Afghanistan: Humanitarianism Under Attack

By Pierre Salignon, Executive Director, Médecins Sans Frontières, and
Marie-Madeleine Leplomb, Program Manager for Afghanistan.

Introduction by Médecins Sans Frontières Australia
Philippe Couturier, Executive Director, and
James Nichols, Head of Communications

Médecins Sans Frontières started working in Afghanistan just a few months after the Soviet invasion in 1980 and since then, hundreds of volunteers including more than 65 Australian and New Zealand doctors, nurses and support staff, have devoted more than 100 missions to helping the people of Afghanistan. Throughout the past 24 years it has been the right of victims to be treated that has guided our operations in Afghanistan as it has in all the countries where we intervene.

The decision to withdraw all our international personnel and cease all humanitarian and medical activities in Afghanistan on 28 July 2004, is a direct consequence of the continuing deterioration of security conditions. The primary cause of this deterioration lies in the blurring of military and humanitarian lines by coalition forces that no longer respect humanitarian principles, and the fact that some extremist groups now clearly consider NGOs as legitimate targets.

Pierre Salignon, Executive Director of Médecins Sans Frontières France, and Marie-Madeleine Lemplomb, Programme Manager of Afghanistan for Médecins Sans Frontières France, deliver to us the truth behind the killing of five Médecins Sans Frontières volunteers in Afghanistan in June this year. They also competently explain the dilemma that humanitarian organisations like Médecins Sans Frontières face in war zones when the fundamental humanitarian principles are no longer respected by all the parties in a conflict.

Since September 11 and the beginning of the so-called ‘just wars’, the increasing difficulty in guaranteeing our neutral, independent and impartial humanitarian assistance to populations in danger, has become evermore challenging. This scenario is particularly highlighted in countries such as Afghanistan, Iraq or regions like the northern Caucuses, where for the moment we have reached a critical situation where our operational capacity is practically diminished. The direct consequence of this limitation is the lack of humanitarian and medical assistance to the victims of these conflicts. For a greater explanation of the problems that we face in this changing world Médecins Sans Frontières has published ‘In The Shadow of Just Wars – Violence, Politics and Humanitarian Action’, which is available from the Sydney office.

Further to the point it is crucial that we make the distinction that Médecins Sans Frontières is not a human rights organisation. This means that we strive to protect, care and treat in all countries where victims of conflict or natural disasters can not gain access to medical treatment or care. We do not serve to protect the rights of individuals however we serve to provide medical treatment and humanitarian assistance where the victims need it the most.

Our humanitarian objective is driven by the medical imperative to save lives regardless of race, religion, gender or political affiliation. Essentially, our objective as a humanitarian organisation is to make things better, not ‘right’ – unlike human rights agencies or organisations justice is not our primary objective.

Afghanistan: Humanitarianism Under Attack

On June 2, five volunteers from Médecins Sans Frontières were assassinated on a road between Khairkhana and Qala-I-Naw in the Badghis province of northwestern Afghanistan. One month after this horrific murder, we are trying to make sense of the attack. The analysis is far from simple, but it is critical that we understand what happened if we are to envisage pursuing our activities in the country…

Our team was the victim of a targeted and planned attack. Our colleagues were shot several times. Bullet holes studded the front and back bumpers and the front passenger-seat window of their car, and shrapnel was embedded in one of the sides, suggesting that a grenade had exploded. The victims had been working for the Dutch division of Médecins Sans Frontières in this rural region setting up, among others, a tuberculosis program. They were Hélène de Beir (Belgian, program coordinator), Fasil Ahmad (Afghan, translator), Besmillah (Afghan, driver), Egil Tynaes (Norwegian, doctor), and Willem Kwint (Dutch, logistician).

Whereas official investigations are still underway in the Badghis region, Taliban spokesman Mullah Abdul Hakim Latifi has claimed responsibility for the murder on two occasions. The first was on the BBC immediately following the assassination. The second was a few days later, on June 11, after 11 Chinese citizens who were working on a building site were killed in the northeast region of Kunduz region. In an AFP report, he stated, “At the slightest incident, the government and the Northern Alliance (the former anti-Taliban coalition that controls the current government) accuse us. When we act, we always assume responsibility. In this particular case, we are not responsible (…). Chinese reconstruction companies can continue to work in Afghanistan, as can all organisations who do not work for the United States.” He added, “The UNAMA (United Nations Assistance Mission in Afghanistan) works directly under American orders and pursues the same goals as the United States (…). Other organisations like Médecins Sans Frontières also work for American interests, and are targets for us,” he concluded. 

These statements that deliberately associate our volunteers with American soldiers are both ridiculous and dishonourable for our organisation that has been working alongside the Afghani people for more than 20 years. But the worst part is that in the current context, they are a call to arms. This is the first time we are aware of that such a call to arms has been launched in Afghanistan against Médecins Sans Frontières. The fact that it didn’t receive much attention from the Afghani, regional or international press doesn’t matter. The Taliban spokesman is targeting our organisation and is calling for action against our representatives. This call to arms must be taken seriously.

