Diagnosing Genocide — The Case of Darfur
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《新英格兰医药杂志》
In the desperate and urgent debate about what to do next in Darfur, Sudan (see map) — where a regional conflict has forced 1.3 million people from their homes and killed at least 30,000 people outright — the fragility of the humanitarian response and the nature of genocide are core themes. Professionals in medicine and public health have much to add to our understanding of both of these issues, most crucially because of our skills in using data to describe patterns of suffering and death in large populations.
What makes this crisis different from many of the dire episodes of drought, famine, and population dislocation that have occurred in the Horn of Africa is that this one appears to be designed and directed by the central government. This crisis comes in the waning days of a 21-year civil war between northern and southern Sudan and is reaching public attention just as a cease-fire in this civil war is about to be implemented. Two rebel groups in the Darfur region of western Sudan, claiming that they have been marginalized in the north–south peace process, took up arms about 18 months ago. Since February 2003, under the pretext of thwarting this rebellion, the Sudanese government has used militia forces called Janjaweed in a sweeping campaign of attack against the non-Arab civilian population of Darfur. The attackers refer to members of this population in derogatory terms in Arabic as "black" or "slave" and have joined with government forces to systematically block efforts by the humanitarian community to reach them. Analysts who have experience with humanitarian crises fear that as many as 300,000 of the 1.3 million people who remain displaced within Darfur will die by the end of the year unless relief can be delivered to them now, before the full onset of the rains.
In mid-June, I traveled to the eastern border of Chad, where about 200,000 refugees from Darfur have fled, as part of a two-person team sent from Physicians for Human Rights to try to determine the humanitarian-relief capacity in the area and to listen to what the refugees could tell us about the circumstances that had prompted them to flee. Over a 10-day period, we visited refugee camps (see Figure) and areas of self-settlement, talked with refugees individually and in small groups, and interviewed members of the international humanitarian-relief community (see Figure). Traveling by four-wheel-drive vehicle with two interpreters and a driver, we spent days making our way to the southeastern edge of the Chad–Sudan border and then back up to the northern stretch, moving at best 20 km per hour along very poor roads that had already been partially destroyed by the rains that come in force to the region in July and August.1
Refugee Camp in Chad.
Courtesy of Physicians for Human Rights.
The Author Interviewing Refugees in Chad.
Courtesy of Physicians for Human Rights.
In our attempts to determine the nature of the campaign, we used a number of observational, interviewing, and statistical skills that are familiar to physicians as we sought information from refugees about what had caused them to flee Darfur. Through interpreters, we spoke to individual refugees and family groups and sought detailed, structured information on key specific issues: limited demographic details about each informant, how long they had been in Chad, how they had gotten to their current location, what had happened that forced them to leave, and details about the attacks and their flight across the border. Each interview was preceded by a discussion of informed consent; we did not proceed unless we received unequivocal oral permission to do so. We also asked similar questions of relief workers who had spent time with the refugees and had heard their stories directly. In this way, we compiled both firsthand testimony and secondhand information from key informants.
The refugees we spoke with, most of them from the Masalit and Fur tribes, described the same pattern of attack: the militia and government forces rush into the villages at dawn, on horseback or camelback or in vehicles, rousing families from sleep or early prayer. Sometimes a government plane drops a bomb, or government helicopters buzz the area. The attackers rapidly kill the men who resist, rape the women, carry off valuable camels and cattle, burn the homes and grain stores, rip up irrigation structures, uproot trees, and spoil or destroy the wells. They chase those who flee into the bush or low hills, then return to complete the destruction of the village site. Depending on where they are, survivors head toward whatever appears to be the closest safe area — either another village deeper in Darfur or the Chad border. Villages along the path of flight are also attacked, driving people from the countryside into the larger towns or across the border into Chad. Everyone we spoke to had traveled for 3 to 10 days with minimal food and water to reach the Chad border, and virtually everyone recounted having lost between one and five extended-family members in the attack that forced them to flee. Relief workers we spoke to in the field offered similar accounts.
To help validate the information obtained from refugees and key informants in Chad, we compared and cross-checked our findings with reports from Darfur. There, members of relief agencies, many of them physicians and health workers, are appalled at what they are seeing and what they project will occur in the near future. They cannot speak as plainly as they would like, lest the government expel them. Observers from human-rights groups assist in carrying out that reporting function.
These features — systematic targeted assaults, massive disruption of livelihood, intensive hot pursuit, organized obstruction of aid, and deliberate consignment to conditions conducive to death from exposure and disease — have prompted observers and organizations that focus on human rights to raise the issue of genocide. The people being attacked are members of identifiable ethnic and linguistic groups, targeted by an organized state authority representing other ethnic and linguistic groups. Prevented by this authority from receiving essential food and water in a barren and harsh environment, the survivors of the immediate attacks face death-dealing conditions over the next several months.
