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International Activity Report 2004

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Military Humanitarianism

On 11 June 2004, nine days after five MSF staff members were killed in Afghanistan, a Taliban spokesperson offered the following justification for their murder: "Organizations like Médecins Sans Frontières work for American interests and are therefore targets for us." As horrific as the crime is that this accusation seeks to legitimize, the statement itself is hardly surprising given the confusion that currently characterizes the symbol of humanitarianism.

Access to people in need has always been blocked and manipulated by those who control the violence against them.

Getting access to the battlefield from belligerents in order to provide impartial aid to non-combatants is a difficult and dangerous undertaking. Field armies are not comfortable with the presence of foreign actors, who are often suspected of serving the enemy's interests. Under these conditions, the safety of international aid workers, and their room to maneuver, is tied closely to the credibility of the humanitarian symbol under which they operate. That symbol says, "We refuse to take sides in this war. Our only goal is to provide aid to its victims." When all is said and done, the only protection humanitarian actors have is the clarity of their image. It must ref lect their position as outsiders to the conf lict and the transparency of their intentions. Both coalition forces and the majority of aid actors have seriously abused this image in Afghanistan , thus perpetuating a deadly confusion between humanitarian organizations and political-military institutions.

Camouflage and cooperation

In Afghanistan , the first aspect of this confusion was caused by camouflaging psychological warfare and intelligence operations as humanitarian action. Clear-cut examples include the coalition's "humanitarian" food drops during the first aerial strikes in 2001, its deployment of special forces in civilian dress who claim to be on a "humanitarian mission," and threatening to suspend humanitarian aid to populations in southern Afghanistan if they refuse to provide information about the Taliban and Al- Qaeda. Winning the hearts and minds of civilian populations and encouraging them to cooperate with military forces are classic and legal military techniques according to the Geneva Conventions. On the other hand, presenting a combat tactic as a humanitarian operation blatantly violates the humanitarian symbol, just as using a Red Cross vehicle to transport weapons clandestinely alongside a patient would be.

After the defeat of the Taliban, many institutional donors required NGOs and UN agencies to help stabilize and rebuild Afghanistan . The vast majority of humanitarian actors placed themselves at the service of the UN Assistance Mission in Afghanistan (UNAMA) and of the interim government. Both of these actors receive varying degrees of support from coalition forces. NGOs and UN agencies thus abandoned the independence essential to providing independent aid and modeled their priorities on those of the new regime and its Western allies, who were still at war with the Taliban. This scenario constitutes the second element of confusion: making it impossible to distinguish between a subcontractor working on behalf of a warring party and an independent, impartial humanitarian aid actor.

Finally, the use of humanitarian rhetoric to justify going to war is another confusing element. Beyond retaliation for the 11 September attacks, the defense of human rights and international humanitarian law were presented as forceful arguments in favor of armed intervention in Afghanistan . The world was told that force and occupation were required to save an exhausted population from famine, to improve women's access to medical care and to ease refugees' return, among other goals. This martial and imperial use of humanitarian rhetoric contributed significantly to blurring the image of aid organizations. If an appeal to humanitarian considerations can justify both a medical aid operation and a military campaign, doesn't that suggest that aid workers and international troops represent two sides of the same coin? Aid actors do not, of course, have a monopoly on the words they use. However, using the sem antic and legal terms that aid workers rely on for military ends obscures the image of humanitarian organizations, making it difficult to determine whether those organizations are outsiders to the conf lict or the vanguard of expeditionary troops of new "just wars".

War as a continuation of aid

It would be wrong to hold governments alone responsible for the confusion surrounding the humanitarian symbol today, as many aid actors are also confusing the situation. A liberal, universalist strain within the charitable aid movement and among human rights defense groups holds that war can be the continuation of humanitarian aid by other means. In the belief that the worldwide export of market democracy is the highest philanthropic calling, this movement considers any action to be "humanitarian" if it contributes to achieving that mission. Such actions include assisting and protecting "good victims" (those whose survival does not threaten the project's success), imposing economic sanctions, dropping bombs, and invading and occupying nations "guilty of massive violations of human rights". Consequently, organizations that take this position have no objection to supporting "just wars" and serving the governments that pursue them. From this perspective, the term "humanitarian action" is only a euphemism for a colonizing mission that imposes, by force, institutions whose every feature is supposed to embody a value system believed to be universal. This interpretation has terrible ramifications for aid workers who display that same humanitarian symbol to conduct their aid missions.

Weakening the meaning of humanitarian language has had the effects we feared it would. On the Afghan political scene, international aid actors are perceived as back-up troops to the Western intervention forces – if not to the Crusaders. How can aid groups make a convincing claim that they are outsiders to the conf lict when the symbol they display is used to justify an armed offensive and, subsequently, an occupation? And when it is used to consolidate the institutions of one party to the conf lict and to provide cover for psychological operations? With this in mind, it is no surprise that the Taliban could believe that we "work for American interests". More than 30 Afghan humanitarian aid workers and 9 international volunteers have been killed in recent months by forces hostile to the coalition, leading to a significant reduction in aid activities and to MSF's withdrawal from Afghanistan after 24 years.

