April 16, 2004
The military intervention in Iraq was still in the planning phase when the first humanitarian shots were fired. Aid organizations were offered US government funds to join the "coalition" and play their humanitarian role under the protection and coordination of "Operation Iraqi Freedom". In bringing humanitarian organizations on board, the White House wanted to demonstrate its attachment to moral values and its concern for the civilian population, just as Colin Powell had done when he addressed American NGOs in October 2001 during "Operation Enduring Freedom" in Afghanistan: "As I speak, just as surely as our diplomats and military, American NGOs are out there serving and sacrificing on the front lines of freedomâ€¦ I am serious about making sure we have the best relationship with the NGOs who are such a force multiplier for us, such an important part of our combat teamâ€¦ [We are] all committed to the same, singular purpose to help humankind, to help every man and woman in the world who is in need, who is hungry, who is without hope, to help every one of them fill a belly, get a roof over their heads, educate their children, have hope, give them the ability to dream about a future that will be brighter, just as we have tried to make the future brighter for all Americans."1 The message was perfectly clear: we share the same values and objectives so let us combine our forces. This appeal to join the "civilised" side was naturally followed by the creation of an "Office of Reconstruction and Humanitarian Assistance" (ORHA), controlled directly by the Pentagon, to which NGOs only had to present themselves in order to serve the liberated Iraqi people.
Rather than cautioning against the appropriation of humanitarian action by a belligerent party to the conflict, several European humanitarian organizations responded by expressing their opposition to the war. In France, the Red Cross called for "the unrelenting pursuit of efforts aimed at reaching a peaceful solution that would avoid subjecting populations to new and cruel hardships," while a consortium of NGOs 2 questioned the necessity of going to war "given the possibilities for the peaceful disarmament of Iraq." In Great Britain, Oxfam stated its "opposition to a military strike on Iraq because of the massive humanitarian crisis that it might create," 3 and, while nonetheless preparing for post-war reconstruction, announced that it would refuse all funds offered by belligerent countries. Nobody thought to ask these NGOs on what information or strategic analysis they based their assertions, nor what instrument Oxfam and others used to measure the intensity of a "humanitarian crisis" caused by bombing in comparison to the crisis produced by Saddam Hussein"s dictatorship. In the United States, by contrast, most NGOs accepted government funding, refrained from judgement on the forthcoming war, and held themselves ready to intervene in Iraq when the time came. In both Europe and the US, these positions had the double distinction of being in phase with public opinion in their respective countries and in contradiction with certain principles generally accepted by the humanitarian movement. NGOs (particularly American) that chose to be financed by their governments for the Iraq intervention accepted to reduce their role to that of sub-contractor to a belligerent party, a debatable choice to say the least. There is a long-standing tendency of NGOs to act as mere service providers of governments and international institutions: a tradition so solidly established in some NGOs through their jargon, discussion forums, and exchanges of personnel, that it is difficult to see differences between public and private institutions other than administrative ones. This tendency has been exacerbated in Iraq by the US government"s increased use of private profit-making companies to undertake functions that were formerly the exclusive preserve of NGOs. Many NGOs fear that they will lose out to private companies, which are already claiming larger amounts of the "NGO market", and hence prefer to play the role requested of them to preserve their "market share".
Neither pro-war nor anti-war
To give NGOs their due, it is true that in Europe they were under great pressure to pronounce an opinion on the war at a time when feelings were running high. Some NGOs faced internal pressure from members who expected their organization to express their own opinions, defend international law, and clearly distance themselves from the US-British position. External pressure came from the media: not a day went by without invitations for aid officials to offer their "expert" opinions on the probable "humanitarian consequences" of the war, to describe preparations and operational scenarios, and often to speak on the conflict"s background. It is equally true that the singularity of the situation led it to be treated in a different manner than previous crises. Hour by hour media coverage of the diplomatic "thriller", set against a background of massive street demonstrations all over the world, turned it into a spectacle in which everyone became an actor well before the first bombs exploded. In this climate of extreme polarisation, there was all the more temptation for humanitarians to align themselves with their respective societies since morality, international law, and human rights were at the heart of both the pro-war and anti-war camps. Médecins Sans Frontières did not escape this debate: supporters of a public anti-war position had been reinforced in their conviction by the organization"s receipt of the Nobel Peace Prize in 1999. Nevertheless, those who considered this position to be illegitimate and incoherent were ultimately in the majority.
