Conflict

Amir Khorram-Manesh, Frederick M. Burkle Jr., Phatthranit Phattharapornjaroen, Milad Ahmadi Marzaleh, Mohammed Al Sultan, Matti Mantysaari, Eric Carlström, Krzysztof Goniewicz, Emelia Santamaria, John David Comandante, Robert Dobson, Boris Hreckovski, Glenn-Egil Torgersen, Luc J. Mortelmans, Mirjam de Jong, and Yohan Robinson. 11/2020. “The Development of Swedish Military Healthcare System: Part II-Re-evaluating the Military and Civilian Healthcare Systems in Crises Through a Dialogue and Study Among Practitioners.” Military Medicine.Abstract

Introduction: Historical changes have transformed Sweden from being an offensive to a defensive and collaborative nation with national and international engagement, allowing it to finally achieve the ground for the civilian–military collaboration and the concept of a total defense healthcare. At the same time, with the decreasing number of international and interstate conflicts, and the military’s involvement in national emergencies and humanitarian disaster relief, both the need and the role of the military healthcare system within the civilian society have been challenged. The recent impact of the COVID-19 in the USA and the necessity of military involvement have led health practitioners to anticipate and re-evaluate conditions that might exceed the civilian capacity of their own countries and the need to have collaboration with the military healthcare. This study investigated both these challenges and views from practitioners regarding the benefits of such collaboration and the manner in which it would be initiated.

Material and Method: A primary study was conducted among responsive countries using a questionnaire created using the Nominal Group Technique. Relevant search subjects and keywords were extracted for a systematic review of the literature, according to the PRISMA model.

Results: The 14 countries responding to the questionnaire had either a well-developed military healthcare system or units created in collaboration with the civilian healthcare. The results from the questionnaire and the literature review indicated a need for transfer of military medical knowledge and resources in emergencies to the civilian health components, which in return, facilitated training opportunities for the military staff to maintain their skills and competencies.

Conclusions: As the world witnesses a rapid change in the etiology of disasters and various crises, neither the military nor the civilian healthcare systems can address or manage the outcomes independently. There is an opportunity for both systems to develop future healthcare in collaboration. Rethinking education and training in war and conflict is indisputable. Collaborative educational initiatives in disaster medicine, public health and complex humanitarian emergencies, international humanitarian law, and the Geneva Convention, along with advanced training in competency-based skill sets, should be included in the undergraduate education of health professionals for the benefit of humanity.

Robert I.S. Macpherson and Frederick M. Burkle Jr. 11/2020. “Humanitarian Aid Workers: The Forgotten First Responders.” Prehospital and Disaster Medicine. Read PublicationAbstract

Humanitarian aid workers are an overlooked population within the structure of posttraumatic stress disorder (PTSD) research and assistance. This negligence is an industry-wide failure to address aid workers’ psychological health issues. The suspected numbers of death by suicide, diagnosed PTSD, depression, anxiety disorders, hazardous alcohol and drug consumption, emotional exhaustion, and other stress-related problems are impossible to quantify but are considered endemic. Tools for establishing organizational frameworks for mental health and psychosocial support are readily available. However, the capacity to implement this assistance requires the creation and practice of an open and non-judgmental culture, based on the realistic acceptance that aid work has become inherently dangerous. The possibility of developing a psychological problem because of aid work has increased along with the rise in levels of disease, injury, kidnapping, and assault. As a result, expressions of traumatic stress have become the norm rather than an exception. This commentary outlines the essential steps and components necessary to meet these requirements.

