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A Framework for Survival: Health, Human Rights, and Humanitarian Assistance in Conflicts and Disasters.

Kevin M. Cahill, ed. (New York: Basic Books and the Council on Foreign Relations, 1993) 340 pp.

For many CNN viewers humanitarian assistance is defined by images of American GIs landing on the strobe-lit beaches of Mogadishu and foreign relief workers cradling starving children. Such images undoubtedly created genuine public concern in the West, and perhaps helped stimulate U.S. intervention in Somalia. Nevertheless, the question arises as to whether or not the media is providing the public with a comprehensive understanding of humanitarian disasters or simply promoting a superficial justification to support the humanitarian cause. Indeed, the mainstream media rarely attempts to analyze and deconstruct crucial issues such as the role of international relief organizations, the relationship between political diplomacy and health initiatives and confrontations between rich and poor countries. A picture may be worth a thousand words, but a picture can also be seen and understood from many different angles, whereas good usage of prose will argue one or two substantive points. Invariably, the unsophisticated supporter of human rights will see and consume images of poverty and assistance from a purely emotional standpoint rather than analyze them from a geopolitical or socioeconomic angle.

What the CNN generation really needs is an informative book that discusses the major issues related to humanitarian assistance. Dr. Kevin M. Cahill, a renowned physician and a senior consultant to the United Nations, has edited such a book appropriately entitled A Framework for Survival: Health, Human Rights, and Humanitarian Assistance in Conflicts and Disasters. The book is a compilation of papers presented at a symposium held in September 1992 in New York City. Twenty knowledgeable and well respected individuals bring diverse views and backgrounds to confront a wide range of issues, from the plight of refugees to the consequences of mine warfare on civilian populations. Cyrus Vance, former U. S. Secretary of State, sets the tone of the entire book in the foreword when he suggests how to meet the challenges posed by the human and geopolitical consequences of famine and disease, ethnic conflicts and military aggression. Although his prescriptions are not original, Mr. Vance's convincing pleas for fostering democracy and human rights along with his international stature make him a credible, although didactic, spokesperson for the cause of humanitarian assistance and human rights.

The other authors address various technical and practical quagmires that arise when providing humanitarian assistance. Tensions that can occur between different policy suggestions for ameliorating the same problem are also discussed. Some of the other issues presented inclued: the roles that the United Nations, donor and recipient governments and non-governmental organizations should play; whether intervention for humanitarian reasons should prevail over traditional notions of national sovereignty; and the competition and conflicts between various groups that can retard relief efforts.

On a deeper level, A Framework for Survival is a battleground: North vs. South, poor vs. rich, donors vs. recipients. Several authors analyze identical issues from different perspectives, historical points of reference and fundamental philosophical outlooks. Overall, Dr. Cahill, to his credit, has included a balanced selection of writings with Western and third world perceptions of humanitarian assistance.

The book is divided into four sections: Legal and Economic Issues, Health Issues, Private Voluntary Response and United Nations Response. The first section, which is the most far- reaching and illuminating in terms of content and scope, addresses the limited potential of international law to confront human rights violations. Next, Partha Dasgupta, in "The Economics of Neglect" shows, through extensive data and research, the possible economic consequences of governments' failure to provide for the basic needs of their people. The juxtaposition of two different perspectives -- those of David Owen, a former British Foreign Minister, and Kofi Awoonor, Ghana's Ambassador to the United Nations -- on the relationship between developed and developing nations best exemplifies tensions between the West and the third world. Owen argues for more responsibility on the part of recipient nations to confront international problems such as pollution. In contrast, Awoonor convincingly calls for donor nations to stop being the "merchants of charity."

One complaint voiced by Awoonor and others in this book perhaps best represents third world views of Western donors: The emphasis of current international policy is on short-term emergency actions rather than on long-term assistance and development programs that can prevent major disasters in the first place. Awoonor writes, "development is the only instrument that will remove the stigma of charity that accompanies all humanitarian relief efforts." Such attitudes are rarely expressed in the Western media and arguably never enter the minds of the average Westerner who likely sees foreign aid, whether in emergency situations or the long-term, as a panacea for all the recipient country's problems. For this reason alone, this book should enlighten the unsophisticated advocate of humanitarian assistance and intervention.

