Q&A: Afghanistan's humanitarian crisis

Austen Davis is the General Director of MSF-Holland, one of five operational centers of Médecins Sans Frontières, also known as Doctors Without Borders. MSF is an international humanitarian aid organization that won the 1999 Nobel Peace Prize. Davis has worked for MSF since 1991 in Liberia, Guinea, Mozambique, Angola, Sudan, Ethiopia, Bosnia, Brazil. In 1999, he visited MSF's projects in Afghanistan.

Mr. Davis was interviewed by The Christian Science Monitor's online producer, Ben Arnoldy.

1) MSF recently released a statement rejecting humanitarian airdrops by US military forces. Can you explain why you do not support this effort?

The American people wish to prosecute the war against terrorism, and they wish not to harm civilians. In order to deal with these two competing imperatives, it is essential to separate the two processes so that the desire to help people is not subordinated to the war effort. The Geneva conventions define humanitarian action as neutral, independent and impartial. This means that humanitarian actors should not take sides and should be free from political influence so they can go after their objectives single-mindedly – to impartially help people based solely on criteria of need.

If aid is not perceived to be entirely neutral and independent of political objectives it can be claimed by one or both sides as a part of the war effort. Then aid and aid workers become a legitimate target of war. Humanitarian action is supposed to be an expression of hope and humanity in times of darkness – crossing borders and serving victims on both sides, to show even parties at war can care for humanity while fighting their war.

Today humanitarian action has irrevocably been brought into the war effort as part of a "hearts and minds" strategy. Humanitarian action has no possibility of access in Afghanistan today – but it will be even more curtailed in the future. And many humanitarian programs are also on standby – withholding vital lifesaving assistance – in many other countries of the world where local populations perceive humanitarian assistance to be part of a Western action that they do not approve of.

2) Since the US military is one of the only organizations in a position to get food aid to Afghanistan, isn't it preferable to offer some food to the people even from the hands of the military? Isn't your position sacrificing hungry people in the short-term, for a long-term philosophy?

The US military dropped a few thousand rations to a nation of hungry people. It is an action that is so minor in relation to the needs – and so poorly targeted – that it is highly unlikely that any needy people would have received any of the food.

The military actions do nothing to address the risk of epidemics today or to blunt the growing famine over the next six months. The actions further reduce any chances of a massive humanitarian effort being feasible in the last few months before the onset of the winter renders all humanitarian action impossible.

UN food convoys, NGOs, and private food merchants have been able to send truck loads of food and relief materials across the borders since September 11. The quantities are far more significant than those dropped by air to date – and are distributed through running programs. The total quantities that were going in before September 11 were insufficient, they were much reduced after September 11 and stopped after the retaliatory bombing – but I believe new supplies are starting to trickle in overland again. The US airdrop is not the only, nor the most significant supply chain at this time. It is threatening what we have and the possibilities for the future.

Why were there no food drops prior to the bombings – for those 26 days the people were hungry and in need? Why can't the US and Taliban authorities negotiate passage for food aid to be dropped by civil planes, disassociated from the military actions?

3) How bad is the humanitarian crisis in Afghanistan, and what are its underlying causes?

MSF has been working in Afghanistan since 1979, on both sides of the conflict. The country has been in constant crisis all this time, affected by the war and the associated collapse in government and the social infrastructure (such as health care, education services, water, electricity etc.). The war has continued to different degrees for 22 years.

In the last year, MSF has become extremely worried by the current extent of the crisis and the capacity of the aid agencies, governments, markets, and local production to deal with this disaster. Central Asia is suffering from the worst drought in 30 years – and the drought has continued for three years now. This means that seed stocks have been eaten, grazing lands for cattle turned to desert and fruit trees chopped down for fuel. Basic food prices have skyrocketed and cattle prices have collapsed. Families have had to sell everything to continue to eat. In Afghanistan, the war has compounded the effects of the drought by disrupting the importation of cheap foods and destroying opportunities to earn an income, and by exposing people to violence and forcing large populations to flee their homes and land. In all areas of Afghanistan the starving populations have been leaving their lands, homes and families out of fear or hunger or both, and fleeing to neighboring countries or to vast makeshift camps around the major cities.

