Around the world, people are getting sicker, and more and more are dying from entirely preventable causes. We have the answers to why, we just don’t have the will to stop it. In the second of a two part series, Dr Lissa Johnson looks at the role of health professionals in mounting the case against war.
In the first of this two-part series I recounted the conclusion of the world’s leading health policy-setting body, the World Health Assembly (WHA), that “the role of physicians and other health professionals in the preservation and promotion of peace is the most significant factor [italics mine]for the attainment of health for all.” I expanded upon this conclusion by way of reference to a recent Lancet article by Professor of Global Public Health David McCoy.
In his article, Professor McCoy has elucidated the ways in which war decimates human health around the globe. McCoy writes, “apart from their direct physical and psychological effects, wars and conflict damage health-care, food, water, and sanitation systems; pollute and degrade the environment; and undermine development.” He adds that “the 59.9 million people who are presently… displaced [and forced into health emergency]because of conflict and violence is the highest number since the end of World War 2.”
This, says the WHA and The Lancet, is a matter for the health community.
I concluded Part 1 by asking, “but what is a health professional to do?” Even if we dispatch ourselves to the front lines, blockades in Yemen prevent assistance from reaching the Yemeni people. In Syria jihadi fighters and airstrikes put health workers at risk. The Lancet may conclude that “the medical community needs to build a new health movement around peace and the prevention of war,” but how?
I noted that it is this question to which the majority of Professor McCoy’s Lancet paper devotes itself. In his article, McCoy advances several specific recommendations for health professionals as to how best to build a health movement around peace.
Recommendation #1: demand democratic controls over the military-industrial complex
McCoy writes, “away from the front line, a health agenda for peace would include demands for effective and democratic controls over the military industrial complex”. He notes that “arms companies spend millions of dollars every year buying political influence”. This, he says, is a health professional’s business.
While human health pays a high price for war, as outlined in Part 1 of this series, the arms industry is raking it in. At the time of his Lancet article (2015) McCoy reported that “the volume of international transfers of major weapons is estimated to have grown between 2005–09 and 2010–14”.
The following year, in 2016, the US election cycle saw one of the highest levels of political donations from arms companies to date, reaching almost $30 million. In a speedy return on investment, the 2016 election also saw an $80bn increase in US military spending, over and above the existing $606bn budget. By way of comparison, Russia spends just $46bn a year on its military. The 2016 US increase was passed in a matter of hours, with no public debate.
Rather than viewing US politics as a cautionary tale, Australia appears to be following suit. Prime Minister Malcolm Turnbull has announced the Australian Government’s aspirations to develop a military-industrial complex of its own, starting with a $200bn injection of military spending.
As part of these ambitions Australia is aiming to become a top 10 arms exporter, on the back of wars such as the war in Yemen, where starvation and disease are used as weapons of war. Saudi Arabia, as it bombs and starves millions of human beings, is one of Australia’s preferred clients.
According to the Lancet paper, all of these developments are the business of the health community. The ‘externalities’ of business-as-usual for the military industrial complex (the price paid by others) is the decimation of global human health.
But what does The Lancet expect us health professionals to do? What do we know about demanding democratic controls over the military industrial complex? We’re health professionals. Even our professional bodies aren’t holding the military industrial complex to account.
Perhaps not, but other examples exist. The Medical Association for the Prevention of War (MAPW), for instance, is one. The MAPW is the Australian affiliate of the International Physicians for the Prevention of Nuclear War (IPPNW). MAPW has recently posted a petition on its website in response to Turnbull’s military-industrial aspirations, urging the Australian Government to stop pushing Australian arms sales.
Recommendation #2: end private profiteering from violence and conflict
McCoy also advises that health professionals demand “an end to egregious cases of private profiteering from violence and conflict”. The latest US-led airstrikes on Syria, for instance, caused defence stocks such as Raytheon, Northrup Grumman and Boeing to soar. Last year, missile providers Lockheed Martin and Raytheon also enjoyed a stock market boost when Donald Trump threatened North Korea with fire and fury.
Arms companies, moreover, are not the only financial beneficiaries of War. David Whyte, professor of socio-legal studies at the University of Liverpool has published a paper titled The Crimes of Neoliberal Rule in Occupied Iraq. Professor Whyte writes, “The scale and intensity of the appropriation of Iraqi oil revenue makes the 2003 invasion one of the most audacious and spectacular crimes of theft in modern history… At least $12 billion of the revenue appropriated by the coalition regime has not been adequately accounted for.”