Adrienne Fricke and Rahaf Safi. 3/2021. Window of Hope: Sustaining education of health professionals in northwest Syria.Abstract
This report is based on a comprehensive needs assessment carried out remotely by the HHI team in Syria in 2019. The OSF HESP grant was awarded to a larger project to understand the impact of humanitarian emergencies, including armed conflict, on students enrolled in medical and nursing programs. The goal is to produce a needs assessment toolkit to help support professional health care education programs during conflict. In addition to Syria, where the conflict is ongoing, the project examines Colombia, a recent post-conflict setting, and Rwanda, a developed post-conflict setting.
Frederick M. Burkle Jr. 3/2020. “Opportunities Lost: Political Interference in the Systematic Collection of Population Health Data During and After the 2003 War in Iraq.” Disaster Medicine and Public Health Preparedness.Abstract

The review of the article, “Developing a Public Health Monitoring System in a War-torn Region: A Field Report from Iraqi Kurdistan,” prompted the writing of this commentary. Decisions to implement health data systems within Iraq require exploration of many otherwise undisclosed or unknown historical facts that led to the politicization of and ultimate demise of the pre-2003 Iraq war systematic health data monitoring system designed to mitigate both direct and indirect mortality and morbidity. Absent from the field report’s otherwise accurate history leading up to and following the war is the politically led process by which the original surveillance system planned for the war and its aftermath was destroyed. The successful politicization of the otherwise extensively planned for public health monitoring in 2003 and its legacy harmed any future attempts to implement similar monitoring systems in succeeding wars and conflicts. Warring factions only collect military casualty data. The field report outlines current attempts to begin again in building a systematic health monitoring system emphasizing it is the “only way to manage the complex post-war events that continue to lead to disproportionate preventable mortality and morbidity.”

Patrick Vinck, Phuong Pham, Eric Stover, Andrew Moss, and Marieke Wierda. 2007. Research Note on Attitudes About Peace and Justice in Northern Uganda.Abstract

In light of human rights violations in Northern Uganda, this research note presents preliminary data on Ugandans’ attitudes on peace and justice. The findings reflect the respondents’ desires for truth reconciliation as well as their desires to hold perpetuators of violence accountable for their actions. However, the findings show that justice is not a top priority for Ugandans in comparison to more tangible needs for health, peace, money, and education. A majority of Ugandans in the North are open to the reintegration of former LRA members in society, albeit conditionally on diminished social and political rights for past LRA leaders.

HPCR. 9/2003. Roundtable Report on Human Rights and Rule of Law: Constitutional and Legal Reform.Abstract

The opportunities for engaging the Afghan public in the process of constitution building and legal reform are quickly disappearing. Decades of war have left the legal system, and its legal culture, in ruins. The project of constitutional and legal reform will be central to the success of reconstruction efforts. For the first time, Afghan legal professionals, civil society leaders, and other groups have the chance to engage in the rebuilding of their country’s legal foundations: both to stabilize a still-insecure country, and to transform their society in more long-lasting ways. However, as the Constitutional Loya Jirga approaches, many key questions regarding the nature of the new Afghan legal order remain, and many Afghans are beginning to feel that they have been left out of the process. The Afghan Independent Human Rights Commission (AIHRC) is in an ideal position to engage civil society groups and legal professionals in wider debate about the protection and integration of human rights standards in the new legal system. Its mandate includes the harmonization of international human rights standards with national law, and perhaps more importantly, the Commission enjoys access to a nation-wide constituency of individuals and groups who support the central government and the modernization of Afghan law. This roundtable report, which presents topics and analysis from a roundtable co-hosted by AIHRC and the Program on Humanitarian Policy and Conflict Research (HPCR) at Harvard University and entitled Human Rights and Rule of Law: Constitutional and Legal Reform, attempts to capture the outcomes of one such effort at engagement and discussion. This Roundtable was one of the first such meetings in Kabul to engage a broad representation of civil society leaders, legal professionals, and Loya Jirga delegates from provinces outside Kabul. In total, there were about forty participants, with half of the group from Kabul and half from other cities and towns. The Roundtable was led by members of the AIHRC, with attendance and participation by members of the Judicial Reform Commission. A series of background papers in Dari was drafted by HPCR (in close consultation with members of the AIHRC) prior to the Roundtable, and made available to the participants along with a copy of President Hamid Karzai’s most recent decree on the Constitutional Loya Jirga and a paper on legal reform in Afghanistan.

