By Devika Nadkarni
On October 3rd, 2015, a Médecins Sans Frontières’ (MSF) Trauma center was bombed during an airstrike in Kunduz, Afghanistan (1). Ten patients and twelve staff members were killed at the facility – the only medical center operating in north-east Afghanistan that treated all people in need of trauma care regardless of political affiliation and ethnicity. MSF mobilized and launched a campaign for an independent investigation of the attacks that overtly thwarted the Geneva Conventions set forth to protect civilians and prisoners of war in regions of conflict. The organization drew attention to the patients that burned in their beds in the hospital, to the medical personnel that were forced to operate on their colleagues, to the MSF staff that had to carry on with their work while their team members died. They demanded nothing less than a transparent investigation without involvement from NATO, nor from Afghan and US forces to find an answer for their losses. The tragedy faced by MSF in Afghanistan shows the worst possible outcome of military intervention interfering in global health initiatives and emergency medical care (1).
The United Nations Security Council uses “humanitarian intervention” as a legitimate justification for armed intervention. The use of foreign military force (including unilateral state troops deployed on behalf of the United Nations) in conflict areas has had mixed effects on medical humanitarian initiatives – ranging from improvement to severe exacerbation of an already dire situation. In 2002, British troops were able to facilitate an end to the civil war in Sierra Leone – eventually allowing for elections to be held in the long divided nation. However, for every Sierra Leone there are countless genocides and civil wars where allegedly humanitarian troops encouraged and supported the perpetrators of violence (2). In his book, An Imperfect Offering, former MSF president Dr. James Orbinski highlights in excruciating and consuming detail instances of this occurring in Rwanda, Cambodia, and Kosovo, among many others (3). A telling excerpt from the book, detailing intervention by French forces in the Rwandan genocide in 1994, reads as follows:
“Some French officers were so disgusted by what their force was doing and not doing that they saw themselves as accomplices to a genocide that they had been told did not exist.”
France had provided arms and military training to the Hutu-led Interhamwe – the perpetrators of the genocide. Medical personnel from MSF and the Red Cross, among aid workers from other non-governmental organizations, witnessed the Interhamwe systematically slaughter 800,000 Tutsis and the mutilation of countless others – all of whom required medical treatment by increasingly small medical teams. When French troops were deployed to establish a safe zone – the Turquoise Zone – to end the genocide, they established a means of escape from justice for the Interhamwe and their supporters (3). It is clear that veiling armed force as humanitarian intervention can not only further war crimes and conflict fueled by states seeking out their own interests, but also hurt and overburden humanitarian operations that are already stretched to their limits. The purpose of the military is to put the interests of the state first – a purpose that in times of war can directly conflict with the purpose of humanitarianism – which is to put the basic needs and safety of people first. This difference in purpose is why unilateral military interventions are not humanitarian. It is time that states and inter-governmental organizations – including and especially the United Nations Security Council – stopped allowing states to use armed force under the guise of humanitarianism.
Following the outcry raised by MSF, the United States admitted to the airstrike in Kunduz – dismissing it as collateral damage before attempting to write it off as the responsibility of the Afghan government. MSF no longer operates the hospital in Kunduz, at a time when “the medical needs are immense”. The relationship between humanitarian agencies and the military forces is a complicated one (1). Indeed, the efforts of military forces have also had incredibly positive impacts on certain global health initiatives – most notably during the Ebola crisis, where the intense training of United States’ and British military personnel to withstand extreme conditions and in logistical command was essential to streamlining efforts to tackle the crisis (4). However, even in cases such as these it must be noted that while the military may provide for support existing humanitarian efforts, military interventions themselves are not humanitarian.
- “Kunduz Hospital Airstrike Share.” Médecins Sans Frontières. Médecins Sans Frontières, 05 Nov. 2015. Web. 22 Feb. 2016.
- “Intervention That Worked.” The Economist. The Economist Newspaper, 2002. Web. 22 Feb. 2016.
- Orbinski, James. An Imperfect Offering: Humanitarian Action for the Twenty-first Century. New York: Walker, 2008. Print.
- Lancet, The. “National Armies for Global Health?” The Lancet 384.9953 (2014): 1477. Web.