Syrian opposition groups and human rights organizations responded with dismay and disbelief on Monday to the World Health Organization’s (W.H.O.) decision to elect the brutal dictatorship of Bashar Assad to a three-year seat on its Executive Board.

Kurdish news service Rudaw on Monday quoted an especially fiery statement from the Syrian Civil Defense, a volunteer rescue group better known as the White Helmets:

“This election rewards the Assad regime despite its systematic destruction of hospitals and health centers, in addition to a long list of other war crimes and violations of international humanitarian law targeting civilians, aid workers and medical personnel over the past decade,” read a statement published by the White Helmets with 18 civil society and humanitarian organizations as signatories.

“We firmly condemn the election of a Syria led by Assad to the WHO Executive Council, just as we refuse to betray our fellow humanitarian workers and the victims of the Assad regime’s attacks,” the statement added. “Syrian civil society organizations will intensify its efforts to expose these violations and will continue to pursue accountability for the Syrian regime as well as the institutions that prop it up until we achieve justice for these victims.”

The White Helmets said W.H.O. “willfully overlooked” not only Assad’s record of human rights violations but also his regime’s decade-long history of interfering with international humanitarian agencies such as W.H.O. 

“The Assad regime’s presence on [W.H.O.’s] Executive Board will only increase its ability to utilize the organization’s policies and work for its own political gains, to the detriment of Syrian civilians in desperate need of medical support and health care,” the statement warned.

The 18 co-signers of the statement included Syrian Christians for Peace USA, Americans for a Free Syria, the Syrian American Council, and Physicians Across Continents.

U.N. Watch Executive Director Hillel Neuer on Saturday denounced the election of Syria to the W.H.O. executive board as a “travesty,” comparing it to “appointing a pyromaniac to be the town fire chief.”

“Syria’s Assad regime, with the help of its allies Russia and Iran, systematically bombs hospitals and clinics, killing doctors, nurses, and others as they care for the sick and injured. Health professionals have also been arrested, disappeared, imprisoned, tortured and executed. Electing this murderous regime to govern the world’s top health body is an insult to Assad’s millions of victims, and sends a terrible message,” Neuer said.

In Saturday posts on Twitter, Neuer called Syria’s elevation to the Executive Board “sick” and “hard to believe.” He called on W.H.O. Director-General Tedros Adhanom Ghebreyesus and U.N. Director-General Antonio Guterres to denounce the election.

Medical workers in Idlib, one of the few rebel-held areas remaining in Syria, marched on Tuesday with banners reading, “We reject the idea that our killer and he who destroyed our hospitals be represented on the executive board.”

German Health Minister Jens Spahn said he was “anything but happy with this decision” on Tuesday, but chalked it up as one of the “shortcomings of realpolitik.”

“Especially when it comes to health issues and the health care of the population, the question is always: Who are we actually punishing here if we don’t make cooperation possible? Are we punishing the regime or the population?” he explained, implying the Assad regime will be more cooperative with W.H.O. now that it holds a seat on the Executive Board.