Beyond Humanitarian Bandages — Confronting Genocide in Sudan
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《新英格兰医药杂志》
The basic contours of what is happening in the Darfur region of western Sudan have been extensively documented. In May, I traveled to Chad, Sudan's neighbor to the west, and interviewed dozens of refugees spread out over hundreds of miles. The stories I heard were remarkably consistent. Person after person, the refugees told me that they had fled after attacks on their villages by Arab Janjaweed militias, which have burned hundreds of villages and murdered tens of thousands of civilians from so-called black African ethnic groups. The distinction between Arab and African has a heavy subjective component, but it is no less significant for that, since it is helping to fuel the violence. To make matters worse, the Janjaweed are backed by the Sudanese government, which wants to put down rebels drawn from the non-Arab tribes.
Physicians for Human Rights, other human-rights groups, United Nations (U.N.) investigators, and journalists have all collected and reported similar testimonies. And in a remarkable undertaking, the U.S. Department of State funded a project carried out by the Coalition for International Justice and the American Bar Association to systematically interview more than 1100 refugees in Chad. Among other things, that broad survey of randomly selected witnesses affirmed the Sudanese government's responsibility for the violence, the ethnic and perceived racial basis for it, and the systematic murder, rape, and plundering of civilian populations, primarily members of the Zaghawa, Masalit, and Fur tribes.
The Sudanese refugees who have crossed into Chad are relatively lucky. A still-underfunded international relief effort is providing them with some food, water, shelter, and health care, and they have some measure of security. For the displaced Darfurians who are still in Sudan, however, the situation is more dire. The Sudanese government in Khartoum originally placed severe limitations on international access to these victims. International pressure has pried open the region to some extent, and more aid is now available inside Darfur than was present earlier in the year. The number of international relief workers on the ground has increased from 40 in April to more than 700 today, many of them doctors and other health care workers.
But it is not enough. Retrospective cluster surveys conducted in West Darfur through June showed that mortality was well above the emergency benchmark, reflecting a high rate of death caused by both direct violence and the conditions of life imposed on the displaced.1 A more recent study by the World Health Organization (WHO),2 whose scope was limited by continued insecurity and government restrictions, nevertheless showed that 6000 to 10,000 people are dying each month from disease and the effects of malnutrition. The main cause of death identified by the WHO was diarrhea, resulting from the shortage of clean water and inadequate hygiene. Respiratory infections and hepatitis E have also taken their toll. People weakened by lack of food find their defenses failing. As one nurse for the International Rescue Committee recently commented, "Because of their newly acquired frailty, the people of Darfur are dying of common diseases, of maladies normally not fatal."3
(Figure)
Carcasses of Dead Animals Being Burned by the International Rescue Committee to Prevent the Spread of Disease.
Courtesy of the U.S. Holocaust Memorial Museum.
The WHO's estimate of the death rate is undoubtedly conservative. Among other things, the organization could accurately measure death rates only among the subgroup of the displaced to whom international agencies have access. The many people who are still beyond international reach are dying in uncounted numbers.
Even if Khartoum's grudging concessions on aid workers' access to the displaced have slowed the rate of dying, they have not fundamentally changed the nature of the emergency. U.N. officials, to their credit, were among the first to raise the alarm over Darfur, almost a year ago, calling it "the world's worst humanitarian crisis." That label continues to be used. But although the situation in Darfur is undoubtedly a humanitarian crisis, the humanitarian problems have political causes. A humanitarian and medical response, such as a recent measles-immunization campaign, is necessary, but it is in no way sufficient.
(Figure)
A Refugee Who Lost His Leg after Being Bombed by Sudanese Government Aircraft.
Courtesy of the U.S. Holocaust Memorial Museum.
The failure to recognize and address the political causes of a humanitarian disaster can be catastrophic, as illustrated by the aftermath of the 1994 genocide in Rwanda. That genocide ended when the perpetrators, extremist leaders of the country's Hutu majority, fled to neighboring Zaire (now the Democratic Republic of Congo), along with more than a million Hutu civilians who feared reprisal from the Tutsi-led Rwanda Patriotic Front. As cholera and other diseases swept crowded refugee camps in Zaire, the world responded with massive humanitarian and medical aid. But the failure to address the political causes of the crisis and its roots in the genocide meant that the humanitarian effort basically allowed the perpetrators to reconstitute themselves, setting the stage for a war in eastern Congo that has claimed more than 3 million lives and still is not resolved.
Similarly, applying a humanitarian bandage to Darfur without addressing the underlying political causes — the decision of the Sudanese government to whip up ethnic hatred and use violence against civilians as a counterinsurgency strategy — cannot possibly end the suffering. Until Khartoum's behavior changes, the "humanitarian crisis" will persist.
