By Lionel Bopage –

Dr. Lionel Bopage

Syria and Iraq: hospitals as targets

The targeting of medical infrastructure has become a documented feature of multiple modern conflicts. It is not a coincidence, but a strategy. In Syria, Physicians for Human Rights (PHR) documented repeated strikes on health facilities by both the Assad government and the coalition forces. Civilian populations developed a fear of seeking medical treatment near hospitals. That fear itself was a strategic outcome. A population unable to access healthcare becomes easier to displace, demoralise, and control.

In Iraq, during the 2003 invasion and subsequent urban operations, similar patterns emerged. Western observers reported that coalition forces struck health facilities in urban areas. PHR documented the consequences. Each incident was attributed to military necessity. The compounded effect was the systematic degradation of civilian survival infrastructure.

The pattern across Syria, Iraq, Gaza, and Sri Lanka is consistent. Hospitals are struck after their coordinates are submitted to military commands. Medical workers are killed. Journalists who document the strikes are intimidated, abducted, or murdered. Each element of this pattern is documented, and none of it is accidental.

Information warfare: concealing the deliberate

Language is not the only tool of concealment. Modern warfare is accompanied by sophisticated information operations designed to prevent accountability.

Psychological operations — PSYOP — have become central pillars of contemporary military strategy. In the digital age, they are classified as cognitive warfare or information warfare. Their purpose is to fragment reality; to flood the information space with competing narratives until the truth becomes inaccessible.

Specific techniques used have been documented. Atrocity propaganda fabricates reports of enemy brutality to justify strikes and demonise opponents. Deepfake technology produces convincing false footage of military events. False flag operations stage attacks or incidents to appear as if conducted by adversaries.

In Sri Lanka, this technique has domestic precedents, for example, the violent attack on the United States embassy in Colombo on March 10, 1971, by the members of the Maoist Youth Front, and the anti-Tamil pogrom of July 1983. Both were covertly orchestrated by the then state and regime leaders, to frame the Janatha Vimukthi Peramuna (JVP) as responsible for both. How many further false flag operations have been created and launched by the state across the country’s many conflicts remains unclear and has yet to be fully revealed.

Allegations surrounding the 2019 Easter Sunday attacks suggest they may have been a false flag operation with political objectives. While government investigations have linked the attacks to local radicals inspired by ISIS, a 2023 documentary revealed that senior intelligence officers met with the attackers in advance to create a security crisis, thereby reinforcing a national security agenda to influence upcoming elections.

Ordinary social media users, amplifying unverified war footage, inadvertently extend official disinformation campaigns. The net effect is the deliberate production of a fog of war in the information domain. Within that fog, distinguishing genuine collateral damage from intentional targeting becomes technically difficult for external observers — and strategically desirable for perpetrating states.

Psychological operations were deployed within Sri Lanka long before the final stage of the civil war in 2009. During the April 1971 uprising, coalition politicians and state broadcasters disseminated fake reports that insurgents were killing children under five and adults over fifty-five, and that an insurgent government would uproot the island’s plantation economy to plant cassava. The broadcasts were calibrated to exploit existing social divisions. Their purpose was not to inform, but to widen the gap between the generation of young fighters and the parental generation whose support they depended upon. Fear, rather than force, was the instrument used to isolate combatants from their communities.

Neutralising local media is a key component of the military strategy. Since 7 October 2023, in Gaza alone 262 journalists have been killed. In Sri Lanka, Amnesty International documented high levels of intimidation, abduction, and murder of journalists, particularly those covering Tamil civilian casualties and government corruption. Without journalists, there are no witnesses. Without witnesses, there are no victims — only damage.

Scale of what is hidden

Statistics, even when incomplete, are clarifying. Since 2001, between 363,000 and 387,000 civilians have been killed in military operations in Iraq, Afghanistan, Syria, Yemen, and Pakistan. In Iraq alone, more than 12,000 civilians were killed in the first nine months of the 2003 invasion. These figures account only for direct killing. They exclude the indirect casualties produced by the destruction of water, food, medical, and electrical infrastructure.

One analysis estimated that when indirect deaths are included, the true toll is four to five times the number recorded in direct casualty counts. Civilian fatalities now considerably exceed combatant deaths in modern armed conflict. The collateral damage rule was designed to limit civilian harm. The empirical record demonstrates that it has failed to do so.

The question that follows is uncomfortable. When a rule consistently fails to protect those, it was designed to protect, while reliably serving the rhetorical interests of those causing harm, it has ceased to function as law. Instead, it only functions as a linguistic instrument, not as a legal instrument for the management of accountability.

Conclusion: naming what is happening

The term collateral damage is not a neutral descriptor, but a political instrument. It transfers moral responsibility from a deliberate act to an impersonal process. It converts the killing of people into a technical problem of targeting geometry. It allows those who ordered the strikes to express regret without admitting intent.

George Orwell wrote that the purpose of political language is to make lies sound truthful and murder respectable. Collateral damage is a precise example of the phenomenon he identified. It makes mass killing sound like the unfortunate margin of error in an otherwise legitimate operation.

The conflicts in Gaza, Ukraine, Syria, Iraq, and Sri Lanka share a structural similarity. In each case, the pattern of destruction — the repeated targeting of hospitals, the deliberate degradation of water and food infrastructure, the killing of journalists, the mass displacement of civilian populations — exceeds any plausible definition of incidental harm. In each case, the language of collateral damage has been deployed to prevent that conclusion from being drawn.

Accountability begins with language. It begins with the refusal to accept that the deaths of tens of thousands of civilians in predictable, documented, repeated circumstances are merely unfortunate consequences of legitimate operations. It requires calling the act by its name.

Deliberate targeting of civilians is a WAR CRIME. The language used to disguise it is not a semantic issue, but a moral one. And the cost of accepting that language, uncritically, is borne by those buried beneath the rubble — people who will never be counted as victims because the vocabulary has already declared them damage.

^{* Sources: UN Human Rights Council reports; Amnesty International; Physicians for Human Rights; Oxford Journal of Conflict and Security Law; Global Policy Journal; West Point Lieber Institute; Wikipedia (Collateral Damage).}

Part 1 – “Collateral Damage”: How A Euphemism Launders Mass Killing In Modern Warfare