War & Health

Last month The Long War Journal published a series of powerful photos depicting the aftermath of Yemeni army attacks in Sa’ada.

The following photos are among the first photos to emerge from the troubled region in years. These photos were taken in Sa’ada and smuggled outside the region. The Long War Journal obtained these photos from contacts in Yemen.

Since 2004 the Yemeni government has battled Zaidi rebels in the country’s northern regions. In April UNHCR estimated the conflict had displaced 77,000.

I just got around to a Human Rights Watch report on the use of cluster munitions during the Israel-Lebanon war. The map to the right appears in the report. Each red dot represents a cluster munition strike.

Throughout the war, Israeli artillery used relatively few cluster munitions. However, in the conflict’s final 72 hours Israel launched more than 800 cluster munition strikes into Southern Lebanon, around 90% of the total made during the conflict. I looked around for a good explanation for this dramatic change in strategy, but did not have much luck. I am not a military expert and so will let readers come to their own conclusions.

One parting fact, Human Rights Watch and others believe 25% of the Israeli submunitions (the little bombs dropped from the big bombs) malfunctioned, not exploding on impact, and litter the Lebanese countryside. The end result is that much of Southern Lebanon has been turned into ‘de facto landmine fields’, unusable for farming or herding.

Bill Murray from The Long War Journal has a good article about a new water distribution site in Baghdad. The $400,000 water facility will provide free water to 3,000 families and cover 60% of the need in the area. Two additional sites under construction will provide the remaining 40%. However, the most interesting fact about the facility is its location:

Water from the site, located within the walls of a US-operated Forward Operating Base, is then piped underneath the 15-foot-high reinforced concrete barriers surrounding the base to taps at a drive-through location.

In that community, Iraqis receive their water directly from a US FOB, a fact that speaks volumes about the securitization of services. Specifically, this is notable for two reasons. First, the placement of the water facility inside the FOB might very well discourage attacks, since an attack on the FOB is also, literally an attack on the community’s access to water. Second, the location gives US and Iraqi security forces full credit for providing the service. That is, the population physically visits the FOB to collect their water and knows clearly who provided it, winning hearts and minds. This point was apparently not lost on the Iraqi security forces:

As services return to the area after many years of sanctions, neglect and civil unrest, police expect increased access to information about the Shia insurgency, because the area has been a haven for arms caches and terrorist cells associated with Muqtada al Sadr’s Madhi Army and Iranian trained “Special Groups.”

Winning hearts and minds, gaining useful intelligence, and providing free, clean water to a poor community. That is a trio anyone can appreciate.

Mary Kaldor’s book, Human Security, is a collection of seven essays describing the historical context, theoretical foundations, and development of human security as a concept. Kaldor argues the world is seeing the emergence of what she coins “new wars”, that is “… wars that take place in the context of the disintegrating of states… fought by networks of state and non-state actors… where most of the violence is directed against civilians” (pg. 3). From this assumption she moves the reader through a series of logical steps, concluding with a new and unorthodox approach to human security and hence, the use of military force.

Kaldor’s first four essays lay out the historical context in which the modern debate over human security takes place. Specifically, the essays explore 1) a decade of intervention, 2) the american concept of power and compliance, 3) new nationalism, and finally 4) a case study of the Balkan intervention. The goal of these essays is to illustrate a new emerging concept of new wars where nationalism, informal combatants, and criminalized informal economies align to perpetuate conflict, and the American classic military doctrine is unprepared and ill equipped to face them.

Her next two essays build the theoretical foundations of human security. Chapter 5 follows the changing meaning of “global civil society” from ancient Greece to the present. The chapter holds an impassioned argument to “establish a set of global rules based on consent” (pg. 153), that is: global governance to minimize domestic and international violence. In Chapter 6, Kaldor tackles Just War doctrine. She argues new wars blur the distinction between international and domestic , combatant and non-combatant, and thus between war and peace, and in the face of this, “a new ethical approach is needed, grounded in the notion that the rights of individuals supersede the rights of states and that, therefore, international law that applies to individuals overrides the laws of war” (pg. 154-155), a concept she defines as “Just Peace”.

The real meat of Kaldor’s book lies in her final chapter. Here, she posits a new definition of security that “is about confronting extreme vulnerability not only in wars but in natural and man-made disasters…” (pg. 183) and a new definition of development that goes beyond improving standards of living to include “feeling safe on the streets or being able to influence political decision-making” (pg. 183). Based on these new definitions, she proposes five principles of human security: the primacy of human rights, legitimate political authority, multilateralism, the bottom-up approach, and regional focus.

