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With the withdrawal of U.S. troops from Afghanistan and ending the longest war in U.S. history, a new era has begun for a country that has experienced the coming and going of invading troops for hundreds of years.
The main news is that Taliban forces quickly took control of the provincial capital and seized Kabul without opposition, as well as Western embassies packing up, Afghans desperately leaving, and many NGOs ceased operations. In stark contrast to these scenarios, Doctors Without Borders (MSF) and a handful of other humanitarian agencies maintained their presence and activities during the heat of the fighting, providing life-saving assistance to the wounded and sick.
How is this possible? MSF has succeeded and failed in Afghanistan, but the core of our approach is always the same: we will only work with the clear consent of all parties to the conflict. These include the Taliban, the U.S. Army, the Afghan National Army, and in some cases local militia organizations.
Our principles of neutrality, independence, and impartiality sometimes seem abstract, but by talking to all parties, rejecting government funding, clearly identifying ourselves so as not to be confused with other groups that may have other interests, and making our hospitals weaponless Area. Whoever comes to the privately funded MSF hospital must leave the gun at the door.
While working in Kunduz or Lashkar Gah hospitals, we regularly explain to American, Afghan and Taliban soldiers that we will never reject any patient, whether they are wounded government soldiers, traffic accident victims or wounded Taliban fighters. Our hospitals are classified only according to needs. We work according to medical ethics, not according to who is considered a criminal, “terrorist”, soldier or politician. If American and Afghan soldiers want to go to the hospital, we often have to ask them to leave and return without weapons.
Our approach often contrasts with the way aid systems (including humanitarian agencies) are promoted by donors to establish an Afghan state, establish stability in areas occupied by the Afghan army, and contribute to the legitimacy of a fledgling United States. Supporting government. Aid is the “soft power” to win popular support for the Afghan government, an important part of the strategy of “win the hearts of the people”, and the “hard power” to support military deployment.
What’s striking is that when we met a Western humanitarian donor in Kabul, they could not tell us where the humanitarian needs are greatest. Map) and disputed area (purple). They are providing assistance to the green and purple areas to help strengthen military efforts.
International NGOs that received government funding from Western countries participating in the fighting were shocked to see that counterinsurgency language such as “clear and control” spread to their funding allocations. As one of the largest government donors explained to us in Kabul: “The Taliban made gains in this province. We told aid agencies to grow wheat in the province, and they did it.”
But our methods do not always protect us. In 2015, after being briefly taken over by the Taliban in Kunduz Province, US special forces bombed our hospital in Kunduz. It shows us the gray area in this type of conflict: aid is tolerated and accepted when it increases the legitimacy of the country, but when it falls into the territory of an entire community designated as a hostile enemy, it is easily destroyed. The country is in a backward state. This gray area is caused by the legal ambiguity between international law and domestic law, creating an environment conducive to the classification of “wrong” by the US authorities.
After our hospital was destroyed, MSF contacted all parties to the conflict again to clarify respect for our medical activities. It can be said that it is our extensive public support and the political cost of attacking MSF that ultimately becomes our best guarantee to prevent the so-called “mistakes” committed by the US and Afghan troops in the future. However, when our maternity hospital was brutally attacked in Dasht-e-Barchi, this kind of deterrence through contact and public pressure was useless. It is likely that the Islamic State of Afghanistan’s dialogue efforts against us are still out of reach.
Although MSF is able to operate in the provincial capital, we have not been able to enter the rural areas to meet the needs there. This is one of the failures of MSF’s work in the past few years. However, when the Taliban entered the city two weeks ago, we were able to continue treating patients: the wounded and sick were able to receive treatment in our facilities adapted to the intense fighting. In Helmand, Kandahar, Kunduz, Herat and Khost, our team continues to work. Today, our medical institutions are crowded with patients.
This is why, as Doctors Without Borders, we seek to negotiate with all parties to the conflict. This is to enable our team to provide assistance when it is most needed. Usually, these moments are in the midst of changes in power and control. This is why we resist efforts to incorporate our activities into the political process of nation-building. This is why when our facilities and employees are hurt, we speak out loudly.
The future of Afghanistan is full of uncertainty, and our activities will still be under pressure. The challenges we face will continue to evolve, and the safety of our team and patients remains worrying. But to weather the storms of the future in Afghanistan, it is best for humanitarian actors to firmly plan their own routes based on existing needs, rather than being swayed by the changing political winds.
Afghanistan demonstrates how foreign-led nation-building has failed, and how insignificant the contributions of humanitarian actors to such efforts have been. It also shows that our work can save the most lives when we can be as independent as possible, whether in a country under construction or when it collapses.
The views expressed in this article are those of the author and do not necessarily reflect Al Jazeera’s editorial stance.
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