Advertisement

Disasters and Conflict Zones Around the World: The Roles and Relationships of the Military and Nongovernmental Organizations

  • Ramey L. Wilson
Chapter

In 2007, Dr. Wilson deployed to Afghanistan as the physician for a 600-soldier Airborne Infantry Battalion on a combat/counterinsurgency mission. During that 15-month deployment, he worked hand-in-hand and shoulder-to-shoulder with varying success with assorted NGOs, IGOs, local physicians, Afghan Ministry of Health officials, allied military forces, and the colocated Provincial Reconstruction Team. His dual duties as the unit surgeon caring for trauma and routine medical aliments of coalition military units and his job assisting in the building of the Afghan health care system as part of the counterinsurgency fight placed him at the crossroads of military and NGO interaction.

This chapter offers Dr. Wilson’s perspective on the current issues facing NGO–military interaction and his recommendations for continued improvement.

This chapter offers Dr. Wilson’s perspective on the current issues facing NGO–military interaction and his recommendations for continued improvement.

The co-location of nongovernmental organizations (NGOs) and military forces in areas requiring humanitarian aid, disaster assistance, or reconstruction has become a reality of the twenty-first century. During the 1990s, numerous complex emergencies, disasters, and military conflicts brought armed forces and NGOs into close proximity, increasing the frequency of interaction as they pursued their missions (Burkle 1999). Although both groups often shared the goals of effecting positive change and building capacity in response to crisis, their backgrounds, motivations, and perspectives differed radically. They tended to misunderstand each other’s goals and methods. As a result, friction arose that hindered both of them in their work (Weiss 1997).

Keywords

Military Force North Atlantic Treaty Organization Civil Affair World Food Program Humanitarian Assistance 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. Aboutanos MB, Baker SP (1997) Wartime civilian injuries: epidemiology and intervention strategies. J Trauma Inj Infect Crit Care 43:719–726CrossRefGoogle Scholar
  2. Army Field Manual 3-07 (2003) Stability operations and support operations. Department of the Army, Washington, DCGoogle Scholar
  3. Army Field Manual 3-24 (2006) Counterinsurgency. Department of the Army, Washington, DCGoogle Scholar
  4. Army Field Manual 6-22 (2006) Army leadership. Department of the Army, Washington, DCGoogle Scholar
  5. Army Field Manual 100-7 (1995) Decisive force: the army in theater operations. Department of the Army, Washington, DCGoogle Scholar
  6. Aylwin-Foster N (2005) Changing the army for counterinsurgency operations. Military Rev Nov–Dec:2–15Google Scholar
  7. Baker JB (2007) Medical diplomacy in full-spectrum operations. Military Rev Sept–Oct:67–73Google Scholar
  8. Baker MS, Ryals PA (1999) The medical department in military operations other than war, part I: planning for deployment. Military Med 164:572–579Google Scholar
  9. Beitler AL, Junnila JL, Meyer JH (2006a) Humanitarian assistance in Afghanistan: a prospective evaluation of clinical effectiveness. Military Med 171:889–893Google Scholar
  10. Beitler AL, Wortmann GW, Hoffman LJ, Goff JM (2006b) Operation enduring freedom: the 48th Combat Support Hospital in Afghanistan. Military Med 171(3):189–193Google Scholar
  11. Bessler M, Seki K (2006) Civil–military relations in armed conflicts: a humanitarian perspective. Liaison 3(3):4–10Google Scholar
  12. Brennan RJ, Nandy R (2001) Complex humanitarian emer­gencies: a major global health challenge. Emerg Med 13:147–156CrossRefGoogle Scholar
  13. Brennan RJ, Sondorp E (2006) Humanitarian aid: some political realities. Br Med J 333:817–818CrossRefGoogle Scholar