Whyte adds that the Iraq war should not be taken in isolation but “understood as part of a wider strategy of political and economic domination”.
More recently, last month, while a child died every 10 minutes from preventable diseases in Yemen, in Washington US president Donald Trump held a press conference with the Saudi crown prince. Trump “prais[ed]the absolute monarchy as a very great friend” while spruiking itemized arms sales to Saudi Arabia – a $13bn THAAD system here and a $3.8bn C-130 Hercules there – amounting to $110bn in the short term and $350bn over the next 10 years. Journalist Ben Norton observed that Trump had “removed the mask on US foreign policy and dispelled any illusions that it is based on human rights rather than economic interests.”
In Australia, Defence Minister Marise Payne has recently cited arms manufacturers’ rights to “market opportunity”, “buyers’ confidence” and “commercial confidentiality” as her government’s chief concerns in its arms sales to Saudi Arabia. Saudi Arabia bombing the hospitals of millions of critically ill people was of secondary, if any, concern. This, says The Lancet and the WHA, is a matter for the health community.
In February this year Dr Sue Wareham, President of MAPW, called for “Australia to rethink the policy of building an economy on war profiteering and having a vested interest in wars and instability.” Dr Wareham is an Australian GP and founder of the Nobel Peace Prize winning International Campaign to Abolish Nuclear Weapons (ICAN).
Dr Wareham made her speech at the acceptance of a Rotary peace prize in Canberra, during the unveiling of Canberra’s first peace bell, an initiative of Rotary and the World Peace Bell Association.
Coverage of this important moment was virtually absent in Australia’s mainstream media. The few committed health professionals such as Dr Wareham, who have been doing the peace work for the rest of us for decades, need the broader mainstream health community to stand with them.
Recommendations #3-6: denuclearlisation, diplomacy, social and environmental security, and accountable government.
Other interventions that McCoy advises health professionals to undertake include offering “support for the… initiative to make nuclear weapons illegal.” A number of international health bodies, for instance, issued a joint statement last year supporting the UN Treaty on the Prohibition of Nuclear Weapons, including the World Medical Association (WMA), the World Federation of Public Health Associations, IPPNW, and the International Council of Nurses.
Locally, after the treaty had been signed by 122 nations, the Australian Medical Association (AMA) also posted a statement in support of other organisations’ support for the treaty. The elephant in the room facing Australian health professions, however, is that the Australian Government boycotted the landmark UN treaty. The AMA stopped short of mentioning this in its post on the subject, instead relaying a nonspecific call by the WMA for more nations to add their signatures.
The MAPW, in contrast, posted an article on its website noting that the Australian Government’s boycott of the UN treaty places Australia on the wrong side of history, and in a “dark moral abyss”.
The treaty was the initiative of ICAN, an international organization that was initially founded in Melbourne by Dr Wareham and others in 2006. In 2017 ICAN won the Nobel Peace Prize for its work achieving the UN nuclear weapons treaty. Tellingly, Prime Minister Malcolm Turnbull has refused to congratulate ICAN on its Nobel peace prize. Peace, clearly, is not an Australian Government priority.
Given this reality, a health agenda for peace requires breaking ranks with the Government over nuclear weapons and other war-related issues. International and peace-oriented health bodies need local mainstream health professionals to stand with them in this regard.
McCoy further argues that “the health community should also examine and challenge approaches to defence and national security that do not emphasise diplomacy, tolerance, or the preconditions for peace.” Opposing the Turnbull Government’s support for war rather than diplomacy with North Korea, as the MAPW has done, would be an example.
McCoy adds that health professionals should “promote a conception of human security that highlights health, social security and environmental protection.” Turnbull’s recent announcement of a historic arms deal, in which he hitched Australia’s economic security to its military security, while ignoring social, health and environmental security, is a case in point. This, according to The Lancet and the WHA, is a matter of concern for health professionals.
Additionally, health professionals should work to promote “accountable government.” Accountable government? Is The Lancet serious? How?
Does The Lancet mean professional associations issuing strong statements and taking strong stands against our government’s human rights abuses and violations of international treaties and laws? Like the Australian AMA’s stand against the Government’s detention of 600 asylum seekers on Manus Island? The one in which the AMA said, “It is our responsibility as a nation with a strong human rights record to ensure that we look after the health and wellbeing of these men”?