Let us be clear, however, that the murders of our colleagues cannot be reduced to "a terrible misunderstanding". Forces hostile to the interim government and to the coalition intend to conduct a total war, one that accepts no compromise with the adversary, including the saving of lives as part of independent and impartial aid operations. We are not so idealistic as to think that a clear understanding of our action principles would be enough to dissuade anyone from attacking us. However, the confusion between occupation forces and humanitarian organizations undoubtedly has encouraged acts of violence against aid agencies. The clarity of the humanitarian symbol may not guarantee absolute security but it is, nonetheless, an essential precondition.

Aid workers' safety at risk

The blurring of the humanitarian symbol and its disastrous consequences for team safety and aid activities are not limited to the Afghan theater. They may be found in most places where international forces are deployed. Those include, of course, Iraq , where many perceive – even more so than in Afghanistan – aid actors as mere auxiliaries to occupation forces. They have been targeted for bloody attacks to such an extent that there is little room for humanitarian action in Iraq . This is also the case in countries like Liberia , where the humanitarian symbol encompasses UN peacekeeping operations, including combat actions and inf luences operations against groups hostile to the peace process. Those groups then consider anyone who claims to be a humanitarian as a potential enemy.

Whatever their legitimacy, armed interventions intended to assist and protect civilian populations put aid workers' safety at risk from the moment they are deployed under the humanitarian banner. If a protection operation is to be serious, it necessarily involves the use of force against the enemy and, creates a risk of non-combatant victims. How can a humanitarian organization provide aid to victims if it is equated with the "humanitarian" protection force doing the fighting? This is the danger that threatens aid organizations in Sudan today. By brandishing the threat of armed intervention in Darfur in the name of humanitarianism, the Security Council and certain Western nations are including humanitarian actors in their camp. In so doing, they are designating those actors as enemies in the eyes of Khartoum 's authorities.

We should remember the obvious: international aid workers have no enemies. The Revolutionary United Front in Sierra Leone , UNITA in Angola and the Taliban in Afghanistan are not their enemies. Neither are the Sudanese pro-government militias. These armed groups are parties to a conf lict, just like a potential international intervention force. If the latter claims a humanitarian role – or worse, if it appeals to aid organizations to provide military intelligence – then humanitarian organizations' position as outsiders to the conflict is discredited. How long until an aid worker in Sudan is killed because he or she "works for the interests of the intervention force"?

It may be good for the UN or Western powers to intervene in Sudan to assist and protect civilians in Darfur . However, that is not a question for aid actors to decide. But conducting a "just war" in the name, and with the participation, of humanitarian organizations poses a deadly threat to aid organizations and the people they assist. After the Iraqi and Afghan populations, will the Sudanese people on the wrong side of the front line become the newest victims, abandoned by humanitarian organizations forced to evacuate the country after their symbol has been militarized?

The murders in Afghanistan highlight the fundamental vulnerability of our work and remind us of the frailty of the humanitarian position. Our allegiance to a humanitarian ideal demands that we go unarmed into areas of crisis to provide assistance where it is most needed. We are not willing to turn into an armed agency of medical providers. We believe that going unarmed into an area of conf lict, trying to save lives, trying to alleviate suffering, is a reaffirmation of human dignity.

The only protection we carry is hope, sometimes a naïve one – that we will be recognized as people outside of the framework of violence and therefore will not be seen as a legitimate target for it. When we talk with faction leaders about gaining access to victims and respect for the safety of aid workers, our key arguments are the content of our aid and our humanitarian identity, that is, our independence from political and military forces and agendas. However, during the last ten years, many governments have sought to rob us of this identity and undermine our argument. More importantly, most other United Nations and private aid agencies seem to have given up on the very idea of a limited humanitarian mandate. Today even UN relief agencies uphold the notion that their assistance has to be coherent with their political strategies.

Many NGOs explicitly mix the promotion of democracy and human rights with their humanitarian agenda. In Iraq , NGOs sought to use humanitarian arguments to advance their political positions against the United States invasion of Iraq . In Afghanistan , many of the larger NGOs even called for NATO deployment throughout the country in order to improve the security situation. The promotion of a partisan military advance is a clear breach of the humanitarian ethic of neutrality. These groups freely depart from humanitarian principles but still seek to be covered by protections associated with humanitarian action. Sharing the same institutional form, their rejection of humanitarian principles erodes the protections for all and undermines the entire field of humanitarian aid.