  14. Brennan RJ, Waldman RJ (2006) South Asian earthquake six months later – an ongoing crisis. New Engl J Med 354:1769–1771PubMedCrossRefGoogle Scholar
  15. Brennan RJ, Burkle FM, Burkholder BT, Lillibridge SR (1998) Letter to the editor. J Trauma Inj Infect Crit Care 45(1):175CrossRefGoogle Scholar
  16. Burkle FM (1995) Complex, humanitarian emergencies. I. Concept and participants. Prehosp Disaster Med 10(1):36–42PubMedGoogle Scholar
  17. Burkle FM (1999) Lessons learnt and future expectations of complex emergencies. Br Med J 319:422–426CrossRefGoogle Scholar
  18. Burkle FM (2001) FM complex emergencies: an introduction. Prehosp Disaster Med 16(4):182–183PubMedGoogle Scholar
  19. Burkle FM (2002) The changing face of disaster management: implications for healthcare providers in the Pacific Island. Pac Health Dialog 9(1):55–57PubMedGoogle Scholar
  20. Burkle FM (2005a) Anatomy of an ambush: security risks facing international humanitarian assistance. Disasters 29(1):26–37PubMedCrossRefGoogle Scholar
  21. Burkle FM (2005b) Integrating international responses to complex emergencies, unconventional war, and terrorism. Crit Care Med 33(1):S7–S12PubMedCrossRefGoogle Scholar
  22. Burkle FM (2006) Difficult discussions: military intervention and United Nation reform. Prehosp Disaster Med 21(4):286–287PubMedGoogle Scholar
  23. Burkle FM, Noji EK (2004) Health and politics in the 2003 war with Iraq: lessons learned. Lancet 364:1371–1375PubMedCrossRefGoogle Scholar
  24. Burnham G, Lafta R, Doocy S, Roberts L (2006) Mortality after the 2003 invasion of Iraq: a cross-sectional cluster sample survey. Lancet 368:1421–1428PubMedCrossRefGoogle Scholar
  25. Bush GW (2001) Address to a Joint Session of Congress and the American People. United States Capitol, Washington, DC. http://www.whitehouse.gov/news/releases/2001/09/20010920-8.html. Accessed 1 Feb 2008
  26. Canadian Broadcast Company (2005) UN promises audit to ensure tsunami pledges are paid. http://www.cbc.ca/story/world/national/2005/01/06/tsunami-summit050106.html. Accessed 1 Feb 2008
  27. Center of Excellence in Disaster Management and Humanitarian Assistance (COE-DMHA) (2008) Web site home page. http://www.coe-dmha.org/. Accessed 1 Oct 2008
  28. Chretien JP, Glass JS, Coldren RC, Noah DL, Hyer RN, Gaydos JC, Malone JL (2006) Department of Defense Global Emerging Infections Surveillance and Response System Indian Ocean tsunami response. Military Med 171(10 Suppl 1):12–14Google Scholar
  29. Convention (I) for the Amelioration of the Condition of the Wounded and Sick in Armed Forces in the Field (1949) 12 August, Geneva, Switzerland. http://www.icrc.org. Accessed 1 Feb 2008
  30. Convention (IV) Relative to the Protection of Civilian Persons in Time of War (1949) 12 August, Geneva, Switzerland. http://www.icrc.org. Accessed 1 Feb 2008
  31. Convention for the Amelioration of the Condition of the Wounded in Armies in the Field (1864) 22 August, Geneva, Switzerland. http://www.icrc.org. Accessed 1 Feb 2008
  32. ——— (1906) 6 July, Geneva, Switzerland. http://www.icrc.org. Accessed 1 Feb 2008
  33. ——— (1929) 27 July, Geneva, Switzerland. http://www.icrc.org. Accessed 1 Feb 2008
  34. Cookson S, Walkman R, Gushulak B, MacPherson D, Burkle F, Paquet C, Kliewer E, Walker P (1998) Immigrant and refugee health. Emerging Infect Dis 4(3):427–428PubMedCrossRefGoogle Scholar
  35. de Torrente N (2006) Humanitarian NGOs must not ally with military. Eur Aff. http://www.doctorswithoutborders.org/publications/opedsarticles/2006-08-30ngo.cfm. Accessed 1 Feb 2008
  36. Department of Defense (2005) Directive 3000.05: military support for stability, security, transition and reconstruction (SSTR) operations. http://www.dtic.mil/whs/directives/corres/html/300005.htm. Accessed 29 Jan 2008
