01 Oct 2014 18:56
Tags war
There are powerful roles that practitioners, educators, and other workers in public health can play in preventing war itself, as well as mitigating the public health consequences of war.
— APHA position paper (2009): The Role of Public Health Practitioners, Academics, and Advocates in Relation to Armed Conflict and War [2]
The US news portrays Sunni militants flying the Islamic State flag as brutal, unstoppable, and threatening to civilians in the the US. Anti-ISIL airstrikes began again in northern Iraq almost two months ago, and the US has been arming and training anti-Sunni militias for an indeterminate amount of time. Most of ISIL's killing was done this year, and amounts to as many as 9,000 dead, including two Americans beheaded to protest US airstrikes. In this blog post, I hope to challenge the idea that more US military intervention in Iraq will serve the interests of any civilians anywhere.
Health impact
ISIL's body count is big and their brutality is terrifying, but it would be wrong to consider them the most violent actor in their region. It would take sixteen years like 2014 for them to rack up the Assad regime's death toll in Syria's 3-year war, and a century to match US kills exceeding a million after thirteen years of preventative war in Iraq, Afghanistan, and elsewhere in the Islamic world [1;14]. Saudi Arabia consistently funds and sends fighters to al-Qaeda, the Taliban, ISIL, and almost every group targeted by the US global war on terror, but is regarded as an ally by the US [4].
This summer, Sunni leaders plead for a non-military negotiated solution to ISIL's brutal insurgency and the resurgence of Shia militias [11]. US- and Iran-backed Shia militias undermined the political process in recent years by massacring unarmed Sunni Iraqi protesters [15]. Sunni adherents were ethnically cleansed from Baghdad [9]. Hundreds of Sunni civilians were rounded up by Shia forces and continue to be held on vague charges [7;11]. The US ignored the call for negotiated political solutions, instead seeking to "degrade and destroy" ISIL via aerial bombing, and continuing to advise and arm anti-Sunni militias.
The World Health Organization recently found that "civilian war deaths constitute 85% to 90% of casualties caused by war, with about 10 civilians dying for every combatant killed in battle." War hurts children's health, leads to displacement and migration, and diminishes agricultural productivity. Child and maternal mortality, vaccination rates, birth outcomes, and water quality and sanitation are worse in conflict zones. War contributed to preventing eradication of polio, facilitated the spread of HIV/ AIDS, and decreases availability of health professionals. [14]. Airstrikes and increased militarism degrade and destroy everyone except militants.
Air strike trauma stories
In the 1960s, US Strategic Air Command began covert aerial bombing in Cambodia against Viet Cong and People's Army of Vietnam bases and sanctuaries. The US Seventh Air Force inherited the campaign in 1970. They expanded and refocused the bombing on the growing local insurgency, the Khmer Rouge. By 1973 the US Air Force had dropped 2,756,941 pounds of bombs,1 directly killing more than 750,000 Cambodians.
The US bombing campaign "significantly increas[ed] the recruiting capacity of the Khmer Rouge, whom over the course of the bombing campaign transformed from a small agrarian revolutionary group to a large anti-imperial army capable of taking over the country" [10]. The US lost the proxy war and withdrew from the increasingly dire civil war it had provoked. In the four years following 1975, the Khmer Rouge government systematically killed almost a quarter of the Cambodian population in the worst genocide since the holocaust.
Aerial bombardment nourished civilian support for Taliban and al-Qaeda anti-US insurgencies. Speaking in March 2010, the US Chairman of the joint chiefs of staff said that "civilian deaths caused by American troops and American bombs have outraged the local population and made the case for the insurgency" [12]. Before air strikes against ISIL began this summer, the US had launched more than 94,000 air strikes since 2001 — mostly on Afghanistan and Iraq, but also on Libya, Pakistan, Yemen and Somalia.
Former Khmer Rouge official, Chhit Do, described the propaganda power of US bombing:
Every time after there had been bombing, [we] would take the people to see the craters, to see how big and deep the craters were, to see how the earth had been gouged out and scorched… The ordinary people… sometimes literally shit in their pants when the big bombs and shells came… Their minds just froze up and they would wander around mute for three or four days. Terrified and half-crazy, the people were ready to believe what they were told… That was what made it so easy for the Khmer Rouge to win the people over… It was because of their dissatisfaction with the bombing that they kept on cooperating with the Khmer Rouge, joining up with the Khmer Rouge, sending their children off to go with them… sometimes the bombs fell and hit little children, and their fathers would be all for the Khmer Rouge [10].
