Armed Forces Operation in the Scope of the Civilian Health Protection during Peacekeeping and Stabilization Missions: A Short Review

Nowadays, the diversity of armed conflicts determines the participants of international relations to undertake various actions in the scope of civilian health protection. It should be noted that tasks resulting from civilian protection are fulfilled in numerous manners, depending on the situation of the armed conflict. The article presents actions undertaken by the armed forces in the scope of the civilian health protection during peacekeeping and stabilization missions. There are also presented engagement of Polish armed forces in Afghanistan and their actions to improve the civilian population.


Introduction
Nowadays, the diversity of armed conflicts determines the participants of international relations to undertake various actions in the scope of civilian health protection. Regardless of the circumstances, the respect for human rights is the duty of all parties involved. The right to respect the dignity of each human being is inalienable, and the compliance with this law is the basis of all military actions. The Latin maxim Inter arma silent leges should not be applied in XXI century. Providing safety for civilians is not only a duty but also is in the best interest of all involved. Under the term protection of civilians during armed conflicts, one should understand protecting human life, but also the protection of their property and the environment, so it does not suffer due to the outside interference. It should be noted that tasks resulting from civilian protection are fulfilled in numerous manners, depending on the situation of the armed conflict. On the one hand, civilian protection is the element of country's defense system and constitutes a set of planning, organizational, training, investment, technical, and supplying undertakings. Those undertakings are realized through central and local government entities, and through organizational units. Civilian protection aims at protecting civilians, workplaces, public utility facilities, cultural goods, saving, and providing aid to those affected by the war, as well as collaboration in combating natural disasters and environmental hazards and removing their effects. [1] On the other hand, in the case of participation in an armed conflict which does not result from the protection of own territory, civilian protection is the part of international human rights norms, which also limit using the methods and the means to conduct hostilities.

Poland's Participation in Peacekeeping and Stabilisation Missions
The history of peacekeeping missions began in 29 May 1948, when the United Nations Security Council (UN) decided (UN Security Council Resolution 50) to station military observers in order to supervise compliance with conditions of the first truce (11 June -8 July 1948) and not to allow the strengthening of the military positions in the region of the fights of the I Israeli-Arab War in 1948-1949. [2] Two weeks after the decision was made by the UN Security Council, group of 36 unarmed Belgian, French, Swedish and American officers came to the Middle East. That UN Security Council decision laid grounds for peacekeeping missions and contributed to the creation of United Nations Truce Supervision Organization (UNTSO) whose primary role is to observe and supervise the ceasefire. To commemorate that first mission, the UN Secretary-General, Kofi Annan announced the 29 of May to be the Day of International Peacemaking Missions' Participants. [3][4][5] Poland has continuously taken part in peacemaking and stabilization missions since 1953. To this day, over 90 thousand soldiers and civil-military workers have taken part in more than 70 operations outside of Poland. At first, they were traditional peacekeeping operations, mainly consisting of monitoring the separation of conflicted parties after the armed operations were ceased. [4] At that time, Polish engagement did not constitute a permanent feature of the national security policy, while the principles of the Polish Armed Forces engagement in missions were developed on ad hoc basis, adapting them to the needs of a given operation. Between 1953-1973, Polish military and civil personnel took part in the works of Neutral Nations Supervisory Commission (NNSC) in the Korean Conflict (Poland still refers their two representatives to NNSC), International Control and Supervisory Agency in Indo-China, and International Observers Group in Nigeria. Between 1953Between -1988 Poland took part in seven military initiatives, including four Disputes Committees and three peacekeeping operations. There were over 17 thousand people involved. [4] The change of the political system in 1989 had a great impact on the Polish engagement in missions outside its territory. International missions were started to be deemed as an essential element of state's defense system. Between 1989-2009, the number of the personnel involved in the missions quadrupled. Over 67 thousand soldiers and civil workers served in 64 operations, including 30 UN peacekeeping operations, 13 Allied Force Operations, nine Monitoring Missions of the Organisation for Security and Cooperation in Europe (OSCE), six European Union missions, and six operations of international communities.
New political and military conditions, especially joining NATO and the European Union, increased terrorism risk, as well as military benefits, resulted in the gradual change of Polish attitude towards the missions. Our involvement in UN operations decreased, while the involvement in NATO, and international coalitions' missions aimed at enforcing peace in regions where it was most at danger, increased. [4] The sign of undertaking the new challenges in the sphere of security was assigning a contingent to an anti-terrorist operation "Enduring Freedom" conducted by an international coalition in Afghanistan in 2002. In 2004, the scale of actions carried out in this country grew rapidly. Today, the engagement in the said operation is the priority of the Polish Army. One of the biggest challenges of Polish Armed Forces was 2003 operation "Iraqi Freedom," during which allied states carried out military operations in Iraq. In September 2003, Poland decided to join multi-task stabilization mission in this country. In 2008, Poland was assigned the command of Central-South Zone within International Stabilization Force in Iraq, i.e., to withdraw the Polish contingent from the region. Until this day, it remains one of the most demanding tasks in the whole history of Polish participation in international missions.
Currently, the involvement of Polish Armed Forces in international military operations is, next to national defense, the key element of the national security strategy. Modern operations are complex activities, which take into consideration the meaning and the impact of various political, military, economic and social factors. Current international operations are often the reaction to inner-state conflicts and cases of mass violations of human rights. The amount of interventions against repressive countries, to protect democracy and human rights, is also on the rise. Today's operations are the part of the broader spectrum of "pro-development" activities, within which military and civil instruments are parallelly used on each stage of restoration and maintaining of peace and safety, as well as during the preventive and post-conflict activities. [4] Currently, Poland is taking part in numerous international operations (including those of Polish UN observers) carried out along with UN, NATO, and EU. Polish operation in Afghanistan with NATO is one of the most significant and biggest missions of Polish Armed Forces. Poland desired to give its engagement in Afghanistan a more complex character. The essential aim of the Polish activities is to supervise the safety and support the stabilization and reconstruction of Afghanistan. Therefore, along with strictly military tasks, Poland seeks to assist the development. [6,7]