First, a human security approach places human rights above everything. Kaldor argues: “this principle means is that unless it is absolutely necessary and legal, killing is to be avoided. For the military it means the primary goal of protecting civilians rather than defeating an adversary. Of course, sometimes it is necessary to try to capture or even defeat insurgents but this has to be seen as a means to an end, civilian protection, rather than the other way round. So-called collateral damage is unacceptable” (pg. 186). Furthermore, she argues gross human rights violations must be as “individual criminals rather than collective enemies” (pg. 186). [Emphasis mine]

Second, human security requires institutions of political authority considered legitimate by local populations. Thus, gaining political legitimacy is a central goal in any operation. This requires a commander “who understands politics and has access to political authority” (pg. 188). I am in firm agreement with her on this point.

Third, human security operations must include a commitment to 1) work with international organizations, 2) create and enforce common rules, and 3) focus on coordination.

Fourth, human security approaches must be bottom-up. That is, decisions in human security operations should be made in consultation with local populations. Regarding this, Kaldor takes a stance many operators would consider naive in the extreme: “the solution is to talk to everyone and it should not be so difficult to identify people with conscience and integrity who could act as local guides” (pg. 189).

Finally, a human security approach demands conflicts be examine at the regional, rather than state, level. She accurately argues new wars have no clear boundaries and thus restricting the focus to state-level perspectives makes us vulernable to epiphenonoma is neighboring states.

Overall, Kaldor’s book is an excellent and interesting perspective on human security, evidenced by the numerous “Wow!” comments I semiconsciously wrote in the margins. The last chapter contains her core argument. The middle five chapters are seemingly present only to (sometimes disjointedly) guide the reader to the logic she presents in the final chapter. Readers strapped for time could gain a good portion of the book’s worth by reading only the introduction and last chapter.

Previously, I discussed the role of providing services (health, education, sanitation, etc…) in counterinsurgency. After security, services represent a critical component in winning hearts and minds and strengthening the legitimacy of the state. With threats to personal security in Iraq on the decline (but still high), the provision of services is gaining increasing importance and this fact has not gone unnoticed by the US military.

Iraq contains a massive and intricate irrigation system of canals and pumping stations. The water it supplies and the flooding it controls are essential to the agriculturally dominated southern Iraq. Much of this canal system was left unusable after the initial 2003 invasion, either through direct damage or simply lack of maintenance. The fields the canal system supports are a sizable proportion of the Iraqi domestic economy.

The fact that a provisional reconstruction team (PRT) is repairing the irrigation canals and their pumping stations is mildly interesting, but nothing to write home about. However, what stands out is the fact that they are using a valuable security resource in an unorthodox way to do it:

In order to help the GoI monitor and maintain the canals, 2nd BCT Soldiers came up with a high-tech solution. In addition to Soldiers performing foot patrols and SoI guarding key points, 2nd BCT Soldiers regularly keep a watch on the canals with unmanned aerial vehicles.

“We’ve done this with every single canal,” Clegg said. “We had (the MoWR) supply us a map, showing the direction of flow. Then we stepped it up with UAV coverage. This actually allowed us to see where the water is flowing.” [Emphasis mine]

Clegg says the images are declassified and shown to MoRW officials every week to give them the information they need.

Simply put, the PRT is using UAV surveillance flights to monitor the status of irrigation canal flows. This is the first example I have found of UAVs being used in a non-security function to improve services to Iraqi civilians. The use of UAVs, a much prized resource amongst commanders, hints at the new importance placed on providing services (particularly water); a ’service surge’ if you will. It is also a reminder of the remarkable flexibility of the US military.

Infant mortality rates (the number of children younger than one year that die per 1000 live births) are incredibly sensitive to disruptions in society. Even a minor disturbance in a region’s economic, social, and political system can create a parallel, observable effect in infant mortality data. Two political scientists, M. Rodwan Abouharb of Louisiana State University and Anessa L. Kimball of Université Laval, offer one of the most comprehensive datasets on infant mortality rates:

Systematic data on annual infant mortality rates are of use to a variety of social science research programs in demography, economics, sociology, and political science. Infant mortality rates may be used both as a proxy measure for economic development, in lieu of energy consumption or GDP-per-capita measures, and as an indicator of the extent to which governments provide for the economic and social welfare of their citizens. Until recently, data were available for only a limited number of countries based on regional or country-level studies and time periods for years after 1950. Here, the authors introduce a new dataset reporting annual infant mortality rates for all states in the world, based on the Correlates of War state system list, between 1816 and 2002. They discuss past research programs using infant mortality rates in conflict studies and describe the dataset by exploring its geographic and temporal coverage. Next, they explain some of the limitations of the dataset as well as issues associated with the data themselves. Finally, they suggest some research areas that might benefit from the use of this dataset. This new dataset is the most comprehensive source on infant mortality rates currently available to social science researchers.

