u0131na ra\u011fmen, sa\u011fl\u0131k hizmetlerine \u00e7at\u0131\u015fma b\u00f6lgelerinde giderek daha fazla sald\u0131r\u0131lar nedeniyle haz\u0131rlad\u0131\u011f\u0131 T\u0131p Hedef Taht\u0131nda: \u00c7at\u0131\u015fma b\u00f6lgelerinde sa\u011fl\u0131k hizmetlerine y\u00f6nelik artan sald\u0131r\u0131lar<\/em><\/strong> raporunda, sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131 bu zorlu sava\u015f ve \u00e7at\u0131\u015fma ko\u015fullar\u0131nda sa\u011fl\u0131k hizmetlerini s\u00fcrd\u00fcr\u00fcrken (11):<\/p>\n\n\n\n

        \n
      • En ba\u015fta kar\u015f\u0131s\u0131ndaki yaral\u0131n\u0131n veya hastan\u0131n insan olmas\u0131ndan dolay\u0131 sayg\u0131y\u0131 hakketti\u011fi bilincinde olmas\u0131<\/li>\n\n\n\n
      • Milliyet, din, cinsiyet ya da s\u0131n\u0131f ay\u0131r\u0131m\u0131 yapmadan t\u0131bbi ihtiya\u00e7 do\u011frultusunda hastaya yakla\u015fmas\u0131,<\/li>\n\n\n\n
      • \u00d6zellikle insani yard\u0131m kurulu\u015flar\u0131 yans\u0131zl\u0131k ilkesi ile hareket etmesi,<\/li>\n\n\n\n
      • Sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131 her t\u00fcrl\u00fc tehdit, siyasi, ekonomik g\u00fc\u00e7ten ba\u011f\u0131ms\u0131z hareket etmesi<\/li>\n\n\n\n
      • Hasta mahremiyetine sava\u015f ve silahl\u0131 \u00e7at\u0131\u015fma durumlar\u0131nda da dikkat etmesi \u00f6nerilmi\u015ftir.<\/li>\n<\/ul>\n\n\n\n

        Kaynaklar<\/h2>\n\n\n\n
        \n

        1.         War | History, Causes, Types, Meaning, Examples, & Facts | Britannica [\u0130nternet]. [a.yer 14 Mart 2026]. Eri\u015fim adresi: https:\/\/www.britannica.com\/topic\/war<\/em><\/p>\n\n\n\n

        2.         Respecting and Protecting Health Care in Armed Conflicts and in Situations Not Covered by International Humanitarian Law.<\/em><\/p>\n\n\n\n

        3.         MARTINI M, VALCHI L, MASSARO E, PARRELLA R, ORSINI D. War and Health: the devastating impact of conflict on Wellbeing and Humanitarian Crises. J Prev Med Hyg. 31 Ekim 2024;65(3):E464-8. doi:10.15167\/2421-4248\/jpmh2024.65.3.3412 PubMed PMID: 39758762; PubMed Central PMCID: PMC11698113.<\/em><\/p>\n\n\n\n

        4.         Aydin \u00d6F, Yilmaz S, Ulusoy M, Polat M. Analyzing emergency department presentations linked to secondary earthquake effects. The American Journal of Emergency Medicine. 01 Mart 2025;89:61-6. doi:10.1016\/j.ajem.2024.12.037<\/em><\/p>\n\n\n\n

        5.         Khirekar J, Badge A, Bandre GR, Shahu S. Disaster Preparedness in Hospitals. Cureus. 15(12):e50073. doi:10.7759\/cureus.50073 PubMed PMID: 38192940; PubMed Central PMCID: PMC10771935.<\/em><\/p>\n\n\n\n

        6.         Protocol Additional to the Geneva Conventions of 12 August 1949, and relating to the Protection of Victims of International Armed Conflicts (Protocol 1) | OHCHR [\u0130nternet]. [a.yer 14 Mart 2026]. Eri\u015fim adresi: https:\/\/www.ohchr.org\/en\/instruments-mechanisms\/instruments\/protocol-additional-geneva-conventions-12-august-1949-and<\/em><\/p>\n\n\n\n

