Properly Diagnose Terrorism and Work for a Just Response

Neil Arya, MD

Medicine and Global Survival

Feb 2002

On June 22, 1985, a bomb planted on Air India Flight 182 from Toronto to London detonated over Shannon, Ireland. Three hundred twenty nine people, mainly Canadians of East Indian origin, lost their lives. This was by far the most massive terrorist attack on Canadian citizens. An hour later, at Narita airport near Tokyo, another suitcase bomb in transfer from a Canadian Airlines flight to Air India killed two baggage handlers. Sikh terrorists, who had killed the Prime Minister of India the previous year in their fight for an independent state, were proved to be responsible for the Narita incident. The other bombing is only now coming to trial in Canada. As a Canadian of East Indian origin, and one who just missed taking the same plane a week prior, this tragedy hit me personally.

The events of September 11, with four plane crashes and more than 6,000 deaths, have left us all shuddering in disbelief, even months later. Citizens from 40 countries are known to have died. Many of them must have died horrible deaths, crushed, asphyxiated, or burned. To target so many innocent civilians, for whatever political goals, is a crime against humanity. And the effects go beyond these deaths and inconvenience to travel. My own patients have suffered with depressive symptoms, hopelessness fear and I too, have found going to work emotionally difficult. The perpetrators may be dead, but justice requires that those who helped organize the attacks be rounded up and that countries and non-state groups who harbor and encourage terrorists be identified and prevented from abetting such acts in the future.

To deter further attacks and limit future damage, we must examine why the events of September 11 happened and develop appropriate strategies for dealing with these situations. Will the measures taken so far—military strikes on Afghanistan, border controls, increased tightening of domestic liberties, increased military budget reduce or to exacerbate the problem?

However satisfying it may be for the US population, is going after terrorism "everywhere," with indiscriminate attacks on bin Laden, Saddam Hussein, Ghadafi, Hamas, and Hezbolah in the 'free world's' best interests? Of course there are moral elements as killing many innocents in other lands in the pursuit of the guilty parties would only propagate the injustice of September 11th, violating basic values including the rights to life, liberty, freedom, and justice and the respect for law.

But the dangers of such a wider war are infinitely greater than even the present operation, despite some apparent military successes, including the removal of the Taliban from power. If many innocent lives are lost, resentment will be cultivated and the supply of suicide bombers will only be increased. The policy of civilian sanctions on Iraq, which has led to the deaths of more than half a million children, has inculcated a sense of grievance throughout the Muslim world. Israel's targeted assassinations, its harsh treatment of families of suicide bombers and the Palestinian population in general has been like slashing heads of a hydra, only breeding more people willing to die for the Cause.

The military, economic and technological might that the US has proudly paraded since the end of the Cold War has been tragically shown to be vulnerable to penknives and box-cutters. Will the addition of $20 billion or even $200 billion to the defense budget solve that problem? Even if by some miracle it were to be functional the $100 billion National Missile Defense plan would have offered no protection from these attacks. We are also left to ponder what might have happened had the terrorists actually used nuclear weapons? Horizontal proliferation occurs when nuclear powers refuse to eliminate their weapons.

The military may be best to fight war, but the problem of terrorism requires a more holistic human security approach that neither the military nor politicians seem capable of providing. Doctors see this as a public health emergency of the highest order.

What alternatives do we propose? In the short term, "End the bombing. Treat the pursuit of Osama bin Laden and al Qaeda as a police action, where protecting human lives is of primary importance.

But this is only a first step: to regain the respect of Afghans, the US and its western allies must move back from their roles as combatants to become honest brokers—peacekeepers and peacebuilders—putting their own financial resources into such an effort. As I have seen the massive operation launched by the US it is painfully apparent that supporting peace processes in Peshawar, Rome, Cyprus, Kabul and Northern Alliance-controlled territories a few months ago might have saved millions. A meeting of the Loya Jirga—the Grand Assembly of Afghans—was estimated to cost less than $1 million. Now we should also move immediately to provide more monetary and logistical support for peace processes, not only in Afghanistan, but in the entire Middle East.

After a time of isolation, in which the Administration refused to participate in completion of the Kyoto agreement on climate change, stepped back from enforcement of the Biological Weapons Convention, undermined efforts at the UN to limit small arms, and flaunted its disdain for the Anti-Ballistic Missile Treaty, the US now sees some benefit to international collective action. Internationally recognized structures such as the International Criminal Court (ICC), and the United Nations must be supported.

Perhaps we might encourage the US Congress to ratify accession to the ICC, whose provisions might have allowed the US a mechanism to deal with terrorists in a framework of international law. The recent conviction in New York of the Bin Laden-linked perpetrators of the US Embassy bombings in Kenya and Tanzania in 1998 points to the effectiveness of strengthened law enforcement in dealing with terrorism.

While many in the US administration are talking about a flexible military response, and have obstinately and dangerously refused to rule out the option to use small nuclear weapons, what might be more helpful are concrete steps toward nuclear abolition. Reducing stockpiles would diminish the opportunities for terrorists to acquire fissile materials for suitcase or backpack bombs, and would alleviate the pressures behind the spread of nuclear weapons to other states, some of which are unstable or even hostile powers.

Increased international control of money supply networks and border controls may be necessary, but must be balanced with respect for civil liberties, for creating resentment within or without our borders will not be helpful to our cause. Extra or intra-territorial US military trials without the right to appeal and with the possibility of death penalties on foreign and US citizens are unlikely to inspire to confidence of even the US' staunchest allies.

A public health model denies the quick fix that military and political leaders want. While many patients want to deal with problems such as obesity with fad diets or surgery, only lifestyle changes—balanced food intake and exercise—are the only proven ways to achieve and maintain a healthy weight. Similarly, dealing with root causes of political, social, and economic injustices would be in accordance with enlightened self interest. Respect for human rights, democracy and good governance, more equitable distribution of resources, investment in education—especially female literacy—and health care give people alternatives and an investment in the stability of their governments. Perhaps a post-conflict investment in Afghanistan along the lines of the Marshall Plan will safeguard us more than any further military buildup. True security is founded upon cooperative, just, and equitable relationships with others.

In February the President-elect of Physicians for Global Survival (IPPNW-Canada), child psychiatrist Joanna Santa Barbara, spent two weeks in Afghan refugee camps in Peshawar, Pakistan on a peace education project. They have developed primary school primers to deal with alienation and prejudice that war brings. These are meant to focus attention of leadership and peoples on supraordinate goals: the long term interests of their people, including their own financial and leadership state which might better be achieved through non-armed means.

Pursuit of justice in the Indian situation while often brutal and severe, did not involve any military action and certainly not carpet bombing. It has now taken 16 years for the presumed Air India bombers to come to trial, yet in the meantime Sikh terrorism in India and around the world has been largely controlled. Lesser known are the Al Qaeda associated terrorists who have been responsible for various massacres in Kashmir in the last five years involving hundreds and likely thousands of innocent civilians. Yet if India had chosen to enter Kashmir or nuclearly-armed Pakistan in pursuit of the terrorists, their trainers, financial backers and supporters, the US would have justifiably criticized the foolhardy nature of such an adventure.

Indeed there were and are a number of more productive alternatives to bombing. What is needed in sober second thought and thinking rather than reacting and looking at our own long term interests; not just what might make us feel that something is being done in the short term.