For humanitarian actors, such considerations are, or should be, immaterial. Unless humanitarians oppose all wars, or, on the contrary, defend the principle of war in defence of human rights, they had no valid reason as humanitarian organizations to take a stand for or against this particular war. No more so, in any case, than for or against other armed conflicts. The first Gulf War, triggered by Iraq"s invasion of Iran in 1980, aroused no declarations of this kind, nor did the numerous wars that bloodied the world in the 20 years that followed. The denunciation of war crimes in Chechnya or the "humanitarian alibi" in Bosnia did not imply judgement on the justness or lack thereof of these wars, but on the responsibilities of combatants and states. We should remember that modern humanitarian action developed out of armed conflicts in the nineteenth century by asking, "who needs help because of this war?" instead of "who is right in this war?" These origins are not recalled as a dogma to condemn some heresy, but to stress the continued importance of this position if aid is to be effective.
Warning! Impending disaster
The UN agencies were deeply affected by the climate of disapproval of the war. Expressing concern in February at the lack of mobilisation of donor countries that hindered contingency planning (for 600,000 refugees), Ruud Lubbers, the High Commissioner for Refugees, was one of the few UN officials to speak out before the war. With the UN pushed aside, others were reticent to comment for fear of appearing to condone the war or of being perceived as Washington"s "colonial office". Stephen Johnson, deputy director of the UN Office for the Coordination of Humanitarian Affairs (OCHA), raised justifiable concerns at the UN"s participation in a "clean-up operation" following acts committed by the world"s "most powerful states": "under certain circumstances, we would have to ask how happy we were with that role. Do we want to play that role, and is that what we were set up for?" Anxiety of a different kind was expressed by Yussuf Hassan, UNHCR spokesman in New York, who was disturbed to see funds for "vital operations" in Angola, Afghanistan and Ivory Coast diverted for preparations in and around Iraq.
But these legitimate concerns that preceded the war were interspersed with catastrophic scenarios that both reflected the difficulty experienced by UN agencies in openly expressing disapproval of the war and fundraising imperatives. The predictions of their spokespersons transformed a political problem into a simple question of funding for a relief operation. Once the war began, the UN led the field in an unprecedented bidding contest to see who could come up with the most catastrophic predictions of its impact. The interruption of food aid distributions under the "oil for food" program, combined with destruction from the bombing, prompted UNICEF to claim that nearly 100,000 children under five were in danger of losing their lives. The World Health Organization forecast increases in cases of cholera and other diarrhoeal diseases and estimated that 400,000 civilians were at risk. World Food Program spokesman Trevor Rowe broke all records by saying: "What we"re looking at is having to feed, eventually, 27 million people. That is the whole population of Iraq. So, what we are envisioning is an enormous program, probably the biggest humanitarian operation in history."
Few NGOs avoided the temptation of being alarmist. Although the president of the French Red Cross spoke out against "certain dramatic depictions of the plight of civilians", he simultaneously launched, "in view of the predicted humanitarian disaster", a public appeal for funds. Many organizations in the US and Europe did the same: fundraising campaigns were launched notably by CARE International, Oxfam, CAFOD, Save the Children, Christian Aid and Action Aid. Many believed the consequences of 12 years of sanctions magnified the risks and that a tragedy was unavoidable. CARE declared that damage to electricity and water treatment plants during the 1991 conflict had caused more deaths than the war itself. Charles MacCormack, president of Save the Children (US), announced that 30 percent of children were suffering from malnutrition before the war and that clearly their situation would not improve. His French counterpart at Action Contre Faim, Jean-Christophe Rufin, denounced coalition troops using "hunger as a weapon" in their conquest of Iraqi towns. Iraq had already accustomed us all to the vastness and mystery of figures. We still do not know how many died in the war of 1991 for none of the protagonists provided a figure. The "Desert Storm" allies do not intend to tarnish the sheen of victory by acknowledging an inevitably sombre death toll, while for the Iraqi government to do so would be an admission of weakness, unthinkable in a dictatorship. The same applies to the number of Shi"a and Kurdish victims of the violent repression that crushed their rebellions in 1991, whose bodies are only now being found. Sanctions, by contrast, gave rise to exceptional numbers: the figure of 500,000 children dead as a consequence of these measures is advanced without any evidence to support such a horrendous accusation. Journalists and NGOs continue to quote it as a proven fact, yet no study or serious inquiry has evaluated the high mortality the sanctions allegedly provoked. The collective punishment of a population, even led by a tyrant, is, of course, profoundly unjust. The sanctions" main effects seem to have been both to reinforce the regime"s control over the population through food distributions organised by the Ba"ath party, and to provoke the economic decline of the country"s middle class. Sanctions enfeebled Iraqi society and consolidated its regime, which is quite enough to condemn them unreservedly - there is no need to resort to figures that are straight out of Ba"ath party propaganda.