Yes, like that. The AMA is to be applauded for holding the Government accountable for the health and welfare of the men on Manus Island. The Lancet and the WHA, however, are here to remind us that the men on Manus are the tip of a very large iceberg. They are just 600 of the 65.6 million people displaced by war and persecution around the world, over half of whom are children.
Those 65.6 million people may not be knocking on our door, but they are, like the men on Manus, innocent victims of our governments’ policies. Tens upon tens of millions of people are living the human reality of wars fought in our name. Their own hospitals and institutions have been destroyed. Their own health professionals cannot speak out on their behalf.
While 8.4 million Yemeni people face starvation and health emergency at the hands of Saudi Arabia and the US, UK and Australia, the Australian Medical, Psychological and Psychiatric Associations are silent on our government’s complicity in Yemen, as far as I am aware. The same is true of the American Medical, Psychological and Psychiatric Associations, even as the US secures a $110bn arms deal, worth $350bn over 10 years, and the promise of $750m worth of military training to Saudi Arabia.
But war is tricky. What do health professionals know about the geopolitics of war, let alone the legalities of international conflicts? Dr Sue Wareham has been doing this since the 1980s, but who are the rest of us, with our medical and psychological degrees, to say which wars are justifiable and which are not?
War as corporate crime
In the case of the war on Yemen, unlike the mainstream health community the legal community has weighed in on the issue of government complicity. In May 2017 The American Bar Association Center for Human Rights issued a detailed opinion to the US Senate advising that assisting the Saudi-led coalition in Yemen is a likely violation not only of international law but also US law.
The opinion was submitted in support of a bill to block a $500m weapons sale to Saudi Arabia in 2017. The bill was defeated by 53 votes to 47. Medea Benjamin of Code Pink observed at the time that, “many of the senators, Democrats and Republicans alike [who opposed the bill], have taken tens of thousands of dollars in campaign contributions from the same corporations benefitting from the [weapons]sales.”
In another effort to hold the US Government to account, in February this year Bernie Sanders led a Senate resolution seeking to withdraw US support for the war on Yemen, based in part on legal grounds. The resolution again failed to pass, gaining 44 of the 51 votes required. Whether the Sanders initiative would have had more success with the weight of the health professions behind it we will never know.
Lawyers are also speaking up over the war in Syria. A group of international lawyers and law professors recently issued a statement affirming that any airstrikes on Syria not taken in self defence, and without UN Security Council authorisation, such as the strikes on April 14th, would be illegal. The April 14th airstrikes were also undertaken without congressional approval, as required by US law.
UN legal expert and Professor of international law at the Geneva School of Diplomacy, Alfred de Zayas, has confirmed that not only were the April 14th airstrikes illegal, but the US presence in Syria, and its support for the Syrian rebels, is also illegal.
More broadly, the legal and criminological professions are logical allies for the health professions in challenging war. In the last decade and a half, the field of criminology has turned its attention to war, which criminologists have conceptualized as a form of white collar crime.
In the literature on the criminology of war, contemporary wars are deemed “elite criminal military action”, and studied as an example of the “crimes of the powerful”. War is typically described as state-corporate crime, or, by some scholars, flat-out corporate crime. For market patriots such as many of our leaders, war is the perfect crime.
In a paper titled Privatizing International Conflict: War as Corporate Crime, Professor Vincenzo Ruggiero writes that rather than being waged on human rights or security grounds as we are led to believe, in contemporary wars, “failure to bow to the exploitation of resources may result in the overthrow of heads of states, or to open aggression, leading to the granting of access to resources and a plethora of related business and predatory opportunities.” This process has also been dubbed “military neoliberalism”.
Many nations that have found themselves in US crosshairs, for example, including Syria, Iraq, Libya, Russia, Iran, China and Venezuela, have failed to bow to the petrodollar. In other words, they have traded, or sought to trade, oil in a currency other than US dollars.
As author Nicholas J.S. Davies observes, if the US really cared about how any of these governments, or any governments, treat their ‘own people’, the US would not have backed fascists, drug lords, dictatorships and terrorists in 35 countries. And it certainly would not be arming and training Saudi Arabia now. It also would not have killed 20 million people itself since World War II.