Activities in the Frame of Protection of Civilian Health Undertaken by Task Force White Eagle in Afghanistan
It needs to be stated, that according to the Concept of Medical Support of the Task Force White Eagle Afghanistan, health service of the Polish Task Force does not provide regular humanitarian aid, rather it offers assistance and support in such actions to governmental and non-governmental organizations. Humanitarian aid is limited to saving lives, limbs, and sight (only for a short period of time). Providing medical support for the local civilians is limited only to the situations, in which it is possible to provide it, and the provision thereof does not endanger the mission of Polish Task Force. [4] Furthermore, the conflict in Afghanistan is not only a war against the Taliban but a combination of several minor conflicts that involve -in addition to an international coalition gathered under the banner of the ISAF -all sorts of entities (both state and private), international terrorist organizations, and criminals. This would also include different tribes, mercenaries, religious and ideological leaders, and intelligence services that have broken away from the control of the state. Therefore, ending the conflict in Afghanistan is an extremely difficult task, and probably one that will prove impossible to achieve for a long time. Additionally, in the case of a "new war," it is very important that international humanitarian law is not toothless and is fully applied. [8] During each shift of Polish Military Contingent in Afghanistan, Polish medical personnel not only provided aid in the events of imminent threat to human lives but also assisted those in need, who reported their problems directly to one of the Polish Military Contingent bases. Most frequently those cases related to trauma consequences, e.g., burns, sprains, broken bones, which demanded immediate treating. However, the work of the paramedics, nurses, and doctors in the Polish bases did not only include the help in case of the injuries. [9] Many people who reached Polish bases were poor, exhausted and dehydrated. "Sometimes ambulatory care or consultation is sufficient after an agreement by phone with a doctor of Bravo combat training camp located in the Warrior base." In the cases of imminent threat to human life, MEDEVAC (Medical Evacuation) helicopters are summoned, and the injured are evacuated to the field hospital in Ghazni. The MEDEVAC helicopter environment is one of the most difficult, if not the most demanding, critical care environments. Medical evacuation is the movement and en route care of injured and medically compromised patients by medical care providers via helicopter. Military MEDEVAC platforms provide lifesaving interventions that improve survival in combat. [10,11] The most common diseases among the local society are lower and upper respiratory tract infections, anemia, malnutrition, bacterial infections, virus and parasite digestive tracts infections, dermatophytosis and scabies. Low awareness of maintaining appropriate levels of hygiene is also an enormous problem. Most diseases require radiological diagnosis and laboratory tests, which are virtually unattainable for the poorest.
There are entities within the Polish Military Contingent which systematically work, adequately to the needs and possibilities, to monitor and help the poorest of Afghans. These include the Civil-Military Cooperation (CIMIC), and the Provincial Reconstruction Team (PRT). The help offered by the Polish reaches schools, universities and medical centers. They also assist those under the care of the Commission for Refugees and the orphanage in Ghazni. The support is also given to the poorest residents, including people of the Kuchi tribe living in the province. [12] Polish soldiers from the CIMIC group, along with the medical personnel and the leaders of the combat training camp, regularly provide medical help to the local community. Most frequently, it takes place during so-called "white Sundays" (Medical Civil Action Program -MEDCAP), during which they try to reach the poorest residents of Afghanistan, e.g., those living in Gelan and Moqur district. During every "white Sunday" Polish medical personnel grants aid and distributes necessary medications, as well as providing extra medical consultations and training local medical personnel. Each adult patient receives a first aid kit, while the younger patients are given clothes, shoes, toys, and sweets. From the reports of the medical personnel, it appears that a major issue they encounter during "white Sundays" is convincing women to undergo the examination. "If they are finally convinced, the examination has to be done by the female personnel, and the local women who are not used to medical examination, do not take off their burkas, under which there are numerous layers of shawls, therefore auscultation of the heart borders on miracle". [13] The aid granted by the specialists of Provincial Reconstruction Team focuses mainly on reconstructing damaged infrastructure and on conducting training. Primarily, it consisted of investments in infrastructure development. The main focus was the development of communal services in the city. Mechanical sewage treatment plant was created because the lack of the sewer economy in Ghazni has a direct impact on the health of the residents. [14] Polish team of PRT Ghazni specialists from Polish Military Contingent in Afghanistan realized over 100 projects in less than three years.
All of the actions of PRT and CIMIC aim at improving the living standards of Afghanistan's residents, one of the poorest regions in Asia. The actions for granting medical aid are the immediate reaction to numerous requests of the local community and district's authorities (very common recently) where the Polish soldiers are stationed. [11]