It seemed as if disapproval of America"s Middle East policy found expression through the operational lexicon employed by various organizations, each one drawing the appropriate accusation from its specific vocabulary. This was also reflected in NGO appeals to the UN, which was suddenly transformed into the shrine of all humanitarian virtues. Most European NGOs beseeched the UN to adopt the leading role in managing the "humanitarian crisis", and some, like Rufin of ACF, wanted the UN to secure access roads to create "humanitarian corridors" along which NGOs could safely transport aid. Although it is understandable that everyone, except America"s leaders, hoped to see the UN return to the operation"s forefront, it is perplexing, to say the least, to see such disdain for reality. Can we really imagine Blue Helmets ensuring the armed protection of relief convoys in Iraq during a war? Can we see the UN ensuring coordination in a conflict from which it was actively excluded? Can we ignore the UN"s limits and deadlocks in providing humanitarian aid during the wars in Afghanistan, Angola or Liberia? Is it so easy to forget that in the latter two countries, the UN took part in blocking aid destined for civilian populations? 4 Under no circumstances could such requests have responded to the problems raised. A UN text dated 21 March warned against any confusion of roles: "anything that could give the impression that the UN is a sub-contractor [of the armed forces] must be avoided." The document notably excluded any military escort for UN convoys. This seemed an astonishing reversal to those who remember that the same UN defended the military protection of humanitarian convoys in all preceding crises.
Confusion was at its height during the five weeks of military operations with "massive" or "targeted" bombing raids, contradictory announcements, political tensions, propaganda, and collateral damage. ICRC, which had been working in the country since the war with Iran, continued as best it could to maintain water supply systems, particularly in Baghdad and Basra. With this prominent exception, little humanitarian activity was undertaken as military operations raged. The MSF team in Baghdad was paralyzed when Iraqi police arrested two of its members at the very moment when the al Kindi hospital was swamped by an influx of wounded. Hence it was unable to carry out its work even though a consignment of materials and medicines had been delivered by truck from Jordan while Baghdad was under attack. Members of the British organization Islamic Relief and several journalists were also arrested. Although no precise count of civilian and military losses is possible, civilian casualties caused by the bombing of "Operation Shock and Awe" seem to have been relatively limited.
When spin doctors embrace humanitarianism
As in previous conflicts involving Western forces, humanitarian rhetoric provided the most visible component of the coalition"s "psychological operations". Like the food airdropped in Afghanistan in October 2001, food aid and bottled water supplied by allied troops during the siege of Basra became the object of intense media attention. The magic of words transformed the landing of troops, munitions and provisions at Umm Qasr into a "humanitarian operation": due to fears of a "humanitarian crisis" resulting from the encirclement of the neighbouring city of Basra, the offensive was accelerated to resolve the crisis and to distribute "humanitarian aid". It is high time we realised that the term "humanitarian", when employed in such conditions, is purely propaganda. Under the laws of armed conflict, it is the responsibility of the occupying power to meet the vital needs of the population and treat prisoners properly. These are legal obligations, not humanitarian gestures: calling the provision of water and food to Iraqi civilians a "humanitarian act" is equivalent to claiming that sparing the life of prisoners of war is a "humanitarian act". For an act to be humanitarian, it should be freely given and be neither obliged by law nor owed as compensation for harm done. Giving people goods of which we have ourselves deprived them is not a donation, but restitution. To refuse to do so constitutes theft. Humanitarian law simply records this fact.
