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Afghanistan: the human cost of war

25-09-2009 Interview

Patrick Hamilton, who has just finished a stint as deputy head of the ICRC’s delegation in Afghanistan, leaves the country as the conflict is spreading and intensifying. He talks about how the ICRC has been able to expand its operations over the past few years thanks to its principles of neutrality and independence.

 

  ©ICRC    
 
  Patrick Hamilton, outgoing deputy head of the ICRC's delegation in Kabul    
   

 What is the state of the conflict today and how have you seen it change in recent years?  

    

When I first arrived in Afghanistan at the end of 2001, most areas were peaceful. Foreign humanitarian workers could go almost anywhere. When the massive international military operation started in late 2001, Afghanistan entered another dark chapter of its history. Early in 2003, Afghanistan became significantly more dangerous for humanitarian personnel, a development that culminated in the murder of an ICRC delegate. That marked the end of humanitarian access as we knew it, and the beginning of a full-fledged insurgency. The conflict has intensified ever since. Today, the area affected by the conflict continues to grow and the fighting is becoming more intense.

 What effect is the conflict having on civilians?  

    

The civilian population is trapped between the armed opposition on the one hand and the international and Afghan forces on the other.

The conflict is being fought out right in among the civilian population, so obviously they’re suffering the direct consequences, like crossfire, airstrikes, suicide bombings and improvised explosive devices.

But then there are the indirect consequences. The fight ing is depriving civilians of basic services such as health, because medics can’t get into remote areas and people can’t get to the towns where the medics are. Pregnant women often spend days trying to get to a hospital because there are no health facilities nearby. Many are still travelling when labour starts and a number have died, along with their unborn children, because they couldn’t reach help in time.

The human cost of the war has steadily increased over the past few years and has reached appalling levels. This must be reversed now!

   
   
 
 
  • The armed conflict has affected virtually everyone in Afghanistan – either directly or indirectly.

  • Many of those affected by the conflict have had to leave their homes, suffered serious damage to their property, have limited access to basic necessities, have lost contact with relatives or have lost their livelihoods.

From a 2009 survey. See the full survey for details.    
       

 You say that the way this war is being fought has a detrimental impact on civilians. What is the ICRC doing with regard to the conduct of hostilities?  

    

Over the last three year s, we initiated or resumed substantive discussions with the foreign countries that have armed forces in Afghanistan, with NATO, with the Afghan security forces and with the armed opposition. The aim is to get all of them to accept the ICRC’s mission, to give us access to those suffering the consequences of the conflict and to discuss ways of modifying the conduct of hostilities, which would reduce the impact of the war on non-combatants.

What we’re now hearing from the leadership of all parties with unprecedented clarity is that they do intend to try and protect civilians from the effects of the conflict. This intent is reflected in, for instance, NATO’s tactical directives and recent statements by the Taliban leadership.

However, fighting continues to kill civilians. Translating intent into better protection is still a major challenge. That will remain so as long as the conflict continues to intensify.

 You say there is now an intent to reduce the effects on civilians. What has brought about this change in attitude?  

    

There have been several factors. The first is the fact that the conflict has been going on for so long, and is now intensifying. The large number of incidents with a severe effect on the civilian population affects the political stakeholders, the combatants, and anyone who reads the news. There is a growing awareness of the need to comply more closely with legal and moral obligations.

But there is also enlightened self-interest. Both sides want to win over the civilian population, and they recognize that civilian casualties can only alienate the people of Afghanistan and generate more resentment and hatred toward those responsible.

Finally, the ICRC’s quiet dialogue with both s ides has made them more aware of the consequences of their actions. This is a case of the ICRC fulfilling its mandate to be both the custodian of international humanitarian law and a voice of the victims of conflict.

 It is difficult for most Afghans to get health care. What about the victims of conflict?  

    

Health care in Afghanistan is minimal at the best of times. The ICRC is particularly concerned about the numerous attacks on health personnel, health facilities, the sick and the wounded. These attacks contravene international humanitarian law and are preventing health personnel from working in the areas where they are most needed.

According to a recent survey conducted by Ipsos for the ICRC, over half the population of Afghanistan has little or no access to health care.

To make matters worse, people in remote areas are so afraid of capture by one side or the other that they often don’t even try to get to medical facilities in towns.

The ICRC will keep plugging the point that protecting health services and those who need them is not just a matter of respecting the law; it’s in everybody’s interests.

 What specific operational challenges does the ICRC face in an environment as complex and dangerous as Afghanistan?  

    

The most obvious challenge is that of obtaining safe access to people and places. The complex nature of the conflict means we need to talk to all sides, at all levels, to make s ure they understand, accept and respect the ICRC’s presence and mandate, and allow us to get on with our job.

Our efforts to re-establish dialogue with all parties over the last three years have restored respect and understanding, at least at leadership level. As a result, we are expanding our geographical coverage into areas that we had been unable to enter for some time, and that is encouraging. However, we still have to move very cautiously. It’s all but impossible to obtain watertight security guarantees, if only because of the thousands of improvised explosive devices and the crime rate.

So although respect for the ICRC has returned in many areas, allowing us to do more, Afghanistan is still a very dangerous environment in which to operate, with many no-go areas.

 How does the ICRC manage to maintain contact with the armed opposition?  

    

The armed opposition and the ICRC started seeking dialogue quite early on, and adding expatriate Pashto speakers to our in-country team certainly made a difference. Regular contact with families who came to see us about relatives in US or Afghan custody helped to build up trust, as people realized we were prepared to listen, to take their problems seriously and then respond, with no ulterior motive. That was crucial.

Dialogue with the armed opposition started with concrete humanitarian issues, such as people injured in the fighting and what we could do to help them. We then moved on to the question of returning the bodies of both fighters and civilians to their families for a dignified burial.

From there, we were able to bring up other topics, such as the conduct of hostilities and access to people and areas. We were also able to talk about facilitating o ther humanitarian programmes, such as a polio vaccination campaign.

Gradually, we convinced all parties that we were doing what we had been doing for the past 30 years, which is to help people affected by war, treating everyone as required by international humanitarian law, regardless of political background. All sides have seen us doing that. They have also seen us staying true to our mandate and to our principles of neutrality and independence. As a result, they have become increasingly willing to let us do our work.

 How would you sum up the position of the ICRC in Afghanistan?  

    

From an ICRC perspective, two things have happened over the last year: the bad news is that the conflict has spread and that the potential for human suffering has increased accordingly; the good news is that all sides are now engaging with the ICRC more concretely on humanitarian issues. That engagement needs to go a lot further, but it is a patch of light in the midst of the darkness.