citation

J. Stephen Morrison and Justin Kenny. "The New Barbarianism." CSIS Commission on Strengthening America's Health Security, Center for Strategic and International Studies, September 06, 2017. Accessed December 21, 2023. https://healthsecurity.csis.org/articles/the-new-barbarianism/

Healthcare and humanitarian workers are increasingly in the crosshairs as hospitals and aid centers have become part of the battlefield in today’s wars.

Photo Credit: GARY RAMAGE/POOL/AFP via Getty Images

CSIS

Healthcare and humanitarian workers are increasingly in the crosshairs as hospitals and aid centers have become part of the battlefield in today’s wars. So far, there has been little to stop the profound surge of violence seen across several open-ended conflicts which has claimed thousands of lives, destroyed health systems, triggered mass displacement and state collapse, and exposed the crisis facing the norms of international humanitarian law contained in the Geneva Conventions.

The New Barbarianism is a CSIS Global Health Policy Center original feature documentary (58 minutes) that examines the crisis, its causes, the limited international response and possible ways forward through dozens of interviews and original footage obtained from inside Syria, Yemen and Afghanistan. It builds on several years of prior GHPC work on the intersection of health and security, the role of militaries, and the human tragedies seen in Syria and Yemen.

Chapter 1 - Aleppo

The brief opening chapter of “The New Barbarianism” examines the April 27, 2016 attack on Al Quds hospital in Aleppo, Syria. The aerial bombardment killed 55 people including one of the city’s last remaining pediatricians - Dr. Muhammad Wassim Moaz.

Featuring Interviews With:

  • Dr. Rami Kalazi, Aleppo Neurosurgeon

Chapter 2 - The Syria Vortex

“The Syria Vortex” explores the unprecedented scope, scale and massive human crisis in Syria, the result of the deliberate military targeting of healthcare and humanitarian infrastructure, actively supported by Russia. There have been more than 450 attacks on medical facilities in-country and more than 800 healthcare workers killed. Nearly a quarter of them were shot and dozens more were tortured to death.

Although Syria represents an obscene “new low,” many experts argue that what we have witnessed in Syria is emblematic of a broader, dangerous new phenomenon — a surge of sustained violent attacks across multiple conflicts by states and non-states alike.

Featuring Interviews With:

  • Sen. John McCain, Chairman, Senate Armed Services Committee (R-AZ)
  • J. Stephen Morrison, Senior Vice President & Director, Global Health Policy Center, CSIS
  • David Miliband, President and CEO, International Rescue Committee (IRC), Former British Foreign Secretary
  • Susannah Sirkin, Director of International Policy, Physicians for Human Rights (PHR)
  • David Harden, Former Assistant Administrator, Bureau of Democracy, Conflict and Humanitarian Assistance, USAID
  • Dr. Rami Kalazi, Aleppo Neurosurgeon
  • Nancy Lindborg, President, United States Institute of Peace (USIP)
  • Jason Cone, U.S. Executive Director, Doctors Without Borders
  • Rabih Torbay, President, Project Hope
  • Robert Mardini, Regional Director, Near and Middle East, International Committee of the Red Cross (ICRC)
  • Ken Isaacs, Vice President, Programs and Government Relations, Samaritan’s Purse

Chapter 3 - Geneva Under Siege

Out of the ashes of World War II, the Geneva Conventions were updated in 1949 to include specific provisions to protect medical staff, humanitarian workers, civilians and even enemy combatants. Those and subsequent updates to the international agreements should be offering protection to vulnerable parties in today’s armed conflicts but are not.

“Geneva Under Siege” examines the roots of today’s crisis — both changes in warfare stretching back 30 years plus major changes post-9/11 in technology, documentation, the emergence of Al Qaeda, ISIS, and powerful non-state actors, counter-terrorism campaigns that rely heavily on aerial bombardment, and egregious violations by major powers with utter impunity. In aggregate, these shifts have shredded international humanitarian law and thrust the Geneva Conventions into a conspicuous crisis.

Featuring Interviews With:

  • J. Stephen Morrison, Senior Vice President & Director, Global Health Policy Center, CSIS
  • Leonard S. Rubenstein, Johns Hopkins University, Bloomberg School of Public Health
  • David Miliband, President and CEO, International Rescue Committee (IRC), Former British Foreign Secretary
  • Dr. Joanne Liu, International President, Doctors Without Borders

Chapter 4 – Yemen’s Cage

Despite large-scale destruction and ever-worsening humanitarian and healthcare crises, the war in Yemen has been largely invisible to the outside world. In the past two years of dramatically intensified war, there has been a Saudi-led aerial campaign against Houthi rebels and blockades of Yemen’s ports, impeding food, medicines and fuel. All parties to the conflict have violently disrupted health and emergency assistance. An already weak health system has been severely damaged, along with water and sanitation systems. Salaries have ceased as the state has imploded. What results from this combination of forces is an utterly massive human crisis: over half of the population with no access to health services, acute malnutrition, a rising famine, and an epoch outbreak of cholera.

“Yemen’s Cage” takes an on-the-ground look at the struggles of those inside the war-ravaged country, including Mohammed Abdulla Ghalib Ali, a wheelchair-bound child who barely survived an airstrike, and Giorgio Trombatore of the International Medical Corps (IMC) as he and his staff navigate the deadly realities of Yemen’s war, including staff abductions, facility attacks and heavy restrictions on the distribution of aid. It explores evolving policy debates over U.S. security cooperation with the Saudi government.

Featuring Interviews With:

  • Mohammed Abdulla Ghalib Ali, Hospitalized Child
  • Anthony Cordesman, Arleigh A. Burke Chair in Strategy, CSIS
  • Rabih Torbay, President, Project Hope
  • Giorigio Trombatore, Yemen Country Director, International Medical Corps 2015-2017
  • Sarah Margon, Washington Director, Human Rights Watch

Chapter 5 – The Kunduz Tragedy

In the early hours of October 3rd, 2015, Doctors Without Borders surgeon Dr. Esmatullah Esmat was awakened by explosions and smoke as his hospital came under attack by an American AC-130 gunship in Kunduz, Afghanistan. The incident, which the Pentagon said was the result of a series of breakdowns including communication/coordination errors and equipment malfunction, resulted in the deaths of more than 40 people including 14 Doctors Without Borders staff members.

“The Kunduz Tragedy” explores the attack and its consequences, the subsequent investigation and disciplining of personnel by the Pentagon, and efforts to improve the U.S. military’s communications and coordination with on-the-ground NGOs.

Featuring Interviews With:

  • Dr. Esmatullah Esmat, Surgeon, Doctors Without Borders
  • Dr. Joanne Liu, International President, Doctors Without Borders
  • Jason Cone, U.S. Executive Director, Doctors Without Borders
  • Theresa Whalen, Principal Deputy Assistant Secretary of Defense for Homeland Defense and Global Security, U.S. Department of Defense
  • Rabih Torbay, President, Project Hope

Chapter 6 – What Can Be Done?

There is mounting exasperation that there is little to stop the increasing threats to healthcare and humanitarian workers, apart from individual states and insurgent movements choosing to do the right thing. “What Can Be Done?” explores recent attempts by NGO’s to press the international community to action (UN Security Resolution 2286) and their limited impact despite exhaustive efforts.

Many, however, believe that the fight must continue with a realistic and sustained high-level effort to stop the slide against hard-won gains in humanitarian law after World War II, while revalidating and updating the Geneva Conventions to align with the new realities of warfare today.

Editing and graphics by Paul Franz at the Center for Strategic and International Studies.

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