Criminologists point out that the modus operandi for contemporary profit-seeking wars of aggression is illegal not only based on international and domestic law, but as Ruggiero writes, due to “the criminality of the private enterprises these states involve in their military venture[s]” and the “illegally generated profits” that result.
In a book chapter titled Corporate War Crimes, Ruggiero adds that drone warfare has introduced a further criminal element to war via its “manhunt doctrine [in which]war can be likened to a shooting party, with a hunter who tries to kill and a prey who attempts to flee… Sovereign borders are deemed the greatest allies of the fugitives, and the hunters are ‘forced’ to… ignore the territorial integrity of states… turning the whole world into a battlefield…These targeted assassinations require the reinterpretation of international law with the aim of authorizing arbitrary extrajudicial executions.”
Ruggiero continues, “[Such] random invasions set precedents… Once the rules of jus ad bellum [’just’ war] are shattered, it becomes easy to invoke an emergency without a foreseeable end,” thereby justifying endless extrajudicial war.
He adds that “successful elite promotion of war in the public mind is indirectly criminogenic, or at least crime-enabling”. He calls this “a macrosocial analogue of interpersonal crime neutralisation.”
We psychologists should be the first to spot elite promotion of war in the public mind. Since well before the 2016 election, for instance, the Russia narrative, like the ‘war on terror’ narrative, has been an obvious case of war propaganda. In its content and execution it has displayed all the hallmarks of what psychologists call “mobilising hate” and “mobilising a population for war.”
Whether that war entails an information war, cyber-war, war on dissent or a war against countries other than Russia, such as Syria or Iran, the objective is to create a public mood in which wars and their attendant crimes will be tolerated, if not embraced.
In their dealings with individuals, psychologists are expected to report crimes of certain magnitudes, and to warn potential victims of reasonably foreseeable violent acts. Given the scholarly literature on the criminality of contemporary war, the endless elite promotion of war in the public mind, and the advice of The Lancet and the WHA, Ruggerio’s macrosocial analogue might be taken one step further. Health professionals’ silence over war could be conceptualised as a failure in their duty to warn.
Militarism, authoritarianism and turning up the heat
As if we health professionals need any other reasons to heed The Lancet and the WHA’s advice, McCoy reminds us that “militarism is positively correlated with authoritarianism, and negatively correlated with respect for human rights [and]tolerance of dissent”.
In Australia, as we ramp up our military, a number of bills are before parliament seeking to criminalise political organising and advocacy; the ‘foreign interference’ legislation. These bills include penalties of life imprisonment for “activity regarded as a threat to the existing political and economic order” and 20 years’ jail for “divulging or circulating any information deemed ‘harmful’ to Australian security or economic interests”.
With such broad language, virtually any criticism of government risks being caught under the act. Should the bills pass, charities could be prohibited from mentioning election issues such as climate change. Julian Assange, it seems, is not the only Australian citizen in danger of being silenced.
As this is taking place, former Greens senator Scott Ludlam warns in The Guardian that “our authoritarian government has turned up the heat.” The World Socialist Website writes, “These extraordinary, chilling measures are bound up with Australia’s ever-closer integration into the US military preparations for war in the Indo-Pacific against China.”
The site adds, “The laws… go well beyond measures in force in other so-called democracies. However, the US, British and European media have already shown interest in the Australian legislation, suggesting it could set a new international benchmark for the demolition of basic democratic rights.”
If health professionals continue to remain silent, what is next? In the United States, Donald Trump has recently appointed John Bolton as National Security Advisor. “John Bolton is one of the most dangerous Americans” according to Colonel Larry Wilkerson, Distinguished Adjunct Professor of Government and Public Policy, formerly with the US State Department and assistant to the Chairman of the Joint Chiefs of Staff .
Bolton is not only dangerous, says Wilkerson, but one of the most dangerous people “that I’ve ever met in all my years, 40, 50 years of service… War with North Korea. War with Iran. War eventually with Russia and China. This is John. This is John Bolton.”
Bolton was beside Trump at the meeting of US generals on Monday April 9th during which Trump warned of military action against Syria, which he took five days later. Trump turned to Bolton during the meeting and said, “you’re going to find it very exciting.”
As Bolton steps into power, war propaganda around the Western world is stepping up. Veteran journalist John Pilger said recently of the Skripal poisoning, “this is a carefully constructed drama, as part of the propaganda campaign that has been building now for several years, in order to justify the actions of NATO, Britain and the United States towards Russia… This is unprecedented since the second World War. Most people in Britain… [and]the United States don’t understand these dangers.”
