Day: August 11, 2011

Safeguarding medical workers in hostilities

Yesterday the ICRC released a report on the very scary and depressing trend of attacks on medical workers in situations of armed conflict and civil disturbances:

According to Dr Robin Coupland, who led the research carried out in 16 countries across the globe, millions could be spared if the delivery of health care were more widely respected. “The most shocking finding is that people die in large numbers not because they are direct victims of a roadside bomb or a shooting,” he said. “They die because the ambulance does not get there in time, because health-care personnel are prevented from doing their work, because hospitals are themselves targets of attacks or simply because the environment is too dangerous for effective health care to be delivered.”

This makes for some pretty grim and reading.

Yet the evidence is clear – whether it is the targeting of medical workers in Libya, the targeting of a hospital in Afghanistan by the Taliban, or the unwarranted persecution of doctors in Bahrain. (A problem that Dan Nexon highlighted earlier this year here at the Duck.)  Even the allegation that the CIA found Osama bin Laden using a vaccination program puts medical workers and vaccination teams at risk – a potential disaster for global health.

(Aisde: Most, if not all of these issues, are being followed by Christopher Albon at his excellent blog, Conflict Health. Go read it. Read it now!)

The neutrality of medical staff in all circumstances is a core tenant of the laws of war, and some of its oldest codified principles. There is, quite simply, no excuse for harming someone who is engages in these tasks. This was the genius of the 1864 Geneva Convention:

Article 1. Ambulances and military hospitals shall be recognized as neutral, and as such, protected and respected by the belligerents as long as they accommodate wounded and sick.
Neutrality shall end if the said ambulances or hospitals should be held by a military force.
Art. 2. Hospital and ambulance personnel, including the quarter-master’s staff, the medical, administrative and transport services, and the chaplains, shall have the benefit of the same neutrality when on duty, and while there remain any wounded to be brought in or assisted.

These principles continues today as is clear in the First Geneva Convention of 1949. At the risk of being long-winded:

Art 15. At all times, and particularly after an engagement, Parties to the conflict shall, without delay, take all possible measures to search for and collect the wounded and sick, to protect them against pillage and ill-treatment, to ensure their adequate care, and to search for the dead and prevent their being despoiled.
Art. 19. Fixed establishments and mobile medical units of the Medical Service may in no circumstances be attacked, but shall at all times be respected and protected by the Parties to the conflict. Should they fall into the hands of the adverse Party, their personnel shall be free to pursue their duties, as long as the capturing Power has not itself ensured the necessary care of the wounded and sick found in such establishments and units.
The responsible authorities shall ensure that the said medical establishments and units are, as far as possible, situated in such a manner that attacks against military objectives cannot imperil their safety.
Art. 20. Hospital ships entitled to the protection of the Geneva Convention for the Amelioration of the Condition of Wounded, Sick and Shipwrecked Members of Armed Forces at Sea of 12 August 1949, shall not be attacked from the land.
Art. 21. The protection to which fixed establishments and mobile medical units of the Medical Service are entitled shall not cease unless they are used to commit, outside their humanitarian duties, acts harmful to the enemy. Protection may, however, cease only after a due warning has been given, naming, in all appropriate cases, a reasonable time limit, and after such warning has remained unheeded.

The idea behind this is that someone who is seriously injured is hors de combat – in other words, out of the fight, and can no pose a military threat. Allowing someone’s wounds to fester or get worse serves no military purpose once they are hors de combat; it only causes what is normally termed unnecessary suffering. (This is the same principle that bans poisoned weapons – there is no need to uselessly aggravate an injury on someone who is seriously wounded.) The individuals who treat these injured combatants (and civilians) of all sides must therefore be protected from attack. This is why they are allowed to wear the Red Cross/Red Crescent/Red Crystal symbols – it identifies them as neutral medical workers and helps to expedite the process of recovery and treatment. (Abusing these symbols, such as using them as a ruse to conduct an armed attack, is a grave breach of the Geneva Conventions.)

Certainly, there is more law I could cite here. But the main point is that the ICRC is absolutely correct to highlight this as a growing problem.

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State of the Field, Redux: What’s Wrong with IPE?



There are a few things that make me really hot under the collar. The first is the unending 100+ degree summer heat in central Texas. The second is the unending debate on the “state of the field”, in particular the state of the International Political Economy (IPE) discipline. It is a topic near and dear to my heart (IPE, not Texas heat). A few years ago, I was so provoked by Benjamin Cohen’s trenchant intellectual history of IPE and the reactions that followed that I put together a special issue on the so-called “American School of IPE” in Review of International Political Economy. This was soon followed by a special issue on the British School of IPE, edited by Nicola Phillips in New Political Economy. Finally, in hopes of achieving some closure on all the kvetching and navel-gazing, Nicola and I combined the two special issues and solicited a new round of essays, which came out last year as a book on the Past, Present and Future of IPE. At that point, I decided to stop worrying about the state of the field and return to more rewarding, substantive research.

But Dan’s blog from a week ago on the state of IPE today brought all the angst back. Dan raised a simple, yet powerful question: why have our top journals (specifically International Organization) had so few articles on the global financial crisis? For that matter, why do the top journals have so few IPE articles on anything of real importance to the world economy today?

Rather than stew in my juices and provide a snarky reply, I turned to some of my uber-talented IPE friends with these questions. Here are two great responses I received from Mark Blyth and Thomas Oatley, which I reproduce here, with my thanks.