International Humanitarian Law Research Initiative. 5/2004. Rules of IHL Applicable to the Conduct of Military Operations in Urban Areas.Abstract

Urban warfare constitutes one of the most serious threats to the security and integrity of civilians in times of war. It represents, consequently, one of the most challenging areas of International Humanitarian Law (IHL) in practice. This note reviews the rules of IHL applicable to the conduct of hostilities in urban environments, and identifies key legal provisions desgned to enhance the protection of civilians in these areas.

HPCR. 5/2002. Securing Communities for Reconstruction in Afghanistan: Final Report of the Conflict Prevention Initiative E-Conference.Abstract

For two weeks in April and May 2002, the Conflict Prevention Initiative (CPI) of the Harvard Program on Humanitarian Policy and Conflict Research (HPCR) hosted the first ever international e-conference on “Securing Communities for Reconstruction in Afghanistan,” attracting over 90 participants. The majority of the participants were Afghan NGO and civil society leaders working in Pakistan and Afghanistan. Others included representatives of various inter-governmental organizations, INGOs, academic institutions and donor governments. This report summarizes the principal themes of the discussion and concludes with a series of recommendations for various actors involved in the process of reconstruction in Afghanistan. These recommendations include both those specifically formulated by participants as well as those drawn more generally from the conference discussion. In addition, actual quotes from the participants are interspersed throughout the report in shaded boxes to suggest the richness and depth of the discussion. The e-conference was preceded by conversations with NGO leaders in Kabul, as well as roundtables with Afghan civil society leaders in Peshawar, Pakistan and Mashad and Zahedan, Iran. The roundtables were designed both to produce substantive inputs for the e-conference as well as to gather perspectives from those who may not have regular internet access. In this way, both the roundtables and the e-conference were designed to engage participants from their separate localities and yet still connect them with broader discussions and analysis. 

HPCR. 2/2004. The Separation Barrier and International Humanitarian Law.Abstract

This briefing note discusses the legal implications under international humanitarian law (IHL) of erecting and maintaining a separation barrier in the Occupied Palestinian Territory (OPT). The main objective of this note is to review the applicable IHL rules and present the various legal perspectives of the parties involved in the debate on the legality of the separation barrier, particularly in the context of the advisory proceedings before the International Court of Justice in the Hague. This briefing note will be updated as arguments of the various parties are presented to the courts, and as the courts’ rulings are made public.

Mohammad-Mahmoud Ould Mohamedou. 3/2005. The Pitfalls of Lawlessness: Disorder, Emergencies, and Conflict.Abstract

