A new report from coalition of more than 30 NGOs says medical facilities and personnel in 19 countries including South Sudan are under attack.

The third annual report, which was compiled by the Washington-based Safeguarding Health in Conflict Coalition, is entitled: “No Protection, No Respect”.

The coalition found that during 2015 and the first three months of 2016, deliberate or indiscriminate strikes on health care have killed medical workers and patients.

The report shows that medical infrastructures were destroyed and countless civilians were robbed of vital medical care in nineteen countries around the world.

The report also found that, in many instances, parties to conflicts failed to take required steps to avoid harm to medical facilities, staff and patients, and obstructed access to health care.

Leonard Rubenstein of the Johns Hopkins Bloomberg School of Public Health and the coalition’s chair, said: “sometimes the attacks are deliberate; sometimes they are a product of indifference to the harms caused.”

He said sometimes these attacks represent gross failures to take steps needed to prevent death and injury, and said all those involved violate long-standing obligations under international law.

The coalition found evidence that hospitals and ambulances were specifically targeted in Afghanistan, Central African Republic, Iraq, Mali, South Sudan, Syria and Thailand.

Among its recommendations, the coalition report calls on the United Nations Secretary-General and the World Health Organization to carefully document and report attacks on health care workers and facilities.

The coalition also recommends that the UN Security Council refer such crimes to the International Criminal Court or other tribunals if states fail to fulfill their obligation to halt strikes on health care personnel and infrastructure.