Doctors cannot stop genocide.

The following summary is based on an interview with Alain Destexhe, Secretary General of Medecins-sans-Frontieres International in Brussels.

The most crucial problem when dealing with situations such as Rwanda is political commitment, maintains Alain Destexhe of Medecins sans Frontieres-International (MSF-International). "It is not a matter of whether lessons have been learned from Somalia or Kurdistan or elsewhere, it is a matter of political commitment. To pretend otherwise is rubbish. Only when there is political commitment do things start moving."

Admitting that not everyone at MSF, a medical agency renowned for its outspokenness, agrees with his concern for political awareness, Destexhe believes that talk within the United Nations of establishing elaborate early warning systems are a "total waste of time." The evidence of impending disaster is usually "staring one in the face" and there are always enough organizations such as MSF or CNN to ring the alarm bells, the MSF Secretary General bluntly adds.

The biggest problem behind the reluctance of the international community to intervene in the Rwanda tragedy was that it failed to recognize the genocidal aspect of the massacres, argues Destexhe. For what was happening in Rwanda was "clearly a genocide that was planned, organized, and systematically carried out by a small group of Hutu extremists." Unfortunately for the Rwandans, however, "all our values of genocide seemed to be based on what happened during World War II."

The outside world was also confused by the fact that both Tutsis as well as Hutu political opponents were being killed. "We failed to see that all Tutsis, whether men, women, or children, were being targeted." As a result, the failure if not reluctance to recognize that the atrocities in Rwanda were part of a deliberate policy meant that when the world finally intervened, "it was far too late." Over a three month period, up to half a million people were slaughtered and 1.5 million forced to flee in terror from their homes.

The United Nations Convention concerned with the prevention and punishment of genocide defines it as all 'acts committed with intent to destroy, in whole or in part, a national, ethnic, racial or religious group.' Only three times this century, says Destexhe, has the world faced such forms of human destruction: the massacres of the Armenians under the Ottoman Turks in 1915-16; the slaughter of Jews and Gypsies during the Nazi holocaust of World War II; and now the attempt by Hutu extemists to exterminate the Tutsi in Rwanda.

Destexhe hastens to add that such a precise definition by no means lessens the horrors experienced elsewhere in recent years. These include the massacres in Uganda; the "killing fields" in Cambodia where the objective of the Khmers Rouges was to stamp out every possible opponent but not the Khmer people as such; and the killings of the Kurds in Iraq. "What is important is to understand what was really happening." Similarly, notes Destexhe, while obviously seeking to emphasize the horrors of the overall catastrophe, some media insisted on referring to the cholera epidemics among the refugees as being 'genocidal'. This detracted

  • albeit unintentionally - from what was happening in Rwanda itself.

    As a relief agency, says Destexhe, MSF was fortunate to have a good infrastructure already in place both in Rwanda and Burundi when the emergency began. During the security crisis earlier this year when almost all foreign agencies were forced to pulled out of Kigali, several MSF doctors and nurses remained behind as part of the overall humanitarian operation of the International Committee of the Red Cross (ICRC).

    As for other international aid agencies, Rwanda represents MSF's biggest operation ever. Most of its work has focused on emergency assistance in the refugee camps dealing with cholera outbreaks, conducting vaccination programmes, and providing other basic health care.

    For the United Nations, however, maintains Destexhe, Rwanda has been a "dead end." It could only perform effectively if given the right support, which it did not receive, particularly from the Americans. "A military intervention was needed at the very beginning and this just did not happen," he says. "The Clinton administration contributed a lot toward minimizing what was happening in Rwanda and failed to give the UN the support it needed."

    A small contingent of soldiers, perhaps 2,000 or so, could have stopped the killings by protecting people in the churches and hospitals and securing a few areas in the country, Destexhe argues. "The French intervention was evidence of that," he adds. "While we did not approve of, and strongly criticized, France's earlier role in Rwanda, it was the only country to finally move to deal with the emergency."

    MSF also asserts that the UN failed to provide the necessary security among the refugees. The agency warns that a repeat of a Khmer Rouge situation could occur among Rwandans. At the beginning of 1979, the Khmers Rouges fled from the advancing Vietnamese army dragging with them hundreds of thousands of refugees. The international community took action, and probably saved thousands of Cambodians from certain death. Nevertheless, the humanitarian effort also fed the Khmers Rouges and allowed them to assert their control over the refugee population.

    Armed soldiers and militiamen of the former Rwandan army are already using their political control over the refugees to legitimize their power, says Destexhe. If the UN does not act immediately to ensure safe conditions not only in the camps but also to assure adequate protection for returnees, it will be too late to prevent the authors of the genocide from asserting control over the refugees. This could inevitably lead to another flare-up in the conflict.

    MSF says the UN urgently needs to do three things:

    First, it should increasingly direct its humanitarian effort from Kigali as a means of creating an atmosphere of security. It is also needs to deploy at least two human rights observers in each administrative district to oversee security conditions. This would require a total of 300. So far, the UN has only provided funding for 20.

    Second, people who have been clearly responsible for the genocide must not be allowed to continue exerting any influence in the refugee camps of Zaire and Tanzania. Nor should the aid agencies use any members of the former Rwandan administration to help them channel aid.

    Third, the authors and perpetrators of the genocide must be put on trial as soon as possible, whether before an international tribunal or before the new Rwandan authorities with the support from the UN, to ensure that trials are carried out fairly and impartially.

    Apart from security, MSF feels, there is no question that the military can play an invaluable role in such situations, particularly in providing logistics such as trucking in water, dealing with transport or burying the dead. "But there is absolutely no need for the military to provide doctors," says Destexhe. "There are enough specialized agencies around such as MSF and the ICRC to do that."

    As regards coordination, MSF still sees this as problem. The UN system should certainly be coordinated better, perhaps with the UN High Commissioner for Refugees (UNHCR) playing a lead role and the World Health Organization (WHO) serving more in an advisory capacity.

    Nevertheless, UNHCR should seek to focus only on refugees outside the country while another UN agency, such as UNICEF or the World Food Programme (WFP), should deal with the situation inside. "Otherwise the problem just becomes too big," says Destexhe. UNHCR, he says, is one of the few UN agencies with a clear mandate. "But it made a big mistake to intervene in ex-Yugoslavia as this seriously weakened its mandate to protect people."

    From April till June, the only agencies on the ground apart from the blue helmets were ICRC and MSF, says Destexhe. Cooperation was good but it all began to turn into a mess when the relief began pouring in. That's when better coordination could have been used.

    "There were too many agencies but not enough with effective skills. Humanitarian emergency relief is very fashionable these days and so a lot people want to get in on it. Even UNESCO (the United Nations Educational, Scientific and Cultural Organization) was in on the act and one really wonders why."

    Destexhe does not see donor fatigue as being a problem with such repeat tragedies as Somalia or Rwanda. People have reacted very positively, but maybe that's only human. For MSF, "the biggest difficulty was imagery such as qualifying cholera epidemics as genocide. This is nonsense and only threatens to efface the realities of genocide inside Rwanda."

    Feeling that the genocide aspect of media coverage was not being put across adequately during the early stages of the emergency, MSF took out two paid ads in the French press. The object? To remind people that "one can't stop genocide with doctors."

    This article was first published in the October special Rwanda issue of CROSSLINES Global Report, an independent newsletter of reporting on humanitarian, development and environmental issues.

=A9Copyright CROSSLINES Global Report 1994