On September 9, 2004, U.S. Secretary of State Colin Powell labeled this violence genocide. His real-time declaration is unprecedented in the history of the U.N. Genocide Convention, but it was not accompanied by new initiatives or immediately embraced by other governments. Although the United States decided to continue trying to ratchet up pressure on Khartoum through the U.N. Security Council, the council seems to lack a sense of urgency. Many would rather treat the consequences of the crisis than deal with its causes.
A July 30, 2004, resolution that threatened sanctions if Khartoum did not disarm the Janjaweed was undercut by Jan Pronk, special representative of the U.N. secretary-general. Pronk agreed to a "plan of action" with Khartoum that effectively rewrote the resolution, requiring only that Khartoum ask the militia groups to stand down. Even this it failed to do, and soon U.N. workers reported renewed air attacks on civilians by Sudanese forces. The council passed a new resolution on September 18, after a renewed threat of sanctions had been watered down. Months are slipping by as the situation deteriorates.
In early November, the Sudanese military and police began attacking camps where civilians had taken refuge, beating inhabitants, burning down their huts, and forcibly relocating them. The attacks continued even after a November 9 peace agreement between the government and rebels, which few believed would be honored. On November 19, the U.N. Security Council passed a new resolution that continued its retreat from responsibility. Omitting any direct threat of sanctions, the resolution was immediately renounced by humanitarian and human-rights organizations.
Powell deserves praise for uttering the word that his predecessors found so hard to say. But uttering the word does not by itself solve the political problems — either the international ones that lead to lethargy and inaction or the ones on the ground in Sudan that led to genocide in the first place. Genocide will not be stopped by words or bandages alone. Decisive action is required, and if the U.N. Security Council is incapable of such action, an alternative must be formed or found — what some have described as a "coalition of the caring."
Powell has undoubtedly invited pressure on himself and the U.S. government to achieve results and has raised the political and moral stakes for other countries. Part of history's judgment of his tenure as secretary of state — and that of his successor — will be the ultimate outcome of the Darfur genocide. Sadly, the hundreds of thousands in Darfur whose lives hang in the balance cannot wait for history.
Source Information
From the Committee on Conscience, United States Holocaust Memorial Museum, Washington, D.C.
References
Depoortere E, Checchi F, Broillet F, et al. Violence and mortality in West Darfur, Sudan (2003-04): epidemiological evidence from four surveys. Lancet 2004;364:1315-1315.
World Health Organization. Retrospective mortality survey among the internally displaced population, Greater Darfur, Sudan, August 2004. (Accessed November 24, 2004, at http://www.who.int/disasters/repo/14656.pdf.)
News BBC. Aiding Darfur: a nurse's story. October 22, 2004. (Accessed November 24, 2004, at http://news.bbc.co.uk/1/hi/world/africa/3946079.stm.)(Jerry Fowler, J.D.)
Physicians for Human Rights, other human-rights groups, United Nations (U.N.) investigators, and journalists have all collected and reported similar testimonies. And in a remarkable undertaking, the U.S. Department of State funded a project carried out by the Coalition for International Justice and the American Bar Association to systematically interview more than 1100 refugees in Chad. Among other things, that broad survey of randomly selected witnesses affirmed the Sudanese government's responsibility for the violence, the ethnic and perceived racial basis for it, and the systematic murder, rape, and plundering of civilian populations, primarily members of the Zaghawa, Masalit, and Fur tribes.
The Sudanese refugees who have crossed into Chad are relatively lucky. A still-underfunded international relief effort is providing them with some food, water, shelter, and health care, and they have some measure of security. For the displaced Darfurians who are still in Sudan, however, the situation is more dire. The Sudanese government in Khartoum originally placed severe limitations on international access to these victims. International pressure has pried open the region to some extent, and more aid is now available inside Darfur than was present earlier in the year. The number of international relief workers on the ground has increased from 40 in April to more than 700 today, many of them doctors and other health care workers.
But it is not enough. Retrospective cluster surveys conducted in West Darfur through June showed that mortality was well above the emergency benchmark, reflecting a high rate of death caused by both direct violence and the conditions of life imposed on the displaced.1 A more recent study by the World Health Organization (WHO),2 whose scope was limited by continued insecurity and government restrictions, nevertheless showed that 6000 to 10,000 people are dying each month from disease and the effects of malnutrition. The main cause of death identified by the WHO was diarrhea, resulting from the shortage of clean water and inadequate hygiene. Respiratory infections and hepatitis E have also taken their toll. People weakened by lack of food find their defenses failing. As one nurse for the International Rescue Committee recently commented, "Because of their newly acquired frailty, the people of Darfur are dying of common diseases, of maladies normally not fatal."3
(Figure)
Carcasses of Dead Animals Being Burned by the International Rescue Committee to Prevent the Spread of Disease.
Courtesy of the U.S. Holocaust Memorial Museum.
