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Civilians and war

The future of war: When civilians are targeted during conflict

The president of Médecins Sans Frontières on the dangers facing civilians and aid workers in today’s conflict zones

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Director of Innovation Strategy, International Rescue Committee
Chief Innovation Officer, International Rescue Committee

International humanitarian law protects civilians, humanitarian relief personnel, and medical workers during wartime. But in today’s deadly conflicts, humanitarians face growing risk. According to the Aid Worker Security Database, 313 aid workers were victims of major attacks against humanitarian operations across 22 countries in 2017. The World Health Organization records 322 attacks against health care operations in 2017.

For Joanne Liu, international president of Médecins Sans Frontières (MSF) or Doctors Without Borders, attacks on aid and health care workers are consistent with the brutal nature of twenty-first century warfare. “We are the collateral damage of this way of waging war that is not sparing anyone,” Liu says, “including the civilians, including the humanitarian aid worker.” Where there used to be clear red lines prohibiting attacks on hospitals, today Liu sees an expanding “grey zone” in which conflict parties violate international humanitarian law with impunity.

Liu describes an erosion of the “post-World War II consensus” on our common humanity, built on shared institutions like the United Nations, the 1951 Refugee Convention, and the International Criminal Court. Following 9/11, Liu argues, the “post-World War II humanitarian era” gave way to the twenty-first century’s “security era”—an era that, she worries, is “creating conditions of inhumanity” and generating blind spots that hinder crisis response.

Joanne Liu

This disregard for civilian wellbeing is compounded by the criminalization of aid in places like Syria, where the Assad regime effectively outlawed the provision of health aid to the opposition in 2012. New technologies, like remote-controlled and autonomous weapons, that reduce the number of boots on the ground may also undermine the laws and norms that govern conduct in war. “Power makers believe that they can lead a clean war,” Liu says, but “it's basically creating a new rhetoric to make awful acts...more acceptable. And I push back on that.”

Organizations like MSF face two critical—but sometimes competing—imperatives: to bear witness to war crimes and atrocities and to maintain access to affected communities in areas controlled by conflict actors. Liu discusses some of the difficult decisions MSF has had to make in places like Libya, Ethiopia, and North Korea. “We weigh in the balances — how much of what we bring is bringing value to the people we want to care [for],” Liu explains, against “how much are we becoming, I would say, the ally of the oppressor by being silent.”

“There's no clean war. War is awful. War is lost of life. War is brutality. War is death. And I say that to portray it differently is basically a flat lie as far as I'm concerned”

Liu reflects on the complex ethical challenges that her organization faces in the field, the crises she’s most concerned about for the coming year, and her own personal journey toward a career in the humanitarian sector. She remembers how Albert Camus’ 1947 novel The Plague inspired her as a teenager: “I remember reading those sentences and then promising myself that I will never trivialize death and I will always fight for life.”

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Related Readings

United Nations Security Council Briefing by Joanne Liu, May 4, 2016 — MSF

Attacks on Health Care —  World Health Organization

Health-Care Workers Suffer Attacks Every Single Week —  International Committee of the Red Cross

Behind the Attacks: A Look at the Perpetrators of Violence Against Aid Workers — Humanitarian Outcomes

The War on Syria’s Health System — Omer Karasapan, Brookings

The Shadow Doctors — Ben Taub, New Yorker

Opinions and views expressed by guests are their own and do not reflect those of the International Rescue Committee.