Download the Codebook

Download the Dataset

Recently, I have been reading treaties on war to find out how hospitals and health systems were legally handled during wartime. So far as I can tell, Article 17 of the Brussels Declaration of 1874 is the earliest instance of the codification of military behavior towards hospitals:

In such cases all necessary steps must be taken to spare, as far as possible, buildings dedicated to art, science, or charitable purposes, hospitals, and places where the sick and wounded are collected provided they are not being used at the time for military purposes. It is the duty of the besieged to indicate the presence of such buildings by distinctive and visible signs to be communicated to the enemy beforehand.

How many Iraqi insurgent attacks will occur next year causing 1 casualty? 10 casualties? 200 casualties? How many FARC attacks will occur next year causing 30 casualties? How many Tamil Tiger attacks will occur next year causing 500 casualties? One very interesting research paper just released argues it knows the answers, and finding them requires a simple number: 2.5.

The paper by Neil Johnson, Mike Spagat, Jorge Restrepo, Oscar Becerra, Juan Bohorquez, Nicolas Suarez, Elvira Restrepo, and Roberto Zarama argues modern insurgent attacks all obey the same power law. In plain english: in all modern insurgent conflict, attacks causing many casualties will occur with the same relative frequency to attacks causing few casualties. Simply by knowing the average number of attacks per year, the authors argue it is possible to predict the number of future attacks causing a certain number casualties in a future year.

Want to calculate your own predictions? It is easy: First, take the average number of attacks per year for the conflict. Second, select a level of attack deadliness (number of casualties) you want to predict. Third, plug them into the formula below.

For example, imagine a conflict with an average of 1000 insurgent attacks per year and we want to calculate how many attacks will cause 10 casualties in a future year:

The model predicts slightly over 3 attacks causing 10 casualties will occur in a one year period.

Are the authors correct? I have no idea, but it is a very interesting approach to an important question. If you want to know more, check out this Physorg article containing a link to the original paper (might be gated).

Update: Check out Drew at Zero Intelligence Agents for a more informed discussion of the paper.

I am a first generation American from Zimbabwean parents, and so the recent events in Zimbabwe have had a particular personal significance. On April 29th, the Times Online reported on the growing evidence Zimbabwean government officials, including the Minister of Health, are using the nation’s health system to facilitate violence against opposition supporters. Accusations include using hospital grounds for political rallies, threatening physicians treating opposition victims of violence, raiding medical wards, and seizing patient lists. Opposition members have reportedly resorted to seeking treatment at sympathetic private clinics.

As evidence of increasing government-sponsored violence against the Zimbabwean opposition mounts a pattern is emerging of deliberate attempts to obstruct medical treatment for its victims and to cover up the violence. The Zimbabwean Minister of Health and other doctors who are linked to the ruling party have been implicated in orchestrating the violence and using government medical facilities for their activities.

The US Ambassador to Zimbabwe James McGee (my new hero) experienced this first hand in May when himself and other diplomats were detained for 45 minutes after visiting hospitals outside the capital to document violence against opposition supporters.

The diplomats involved in the incident at a roadblock on the edge of the capital, Harare, had just completed a tour of hospitals and an alleged torture camp when police demanded they prove they had official permission to visit the sites.

At one point, a police officer threatened to beat one of Mr. McGee’s senior aides. The officer got into his car and lurched toward Mr. McGee after he had demanded the officer’s name. The car made contact with Mr. McGee’s shins, but he was not injured.

Mr. McGee climbed onto the hood of the car while his aide snatched the keys from the ignition, then the diplomats used their mobile phone cameras to take photographs of the officer.

Zimbabwe’s healthcare system is already in deep trouble and these reports do not make me hopeful for the country’s health prospects in the future.

Recently, a ‘Meme of Se7en‘ has been filtering through the conflict blogosphere. The best part of the meme was the requirement that the blogger pass it along to seven other bloggers via links. Why? Because I have been exploiting that rule to discover new and interesting blogs. Below are two blogs that have entered my required daily reading list.

Zero Intelligence Agents - What does political science, mathematics, and programming have in common? Ask Drew Conway. A doctoral candidate in political science at NYU, Drew blogs on the type of quantitative social science research I have fallen in love with. Think Freakonomics for national security. He also reads xkcd, which secures his place on my reading list.

Complex Terrain Laboratory - Matt Armstrong, Mark Safranski, Tim Stevens, and Michael Tanji are innovators in the conflict blogosphere and all are on my feedreader. Their group blog, CTLab, looks at conflict research through the lense of digital media. What does that mean to you? It means an approach to understanding conflict you have never seen before.