This paper examines the issues of disorder, emergency, and conflict and their management in a rule of law-based framework, with illustration from the aftermath of the September 11, 2001 attacks on the United States and the war in Iraq. Noting that the promotion of the rule of law by state institutions has decreased in recent years, the paper postulates that the manifestation of violence as a result of sociopolitical unrest and armed conflict, whether domestic or international, is an indicator of a defective functioning of institutions, and that the maintenance and strengthening of the rule of law at all times are key to an effective enjoyment of human rights and to the practice of democracy. The paper notes that there exist a number of distinct corpora of rules in international and domestic law that are applicable to an orderly, efficient, and rights-respecting management of disorder. In particular, it calls for a symbiotic application of international humanitarian law and international human rights law. Whereas the latter is a general law which is implemented at all times, the former is a special branch of law that to be only enacted during conflicts. Yet, though clearly different, the two bodies overlap, particularly in times of emergency as both seek to protect human dignity and reduce human suffering. Clarifying the core connections and establishing an explicit recognition of the international human rights normative framework and humanitarian values to democracy is particularly called for in times of emergency. The typical state response to internal disorder is to enforce stricter interpretations of security laws, assert the power of the state government, and enact emergency legislation meant to facilitate investigation and prevention of violent emergencies. In that respect, the paper places emphasis on the existence of legal limits to emergency powers noting the extent to which derogation is codified formally. Similarly, the paper argues that legitimacy of the power to compel is a fundamental component of the rule of law, particularly in situations where institutions are failing. The practical result, during emergencies, is that no room is provided (or no longer available) for the articulation of citizens’ aspirations as no structural accountability derivative of democratic dynamics is present. In times of crisis and social disorder, dangers to the effective enjoyment of rights can originate (i) in the context of the implementation of derogation to rights, (ii) in the process of the administration of justice, or (iii) in the course of the enforcement of security laws. Limiting the effect of emergency powers and delineating clearly permissible derogations, so that the state of emergency is regarded as a temporary situation and not a norm, is a central aspect of the regulation of societal disorder processes. During emergencies, particular attention should also be paid to the administration of justice, which can come to suffer from degraded or weakened institutions. The modus operandi is the perpetuation of effective and justiciable remedies under the umbrella of a constitution incorporating the principles of international human rights and freedoms. 

Claude Bruderlein. 6/2001. “People's Security as a New Measure of Global Stability.” International Review of the Red Cross, 83, 842.Abstract

Despite renewed commitment by States to respect and ensure respect for the rules of international humanitarian law, the surge of violence against civilians has continued. Entire populations in Europe, Africa and Central Asia have been displaced, harassed or subjected to extreme forms of violence as a consequence of armed conflicts, in violation of the most fundamental rules of international humanitarian and human rights law.As a result, traditional schemes of protection enshrined in international law are increasingly questioned, revealing the need to develop new strategies to enhance the protection of civilians in times of war. In his Report to the Millennium Assembly, United Nations Secretary General Kofi Annan wrote: “International conventions have traditionally looked at states to protect civilians, but today this expectation is threatened in several ways. First, states are sometimes the principal perpetrator of violence against the very citizens that humanitarian law requires them to protect. Second, non-state combatants, particularly in collapsed states, are often ignorant or contemptuous of humanitarian law. Third, international conventions do not adequately address the specific needs of vulnerable groups, such as internally displaced persons, or women and children in complex emergencies.”

Bertrand Ramcharan. 5/2005. OPS Issue 3: The United Nations High Commissioner for Human Rights and International Humanitarian Law.Abstract

International human rights law and international humanitarian law are parallel and complementary branches of international law with their distinct and distinctive supervision arrangements. In the conflicts taking place in the world today, both the institutions of international humanitarian law and international human rights law are called upon to apply and uphold international humanitarian law. The International Committee of the Red Cross has the lead responsibility internationally for watching over the implementation of international humanitarian law, while the United Nations High Commissioner for Human Rights, the Commission on Human Rights, its subsidiary bodies, and the human rights treaty bodies have the lead responsibility for overseeing the implementation of international human rights law. Basic human rights are being violated on a widespread scale during armed conflicts, and international human rights law operates in parallel alongside international humanitarian law in situations of armed conflict. Violations of international humanitarian law, especially as regards civilians, women and children, are violations of basic human rights with which the High Commissioner for Human Rights must be concerned as part of her responsibilities for the worldwide promotion and protection of human rights. Situations may arise increasingly when a High Commissioner for Human Rights is called upon to react to human rights violations in situations of armed conflict. In such situations, a High Commissioner is perforce required to address violations of international humanitarian law. This calls for the exercise of care and discernment on the part of the High Commissioner. Situations must be handled on the basis of principles, first of international humanitarian law, second of international human rights law, and principles of coexistence regarding institutions of international humanitarian law and international human rights law. Specifically, it is fundamental that the High Commissioner be cognizant of and act in the spirit of the principles pervading international humanitarian law. Generally, it is imperative upon a High Commissioner to help discharge the duty of protection and the responsibility to protect. 