  37. DeZee KJ, Berbano EP, Wilson RL, Rinaldo JE (2006) Humanitarian assistance medicine: perceptions of preparedness. A survey-based needs assessment of recent U.S. Army Internal Medicine Residency graduates. Military Med 171(9):885–888Google Scholar
  38. Drifmeyer J, Llewellyn C (2004a) Military training and humanitarian and civic assistance. Military Med 169:23–29Google Scholar
  39. ——— (2004b) Toward more effective humanitarian assistance. Military Med 169:161–168Google Scholar
  40. Drifmeyer J, Llewellyn C, Tarantino D (2004) Humanitarian service and recruitment and retention of uniformed services medical personnel. Military Med 169:358–360Google Scholar
  41. Dziedzic MJ, Seidl MK (2005) Provincial reconstruction teams and military relation with international and nongovernmental organizations in Afghanistan. Special report 147, United States Institute of Peace. http://www.usip.org/pubs/specialreports/sr147.html. Accessed 1 Feb 2009
  42. Eisenhower D (1953) Eisenhower National Historic Site. http://www.nps.gov/archive/eise/quotes2.htm. Accessed 13 July 2008
  43. Emergency medical aid is not for amateurs (1996) Lancet 348:1393Google Scholar
  44. Global Policy Forum (2007) Chapter 4: unlawful detention documentation about Abu Grab. In: War and occupation in Iraq. Global Policy Forum, New York, pp 31–42. http://globalpolicy.igc.org/security/issues/iraq/occupation/report/4detention.htm. Accessed 1 Feb 2008
  45. Goma Epidemiology Group (1995) Public health impact of Rwandan refuge crisis: what happened in Goma, Zaire, in July 1994? Lancet 345:339–344CrossRefGoogle Scholar
  46. Grissom TE, Farmer JC (2005) The provision of sophisticated critical care beyond the hospital: lessons from physiology and military experiences that apply to civil disaster medical response. Crit Care Med 33(1):S13–S21PubMedCrossRefGoogle Scholar
  47. Hansch S, Burkholder B (1996) When chaos reigns: responding to complex emergencies. Harvard Int Rev 18(10–11):53–54Google Scholar
  48. Hardesty JM, Ellis JD (1997) Training for peace operations: the U.S. Army adapts to the post-cold war world. Peaceworks, No. 12. United States Institute of Peace. http://www.usip.org/pubs/peaceworks/pwks12.html. Accessed 1 Feb 2008
  49. Helton AC, Loescher G (2003) NGOs and governments in a new humanitarian landscape. OpenDemocracy.com and Council on Foreign Relations. http://www.cfr.org/publication/6084/ngos_and_governments_in_a_new_humanitarian_landscape.html?breadcrumb=%2Fissue%2F40%2Fnongovernmental_organizations. Accessed Sept 19 2008
  50. Hersh SM (2007) The general’s report. The New Yorker Magazine, 25 June. http://www.newyorker.com/reporting/2007/06/25/070625fa_fact_hersh . Accessed 1 Feb 2008
  51. Interaction (2007a) Guidelines for InterAction staff relations with military forces engaged in, or training for, peacekeeping and disaster response. http://www.interaction.org/hpp/military.html. Accessed 1 Feb 2008
  52. ——— (2007b) Guidelines for relations between U.S. armed forces and non-governmental humanitarian organizations in hostile or potentially hostile environments. http://www.interaction.org/files.cgi/5896_InterAction_U.S._Mil_CivMil_Guidelines_July_07_flat.pdf. Accessed 1 Feb 2008
  53. International Commission on Intervention and State Sovereignty (2001) The Responsibility to Protect. Commission established by interested UN member states in response to a challenge by the Secretary General. International Development Research Centre, Ottawa. http://www.responsibilitytoprotect.org/index.php/pages/20. Accessed 19 Sept 2008
  54. International Committee of the Red Cross (2004) From the battle of Solferino to the eve of the First World War. 28 Dec 2004. http://www.icrc.org/Web/Eng/siteeng0.nsf/html/57JNVP. Accessed 19 Sept 2008
  55. ——— (2006) The Geneva Conventions: the core of international humanitarian law. 9 Jan 2006. http://www.icrc.org/Web/Eng/siteeng0.nsf/html/genevaconventions. Accessed 19 Sept 2008