The 1948 Convention on the Prevention and Punishment of the Crime of Genocide, developed in the wake of mass communal atrocities committed during World War II, has been signed and ratified by 135 countries. Sudan has not signed it but has signed the Rome Statute of the International Criminal Court, which defines the crime of genocide in exactly the same language as the convention. The Genocide Convention characterizes genocide as a crime that signatory nations must prevent and punish. If a signatory nation determines that a genocide is under way, that nation is obliged, either by itself or through a multilateral arrangement, to intervene in some way to prevent that genocide from taking place. In other words, when we attest that an assault on a given population is in fact genocide, the nations of the world must do something to stop it. Hence the significance of applying the designation of genocide during an actual ongoing situation: if the determination must wait many months until extensive evidence is compiled, the Genocide Convention is a sterile document that allows us to label certain kinds of mass death only after it is too late to stop them.
The definition of genocide has two aspects: intent and acts. We must determine whether the actions of the perpetrators are carried out with the aim or goal of effecting the destruction of a people, in whole or in part, on the basis of nationality, ethnic background, race, or religion. The Genocide Convention identifies specific acts as genocide, such as killing members of one of these groups or destroying their physical conditions and life supports, if it can be shown that these acts were carried out with genocidal intent. Not all mass killings are genocide, according to the terms of the convention, and not everyone in the targeted group nor every component of its conditions of life needs to be destroyed for the term "genocide" to apply.2
Beyond this level of detail, the convention does not address the steps required to apply the definition to an actual instance. It is often difficult, when one is assessing the actions of a state authority, to determine intent until the events in question are over and one gains access to deposed witnesses and government documents. Determining the effects while the destructive actions are going on may also be difficult, because the populations may be sequestered and general insecurity may impede the gathering of information. This gap between legal definition and operational guidance has been closed partially by judicial findings in the war-crimes trials after the mass killings in the former Yugoslavia and in Rwanda (in which the pattern of actions has been used to infer intent) and by discussion in the charter of the new International Criminal Court.
So human-rights investigators and analysts are left with this important problem — how to move from definition to application while the action is in progress. The Genocide Convention is silent on what information is relevant and on how to gather or interpret the kind of data that are actually available while a conflict or organized assault is taking place. In this vacuum, the human-rights community has resorted to collecting data that will inform the process of pattern recognition and inference based on particular patterns. When one sees sufficient evidence that many people from target groups are being attacked in a coherent and organized manner across a broad swath of territory in a systematic campaign, one can begin to establish patterns of impact. If these patterns match or resemble those implied by the legal terms of the convention, then one must look for intent. If the patterns are so widespread, organized, and sustained that they would be possible only with the deliberate actions or indirect concurrence of the state, then one may infer the intent.
These tasks — describing effects in order to arrive at patterns and interpreting these patterns to determine what factors may have given rise to them — are familiar to physicians and public health professionals. Using sampling methods to assemble social, economic, and demographic information that describes what is occurring in a given population over time is the function of descriptive epidemiology. Inferring causes from patterns relies in part on methods of qualitative and quantitative statistics and in part on contextual knowledge of particular causal pathways.
These methods are always more difficult to use when data are fragmentary, populations are moving, or conditions are insecure. With practice and hindsight, the humanitarian community has developed some very reliable and rapid public health–assessment tools that permit the derivation of good estimates of crude mortality and nutritional status and then, on the basis of accumulated knowledge of how populations fare in harsh environments and famine settings, allow the projection of death rates. There is not yet such practical certainty regarding methods and projections for the assessment of genocide, particularly when the process is ongoing. Yet the approach required is very similar. The data-related tasks are still acquisition, aggregation, and finally, interpretation — bringing in other information related to pace, scope, extent, and political context — to map out patterns of action from which to make inferences about intent.
The events in Darfur bring into sharp relief the lesson that the humanitarian enterprise can work only when political obstruction does not play upon severe constraints of distance and an absence of infrastructure. Darfur also raises the spectre of slow-motion genocide, malignantly engineered by a totalitarian state, crafted to appear to have arisen as the result of a failure of humanitarian assistance. What is at stake is hundreds of thousands of lives and the real possibility that, once again, we will fail to prevent genocide. These failures are not yet certain. The message of what is transpiring, properly grounded in data and analytic interpretation, may yet help to make the difference.
Source Information
From the Program on Humanitarian Crises and Human Rights, Harvard School of Public Health, Boston.
References
Physicians for Human Rights. PHR calls for intervention to save lives in Sudan: field team compiles indicators of genocide. (Accessed July 30,2004,athttp://www.phrusa.org/research/sudan/pdf/sudan_genocide_report.pdf.)