From Thomas Oatley, Associate Professor at UNC Chapel Hill, author most recently of a great IPE piece in IO, “The Reductionist Gamble: Open Economy Politics in the Global Economy“:

Perhaps no research directly relevant to the American financial crisis has appeared in IO because mainstream American IPE values general knowledge over case-specific knowledge. It believes further that general knowledge is produced through the statistical analysis of large samples. David Singer, in a recent APSA Political Economy section newsletter, nicely summarizes the kind of research this orientation implies. “From a research design perspective, a reasonable way forward is to test hypotheses about the conditional impact of capital inflows on the probability of financial crises in the developed world. The scope and quality of regulation are likely contenders for inclusion in such a model. The cases of Australia and Spain suggest that large capital inflows might be less destabilizing if the banking system faces strict capital requirements and prohibitions against non-traditional banking activities. Other possible conditioning variables include, inter alia, resource endowments, partisanship, and corporate governance.”

So why hasn’t IO published research along the lines Singer proposes? I suspect that such research has yet to appear because standard statistical techniques are not well suited to the complex causality that characterizes banking crises. This causal complexity has two dimensions. The first is equifinality: multiple causal paths produce banking crises. Post liberalization “capital inflow bonanzas” that drove the Scandinavian crises is a different mechanism than the “post-Louvre over-valued yen with abundant domestic savings” mechanism that generated Japan’s banking crisis in the late 1980s, which is a different mechanism than the over-exposure to Greek sovereign debt that underlies current weakness of German banks. All three mechanisms might be different than the “zero private savings, large government deficit and global savings glut of historic proportions” mechanism that caused the US crisis.

Second, causality may be conjunctural. That is, rather than having a consistent effect across cases, the impact of a variable might depend on how it combines with other factors. An over-valued currency on its own may not increase the probability of a banking crisis, but an over-valued currency in combination with surplus domestic savings and a particular regulatory structure may have caused Japan’s banking crisis. Multiple conjunctural causality is challenging for standard statistical techniques, although techniques for managing these challenges do exist (see Bear Braumoeller. 2003. “Political Complexity and the Study of Politics,” Political Analysis 11: 209-233).

Why haven’t quantitatively oriented IPE scholars applied techniques such as Braumoeller’s to the study of banking crises? I think the problem may rest in the rarity of major banking crises. According to Reinhart and Reinhart, only 5 major systemic banking crises occurred in developed countries between 1973 and 2007. If three or four distinct causal mechanisms are at work in these five crises, it will be difficult to find statistically significant configurations among sub-sets of crises.

In short, I would argue that no articles directly relevant to the financial crisis have appeared in IO because the field attaches little value to studying the US crisis in isolation, and the banking crises with which it might share common properties are so infrequent that statistical techniques are unlikely to identify general relationships. As a result, an event of supreme global importance gains very little attention from American IPE scholars.

From Mark Blyth, Professor at Brown University, hard at work on a book about the financial crisis that is bound to be a classic in the field:

There are more than a few IPE scholars who have written about the financial crisis and its aftermath. Its just that they have done so in venues that are not as cumbersome as traditional peer reviewed journals. There are two problems with looking to such journals as venues.

The first is the ‘hit the moving target’ problem. I wrote a piece in 2008 called ‘this time it really is different’ on the 2008 crisis and the EU, and by the time I got editor comments, it had morphed into the Euro crisis. Add publication time-tabling into this and almost anything you can say about this is redundant. By the time you revise it to catch up its redundant again. Economists (as usual) have an advantage over us with sites like the NBER and VOXEU designed to get it out quickly, so they get the press.

The second is the ‘discipline of discipline’ problem. Frankly, younger IPE scholars are taught to work with quant data and not say anything beyond it. That’s the skill set. They are taught to do ‘tractable’ questions. What’s tractable about the GFC? That’s a problem when past data is absolutely no use in discerning future trends beyond broad Reinhardt and Rogoff ‘lets dump medieval Spain and modern France in the same data set and talk about defaults’ approach.

Others can talk about intellectual hegemony and the like, but as someone who has sat on a board for many years, I can say its the submissions or lack thereof the is the real killer. Why aren’t IPE journals publishing crisis work? Possibly because no one is submitting it? Or because its much more bang for the buck and much faster to publish in Foreign Affairs or on line?

One last thought. All journal submissions need to be tied into disciplinary debates in order to pass the sniff test at a journal. So what is the debate that the crisis ties into that IPE has a track record on? US decline (got that wrong several times)? Institutional change (most popular models are all about incremental change while the world gets smacked by a Black Swan every week)? Diffusion? (of what, panic)? Human Rights and Trade? (relevance?)

The fundamental problem is that IPE imagines a world quite unlike the one we actually inhabit much of the time. As a consequence when we are asked to comment on the world we actually inhabit, we have little to say.

Finally, I should note that there are in fact some great works out there by IPE scholars that directly hit on the current global financial crisis. I won’t try to be comprehensive, in fear of overlooking several obvious examples, but I’ve read (or re-read) three in the past month that are simply terrific: Herman Schwartz’s Subprime Nation; Randy Germain’s Global Politics and Financial Governance, and Eric Helleiner, Stefano Pagliari and Hubert Zimmermann’s (eds) Global Finance in Crisis.

If anyone out there can point to other great sources – in journals and books – please send in your suggested readings list.

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