For those governments like Spain, Italy and Lithuania that were eager to demonstrate their commitment to the US but were not in the position to offer military support, "humanitarian" action served as the link. Turkey, reproducing what it did during Operation Desert Storm, invoked a humanitarian pretext in an attempt - unsuccessful on this occasion - to justify a military presence in Iraqi Kurdistan. It is true that the eight war objectives established by the Pentagon included "putting an end to sanctions and immediately providing "humanitarian" aid, food and medicines to displaced persons and the many Iraqis in need". But after twelve years of sanctions imposed by the US itself, this objective reeked of cynicism.
In such a context, where the use of the word "humanitarian" by the coalition forces did not seem to pose a problem for anyone (except the NGOs) it is noteworthy that nobody thought to qualify as "humanitarian" the distribution of provisions that Saddam Hussein began before the war broke out. This food was just as useful to recipients as that provided by the coalition, but in this case, its usefulness could not be the only criterion by which this transfer of goods qualified as "humanitarian". Saddam Hussein"s intention was obviously not to ease the lot of his compatriots and that was enough to prompt all commentators to refer to this food as "provisions" and not as "humanitarian aid". What secret hierarchy of values come into play when the delivery of provisions by US-British troops is dressed up in this convenient adjective while it is refused, for the same operation, to the Iraqi administration?
Whatever the case, the confusion caused by the misplaced use of this all-purpose word did not disappear with the end of military operations, far from it. The chaotic situation created by the war - looting, score settling, general insecurity - was also described as a "humanitarian crisis". It is a curious term, applied exclusively to a context of misfortune (always exotic) to denote a disorder that rescuers (always Western) are supposed to remedy. Given the advantages such a convenient expression affords, it is hardly surprising that the spin doctors employed by heads of state and high commands are so fond of it: in one context it permits the response to be confined purely to relief like during the genocide in Rwanda; in another it justifies military intervention, as in Kosovo. Wherever it is applied, it is an elegant version of "thing" or "whatsit", in other words what Roland Barthes described as "an indeterminate value of signification in itself empty of meaning and therefore susceptible to receiving any meaning." 5 It is more surprising to see the term figuring so prominently in the vocabulary of NGOs for its use reflects the basic communicative strategy - propaganda, in other words - of political power. Some humanitarian NGOs have doubtless adopted it for the sake of convenience, seeing it as an immediately intelligible way of designating their natural place and of legitimising their actions even before they are carried out. In this sense, the use of it serves their interests. But they reap short-term benefit because the first to profit from the confusion to which they thus contribute are those who use humanitarianism for other ends.
Desperately seeking a humanitarian crisis
In the absence of deliberate and repeated attacks on civilians which might have generated massive population displacement and an acute collective emergency, the problem of immediate relief amounted to re-establishing the water supply and treating the injured. Although ICRC was able to act quickly on water supply as its specialists had worked in this field since sanctions started, the injured faced a different situation in spite of the 33 public hospitals in Baghdad which are capable of providing Western standards of care. Basic care is assured by a large number of doctors" surgeries and private clinics, a sector that has flourished for several years due to the traffic in medicines and materials created by the sanctions. When Baghdad was attacked, most directors and qualified doctors disappeared from the hospitals, leaving the wounded in the hands of a reduced staff of volunteers and young trainee surgeons. It was a classic situation and justified the despatch of expatriate medico-surgical teams to serve in the critical period of a war whose evolution was unpredictable.
Although no precise evaluation has been undertaken, the number of injured seems to have been relatively low. It is estimated that between 1,500 and 2,000 casualties still required treatment in the days following the cessation of air strikes, at a time when the city was prey to looters. Some hospitals, especially military, were totally devastated while others were defended tooth and nail by their staff or protected by groups of armed Shi'as. Private clinics were spared and some of them, as well as certain public hospitals, were in direct receipt of looted materials. Despite the chaos, much of the medical infrastructure still functioned although only at 10 percent of its capacity because severe disorganization caused a dramatic fall in the quality of care. Only the private sector functioned in a more or less normal fashion, ensuring, for example, almost all caesarean births. 6
What kind of humanitarian relief should be provided in a context where medical staff are present but cannot, or are reluctant to, work and where the material means are available? Deliveries of drugs and medical equipment are always welcome and photogenic but are of little use, to which the piles of unopened cases encumbering hospital corridors and pharmacies attest. The reorganization of a city"s public life is beyond the capacities of aid organizations, and no NGO could envisage working under the armed protection of American forces unless it wanted its staff to become prime targets. More generally, humanitarian aid is unjustified in countries rich in skills and material resources, which are undergoing physical reconstruction and socio-political change. Of course, "humanitarian needs" can be found in Iraq, as in almost all countries of the world, but they bear no relation to the enormous budgets put at the disposal of NGOs by the European Commission and the US government as an incentive to participate in the reconstruction of Iraq. Most NGOs realised this shortly after the termination of the "military phase".
