Health and politics: Lessons learned from the Iraq conflict

A Viewpoint in this week's issue of THE LANCET discusses the complex issues concerning the provision of humanitarian relief in the Iraq conflict. The authors of the article comment that 'the US armed forces have increased engagement in humanitarian projects, such as community health and food programmes. Relief organisations believe that this engagement contributes to insecurity by blurring the lines between civilian and military function, and falsely associates them with the military forces'.

In the run-up to the invasion of Iraq, the US administration gave the task of planning and execution of humanitarian relief to the Department of Defense. That relief effort is now widely perceived to have been mismanaged. Frederick M Burkle and Eric K Noji (Johns Hopkins University, USA) discuss how the US-led relief effort was planned, its failures and successes, and the lessons learned. The authors focus on the immediate relief effort rather than the subsequent reconstruction programme.

Dr Burkle concludes: "Judging from the experience in Iraq, the armed forces should be prevented from dominating humanitarian assistance as much as possible and should leave this task to agencies that have traditionally handled humanitarian crises, such as the Office of Foreign Disaster Assistance in the case of the USA. This office and its disaster assistance response team have extensive experience with relief operations and liaison duties between civilian and military agencies. The Office of Reconstruction and Humanitarian Assistance, which mainly had policy experience without operational expertise, was an additional, unnecessary, level of bureaucracy".

Contact: Dr Frederick Burkle, The Center for International Emergency, Disaster and Refugee Studies, The John Hopkins University Medical Institutions, c/o 452 Iana Street, Kailua, Hawaii 96734, USA; T) 808-262-2098; skipmd77@aol.com; fburkle@jhsph.edu

ISSUE: 9–15 October 2004

---

---