Warning that, if it comes, military victory in Afghanistan will not change the terrorism threat, Richard Feachem, professor and director of UCSF’s 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.

Feachem’s 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 Feachem’s car was shot at during a foray outside of the Afghan capital of Kabul.

Indeed, Afghanistan’s 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.

Feachem’s 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 Pakistan’s 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 region’s 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 friendlier.”

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 Afghanistan’s 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 States.”

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.

UCSF News Source:

Jeff Miller