Sunni civilian leadership in Iraq organized against and fought ISIL before the US bombing began. Recent US-sponsored shelling and airstrikes killed civilians and refugees, brought a rival al Qaeda-affiliated militia together with ISIL, and drove recruitment of more than 6,000 new fighters [6;8]. Bombing trauma stories are likely to make more civilians cynical of political solutions and willing to bear arms with extremists to settle grievances.
Military advisors
The US demobilized the Iraqi army that served under Saddam Hussein, and organized, advised, and equipped an inexperienced sectarian Shia army. Many of the experienced officer corps of the previous Iraqi army, prohibited from serving in the new regime, participated in the anti-US insurgency in Iraq and the anti-Assad insurgency in Syria, and now form the officer corps of ISIL.
ISIL conducts mobile offensives — mostly from the back of pick-up trucks — on flat ground. Their stock of weapons and ammunition originated almost entirely from US military aid. The US directly supplied arms to the anti-Assad forces of which ISIL is one faction. Much of the heavy weaponry was captured from the the well-equipped2 Shia Iraqi military that the US put in place of Saddam Hussein's formidable armed forces [5]. The Iraqi army is formidible in Shia-controlled areas, but halfheartedly abandoned tanks and heavy weaponry when sent to fight in Sunni areas.
Even as US bombs fall, all sides of the conflicts in Syria and Iraq are fought with US weapons and munitions. In 2011 the United States ranked first in worldwide conventional weapons sales, accounting for 78% of global weapons sales [14]. Through foreign military aid programs, the US provides the money to buy most of the weapons it sells.3 Before ISIL, the US provided training, funds, and arms to mujaheddin (who became the Taliban) against the Soviet Union, and Somali irregulars (who became al-Shabab) against Ethiopia. The US provided arms and advice to Saddam's Ba'athists even as they used poison gas against civilians in Iran, and — before the rise of Islamic fundamentalism — sponsored coups by dictators like the Shah in Iran [3;13]. In a world with a sole military superpower, it isn't surprising when that superpower arms and trains all the groups it eventually fights.
Militarism and trauma narratives
Militarism is the deliberate extension of military objectives and rationale into shaping the culture, politics, and economics of civilian life so that war and the preparation for war is normalized, and the development and maintenance of strong military institutions is prioritized … It glorifies warriors, gives strong allegiance to the military as the ultimate guarantor of freedom and safety, and reveres military morals and ethics as being above criticism … Studies show that militarism is … negatively related to respect for civil liberties, tolerance of dissent, democratic principles, sympathy and welfare toward the troubled and poor, and foreign aid for poorer nations [14].
Once produced and distributed, most modern weapons have a long service life. An AK-47 can fire 60-70,000 rounds before the barrel starts to erode and accuracy suffers. That's easily enough for 20—30 years of continuous duty in a hot war. There are AK rifles in use in Africa with the rifling in the barrels worn almost completely away leaving a near-smooth bore, and the rifles are still shooting. Almost half of US taxpayer dollars go into military spending, which directly or by proxy keeps the weapons coming off the assembly line and the bullets from running out [14].
As durable as weapons are, the other products of military advisor relationships are even more long-lasting. Militarism, once built up in a society, can last for decades, and trauma stories persist for generations and become woven into cultural and historic identity.
Societies emerging from brutal wars include tens of thousands, if not hundreds of thousands of … victims and perpetrators, shackled by their own pain and fear and unable to participate fully in life or in postwar reconstruction … The great majority of people are guilty of acts of omission and comission, acquiescence and witnessing, silence and suppression … People are never sure of the mindset of those to whom they are talking [and] never sure what they need to conceal….
Yet, in this silence, stories are constructed and relayed … These stories provide meaning and explanatory frameworks in a postwar context in which people no longer trust in what they used to believe … These stories travel across generations. They sustain the trauma narrative by providing encapsulated messages as to why one group must always be percieved as cruel, dominating, racist, or evil and the other group must always stay on guard [13].
So what?
This is part one of a two-part blog post. The second part discusses promoting health in Iraq, Syria, and the rest of the Levant.