Such threats against NGOs are nothing new. Since the fall of the Taliban regime and the military intervention of the American-led coalition, the confusion between military and humanitarian organisation is total. NGOs have been seen by many Afghans as serving the goals of the “occupation” regime run by the Americans and their allies, including the United Nations. They have been accused of espionage and corruption, and of not doing their work. This feeling has been strengthened by the attitude of the American army and some humanitarians who are closely linked to the coalition forces through their financing and the way they operate. The confusion has also been fed by American propaganda. For example, GIs have been handing out tracts in southern Afghanistan asking citizens to “give the coalition forces any information related to the Taliban, Al-Qaeda, or Gulbuddin Hekmatyar” if they want to “continue to receive humanitarian aid.”  The handouts, showing a picture of young girl carrying a sack of wheat, are a clear attempt to use humanitarian aid for military ends. As humanitarians, we denounce this. It attacks the very principles that guide our actions, and is unacceptable.

Apparently, the people who are behind this blackmail don’t care that it is undermining the very foundations of humanitarianism. The result is that some Afghans are no longer receiving aid because they’re on the “wrong side.” Yesterday, the Afghani people were “in danger.” Yet in today’s war against terrorism, they have become “dangerous.” It is in this context that radical groups, using the frustration of the Afghani people to spread their influence and to carry out guerrilla operations throughout the country, are targeting humanitarian workers.

Since 2003, many organizations have been targets of attacks, mainly in the south. More than 30 Afghani humanitarian workers have already been killed over these last few months. Hostility towards foreigners is on the rise. On March 27, 2003, a Salvadorian delegate from the International Committee of the Red Cross (ICRC) was beaten and killed on a road between the Kandahar province in the south and the Oruzgan province in the centre. On November 16, 2003, Bettina Goislard, a French employee of the United Nations High Commissioner for Refugees (UNHCR) was assassinated at a market in Ghazni, in the southeast. Then, the five Médecins Sans Frontières volunteers were assassinated on June 2.

Over the past few months, Médecins Sans Frontières had decreased its activities in Afghanistan because of the insecurity and risks associated with the conflict between coalition forces and opposing groups. For example, we withdrew our staff from the city of Ghazni, where we work with the regional hospital and a care centre for tuberculosis patients. Because the risks are high for humanitarian groups, we had designated several “no go areas.” Médecins Sans Frontières teams had continued to work in calmer areas where it “seemed” easier to operate and where we thought we were less exposed to risks. On the whole, 70 international Médecins Sans Frontières volunteers were still in the country in early June. However, since our colleagues were assassinated, all activity has been suspended for a period of mourning, and our teams have been significantly reduced. Only one international team is left, in Kabul, the capital.

With the assassination of our colleagues and the Taliban’s claiming responsibility, we believe a line has been crossed. We need to examine our activities in Afghanistan and evaluate the safety of our teams (international and national). Practically speaking, we have asked our volunteers to regroup in Paris to assess the situation, and our Afghani colleagues are participating in these talks. With the help of the management committee and the board of directors, we now need to define our position on what seem to be our concrete options: discontinuing all activities, suspending them for a set length of time, or maintaining a minimal level of activity. Faced with attacks against our organisation, we must act unambiguously. A cessation of activities in Afghanistan is therefore a seriously considered option.

Whatever we do decide, we also need to evaluate our recent working methods in Afghanistan, and if possible, establish contact, both inside and outside the country, with communities who can explain who we are and what we do. We must ask those responsible for the killings to lift their call to arms. With this in mind, in order to make our actions and our position known, we are assessing ways in which we could develop political contacts outside the crisis and build up communication in the Arab and Muslim world as well as in Central Asia. All of this will be necessary before we can even think of resuming operations with a minimum guarantee of safety. We have important responsibilities towards our current projects and the safety of our staff. One particular threat against Médecins Sans Frontières remains that we need to understand and analyse.

In Afghanistan, the area open to humanitarian action keeps getting smaller and smaller, if it even still exists at all. Some extremist groups have chosen a “headlong flight” strategy, targeting anyone who, according to them, is working in the interests of the west, the coalition or the government of Hamid Karzaï. In itself, this is nothing new, but the situation is getting worse and worse, conflict is intensifying, Afghani elections are approaching, and the regional and international climate is extremely tense. 

In addition, we are faced with the increasing confusion between western NGOs—this is how we’re viewed—and western armed forces, which has been further reinforced by “military humanitarian” operations like those I mentioned earlier. Radical groups are stirring things up and creating a hostile atmosphere for foreign ‘infidels’. We need to keep in mind that Afghanistan has been torn apart by a succession of wars for over 25 years. It’s with good reason that people talk about the “brutalisation” of this society.

It seems like both sides of this “war against terrorism” want us to choose sides. We refuse to do so.

Paris, June 29, 2004

Mix-up of genres…
Extract from the Francophone newspaper, “Les nouvelles de Kaboul,”
June, Kabul

“Afghans call them the French Doctors in memory of the doctors who helped them all through the war. They are doctors from the French military health service. In Afghanistan, they are a separate unit and have become a myth for the people. An encounter with these compassionate combatants...”

Published with introduction in the Human Rights Defender, Australian Centre for Human Rights, by the Faculty of Law, University of New South Wales, November, 2004 (vol 13 issue 2).