  56. International Red Cross/Red Crescent Society (2002) Code of conduct for combatants. http://www.genderandpeacekeeping.org/resources/5_ICRC_Code_of_Conduct.pdf. Accessed 1 Feb 2008
  57. Jennings SA, Cohen DL, Corrow LK, Harper ML, McCain G, Wiedeman J (1993) Deployment of an air transportable hospital in support of allied forces during Operation Provide Comfort: April 29 to July 17, 1991. Military Med 158:135–141Google Scholar
  58. Kapp C (2003) Relief crisis unfolds as Iraq war progresses. Lancet 361:1103–1104PubMedCrossRefGoogle Scholar
  59. Kennedy JF (1961) Presidential address. United States Naval Academy Graduation. Annapolis, MD. http://www.presidency.ucsb.edu/ws/index.php?pid=8181. Accessed 1 Feb 2008
  60. Kerstein MD, Burkle FM (1993) Medical reservists in support of humanitarian effort. Am J Surg 166:86–90PubMedCrossRefGoogle Scholar
  61. Kondro W (2007) Where’s the health in Afghanistan’s reconstruction? Can Med Assoc J 177(3):233Google Scholar
  62. Kosovo UN troops ‘fuel sex trade.’ (2004) BBC News, 6 May. http://news.bbc.co.uk/2/hi/europe/3686173.stm. Accessed 1 Feb 2008
  63. Lewis T (2001) Madame de Stael: the inveterate idealist. Hudson Rev, 1 Oct. http://www.hudsonreview.com/lewisAu01.html. Accessed 13 July 2008
  64. Loconte J (2005) The UN sex scandal. Weekly Standard. http://www.weeklystandard.com/Content/Public/Articles/000/000/005/081zxelz.asp. Accessed 1 Feb 2008
  65. Manocourt S, Doppler B, Enten F (1992) Public health consequences of the civil war in Somalia. Lancet 340:176–177CrossRefGoogle Scholar
  66. Martone G (2006) Transcript of interview on American Morning. Cable News Network, 20 June. http://transcripts.cnn.com/TRANSCRIPTS/0606/20/ltm.03.html. Accessed 1 July 2008
  67. McGuinness KM (2006) The USNS mercy and the changing landscape of humanitarian and disaster response. Military Med 171:48–52Google Scholar
  68. McHugh G, Gostelow L (2004) Provincial reconstruction teams and humanitarian–military relations in Afghanistan. Special report for Save the Children. http://www.savethechildren.org.uk. Accessed 1 Feb 2008
  69. Michoacán Incident (2007) USA Today, 21 September. http://www.usatoday.com/news/world/2007-09-21-mexico-army_N.htm. Accessed 1 July 2008
  70. Morris J (2004) Executive Director of the World Food Programme to Informal Consultations of the Security Council on the High-Level Mission to Darfur, Sudan. http://documents.wfp.org/stellent/groups/public/documents/newsroom/wfp076507.pdf. Accessed 1 Feb 2008
  71. Musani A, Shaikh I (2006) Preparedness for humanitarian crises needs to be improved. Br Med J 333:843–845CrossRefGoogle Scholar
  72. NATO Civil-Military Co-Operation (CIMIC) Doctrine (NATO AJP-9) (2003) North Atlantic Treaty Organization. http://www.nato.int/ims/docu/AJP-9.pdf. Accessed 1 July 2008
  73. Parke TR, Haddock G, Steedman DJ, Pollok AJ, Little K (1992) Response to the Kurdish refugee crisis by the Edinburgh MEDIC 1 team. March 14. Br Med J 304(6828):695–697Google Scholar
  74. Patrick S, Brown K (2007) The Pentagon and global development: making sense of the DoD’s expanding role. Working paper 131. Center for Global Development, Washington, DC. http://www.cgdev.org/content/publications/detail/14815. Accessed 1 Feb 2008
  75. Perito R (2005) The U.S. experience with provisional reconstruction teams in Afghanistan: lessons identified. Special report 152. United States Institute of Peace, Washington, DC. http://www.usip.org/pubs/specialreports/sr152.html. Accessed 1 July 2008
  76. ——— (2007a) Provincial reconstruction teams in Iraq. Special report 185. United States Institute of Peace, Washington, DC. http://www.usip.org/pubs/specialreports/sr185.html. Accessed 1 July 2008
  77. ——— (2007b) Guide for participants in peace, stability, and relief operations. United States Institute of Peace Press Books, Washington, DCGoogle Scholar
