War & Health

The Jamestown Foundation has a new article by Sunguta West on the targeting of aid agencies in Somalia. Aid groups in the country are increasingly being attacked and humanitarian operations have largely halted due to security concerns. The dangers of aid work come with the territory, but while most attacks against aid workers worldwide are robberies or mistaken identity, the attacks in Somalia, for political reasons, purposely strike against humanitarians.

According to Shaykh Muhammad: “The UN relief agencies took part in the war that resulted in the defeat of the Islamic Courts Union by giving arms, money and fuel to the forces ranged against the mujahideen… I urge the mujahideen to make relief agencies their main target because they are assisting the enemy. This struggle has started and is yet to be accomplished (Codka Nabadda Radio [The Voice of Peace], July 14; Garowe Online, July 14). [Emphasis Mine]

Insurgencies are contests for the minds and will of the population. In the eyes of insurgents, humanitarian organizations are competitors for the support of local populations. Thus, humanitarian NGOs and IGOs threaten to lose their century old, sacred position of neutrality.

Whether we like it or not, in insurgencies nobody is neutral.

Any quantitative conflict researcher has heard of RAND’s Worldwide Terrorism Incident Database (RWTID). RWTID is one of the best sources of data on terrorism, the whole thing was web-accessible and well documented (like a Google for terrorist attacks). So, you can understand my annoyance when RAND took the database offline and now wants to start charging to access:

On March 31, 2008, support for development and dissemination of the Worldwide Terrorism Incident Database lapsed, causing the Memorial Institute for the Prevention of Terrorism to remove web-based search of that database from its website. Since then, RAND has received many requests for access to the data. RAND is exploring options for making the data available on a subscription basis. If you wish to subscribe to a web-based search engine accessing the database, please contact us. Until RAND concludes this inquiry, we will provide customized search results on a fee-for-service basis. To price such a search, please send us the details of your request, including the types of terrorist events you wish to search for, the countries you are searching, the time period over which the search should be run, and any particular key words (groups, weapons, targets, etc.) you may be searching for.

Sigh.

No doubt high-tech, precision air strikes reduce civilian casualties. However, no technology is perfect and no human operator is error-proof. In mid July a US air strike hit an Afghan wedding convoy, mistaking it for a Taliban force. 47 civilians died in the air strike, 39 were women and children.

The issue of civilian casualties is an emotive one in Afghanistan, feeding a common perception international forces do not take enough care when launching air strikes, and undermining support for their continued presence in the country.

When the battle is over minds and wills, this kind of scene [video] must be an anomaly, not a trend.

In 1989, Serbian forces dissolved the government of the local Kosovars and absorbed the Kosovar health system into the Serbian administration. This move dramatically limited access to healthcare for the people of Kosovo. Three years later, the Kosovo Liberation Army’s (KLA) increasingly violent clashes with Serbian forces highlighted the need for a Kosovar field health system, serving both combatants and civilians.

The article “Field-Improvised War Surgery in Kosovo: Use of Kitchen Utensils as Surgical Instruments” [gated] in the journal Military Medicine tells the compelling story of a Kosovar field hospital hidden in the Molopolce mountain region:

The conflict in Kosovo left surgeons and medical personnel with limited supplies during a time of war. The field hospital, located in a three-story building in the Molopolce mountain range, consisted of one operating theater, one recovery room, one examination room, and a room where minor surgical procedures could be performed (Fig. 1). At the Nerodime field hospital, skilled surgeons had to resort to the use of simple kitchen utensils as tools in the operating theater. Utensils with handles of plastic were transformed into retractors and used during major abdominal operations (Fig. 2, 3). The concavity of tablespoons was taken advantage of, allowing these utensils to be employed as retractors during appendectomy procedures. A light used for theatrical stage shows was improvised and used to illuminate the surgical field during procedures at the field hospital.

In addition to the main field hospital, the Kosovars established several second-line clinics consisting of one physician and three nurses working out of a private home. These clinics treated postoperative and minor wounded patients, thus increasing bed avalilablity in the main field hospital.

The incredible story of this make-shift health system in the Molopolce includes an equally dramatic ending.

After a NATO air strike on Yugoslavia in March 1999, the Serbian campaign more aggressively bombarded the Molopolce mountain region. A Serbian operation was launched in the eastern and southern areas and advanced in the direction of the KLA-controlled area. Eventually, an emergency midnight evacuation of all medical staff, patients, and remaining medical equipment was necessary. This evacuation was accomplished on a footpath through the hills with doctors and other medical personnel carrying patients on hand stretchers to a previously established rendezvous point located in a cave.

I have been holding back mentioning anything until the details were finalized. However, as of this morning everything is set and confirmed. Therefore, I am pleased to announce I will be accompanying the USS Kearsarge (LHD-3) for the first two weeks of her deployment as part of Operation Continuing Promise, and (most importantly) taking War & Health’s readers along for the ride!