Kenneth Watkin. 1/2005. OPS Issue 2: Warriors Without Rights? Combatants, Unprivileged Belligerents, and the Struggle Over Legitimacy.Abstract

Combatancy has throughout the history of organized warfare been an exclusionary concept. Distinguishing between combatants and civilians has long represented an important aspect of warfare and has been recognized as the indispensable means by which humanitarian principles are injected into the rules governing conduct in war. Yet the protection of participants in warfare under international humanitarian law remains characterized by a certain level of uncertainty as regards the codified provisions for combatants and civilians. Who qualifies as a combatant is a question that has plagued those seeking to establish a comprehensive normative regime governing participation in hostilities. Acting on behalf of a state has constituted the primary means of attaining combatant, and therefore legitimate, status. As a result, a significant number of participants in warfare do not meet the established criteria and are, consequently, considered ‘illegitimate’ or ‘unlawful.’ This includes those fighting in international armed conflict as well as groups engaged in armed conflict not of an international character. The uncertain status of these ‘illegitimate’ warriors is evidenced by the variety of terms used to describe them. The traditional dual privileged status approach of dividing a population into combatants and civilians is only as effective as the accuracy with which the definition of ‘combatant’ is established and to the extent there is a clear understanding of when civilians lose the protection of their status by participating in hostilities. Recently, the question of combatancy and the protection of captured enemy personnel has gained prominence due to the decision of the United States government in 2002 to deny prisoner of war status to the Taliban and Al Qaeda fighters. Similarly, there is considerable controversy as to the standard of treatment to be applied to captured unlawful combatants. Historically, a consistent result of being determined to be an unauthorized participant in hostilities has been harsh treatment at the hands of the captor. Questions are asked whether civilian participants in combat are a type of ‘illegal’ combatant, fall under civilian status, or merit their own status under international humanitarian law. The idea of an intermediate status is rejected by many analysts. 

Yoram Dinstein. 10/2004. “OPS Issue 1: Legislation Under Article 43 of the Hague Regulations: Belligerent Occupation and Peacebuilding”.Abstract

Article 43 of the Regulations Respecting the Laws and Customs of War on Land, annexed to Hague Convention (II) of 1899 and (IV) of 1907, is the linchpin of the international law of belligerent occupation. Two diverse obligations are imposed on the Occupying Power by Hague Article 43: (a) to restore and ensure, as far as possible, public order and life in the occupied territory; (b) to respect the laws in force in the occupied territory unless an “empêchement absolu” exists. The first obligation has to be implemented by the executive (and the judicial) branch of the Military Government of the Occupying Power, whereas the second obligation devolves to the legislative branch. The first obligation requires acts of commission, and the second duty postulates primarily acts of omission. Neither obligation is absolute. Although in principle the Occupying Power has to maintain the laws in force in the occupied territory, it is generally understood that the preexisting legal system can be modified through new legislation when a necessity arises. In principle, any legislation enacted by the Occupying Power in the name of necessity applies in the occupied territory during the occupation and not beyond that stretch of time. Article 64 of the 1949 Fourth Geneva Convention expresses in a more precise and detailed form the terms of Article 43 of the Hague Regulations. Without exhausting the concept Article 64 allows for suspension or repeal of existing laws and the enactment of new legislation in three exceptional situations: (i) the need of the Occupying Power to remove any direct threat to its security and to maintain safe lines of communication, (ii) the duty of the Occupying Power to discharge its duties under the Geneva Convention, and (iii) the necessity to ensure the “orderly government” of the occupied territory. Obviously, the orderly government exception becomes more prominent under conditions of prolonged occupation. It is, therefore, required to establish a litmus test for resolving disputes concerning the validity of legislation enacted by the Occupying Power in the name of orderly government. How far can the Occupying Power go in tampering, in the name of necessity, with the institutions of government of the occupied territory? Under Article 47 of the Fourth Geneva Convention, should institutional changes be introduced by the Occupying Power, they must not deprive the civilian occupation in the occupied territory of any benefits conferred by international humanitarian law. But the paramount question is whether the Occupying Power can transform radically the political institutions of government in the occupied territory when its action does not affect adversely those benefits. While the practice of States is somewhat ambiguous, it is believed that such changes ought to be undertaken only by the territorial sovereign. The Occupying Power should not be allowed to interfere with fundamental institutions of government in the occupied territory, inasmuch as there is a disquieting possibility that the structural innovations (albeit temporary in theory) may take root and have enduring consequences. Under the Hague Regulations and the Fourth Geneva Convention, the rules stated above relate only to belligerent occupation. However, there is possibly room for their application by analogy also in circumstances of peacebuilding, subject to any binding resolution adopted by the United Nations Security Council.