  78. ——— (2007c) Testimony before the House of Armed Services Subcommittee on oversight and investigations. United States Institute of Peace, Washington, DC. http://www.usip.org/congress/testimony/2007/1017_perito.html. Accessed 1 Feb 2008
  79. Powell C (2001) In: Katz IT, Wright AA (2004) Collateral damage – Médecins sans Frontières leaves Afghanistan and Iraq. New Engl J Med 351:2571–2573. The actual transcript for the quote by Secretary Powell on the U.S. State Department Web site has been removed. It was previously located at http://www.state.gov/secretary/rm/2001/5762.htm Google Scholar
  80. Pugh M (1998) Intervention and humanitarian actions: trends and issues. Disasters 22:339–351PubMedCrossRefGoogle Scholar
  81. Quigley and Associates (1996) Towards broader and more effective NGO participation in World Bank activities in Eastern Europe: two case studies—Poland and Slovakia. Beyond Transition: The Newsletter About Transforming Economies, October. http://www.worldbank.org/html/prddr/trans/novdec96/doc2.htm. Accessed 1 July 2008
  82. Salama P, Buzard N, Spiegel P (2001) Improving standards in international humanitarian response: the Sphere Project and beyond. J Am Med Assoc 286(5):531–532CrossRefGoogle Scholar
  83. Seiple C (1996) The U.S. military/NGO relationship in humanitarian interventions. Peacekeeping Institute Center for Strategic Leadership, Carlisle Barracks, PAGoogle Scholar
  84. Seybolt TB (2007) Humanitarian military intervention: the conditions for success and failure. Oxford University Press, New YorkGoogle Scholar
  85. Sharp TW, Yip R, Malone J (1994) U.S. military forces and emergency international humanitarian assistance: observations and recommendations from three recent missions. J Am Med Assoc 272(5):386–390Google Scholar
  86. Sharp TW, Wightman JM, Davis MJ, Sherman SS, Burkle FM (2001) Military assistance in complex emergencies: what have we learned since the Kurdish relief effort? Prehosp Disaster Med 16(4):197–208PubMedGoogle Scholar
  87. Sharp TW, Burkle FM, Vaughn AF, Chotani R, Brennan RJ (2002) Challenges and opportunities for humanitarian relief in Afghanistan. Clin Infect Dis 35(Suppl 5):S215–S228CrossRefGoogle Scholar
  88. Sheik M, Gutierrex MI, Bolton P (2000) Deaths among humanitarian workers. Br Med J 321:166–168CrossRefGoogle Scholar
  89. Sphere Project (2008) http://www.sphereproject.org. Accessed 1 Feb 2008
  90. Spiegel PB (2000) Health issues affecting displaced populations. Refugee 18(5):1–3Google Scholar
  91. Spiegel PB, Burkle FM, Dey CC, Salama P (2001) Developing public health indicators in complex emergency response. Prehosp Disaster Med 16(4):281–285PubMedGoogle Scholar
  92. Summers L (1991) How to be the world’s policeman. New York Times, 19 May. http://query.nytimes.com/gst/fullpage.html?res=9D0CE7DB133AF93AA25756C0A967958260&sec=&spon=&pagewanted=5. Accessed 11 July 2008
  93. Terbush J, Clarke T, Romine D (2007) The joint expeditionary medicine specialist. Military Med 172:ii–ivGoogle Scholar
  94. Toole MJ (1995) Mass population displacement: a global public health challenge. Infect Dis Clin North Am 9:353–366PubMedGoogle Scholar
  95. Toole MJ, Galson S, Brady W (1993) Are war and public health compatible? Lancet 341:1193–1196PubMedCrossRefGoogle Scholar
  96. Twenty-Sixth International Conference of the Red Cross and Red Crescent (1995) The code of conduct. http://www.ifrc.org/publicat/conduct/ and http://www.ifrc.org/publicat/conduct/code.asp. Accessed 10 July 2008
  97. UN: Nations falling behind in tsunami pledges: only one-third of money has been delivered, rebuilding aid needed (2005) MSNBC.com. http://www.msnbc.msn.com/id/6914609/. Accessed 1 July 2008
  98. Uniformed Services University of the Health Sciences (2008) Military Medical Humanitarian Assistance Course. http://www.usuhs.mil/pediatrics/mmhac/manual.htm. Accessed 1 July 2008