The second and third sections -- Health Issues and Private Voluntary Response -- present eyewitness accounts by medical personnel of the suffering in countries such as Somalia; the consequences of mine warfare on refugee and civilian populations; a highly critical analysis of the American medical establishment's weak response to the international health crisis; and the challenges faced by non-governmental organizations. In most of the articles, the authors give recommendations for improving the distribution of humanitarian aid. Many also express the fear that an inability to adapt to the demands of current and emerging humanitarian concerns on the parts of all the actors involved -- governments, United Nations, NGOs, the western public -- could exacerbate already dismal human conditions around the globe. Indeed, a major theme of this section, which weaves through the entire book, is that health workers and NGOs need to be completely independent of governments in order to adequately perform their duties. Without this independence, NGOs could become "the tools or simply the contractors of donor governments."

The last section -- United Nations Response -- analyzes the effectiveness of the United Nations in coping with the increasing numbers of humanitarian problems around the globe. The central question is: Does the United Nations have a comprehensive response mechanism to deal adequately with disasters and conflicts? Although all the authors are U.N. officials, the articles are extremely candid analyses of the problems facing the United Nations in its relief efforts. Abdulrahim Farah, consultant director of the Center for International Health and Cooperation and a former U.N. under-secretary general, criticizes the delayed reaction of donor countries and the United Nations towards the crisis in Somalia. In a similar fashion, Sadako Ogata, the United Nations High Commissioner for Refugees, makes an appeal for a more concerted and coordinated effort by the "United Nations family" as a whole to address the "political, humanitarian and economic dimensions of current emergencies."

Perhaps the most controversial issue in this section, alluded to in other parts of the book, is the debate about national sovereignty in the context of humanitarian intervention. Farah, a Somali national, notes that most developing nations think sovereign rights should not be violated "even in the name of the noblest gestures." Vance, and several other authors, not surprisingly argue that human rights violations within a nations boundaries are sufficient grounds for intervention or assistance on humanitarian grounds.

One important North-South issue -- the perception by developing nations that the issue of human rights is used as a political and foreign policy tool by their developed counterparts, despite the end of the Cold War, and that a double standard exists -- could have been more thoroughly explored in a separate article, although Richard Falk of Princeton University does a good job in presenting this view. He writes, "the overwhelming number of instances will involve the flow of force from North to South, and the strong states in the North are definitely off-limits. (Can anyone imagine a U.N. humanitarian intervention in the United States to protect Native Americans against allegations of ethnocide?)"

Most of the twenty articles are well-written and edited, and provide extensive yet manageable amounts of information. A Framework for Survival is a good resource for academics and journalists, but can provide even the lay reader with a better understanding of current humanitarian and human rights concerns around the world. The ability to enlighten the average CNN viewer, or for that matter, any other citizen, on humanitarian issues is important: simply put, these viewers are the ones who vote for Presidents and Prime Ministers, who lobby for Congressional spending on humanitarian aid and who demonstrate for human rights in the urban capitals of the world. Images of poverty and suffering, combined with substantive arguments and analysis, such as those presented in this book, can only create a more sophisticated and influential citizen of the world.

Yancy Ruben Garrido received his J.D. from Columbia Law School in 1993, and will receive a Master of International Affairs (MIA) degree from Columbia University's School of International and Public Affairs (SIPA) in 1994; he is a Ford Foundation Fellow in Public International Law. Scott Johnson will graduate from Columbia College in May 1994. Anton Farrel Katz holds B.S. and LL.B. degrees from the University of Capetown and is an LL.M. degree candidate at Columbia Law School, with a focus on international human rights. Kellee Tsai is a doctoral candidate in political science at Columbia University. Elie Singer will receive his MIA from SIPA in May 1994. Sudarsan V. Raghavan is a May 1993 graduate of Columbia Journalism School and is currently a student at SIPA.
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Author:Raghavan, Sudarsan
Publication:Journal of International Affairs
Article Type:Book Review
Date:Jan 1, 1994
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