Conclusion
Modern international humanitarian law provides protection for the civilians. It needs to be remembered that even if the engagement of the armed force is morally and legally justified, there are specific means which cannot be applied. The undeniable need for the fight against the plague of the 21st century, the terrorism, does not justify the usage of certain forms of violence, especially against the civilians. [15] Attacking civilians constitutes a violation of the Geneva Convention and is deemed as a war crime and a crime against humanity. The parties taking part in the military conflict are obliged to grant aid to the civilians. All countries which ratified the Geneva Convention and the additional protocols have the duty to respect their rules in the time of war and to spread them during the time of peace.
Nowadays, the Geneva Conventions apply in all cases where hostilities are ongoing, regardless of whether the war is declared or not. Moreover, the classification of the armed conflict by its participants does not matter. In addition to war, the Geneva Conventions are concerned with the occupation, even if there is no armed resistance. Furthermore, the Conventions apply to all states, including situations where one of the countries involved in the conflict may not be a party to the Convention. [16] In accordance with Articles 47, 48, 127, and 144 of Geneva Conventions I, II, III, and IV, respectively, it is a legal obligation of countries to spread knowledge of these Conventions and Protocols. [17] Active participation of Polish Armed Forces in Afghanistan has a greater meaning, outside of the military one. Polish program of developmental collaboration for Afghanistan, realized through the Foreign Affairs Ministry, aims not only at the support for the better government but also to expand the public infrastructure, including schools, water, and electricity supply. New workplaces are created, and the support is given to the refugees. There are also projects conducted in the health service sector. International humanitarian law provides special protection devices and medical personnel during armed conflicts. In today's wars, the lack of respect for the protective emblems of the red cross and red crescent and the lack of respect for medical activities become more frequent. [18] Military personnel, as well as the police and civil Polish Military Contingent in Afghanistan, can take pride in excellent results when it comes to improving the respect for human rights, reacting to the vulnerable situation of the civilians, and triggering proper support for them.