  99. United Nations (2004) The high-level panel on threats, challenges and change. A more secure world, our shared responsibility. United Nations Report. http://www.responsibilitytoprotect.org/index.php?module=uploads&func=download&fileId=102. Accessed 1 Feb 2008
  100. ——— (2005) Resolution 1645. http://daccessdds.un.org/doc/UNDOC/GEN/N05/654/17/PDF/N0565417.pdf. Accessed 10 July 2008
  101. ——— (2008) Peacekeeping best practices. Policy, analysis and lessons learned for the peacekeeping community. http://www.un.org/Depts/dpko/lessons/. Accessed 1 July 2008
  102. United Nations Office for the Coordination of Humanitarian Affairs (OCHA) (1999) OCHA orientation handbook on complex emergencies. http://www.reliefweb.int/library/documents/ocha__orientation__handbook_on__.htm. Accessed 1 Feb 2008
  103. United Nations Peace Building Commission (2008) http://www.un.org/peace/peacebuilding/mandate.shtml. Accessed 10 July 2008
  104. United States Government Accountability Office (2005) Rebuilding Iraq: U.S. water and sanitation efforts need improved measures for assessing impact and sustained resources for maintaining facilities. Report GAO-05-872. http://www.gao.gov/htext/d05872.html. Accessed 1 Feb 2008
  105. United States Institute of Peace (2000) Taking it to the next level: civilian–military cooperation in complex emergencies. Virtual Diplomacy. http://www.usip.org/virtualdiplomacy/publications/reports/nextlevel.html. Accessed 1 July 2008
  106. ——— (2008) http://www.usip.org. Accessed 13 July 2008
  107. Vanderwagen W (2006) Health diplomacy: winning hearts and minds through the use of health interventions. Military Med 171:3–4Google Scholar
  108. VanRooyen MJ, Eliades MJ, Grabowski JG, Stress ME, Juric J, Burkle FM (2001) Medical relief personnel in complex emergencies: perceptions of effectiveness in the former Yugoslavia. Prehosp Disaster Med 16(3):145–149PubMedGoogle Scholar
  109. Vidal J (2005) States failing to pay tsunami pledges. The Guardian. http://www.guardian.co.uk/tsunami/story/0,15671,1408047,00.html. Accessed 1 Feb 2008
  110. Watkins C (2003) Provincial reconstruction teams (PRTs): an analysis of their contribution to security in Afghanistan. Oxford Brooks University, Oxford. http://www.institute-for-afghan-studies.org/Contributions/Projects/Watkins-PRTs/. Accessed 1 Feb 2008
  111. Wax E (2005) Congo’s desperate ‘one-dollar UN girls’: shunned teens, many raped by militiamen, sell sex to peacekeepers. Washington Post, 21 March. p A01. http://www.washingtonpost.com/ac2/wp-dyn/A52333-2005Mar20?language=printer. Accessed 1 Feb 2008
  112. Weiss TG (1997) A research note about military–civilian humanitarianism: more questions than answers. Disasters 21(2):95–117PubMedCrossRefGoogle Scholar
  113. Wilensky RJ (2001) The medical civic action program in Vietnam: success or failure? Military Med 166(9):815–819Google Scholar
  114. ——— (2004) Military medicine to win hearts and minds: aid to civilians in the Vietnam war. Texas Tech University Press, Lubbock, TXGoogle Scholar
  115. Williams HR (2000) Appendix 1: the realities of coordination/cooperation: debunking as a survival tool. In: Taking it to the next level: civilian–military cooperation in complex emergencies. United States Institute of Peace, Washington, DC. http://www.usip.org/virtualdiplomacy/publications/reports/nextlevel.html. Accessed 10 July 2008
  116. Wilson RL, Truesdell AG, Rinaldo JE (2005) Why the military needs humanitarian medicine specialists. Military Med 170(4):xi–xiiiGoogle Scholar
  117. Yip R, Sharp TW (1993) Acute malnutrition and high childhood mortality related to diarrhea: lessons learned from the 1991 Kurdish refugee crisis. J Am Med Assoc 270:587–590CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  1. 1.

Personalised recommendations