Before September 11, we had been demanding that humanitarian agencies and the UN raise more money, truck in more food, and develop more capacity to help – otherwise there would be a famine of huge proportions. With all the aid agencies leaving Afghanistan after September 11th, not only is there no assistance to those dying from hunger and disease today – but we are losing critical time to bring in the food to distribute before this coming winter.

4) What humanitarian efforts has MSF undertaken in Afghanistan (and surrounding nations)? What impact has the US military action had on your operations in Afghanistan?

MSF is still managing operations inside Afghanistan, largely through local staff. We have been feeding people and running health centers and hospital wards. We have teams in Iran, Turkmenistan, Tajikistan and Pakistan. We have supplies in all the surrounding countries with teams ready to re-enter Afghanistan. We have sent in convoys of materials since September the 11th to re-supply our projects.

Since the bombings, there have been violent demonstrations in various locations in Pakistan, forcing our expatriate staff to withdraw from Quetta and Peshawar to Islamabad. UN offices have been attacked and aid workers denied access to potential areas where refugees might be arriving or abused. Communications with local staff left in Afghanistan have been cut and operations put on standby, as the risk is too great to their lives. Even actions by local staff in Pakistan, serving Afghan refugees in Jalozai camp have been suspended due to the insecurity.

5) The United Nations High Commissioner for Refugees predicted a widespread exodus of refugees from Afghanistan in anticipation of US military strikes. Has this happened? Are refugee camps overburdened?

There were an estimated 3.5 million Afghan refugees in Pakistan and Iran from before September 11th. Many thousands have arrived in the last year fleeing drought and hunger. There are reports of movements of people – fleeing the major cities. But it is unclear if they are trying to get out of Afghanistan and are prevented, or if they are going to rural areas. There is a slow stream of new refugees coming to Pakistan and Iran. The tales from the new arrivals are of hideous abuse and obstruction on the roads, and only the wealthiest are able to buy their way out. The bandits are having a field day, but it is not clear if there is organized obstruction of people trying to flee Afghanistan by the Taliban authorities.

But we also have to be clear: there are not large and well-equipped refugee camps, waiting for new arrivals. The sites so far identified are just patches of desert without water or shade and the aid agencies no longer have access to assess or prepare these sites for arrivals. If there is a mass exodus there is no capacity to receive these new arrivals today.

6) Have Islamic charities played a large role in the humanitarian efforts so far?

Afghan and Islamic charities have played a large role in the past in delivering assistance to Afghan people inside Afghanistan. At the moment it is impossible to access Afghanistan and services to Afghan refugees already in Pakistan are severely limited. No one is doing anything meaningful at this moment.

7) Do you support the notion that the US can engage in a war against the Taliban and Al Qaeda, but not the Afghan people?

Any war will end up killing people – and some of these people may die unnecessarily. It is not our responsibility to comment on the war, just or unjust. War is a fact of current human society. It is also beyond our understanding to say how the war should be fought – what are legitimate targets, what are the best methods for fighting such a war and how to win a war. We are not soldiers.

However we do believe it is critical to respect human life and dignity, even in war. And while good intentions may suggest actions such as food drops, they may actually do more harm than good and restrict possibilities for future, more substantial and more meaningful, action on behalf of innocent and suffering people. It is our responsibility to demand that warring parties use proportional force, respect the impartial nature of humanitarian assistance, and avoid co-opting humanitarian actions for their own political and military aims.

8) How can ordinary citizens help? Are there ways to contribute to the relief efforts besides sending money?

I think, first and foremost, it is important for us as citizens to stay informed, to try and hear different sides of any story, and to try and come to an independent analysis. It is most critical not to fall easy victims to the considerable powers of state rhetoric in war. We must have the ability, in open and free societies, to question our governments – even when we believe their aims and methods are justified. So play your role and participate as responsible citizens.

Secondly, we need committed volunteers prepared to go and work for us in humanitarian situations around the world. These volunteers forward the notion that it is possible to stand for the dignity of all human beings, thereby counteracting the logic of terror and political or ethnic division. I hope that our volunteers feel they are doing some small thing that is within their power to stand for a different understanding of humanity.

If it is impossible to volunteer and go abroad, then it is always possible to organize discussion groups, debates, or support groups. Such groups can be in contact with MSF or any other active humanitarian agency to ask how they can help or support with time and organization.