In early August, I will be blogging onboard the Wasp-class amphibious assault ship as it deploys to South America to provide humanitarian and medical assistance. Readers of War & Health will get to see a US Navy humanitarian assistance mission from the inside. Is the USS Kearsarge equipped to be a floating hospital? How well does the US Navy interact with humanitarian NGOs? Does providing health care really win minds and wills? Is the US Navy an appropriate tool for delivering long term medical care? Are humanitarian deployments the white fleets of the 21st century? Does Chris get sea-sick? All these questions and more will be tackled through daily (hopefully more) articles on War & Health.

So, stay tuned to War & Health, it is going to be one heck of a journey!

And, if you haven’t subscribed to War & Health already, now is your chance to get regular updates sent straight to your feedreader.

On July 2nd, the Colombian military staged a stunning dupe, convincing FARC to hand over 15 hostages, including three Americans and Ingrid Betancourt, to a helicopter belonging to a fake humanitarian NGO. Today, CNN described some unpublished video taken during the rescue that included the name of the fake humanitarian organization the operation used as cover:

The unpublished video also reveals an emblem that bears the Spanish words “Mision Internacional Humanitaria” (International Humanitarian Mission) and a stylized red bird made up of wavy red lines above two curved branches of blue leaves. In the 3½-minute video of the operation issued by the military, emblems pasted on the side of the rescue helicopter cannot be seen. But in the unpublished video and photos shown to CNN, emblems measuring about one square meter (one square yard) are pasted onto the outside of the chopper.

The same emblem appears on the Web site for Mision Internacional Humanitaria, which describes itself as a non-governmental organization based in Barcelona, Spain, that “works to improve the processes of development to guarantee equality of opportunity for individuals and peoples.”

It appears the Colombian military even went so far as to setup a website for the fictional NGO just in case FARC leaders googled it. However, luckily the FARC did not have even basic knowledge of domain names. Why? Because a simple whois query, used to determine the owner of a domain name, reveals the the NGO’s domain name (Misionhi.org) was registered just six days before the rescue. If FARC did a whois search, something your son or daughter probably already knows how to do, the cover story of the NGO and perhaps the entire operation could have been blown.

Here is the full whois data:

Domain ID:D153122982-LROR
Domain Name:MISIONHI.ORG
Created On:27-Jun-2008 21:50:45 UTC
Last Updated On:27-Jun-2008 22:03:57 UTC
Expiration Date:27-Jun-2009 21:50:45 UTC
Sponsoring Registrar:Netfirms, Inc. (R1427-LROR)
Status:TRANSFER PROHIBITED
Registrant ID:NF-OWNER-93790
Registrant Name:david olarte
Registrant Organization:darts studio
Registrant Street1:cll 6d # 79a - 56 int 6 apt 446
Registrant Street2:
Registrant Street3:
Registrant City:Bogota
Registrant State/Province:NA
Registrant Postal Code:00000
Registrant Country:CO
Registrant Phone:+1.4126184000
Registrant Phone Ext.:
Registrant FAX:
Registrant FAX Ext.:
Registrant Email:davidolarte99@hotmail.com
Admin ID:NF-ADMIN-93790
Admin Name:david olarte
Admin Organization:darts studio
Admin Street1:cll 6d # 79a - 56 int 6 apt 446
Admin Street2:
Admin Street3:
Admin City:Bogota
Admin State/Province:NA
Admin Postal Code:00000
Admin Country:CO
Admin Phone:+1.4126184000
Admin Phone Ext.:
Admin FAX:
Admin FAX Ext.:
Admin Email:davidolarte99@hotmail.com
Tech ID:NF-TECH-93790
Tech Name:Domains Manager
Tech Street1:5160 Yonge St., 1800
Tech Street2:
Tech Street3:
Tech City:Toronto
Tech State/Province:ON
Tech Postal Code:M2N 6L9
Tech Country:CA
Tech Phone:+1.4166612100
Tech Phone Ext.:
Tech FAX:
Tech FAX Ext.:
Tech Email:support@netfirms.com
Name Server:NS100.WHBDNS.COM
Name Server:NS101.WHBDNS.COM

This week the non-governmental humanitarian organization (NGO) CARE delivered $129,951 in new medical equipment to the Sheikh Zayed Hospital in Ramallah. The equipment included a blood gas analyzer, a blood pressure machine, an electrocardiograph, and a vital signs monitor. A second delivery of equipment is scheduled next month and shipments of medical disposables (latex gloves etc..) will continue until September 2008. This is good news for for the West Bank and Gaza, since Sheikh Zayed Hospital is the only emergency facility and serves 270,000 Palestinians.

What is less known is that the all the equipment was paid for by US taxpayers under US Agency for International Development’s (USAID) Emergency Medical Assistance Program. The US program provides $30 million to prevent medical equipment shortages in Palestinian health services in the West Bank and Gaza. In fact, since 1993 the United States has given more than $1.7 billion in development programs to the West Bank and Gaza.

Now if only the US’ public diplomacy folks could make something of this…

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.