        7.         Rubenstein LS, Bittle MD. Responsibility for protection of medical workers and facilities in armed conflict. The Lancet. 23 Ocak 2010;375(9711):329-40. doi:10.1016\/S0140-6736(09)61926-7 PubMed PMID: 20109960.<\/em><\/p>\n\n\n\n

        8.         Yayin 1949 Tarihli Cenevre S\u00f6zle\u015fmeleri ve Ek Protokoller [\u0130nternet]. [a.yer 14 Mart 2026]. Eri\u015fim adresi: https:\/\/insanhaklariizleme.org\/vt\/yayin_view.php?editid1=485.<\/em><\/p>\n\n\n\n

        9.         Haar RJ, Read R, Fast L, Blanchet K, Rinaldi S, Taithe B, vd. Violence against healthcare in conflict: a systematic review of the literature and agenda for future research. Confl Health. 07 May\u0131s 2021;15:37. doi:10.1186\/s13031-021-00372-7 PubMed PMID: 33962623; PubMed Central PMCID: PMC8103060.<\/em><\/p>\n\n\n\n

        10.       Epidemic of violence: Violence against health care in conflict 2024 – World | ReliefWeb [Internet]. 2025 [a.yer 14 Mart 2026]. Eri\u015fim adresi: https:\/\/reliefweb.int\/report\/world\/epidemic-violence-violence-against-health-care-conflict-2024<\/em><\/p>\n\n\n\n

        11.       The British Medical Association is the trade union and professional body for doctors in the UK. [Internet]. 2025 [a.yer 14 Mart 2026]. Medicine under attack: the increasing assault on healthcare in conflict zones. Eri\u015fim adresi: https:\/\/www.bma.org.uk\/what-we-do\/working-internationally\/our-international-work\/medicine-under-attack-the-increasing-assault-on-healthcare-in-conflict-zones<\/em><\/p>\n\n\n\n

        12.       Stopping attacks on health care [\u0130nternet]. [a.yer 14 Mart 2026]. Eri\u015fim adresi: https:\/\/www.who.int\/activities\/stopping-attacks-on-health-care<\/em><\/p>\n\n\n\n

        13.       Our emblems | ICRC [\u0130nternet]. [a.yer 14 Mart 2026]. Eri\u015fim adresi: https:\/\/www.icrc.org\/en\/our-emblems<\/em><\/p>\n\n\n\n

        14.       IFRC Branding | cadrim [\u0130nternet]. [a.yer 14 Mart 2026]. Eri\u015fim adresi: https:\/\/www.cadrim.org\/ifrcbranding<\/em><\/p>\n\n\n\n

        15.       WMA – The World Medical Association-Health Care in Danger [Internet]. [a.yer 14 Mart 2026]. Eri\u015fim adresi: https:\/\/www.wma.net\/what-we-do\/campaigns\/health-care-in-danger\/<\/em><\/p>\n\n\n\n

        16.       ICN – International Council of Nurses [Internet]. [a.yer 14 Mart 2026]. Health Care in Danger. Eri\u015fim adresi: https:\/\/www.icn.ch\/how-we-do-it\/campaigns\/health-care-danger<\/em><\/p>\n\n\n\n

        17.       \u00c7amyama\u00e7 DA. ULUSLARARASI HUKUKTA BARAJLAR VE S\u0130L\u00c2HLI \u00c7ATI\u015eMALAR HUKUKU. C. 6. 2024;6.<\/em><\/p>\n\n\n\n

        18.       Ayr\u0131nt\u0131lar: 12 A\u011fustos 1949 Cenevre S\u00f6zle\u015fmeleri ve Ek Protokolleri \/ \u203a AVUKAT YEKTA G\u00dcNG\u00d6R \u00d6ZDEN K\u00dcT\u00dcPHANES\u0130 katalog [\u0130nternet]. [a.yer 14 Mart 2026]. Eri\u015fim adresi: http:\/\/kutuphane.ankarabarosu.org.tr\/cgi-bin\/koha\/opac-detail.pl?biblionumber=5688<\/em><\/p>\n\n\n\n

