For three years now, Medecins sans Frontières-Doctors Without Borders1-has been in Afghanistan. The first medical teams it sent arrived in May 1980, five months after the Soviet invasion. Since then, we have sent 162 physicians and nurses who replace each other in relays for periods of four to eight months, providing an uninterrupted MSF presence. We have equipped and operated a total of 12 hospitals in the provinces of Nuristan, Paktia, Badakhshan (close to the Soviet border), Wardak (some 40 km from Kabul), Bamiyan, Uruzgan, and Zabul. Four of these hospitals were deliberately bombed and destroyed by Soviet planes in the fall of 1981. We evacuated two other hospitals in areas where we felt the need for medical services was limited and where local medics whom we have trained have been able to take over. At the present time, the MSF has 22 persons working in six hospitals. From our uninterrupted presence in Afghanistan, we have been able to evaluate the situation in the country since the beginning of the war, specifically in the areas where we are working. The current situation in Afghanistan is one of protracted war. The duration and character of the war derive directly from the Soviet style of anti-guerrilla warfare.

Guerrilla warfare has already demonstrated its effectiveness elsewhere, and until recently no one has known how to counter it. The scattering of populations, the creation of village strongholds, and control and card-indexing of inhabitants have proved to be very useful means of restricting guerrilla advances, but the resistance fighters have always won out in the end.

It is true that there are examples to the contrary, such as the victory of the British army in Malaysia, and that of the French expeditionary corps in Algeria. But in the latter case, de Gaulle realized that France's long-term position was untenable and so he complied with the demands of the National Liberation Front, even though the Front was in a very poor military position when negotiations began.

Totalitarian regimes have analyzed these repeated failures and found a new answer to the guerrilla "problem," one that is simple, logical and effective. Since the basis of the strength of a resistance movement lies in the practice that Mao Zedong called "the fish taking to the water," the easiest way to separate the guerrillas from the population is to empty the fish bowl and capture its contents. In other words, an effective counter-strategy in the face of guerrilla action involves massive reprisals against the population, sometimes including the extermination of a large part of that population.

Some might think that such prospects would be repulsive to even the most determined invader. But this has not been the case; this philosophy has become a reality before our very eyes over the past several years. In the province of Ogaden, which revolted against the regime in power in Ethiopia, towns and villages were leveled one after the other. Nearly one million refugees-almost all the inhabitants-are now in refugee camps in nearby Somalia. And air units from Addis Ababa have no scruples about making raids on the camps.

In Kampuchea, the Vietnamese victory over the Khmer Rouge four years ago would never have been possible if the people had not been starved into submission by the Vietnamese, who feared that part of the relief support might fall to the enemy forces of Pol Pot. While tens of thousands of Kampucheans died of hunger and hundreds of thousands fled into Thailand, thousands of tons of food provided by international relief organizations spoiled on the docks of Kompong Som. The only portions of these supplies that were used went to feed the occupying Vietnamese forces and the Kampucheans under control in the pacified areas.

This type of warfare is currently being used in Afghanistan, the only difference being that the Afghan resistance groups have thus far made it fail. It may therefore be more difficult to recognize the pattern in all of these anti-guerrilla campaigns, but their common characteristics can be divided into three main categories: how the Soviet version of anti-guerrilla warfare compares with traditional Western anti-guerrilla warfare; what specific means it uses; and what the final outcome is.


One difference between the type of warfare used by the Russians in Afghanistan and that used by Western armies, such as the French in Algeria or the Americans in Vietnam, is that Western armies try to control the population and make every effort to prevent infiltration by guerrillas. From the bases they set up in towns, they try to establish a sphere of influence, to find support in the villages and hamlets, and to create militias to defend areas that might be attacked by guerrilla fighters before reinforcements from the regular army arrive. To ensure that resistance groups cannot get supplies from the people, the Western armies set up protected villages where the people are brought together and where food, supplies, and livestock are stored.

Manhunts are continuously organized, from the bases that are considered safe, to capture or kill guerrillas or to seize their caches of arms and ammunition. In all, despite the irresponsible acts committed by the French army in Algeria and the U.S Army in Vietnam, their anti-guerrilla warfare was based on one principle: to obtain the support of the population by any means, such as by giving privileges to newfound allies and by waging a hard war against the enemy. I have already noted the poor results of this type of warfare.

The Soviets operate differently. In Afghanistan, the towns held by the occupying Soviet forces are not used as bases to secure a hold over the neighboring areas. The towns are used as garrisons and as logistical stepping-stones. They provide storage facilities, aviation bases, barracks, and strongholds. The rest of the country is not under Soviet control. Protected villages do not exist. No effort is made to offer privileges to try to win over the population. The few military operations that involve ground forces are merely for strategic purposes. Some examples are the engagements that have taken place on the road from Kabul to the Soviet border, in the Panjshir Valley and the Wakhan corridor; operations there are not designed to capture resistance fighters.

The reason for this difference in anti-guerrilla tactics is very simple: the Soviets are not as naïve as the Westerners. They understood long ago-perhaps back at the time of the 1933 Ukrainian genocide when this tactic was used quite successfully-that a war involving guerrillas and anti-guerrilla fighters would never be won by either side if the emphasis was placed on being in the good graces of the population. On the contrary, the war would be won by the side that succeeded in making terror reign.


This brings me to the second aspect: specific means used to counter resistance movements. This does not involve a warm bath/cold shower tactic, but the exclusive use of boiling water-again and again and again, until both the guerrilla fighters and the population ask for mercy.