The WHO's estimate of the death rate is undoubtedly conservative. Among other things, the organization could accurately measure death rates only among the subgroup of the displaced to whom international agencies have access. The many people who are still beyond international reach are dying in uncounted numbers.
Even if Khartoum's grudging concessions on aid workers' access to the displaced have slowed the rate of dying, they have not fundamentally changed the nature of the emergency. U.N. officials, to their credit, were among the first to raise the alarm over Darfur, almost a year ago, calling it "the world's worst humanitarian crisis." That label continues to be used. But although the situation in Darfur is undoubtedly a humanitarian crisis, the humanitarian problems have political causes. A humanitarian and medical response, such as a recent measles-immunization campaign, is necessary, but it is in no way sufficient.
(Figure)
A Refugee Who Lost His Leg after Being Bombed by Sudanese Government Aircraft.
Courtesy of the U.S. Holocaust Memorial Museum.
The failure to recognize and address the political causes of a humanitarian disaster can be catastrophic, as illustrated by the aftermath of the 1994 genocide in Rwanda. That genocide ended when the perpetrators, extremist leaders of the country's Hutu majority, fled to neighboring Zaire (now the Democratic Republic of Congo), along with more than a million Hutu civilians who feared reprisal from the Tutsi-led Rwanda Patriotic Front. As cholera and other diseases swept crowded refugee camps in Zaire, the world responded with massive humanitarian and medical aid. But the failure to address the political causes of the crisis and its roots in the genocide meant that the humanitarian effort basically allowed the perpetrators to reconstitute themselves, setting the stage for a war in eastern Congo that has claimed more than 3 million lives and still is not resolved.
Similarly, applying a humanitarian bandage to Darfur without addressing the underlying political causes — the decision of the Sudanese government to whip up ethnic hatred and use violence against civilians as a counterinsurgency strategy — cannot possibly end the suffering. Until Khartoum's behavior changes, the "humanitarian crisis" will persist.
On September 9, 2004, U.S. Secretary of State Colin Powell labeled this violence genocide. His real-time declaration is unprecedented in the history of the U.N. Genocide Convention, but it was not accompanied by new initiatives or immediately embraced by other governments. Although the United States decided to continue trying to ratchet up pressure on Khartoum through the U.N. Security Council, the council seems to lack a sense of urgency. Many would rather treat the consequences of the crisis than deal with its causes.
A July 30, 2004, resolution that threatened sanctions if Khartoum did not disarm the Janjaweed was undercut by Jan Pronk, special representative of the U.N. secretary-general. Pronk agreed to a "plan of action" with Khartoum that effectively rewrote the resolution, requiring only that Khartoum ask the militia groups to stand down. Even this it failed to do, and soon U.N. workers reported renewed air attacks on civilians by Sudanese forces. The council passed a new resolution on September 18, after a renewed threat of sanctions had been watered down. Months are slipping by as the situation deteriorates.
In early November, the Sudanese military and police began attacking camps where civilians had taken refuge, beating inhabitants, burning down their huts, and forcibly relocating them. The attacks continued even after a November 9 peace agreement between the government and rebels, which few believed would be honored. On November 19, the U.N. Security Council passed a new resolution that continued its retreat from responsibility. Omitting any direct threat of sanctions, the resolution was immediately renounced by humanitarian and human-rights organizations.
Powell deserves praise for uttering the word that his predecessors found so hard to say. But uttering the word does not by itself solve the political problems — either the international ones that lead to lethargy and inaction or the ones on the ground in Sudan that led to genocide in the first place. Genocide will not be stopped by words or bandages alone. Decisive action is required, and if the U.N. Security Council is incapable of such action, an alternative must be formed or found — what some have described as a "coalition of the caring."
Powell has undoubtedly invited pressure on himself and the U.S. government to achieve results and has raised the political and moral stakes for other countries. Part of history's judgment of his tenure as secretary of state — and that of his successor — will be the ultimate outcome of the Darfur genocide. Sadly, the hundreds of thousands in Darfur whose lives hang in the balance cannot wait for history.
Source Information
From the Committee on Conscience, United States Holocaust Memorial Museum, Washington, D.C.
References
Depoortere E, Checchi F, Broillet F, et al. Violence and mortality in West Darfur, Sudan (2003-04): epidemiological evidence from four surveys. Lancet 2004;364:1315-1315.
World Health Organization. Retrospective mortality survey among the internally displaced population, Greater Darfur, Sudan, August 2004. (Accessed November 24, 2004, at http://www.who.int/disasters/repo/14656.pdf.)
News BBC. Aiding Darfur: a nurse's story. October 22, 2004. (Accessed November 24, 2004, at http://news.bbc.co.uk/1/hi/world/africa/3946079.stm.)(Jerry Fowler, J.D.)