Convention on the Prevention and Punishment of the Crime of Genocide, 1948.(AccessedJuly30,2004,athttp://www.hrweb.org/legal/genocide.html.)(Jennifer Leaning, M.D., S)
What makes this crisis different from many of the dire episodes of drought, famine, and population dislocation that have occurred in the Horn of Africa is that this one appears to be designed and directed by the central government. This crisis comes in the waning days of a 21-year civil war between northern and southern Sudan and is reaching public attention just as a cease-fire in this civil war is about to be implemented. Two rebel groups in the Darfur region of western Sudan, claiming that they have been marginalized in the north–south peace process, took up arms about 18 months ago. Since February 2003, under the pretext of thwarting this rebellion, the Sudanese government has used militia forces called Janjaweed in a sweeping campaign of attack against the non-Arab civilian population of Darfur. The attackers refer to members of this population in derogatory terms in Arabic as "black" or "slave" and have joined with government forces to systematically block efforts by the humanitarian community to reach them. Analysts who have experience with humanitarian crises fear that as many as 300,000 of the 1.3 million people who remain displaced within Darfur will die by the end of the year unless relief can be delivered to them now, before the full onset of the rains.
In mid-June, I traveled to the eastern border of Chad, where about 200,000 refugees from Darfur have fled, as part of a two-person team sent from Physicians for Human Rights to try to determine the humanitarian-relief capacity in the area and to listen to what the refugees could tell us about the circumstances that had prompted them to flee. Over a 10-day period, we visited refugee camps (see Figure) and areas of self-settlement, talked with refugees individually and in small groups, and interviewed members of the international humanitarian-relief community (see Figure). Traveling by four-wheel-drive vehicle with two interpreters and a driver, we spent days making our way to the southeastern edge of the Chad–Sudan border and then back up to the northern stretch, moving at best 20 km per hour along very poor roads that had already been partially destroyed by the rains that come in force to the region in July and August.1
Refugee Camp in Chad.
Courtesy of Physicians for Human Rights.
The Author Interviewing Refugees in Chad.
Courtesy of Physicians for Human Rights.
In our attempts to determine the nature of the campaign, we used a number of observational, interviewing, and statistical skills that are familiar to physicians as we sought information from refugees about what had caused them to flee Darfur. Through interpreters, we spoke to individual refugees and family groups and sought detailed, structured information on key specific issues: limited demographic details about each informant, how long they had been in Chad, how they had gotten to their current location, what had happened that forced them to leave, and details about the attacks and their flight across the border. Each interview was preceded by a discussion of informed consent; we did not proceed unless we received unequivocal oral permission to do so. We also asked similar questions of relief workers who had spent time with the refugees and had heard their stories directly. In this way, we compiled both firsthand testimony and secondhand information from key informants.
The refugees we spoke with, most of them from the Masalit and Fur tribes, described the same pattern of attack: the militia and government forces rush into the villages at dawn, on horseback or camelback or in vehicles, rousing families from sleep or early prayer. Sometimes a government plane drops a bomb, or government helicopters buzz the area. The attackers rapidly kill the men who resist, rape the women, carry off valuable camels and cattle, burn the homes and grain stores, rip up irrigation structures, uproot trees, and spoil or destroy the wells. They chase those who flee into the bush or low hills, then return to complete the destruction of the village site. Depending on where they are, survivors head toward whatever appears to be the closest safe area — either another village deeper in Darfur or the Chad border. Villages along the path of flight are also attacked, driving people from the countryside into the larger towns or across the border into Chad. Everyone we spoke to had traveled for 3 to 10 days with minimal food and water to reach the Chad border, and virtually everyone recounted having lost between one and five extended-family members in the attack that forced them to flee. Relief workers we spoke to in the field offered similar accounts.
To help validate the information obtained from refugees and key informants in Chad, we compared and cross-checked our findings with reports from Darfur. There, members of relief agencies, many of them physicians and health workers, are appalled at what they are seeing and what they project will occur in the near future. They cannot speak as plainly as they would like, lest the government expel them. Observers from human-rights groups assist in carrying out that reporting function.
These features — systematic targeted assaults, massive disruption of livelihood, intensive hot pursuit, organized obstruction of aid, and deliberate consignment to conditions conducive to death from exposure and disease — have prompted observers and organizations that focus on human rights to raise the issue of genocide. The people being attacked are members of identifiable ethnic and linguistic groups, targeted by an organized state authority representing other ethnic and linguistic groups. Prevented by this authority from receiving essential food and water in a barren and harsh environment, the survivors of the immediate attacks face death-dealing conditions over the next several months.