        19.       Crowley J, Wells JSG. Assaulting Medical Neutrality: Reflections on Attacks on Healthcare and Clinicians in the Two World Wars and Implications for Contemporary Conflicts. Nurs Inq. Ekim 2025;32(4):e70052. doi:10.1111\/nin.70052 PubMed PMID: 40917073; PubMed Central PMCID: PMC12415934.<\/em><\/p>\n\n\n\n

        20.       I\u015f\u0131k A. Uluslararas\u0131 Silahl\u0131 \u00c7at\u0131\u015fmalar Hukukunda Hastanelerin, T\u0131bbi Personelin ve Tedavi G\u00f6renlerin Korunmas\u0131. Marmara \u00dcniversitesi Hukuk Fak\u00fcltesi Hukuk Ara\u015ft\u0131rmalar\u0131 Dergisi [Internet]. 15 May\u0131s 2017 [a.yer 14 Mart 2026];23(1):159-93. Eri\u015fim adresi: https:\/\/dergipark.org.tr\/tr\/pub\/maruhad\/article\/332719<\/em><\/p>\n\n\n\n

        21.       ogmmateryal.eba.gov.tr\/panel\/panel\/ZamanCizelgesiOnizle.aspx?alistirmaId=15142 [\u0130nternet]. [a.yer 14 Mart 2026]. Eri\u015fim adresi: https:\/\/ogmmateryal.eba.gov.tr\/panel\/panel\/ZamanCizelgesiOnizle.aspx?alistirmaId=15142<\/em><\/p>\n\n\n\n

        22.       Convention (IV) relative to the Protection of Civilian Persons in Time of War. Geneva, 12 August 1949. [Internet]. [a.yer 14 Mart 2026]. Eri\u015fim adresi: https:\/\/ihl-databases.icrc.org\/en\/ihl-treaties\/gciv-1949\/article-18\/commentary\/2025<\/em><\/p>\n\n\n\n

        23.       Security Council Adopts Resolution 2286 (2016), Strongly Condemning Attacks against Medical Facilities, Personnel in Conflict Situations | UN Meetings Coverage and Press Releases [\u0130nternet]. [a.yer 14 Mart 2026]. Eri\u015fim adresi: https:\/\/press.un.org\/en\/2016\/sc12347.doc.htm<\/em><\/p>\n<\/div>\n\n\n\n

        <\/p>\n","protected":false},"excerpt":{"rendered":"

        Giri\u015f Sava\u015f, tarih boyunca ekonomik, dini, siyasi \u00e7\u0131karlar gibi nedenlerden dolay\u0131 ba\u015flayan ve sonu\u00e7lar\u0131n\u0131 ise \u00e7o\u011funlukla sivillerin ya\u015fad\u0131\u011f\u0131 insan eliyle ortaya \u00e7\u0131kar\u0131lm\u0131\u015f…<\/p>\n","protected":false},"author":562,"featured_media":1735,"comment_status":"open","ping_status":"open","sticky":true,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"categories":[10043],"tags":[10059,10053,10079,10144,10145,10141,10139,10140,10143,10142],"class_list":["post-1734","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-afet-yazi-dizisi","tag-afet","tag-afet-tibbi","tag-afet-yonetimi","tag-etik","tag-saglik-hizmeti","tag-savas","tag-silah","tag-silahli-atismalar","tag-sivil","tag-sivil-saglik"],"acf":[],"_links":{"self":[{"href":"https:\/\/tatd.org.tr\/afet\/wp-json\/wp\/v2\/posts\/1734","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/tatd.org.tr\/afet\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/tatd.org.tr\/afet\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/afet\/wp-json\/wp\/v2\/users\/562"}],"replies":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/afet\/wp-json\/wp\/v2\/comments?post=1734"}],"version-history":[{"count":0,"href":"https:\/\/tatd.org.tr\/afet\/wp-json\/wp\/v2\/posts\/1734\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/afet\/wp-json\/wp\/v2\/media\/1735"}],"wp:attachment":[{"href":"https:\/\/tatd.org.tr\/afet\/wp-json\/wp\/v2\/media?parent=1734"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tatd.org.tr\/afet\/wp-json\/wp\/v2\/categories?post=1734"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tatd.org.tr\/afet\/wp-json\/wp\/v2\/tags?post=1734"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}