You enjoyed Somalia...?
As May drew to a close, the main NGOs began announcing their forthcoming withdrawal from Iraq. They were motivated by three reasons: the difficulty of operating in chaotic and unsafe conditions compounded by omnipresent political pressures and hidden agendas; other, more pressing priorities in the world; and finally the uneasiness induced by having to work under the control of a military administration of occupation. 7 MSF teams observed the intensity of power struggles between former hospital managers, consultants, the new guard of volunteers, new managers, and self-proclaimed management committees, all conducted against a background of rumours about US intentions and pressure from mullahs in Shi"a areas. These severe tensions negated the practical possibility of serious involvement in health structures. Moreover, no humanitarian organization could serenely countenance the frightening disproportion between budgets allotted to "humanitarian aid" in Iraq, which had few urgent needs, and the paltriness of sums available for critical situations, notably in West and Central Africa. Refusal to cooperate with US authorities - even more understandable for American NGOs that feared being confused with their government - began to be expressed by those NGOs that had been openly against the war from the start, and in the name of that opposition. It was these NGOs that made the above-mentioned appeals to the UN to ensure the coordination of humanitarian aid.
In fact, humanitarian organizations would have felt at ease in their roles (supposing that they had a real task to accomplish) if the scenario predicted by US strategists had been realised. But unlike Kosovo and East Timor, where the majority of the populations welcomed the troops as liberators, most Iraqis, like the Somalis before them, regarded the coalition forces as invaders. The US administration"s unease at the unexpected difficulties encountered is evident from the unprecedented media restrictions that USAID unsuccessfully attempted to impose on American NGOs including the right to filter all contacts with journalists. Furthermore, in an address to US NGOs, USAID director, Andrew Natsios, said that NGOs under US contracts are "an arm of the US government" and that they should do a better job highlighting their ties to the Bush administration if they want to continue receiving money. 8
Humanitarian aid organizations cannot, of course, choose their interlocutors. They can only compromise with whatever form power may take, whether a guerrilla command, military authority, international administration, or a government. Their only concern should be to obtain sufficient freedom of movement so that they are able to assist the victims before serving political interests. 9 To do so, it is essential that the population concerned perceive them as acting independently of the powers that be, especially when that power is the object of widespread hostility. This fundamental problem exists in US occupied Iraq just as it did when Saddam Hussein was in control. Humanitarians should not be concerned with assessing the legitimacy or legality of a power - on what basis could they do so? - but with the population"s perception of their autonomy vis-Ã -vis that power. This explains, above and beyond actual needs, why an NGO can work in occupied Palestine but feels it cannot do so in occupied Iraq. With more troops deployed, resistance continuing, reconstruction slowed and "democracy" still a slogan, tensions between occupiers and Iraqis infect everything. It is probable that we are moving towards a "Palestinisation" of the situation in Iraq but it is unlikely that NGOs will find the minimum conditions required for the delivery of effective aid. Rather than being a field of action of humanitarians, Iraq risks turning into a lasting minefield for everybody.
1 Colin L. Powell, Remarks to the National Foreign Policy Conference for Leaders of Non-Governmental Organizations, State Department, Washington DC, 26 October 2001.
On April 16, 2004, Rony Brauman presented three case studies at the Brookings Institution: Angola, Liberia and Iraq. Joel Charny and Maj.Gen. Nash commented, followed by audience discussion. Click the links below to view the video of the event:
© 2013 Doctors Without Borders/Médecins Sans Frontières (MSF)