Pilger is right that the Skripal narrative bears all the fingerprints of propaganda, and clumsy propaganda at that. As former Ambassador Craig Murray explains, the official story makes no sense. It makes the Iraqi WMD deception look convincing. It makes Bigfoot look convincing.
Narratives regarding the Assad Government using chemical weapons are equally unsustainable in light of evidence. Claims that the Assad Government used chemical weapons in 2013, crossing the “red line” that paved the way for direct US involvement, have long since proved unsubstantiated, at best.
The airstrikes on Khan Shaykhun on April 7th 2017 were again based on unverified claims of a chemical weapons attack. Those 2017 US airstrikes were launched before an investigation could take place, based purely on social media imagery. In retrospect, according to both the UN and US Secretary of Defense James Mattis, there was never any evidence that the Syrian Government launched a chemical weapons attack in Khan Shaykhun.
The latest US-led strikes on Syria were similarly based on social media imagery. This time, social media claimed to depict a Syrian Government chemical weapons attack in Douma, Eastern Ghouta. The retaliatory US-led airstrikes were launched on the morning of the day UN investigations into the claims were due to take place.
The social media claims of gas attacks in Douma emanated largely from two sources. One is a group called the ‘Syrian American Medical Society’ (SAMS), which, writes award winning journalist Max Blumenthal, possesses ties to Al Qaeda and is funded by the US State Department. The other is the White Helmets, described by Blumenthal as an ‘influence operation’ established by a former MI5 officer.
The White Helmets, explains Dr Tim Anderson, has received over $100m in funding from US, UK and Qatari Governments and, like SAMS, possesses ties to jihadist groups. The White Helmets’ operations in Syria have been documented in detail by Vanessa Beeley of 21st Century Wire.
Unlike SAMS and the White Helmets, local Syrian doctors and medical professionals at the scene of the alleged Douma gas attack say that they were treating victims of smoke and dust inhalation, not chemical weapons.
As the situation continues to unfold, for credible information on Syria and the PR campaign surrounding the Syrian war see Dr Tim Anderson, Professor Tim Hayward, Professor Piers Robinson, Professor Theodore Postol, Gareth Porter, Seymour Hersh, Vanessa Beeley, Eva Bartlett, Max Blumenthal, Ben Norton, Rania Khalek and publications such as Consortium News and 21st Century Wire.
Demonising the Assad Government irrespective of evidence not only perpetuates the war in Syria but helps to demonise Russia, and vice versa. In an interview on BBC radio, former British Ambassador to Syria Peter Ford said of the Western response to the Douma incident that he “greatly fear[s]that it will lead us to the edge of Armageddon…. as a result of hysteria and distortion.”
Even before the latest chemical weapons crisis, eminent Scholars of Russian studies agreed with John Pilger and Peter Ford that current US-Russia relations are dangerous. Richard Sakwa, Professor of Russian and European Politics at the University of Kent, says that the situation “couldn’t be more dangerous… we’re in a new nuclear age in which there is for the first time since… the Cuban Missile Crisis of 1962… no serious substantive nuclear arms talks.”
Stephen F. Cohen, professor emeritus of Russian studies at New York University and Princeton adds, “One reason this situation is so dangerous… is that in the ’70s and ’80s… the anti-Cold War people had lots of very senior allies, many in Congress… There is no one today… [Russiagate] is warmongering. That’s exactly what it is… And we’re talking about nuclear war potentially. So… we have descended into a morass of degraded commentary on Russia… even during the worst days of the Cold War, we didn’t have this kind of discourse.”
With God-Knows-What-He’ll-Do-Next Trump and The-Most-Dangerous-American Bolton in the White House, Pilger, Ford, Sakwa and Cohen may be right. If John Bolton has his way, the era of illegal and extrajudicial airstrikes, drone warfare, siege warfare, depleted uranium, proxy-wars and cluster bombs in other people’s countries may look like peace-time.
It is difficult to tell from afar whether those in power are genuinely insane enough to contemplate great power conflict. They may well be. Even if not, they do appear inept enough to cause such a conflict by accident.
What is undeniably insane is to wait and see. Professor McCoy’s call to resurrect “health professionals as effective advocates for the prevention of war” was never more timely.