Mohammad-Mahmoud Ould Mohamedou. 7/2005. Non-Linearity of Engagement: Transnational Armed Groups, International Law, and the Conflict between Al Qaeda and the United States.Abstract

The conflict between Al Qaeda and the United States illustrates the evolution of warfare in three respects. First, in an effort to compensate for the disparity in logistical military capability, a non-state actor party to an international conflict has sought to expand the platform of combat, regarding disparity of forces not as a deterrent but as an opportunity. This has implied the expansion of the panoply of means at the disposition of Al Qaeda; not merely terrorism but the full range of kinetic force to influence its enemy. Second, a non-state armed group, whose membership transcends borders and nationality, has declared war on a state and its citizens, regarding war as retaliation for what can be termed ‘privatized collective responsibility.’ Al Qaeda estimates that the citizens of the countries with whom it is at war bear a responsibility in the policies of their governments. Such democratization of responsibility rests, it is argued, in the ability that citizens of the enemy state have to elect and dismiss the representatives which take foreign policy decisions on their behalf. Third, a political movement with a demonstrated military ability has sought to overstep the state while co-opting the latter’s attributes and channeling its resources. In that sense, Al Qaeda’s is a claim to circumvent statehood, and particularly its monopoly over legitimate violence. The leading conflict of our time takes the form of war between a major state (and allies) and a group of a few thousand individuals harboring a perceived right of self-defense that is substituted for statist authority. Al Qaeda’s actions alter the grammar of the existing international relations regime thus: • the geographical indeterminacy of the group’s action speaks of the dissolution of territorial power; • Al Qaeda’s pretension has an important twofold implication for enduring principles of international humanitarian law, namely the obliteration of the combatant/civilian status categories and the refusal to distinguish between civilian and military targets; and • a rational disputation has arisen whereby the authority to fight may no longer be related to the state authority that governs lawfully, and the will and power to act militarily is affirmed by a private entity. Claiming a valid jus ad bellum case, Al Qaeda sets itself as deciding war as a proper authority whose just cause is a case of self-defense. Permissible warfare is channeled within (i) aggrandizement of the principle of necessity, (ii) literalization of civilian responsibility, and (iii) tactical instrumentalization of technological imbalance. Coming to grips with such metamorphosis of offense means acknowledging the logic in which terrorism is used as a method of warfare, according to a principle of indiscrimination whose rationale is negation of the notion of innocence of the civilian population, and imputation of collective responsibility. Al Qaeda is an industrious, committed, and power-wielding organization waging a political, limited, and evasive war of attrition — not a religious, open-ended, apocalyptic one. Since its creation, it has implemented a clearly articulated policy, skillfully conducted complex military operations, and demonstrated strategic operational flexibility. Of late, this versatile transnational phenomenon has exhibited an ability to operate innovatively amid heightened international counter-measures. The organization has also suffered setbacks, chiefly the loss of Afghanistan as an operational base and the arrest or death of several key figures.

Pages