|November 15, 2001
for Winning Peace in Afghanistan
Warning that, if it comes, military
victory in Afghanistan will not change the terrorism threat, Richard Feachem, professor
and director of UCSFs Institute for Global Health, urged that world leaders make a
massive public health relief effort the linchpin of any post-Taliban policy. We need
to win the peace.
The plea came before a Cole Hall audience on Nov. 8 during the third in an ongoing
series of Bioterrorism and the Health Professional lectures sponsored by the
UCSF department of epidemiology and biostatistics.
Major famine is imminent in a country that already is undernourished, where 33
percent of children in the refugee camps die before the age of 5, where polio stubbornly
persists and where the maternal mortality risk is one in seven (compared to one in 10,000
in Canada), said the former Director of Health, Nutrition and Population at the
World Bank and former Dean of the London School of Hygiene and Tropical Medicine.
Feachems self-described amateur account was a fast-paced coupling of
history and geopolitics, peppered with personal anecdotes of his time in Afghanistan in
1978 when a reformist-minded Communist government first came to power.
The government tried to carry out a platform of land re-distribution, the
education of women, the building of a public health infrastructure all things we in
this room would likely support. But the mullahs, or religious leaders, in the
countryside were hostile to the reforms a fact made very obvious when
Feachems car was shot at during a foray outside of the Afghan capital of Kabul.
Indeed, Afghanistans hostility toward outsiders and would-be conquerors, and its
strategic location at the crossroads between Russia and its former client states such as
Uzbekistan and Tajikistan to the north, India and Pakistan to the east and south and other
Muslim states on the west, has made it a focal point of big-power politics. That was true
in 1989 when, after a 10-year war, defeated Soviet armies retreated north and in the19th
century as well when Britain suffered two crushing defeats at the hands of Afghan
warlords. Any post-Taliban government will not succeed if it is imposed by
outsiders, Feachem said.
Feachems already grim assessment darkened further while discussing the
instability of the Pakistani government and its bitter dispute with India over control of
Kashmir, a border province on Pakistans northeastern frontier. An important
part of winning the peace is to stabilize and shore up Pakistan while not inflaming India.
And let us remember that both countries have nuclear weapons.
One cause of the enduring instability, Feachem explained, is the British-drawn border
between Pakistan and Afghanistan a border that splits the regions largest
single ethnic group, known in the former country as Pathans and in the latter as Pashtuns.
The Taliban are predominantly Pashtun, said Feachem, which gives them instant support and
loyalty in large areas of Pakistan.
That said, Afghanistan remains a country torn by decades of chaos, anarchy and
suspicion but not necessarily one prone to terrorism against the West. Afghans have
always reserved their greatest hatred toward those not of the book such as
Hindus or the Soviets. Relationships with Jews and Christians have traditionally been much
And while hatred against the West may now be part and parcel of a new wave of religious
schools, called madrasas, that have become a staple in both Afghanistan and Pakistan,
Feachem took pains to remind the UCSF audience that the terrorism we in the West fear is
rooted more in 13 unstable Arab countries than in simply Muslim ones.
The largest Muslim countries in the world, Indonesia, Bangladesh and Pakistan are
not the sources of terror. All three of them have been led by women and two are today.
When I last checked, this had not yet happened in the US.
Still, Feachem argued, it would be a grave mistake for Westerners to assume that
Afghanistans most recent descent into the Middle Ages, its division into five or six
feuding ethnic groups, its despoiled infrastructure and desiccated landscape make it an
empty page upon which to write a whole-scale Americanization of any kind. The major
health initiative I envision must be led by the United Nations, not the United
Feachem spent the closing moments of his presentation chiding that international body
for its lack of post-Taliban planning. Where is the international leadership? Where
is the call for native Afghan doctors around the world to help rebuild their
country? Like so many other questions about the troubled region, Feachem offered his
audience no easy answers.
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