The 1948 Convention on the Prevention and Punishment of the Crime of Genocide, developed in the wake of mass communal atrocities committed during World War II, has been signed and ratified by 135 countries. Sudan has not signed it but has signed the Rome Statute of the International Criminal Court, which defines the crime of genocide in exactly the same language as the convention. The Genocide Convention characterizes genocide as a crime that signatory nations must prevent and punish. If a signatory nation determines that a genocide is under way, that nation is obliged, either by itself or through a multilateral arrangement, to intervene in some way to prevent that genocide from taking place. In other words, when we attest that an assault on a given population is in fact genocide, the nations of the world must do something to stop it. Hence the significance of applying the designation of genocide during an actual ongoing situation: if the determination must wait many months until extensive evidence is compiled, the Genocide Convention is a sterile document that allows us to label certain kinds of mass death only after it is too late to stop them.
The definition of genocide has two aspects: intent and acts. We must determine whether the actions of the perpetrators are carried out with the aim or goal of effecting the destruction of a people, in whole or in part, on the basis of nationality, ethnic background, race, or religion. The Genocide Convention identifies specific acts as genocide, such as killing members of one of these groups or destroying their physical conditions and life supports, if it can be shown that these acts were carried out with genocidal intent. Not all mass killings are genocide, according to the terms of the convention, and not everyone in the targeted group nor every component of its conditions of life needs to be destroyed for the term "genocide" to apply.2
Beyond this level of detail, the convention does not address the steps required to apply the definition to an actual instance. It is often difficult, when one is assessing the actions of a state authority, to determine intent until the events in question are over and one gains access to deposed witnesses and government documents. Determining the effects while the destructive actions are going on may also be difficult, because the populations may be sequestered and general insecurity may impede the gathering of information. This gap between legal definition and operational guidance has been closed partially by judicial findings in the war-crimes trials after the mass killings in the former Yugoslavia and in Rwanda (in which the pattern of actions has been used to infer intent) and by discussion in the charter of the new International Criminal Court.
So human-rights investigators and analysts are left with this important problem — how to move from definition to application while the action is in progress. The Genocide Convention is silent on what information is relevant and on how to gather or interpret the kind of data that are actually available while a conflict or organized assault is taking place. In this vacuum, the human-rights community has resorted to collecting data that will inform the process of pattern recognition and inference based on particular patterns. When one sees sufficient evidence that many people from target groups are being attacked in a coherent and organized manner across a broad swath of territory in a systematic campaign, one can begin to establish patterns of impact. If these patterns match or resemble those implied by the legal terms of the convention, then one must look for intent. If the patterns are so widespread, organized, and sustained that they would be possible only with the deliberate actions or indirect concurrence of the state, then one may infer the intent.
These tasks — describing effects in order to arrive at patterns and interpreting these patterns to determine what factors may have given rise to them — are familiar to physicians and public health professionals. Using sampling methods to assemble social, economic, and demographic information that describes what is occurring in a given population over time is the function of descriptive epidemiology. Inferring causes from patterns relies in part on methods of qualitative and quantitative statistics and in part on contextual knowledge of particular causal pathways.
These methods are always more difficult to use when data are fragmentary, populations are moving, or conditions are insecure. With practice and hindsight, the humanitarian community has developed some very reliable and rapid public health–assessment tools that permit the derivation of good estimates of crude mortality and nutritional status and then, on the basis of accumulated knowledge of how populations fare in harsh environments and famine settings, allow the projection of death rates. There is not yet such practical certainty regarding methods and projections for the assessment of genocide, particularly when the process is ongoing. Yet the approach required is very similar. The data-related tasks are still acquisition, aggregation, and finally, interpretation — bringing in other information related to pace, scope, extent, and political context — to map out patterns of action from which to make inferences about intent.
The events in Darfur bring into sharp relief the lesson that the humanitarian enterprise can work only when political obstruction does not play upon severe constraints of distance and an absence of infrastructure. Darfur also raises the spectre of slow-motion genocide, malignantly engineered by a totalitarian state, crafted to appear to have arisen as the result of a failure of humanitarian assistance. What is at stake is hundreds of thousands of lives and the real possibility that, once again, we will fail to prevent genocide. These failures are not yet certain. The message of what is transpiring, properly grounded in data and analytic interpretation, may yet help to make the difference.
Source Information
From the Program on Humanitarian Crises and Human Rights, Harvard School of Public Health, Boston.
References
Physicians for Human Rights. PHR calls for intervention to save lives in Sudan: field team compiles indicators of genocide. (Accessed July 30,2004,athttp://www.phrusa.org/research/sudan/pdf/sudan_genocide_report.pdf.)
Convention on the Prevention and Punishment of the Crime of Genocide, 1948.(AccessedJuly30,2004,athttp://www.hrweb.org/legal/genocide.html.)(Jennifer Leaning, M.D., S)