When aid is blocked

In many countries where we work our access to populations in crisis continues to be threatened in other ways. We have seen it in Darfur . Starting in the middle of 2003, villagers in Darfur , western Sudan , have faced a violent campaign of terror, in which their villages have been burned and their livelihoods destroyed. Thousands have died and hundreds of thousands more have been forced to f lee across the border into Chad or into overcrowded, makeshift camps in Darfur itself where they have sought, but never found, safety in numbers. In addition to the massacres and campaign of rape which occurred during attacks, hundreds of thousands of displaced people soon started a slow slide into malnutrition and death. In spite of the enormity of the abuse and urgent needs, it would take months before MSF could mount interventions of any scale. Although we had small teams on the ground back in November 2003, the large-scale intervention demanded by the situation would not become a reality until April and May 2004. For months, the displaced lived in destitution and misery with little aid from MSF or anyone else. MSF watched with frustration as the Sudanese government blocked volunteers' visas and cargo shipments while we were torn between the desire to denounce their delay tactics and the hope that we could still negotiate our way in. It was only months later that international pressure forced the government to lower the barriers, allowing MSF and other agencies to provide some of the massive amount of assistance required.

While such situations conjure up a feeling of frustration, it would be wrong to assume that this is a new phenomenon. Access to people in need has always been blocked and manipulated by those who control the violence against them Humanitarians have had to continuously struggle to ensure that aid is provided in a way that allows dignity and does not get turned against the very victims we seek to assist. But to be honest, it is not difficult for governments or military forces to keep us out. The humanitarian aid worker is not a powerful negotiating partner. We come to the table with no force of arms. We offer practical assistance to those in need, but the survival of those abused and neglected in crisis often holds little interest for the powerful. In the negotiation for access, we offer little else but a clear and compelling position on caring for those in need.

There are other ways in which our ability to reach people in crisis is blocked. For many years, we have been unable to provide the levels of assistance in Somalia which the crisis demands. Ravaged by 15 years of war, massive levels of malnutrition periodically plague much of the country. Armed clashes between warring militias continue to leave hundreds or even thousands of wounded who receive little or no care. In spite of the clear needs, neither MSF nor other agencies has been able to negotiate safe and secure arrangements which allow us to work fully and openly in the country. The armed groups are too fractious and numerous to allow a stable negotiation of access. The blurred lines between humanitarian assistance and the international military takeover in the early 1990s as well as the UN's use of aid to advance its military strategy has crippled the respect which humanitarians could have enjoyed as neutral and independent caregivers.

In Chechnya , where civilians have endured a brutal bombing campaign and waves of oppression, MSF and other humanitarian aid groups have likewise been forced to reduce, if not completely stop, assistance. As in Somalia , MSF has found it impossible to negotiate a protected space to work amid the intertwined mix of criminal and military endeavors in the region. More insidiously, the Russian government and some Chechen rebel groups have tolerated and even encouraged attacks on humanitarian actors. After dozens of kidnappings, assassinations and other abuses, the powers that be do not need to construct administrative obstacles to bar our entry which we can publicize and denounce. We are no longer willing to take the risk of sending our volunteers there. We want our work to be a gesture of solidarity with those who suffer in crisis, but we do not want to martyr ourselves on the suffering of others.

It is simple for totalitarian regimes to keep out humanitarians. North Korea has, for years, denied any possibility for independent humanitarian action. MSF left the country when we saw that our assistance was controlled by the government which would not allow us to reach those most in need or ensure that the aid was not diverted by those in power, contributing to further oppression of the most vulnerable. Denied access to the vast misery in the country, MSF has, for years only been able to provide limited assistance to the lucky few who manage to escape its borders. Knowing the suffering of millions inside the country, the denial of the ability to provide aid to all but these few refugees, who have risked forced repatriation, imprisonment and execution, should be a constant provocation to our conscience.

Overcoming suspicion in communities

As humanitarian workers, we always seek to negotiate our presence with the armed actors that rule an area. However, the degree of respect and understanding that we generate in the communities where we work is even more crucial. Our acceptance by aid recipients and their communities keeps us safe too. In some countries, a loss of acceptance and even the demonstration of mistrust or suspicion due to changes in global political contexts are a great threat to our relations with the communities we seek to serve. In a time of Western political and economic domination, many communities find it hard to imagine that our activities represent individual action with a separate set of ethics and objectives. Instead of health care and human solidarity, they fear that we bring unwanted Western inf luences or carry hidden motives. While we cannot force our help on those who do not want it, we also cannot passively abandon our ambition to ignore boundaries in our increasingly polarized world.

The struggle to reach populations living in crisis is not new. Providing care to those who are abused and neglected inevitably brings humanitarian aid workers into conf lict with those who conduct this violence. This is a confrontation we should not avoid. The greater tragedy would be if our daily, hands-on work with individuals and communities fails to create an understanding and tolerance that overrides the fears and suspicions generated by an increasing global divide.

MSF Projects 2004