Hiroshima’s medical witnesses and the Red Cross legacy: humanitarian testimony and nuclear prevention

On 6 August 1945, Hiroshima became the first city in history to experience the effects of an atomic bomb used in war. Within seconds, thousands of people were killed, health facilities were destroyed, and medical workers faced a catastrophe beyond any previous experience.

Many physicians and nurses died immediately. Those who survived confronted thousands of injured people with limited supplies, damaged hospitals, and no established knowledge of radiation injury. Yet they continued their work. They treated the wounded, documented symptoms, and created a medical record that would become essential for future generations.

Among these medical witnesses were Dr. Shuntaro Hida, Dr. Fumio Shigeto of the Hiroshima Red Cross Hospital, Dr. Terufumi Sasaki, and Dr. Michihiko Hachiya, whose Hiroshima Diary remains one of the most detailed accounts of the immediate medical consequences of the bombing. In Nagasaki, Dr. Takashi Nagai documented the suffering of survivors while continuing to serve patients despite his own injuries and personal loss.

Their contribution was not limited to medical care. By recording what they observed, they ensured that the humanitarian consequences of nuclear weapons could not be ignored or misunderstood.

Hospitals as humanitarian sanctuaries

The experience of Hiroshima demonstrated a fundamental reality of armed conflict: when health care systems collapse, civilian suffering increases dramatically.

The hospitals that remained standing became places of survival in a city where normal life had disappeared. Medical teams worked without adequate equipment, medicines, electricity, or clean water. Many patients suffered from injuries that conventional medicine could treat, but others developed symptoms that were initially unknown. Bleeding, fever, severe weakness, hair loss, and infections appeared among people who had not suffered obvious external injuries. These observations revealed the effects of radiation exposure and introduced the world to acute radiation syndrome on a massive scale.

Nurses, midwives, and volunteers played an equally significant role. Many were injured themselves, yet they continued transporting patients, providing comfort, and maintaining basic care under impossible conditions. Their actions reflected a core humanitarian principle: preserving human dignity remains essential even when the possibility of saving every life has disappeared.

The lessons of Hiroshima continue to apply today. Across modern conflicts, attacks on medical facilities and disruption of health services create consequences that extend far beyond immediate casualties. The protection of medical personnel, hospitals, and humanitarian services is therefore not only a legal obligation but a practical necessity for reducing civilian harm.

From medical documentation to humanitarian evidence

The physicians of Hiroshima understood that documentation was an ethical responsibility. Their records were scientific observations, but they were also acts of humanitarian witness.

Dr. Michihiko Hachiya’s diary, together with other medical accounts, provided detailed evidence of the physical and psychological consequences of nuclear weapons. These records demonstrated that the effects of nuclear explosions were not limited to the moment of impact. They continued through radiation illness, long-term health consequences, social disruption, and intergenerational concerns.

When Marcel Junod of the International Committee of the Red Cross (ICRC) visited Hiroshima in September 1945, he became one of the earliest international humanitarian witnesses to the consequences of the bombing. His observations documented the destruction of medical services and the immense challenges faced by survivors and health workers.

Junod’s mission reflected the humanitarian role of independent observation: documenting suffering, informing the international community, and ensuring that the experiences of victims remain part of the historical record.

Hiroshima and International Humanitarian Law

The medical testimony from Hiroshima contributed to a deeper humanitarian understanding of warfare and its consequences. While international humanitarian law did not develop from a single event, Hiroshima reinforced questions that remain central to the law of armed conflict.

The principles of distinction, proportionality, and precautions in attack require parties to armed conflicts to limit harm to civilians and civilian objects. The experience of Hiroshima demonstrated the difficulty of controlling the consequences of nuclear weapons once they are used, particularly because their effects may extend across time, geography, and generations.

The medical evidence also strengthened humanitarian concerns regarding weapons that cause unnecessary suffering or have effects that cannot be adequately controlled. Hiroshima showed that assessing weapons requires consideration not only of their immediate destructive power but also of their broader humanitarian consequences.

The protection of health care is another important lesson. The destruction of hospitals and medical capacity in Hiroshima illustrated that civilian survival depends on maintaining functioning health systems during war. International humanitarian law provides special protection for medical services because they are essential for preserving life and reducing suffering.

The humanitarian consequences of nuclear weapons

Over the decades following Hiroshima and Nagasaki, physicians, humanitarian organizations, and scientific communities continued to examine the consequences of nuclear weapons. A consistent conclusion emerged: no humanitarian system could adequately respond to a nuclear detonation in a populated area.

The combination of mass casualties, destroyed infrastructure, radiation contamination, and overwhelmed health services would exceed available emergency capacity. Medical professionals could provide care, but they could not restore what nuclear weapons destroy.

This understanding contributed to broader international efforts addressing nuclear risks, including the adoption of the Treaty on the Prohibition of Nuclear Weapons in 2017. The treaty’s humanitarian foundation reflects decades of evidence provided by survivors, medical professionals, and humanitarian organizations.

Contemporary relevance

Hiroshima remains relevant in today’s changing security environment. Nuclear modernization, geopolitical tensions, cyber vulnerabilities, and emerging technologies such as artificial intelligence create new challenges for preventing catastrophic harm.

Technological advancement does not remove the humanitarian consequences of nuclear weapons. Medicine cannot reverse widespread radiation exposure, rebuild destroyed hospitals immediately, or provide adequate care for overwhelming numbers of casualties after a nuclear detonation.

For this reason, the testimony of Hiroshima’s physicians remains important for policymakers, humanitarian organizations, legal experts, and health professionals. Their experience reminds us that security must ultimately be measured by the protection of human life and the prevention of irreversible humanitarian harm.

Conclusion

Eighty-one years after Hiroshima, the testimony of its physicians and humanitarian workers remains a powerful reminder of both the responsibilities and limits of humanitarian action. Their legacy is not only a record of suffering. It is a foundation of knowledge that continues to inform humanitarian law, medical ethics, and efforts to prevent catastrophic violence.

The experience of Hiroshima demonstrated a fundamental reality: once nuclear weapons are used, humanitarian response can only address part of the consequences. Prevention remains the most effective protection for civilians, health systems, and future generations.

Hiroshima therefore remains more than a memory of the past. It is an enduring call to protect human dignity, preserve health care, strengthen humanitarian norms, and ensure that the lessons written by its physicians are not forgotten.

Dr. Ghassan Shahrour is a physician, humanitarian disarmament advocate, and author on health and disability. He coordinated the Arab Declaration on Volunteering at the 2001 International Symposium on Volunteering in Geneva and has contributed to international discussions on human dignity, environmental accountability, and restraint in armed conflict. A campaigner with the ICBL, CMC, and ICAN, he supports global humanitarian efforts and also volunteers with the Greater Triangle Area Chapter of the American Red Cross.