During the first phase, until late 1980, air and ground equipment and infantry units were brought together to establish the reign of terror in this fashion. To mention just one example, in the province of Hazarajat in central Afghanistan, several hundred armored vehicles would leave either Kabul or Jaghori and occupy a valley that could easily be entered. The population, which had warning either by rumor or because they had seen the helicopter movement, fled into the mountains. The Soviet troops therefore entered empty villages where they remained for a few days, harassed by the Muslim resistance groups-the Mujahedeen-who also barred their access to the upper valleys. During those few days, the soldiers pillaged and burned homes, set fire to crops and dragged off with them the few inhabitants left behind-mostly old people, whom they interrogated or summarily executed.

In 1980, three of these raids by Soviet troops took place along the Shibar Pass road; the soldiers thereby managed to occupy Bamiyan, Yakaolang, and Panjau for about ten days in June with 300 armored vehicles, in August (again with 300 armored vehicles), and in September (with 120 armored vehicles). In their last attack, the Russians destroyed everything in sight, set fire to crops, and burned bazaars to the ground in Panjau, Yakaolang, and several villages on the road to Shibar. They left the former American hospital in Yakaolang in ruins.

During a similar expedition in the fall of 1980, many homes were burned down in the region of Turkmen, west of Kabul, and the small hospital in Lolenj was also completely destroyed. The same kinds of destruction took place in mid-December in the northern part of Ghazni province. When one of our medical teams arrived two days after the end of the fighting, fires were still smoldering in a number of villages, and people were being wounded by booby traps left behind by the Soviet troops. Once again, the effect sought was terror, not strictly military victory.

Since late 1980, warfare using such operations has dropped off, probably because the Red Army has lost too many of its troops. But the Russians have now found other ways to impose a reign of terror, particularly by the use of air raids against which the poorly equipped resistance fighters are completely defenseless. In the Hazarajat region, for example, the villages bombed in the last two years are much too numerous to be listed here in full. Just a few of the targets were Jaghori, Panjau, Behsud, Jalrez and Waras. In Jalrez, a home where a wedding was taking place was bombed and the tragedy left several dozen victims. In Waras, where the independent provisional government of Hazarajat has its headquarters, the helicopters bypassed this organization, which should have been a tempting target, and attacked the village bazaar.

Military intervention carried out mainly by helicopter also includes dropping mines and booby-trapped toys. I shall not go into detail, but only stress two points. First, camouflaged anti-personnel mines are not designed to kill, but to injure. The Russians know quite well that in this type of war, an injured person is much more trouble than a dead person. The injured person demobilizes fighters who have to transport him, and, of course, he can no longer fight. In many cases, he will die several days or weeks later from gangrene or from staphylococcus or gram-negative septicemia, with atrocious suffering, which further depresses those who must watch him die. The MSF has also seen the damage caused by the explosion of booby-trapped toys, in most cases plastic pens or small red trucks, which are choice terror weapons. Their main targets are children whose hands and arms are blown off. It is impossible to imagine any objective that is more removed from conventional military strategy, which forswears civilian targets.

The second aim of dropping of anti-personnel mines is to affect the economy. First, troops try to set up a blockade using mines that are scattered by the thousands along the passes leading to Pakistan (but with almost no success), and second, they try to scatter the people's livestock. When I arrived in Afghanistan for the first time in 1980, I was immediately struck by the number of goats and cows that had legs in splints made of bamboo sticks and tied with wire. The herdsmen explained to me what had happened: these animals had stepped on mines and been injured as a result of the explosion. But the greatest loss, the herdsmen told me, is not so much the ones with splints, but rather all those animals that were killed from secondary infections. And although the Afghans clear the mines from the roads to prevent more human deaths, the animals in the fields continue to get killed. Livestock in several regions of the country has been slaughtered in this way. The effect of this slaughtering on the food supply in Afghanistan is clear.

Another point to be considered is the question of refugees-those still in Afghanistan as well as those who have fled. These refugees should not be considered in the traditional way, as an unfortunate but unintended consequence of the war, but rather as part of Soviet warfare strategy, the same that was used in Kampuchea, the Ogaden and Eritrea. The objective is, as mentioned earlier, to evacuate the country in order to isolate the guerrilla fighters.

The methodical pursuit of this objective is the only possible explanation for the incredible number of Afghan refugees. Some flee the country to Iran and Pakistan, where they are once again "used" by the Russians, whose agents infiltrate the refugees' ranks to further aggravate the conflicts that exist in Pakistan between different ethnic groups, as many believe is happening in Baluchistan. The figures for Afghan refugees in Pakistan and Iran as reported to international bodies run in excess of four million.2 Out of an Afghan population of 15 to 17 million, this figure is already enormous.

But to this figure must be added the hundreds of thousands of "internal" refugees who remain within Afghanistan. They have fled to the main towns, where they come under the control of the state army. Thus, this enlarged refugee count should be compared not to the total population of Afghanistan, but to the population in the rural areas that are held by the resistance fighters. When one adds to that the number of persons killed either in the fighting or by diseases that frequently find their cause in malnutrition-especially among children-one can better understand why that Soviet strategy is highly effective and that it has no doubt been responsible for chasing nearly half of the population away from guerrilla strongholds.

Also, several thousand children are sent to the Soviet Union to study to be officers one day in the Socialist Republic of Afghanistan; this offers a very close comparison with the Russians' "liberation" of the southern republics of the U.S.S.R. in the 1920s and 1930s, which led to a total victory over what has been called the Basmachi ("bandit") revolt.


Before coming to the last issue, which concerns the final outcome of the tactics just discussed, a word must be said about one of the conditions needed for this strategy to be a success: secrecy.

International public opinion would never accept such enormities if it were informed daily on the developments in Afghanistan. The need for secrecy explains why borders are systematically closed and why journalists are not allowed to enter the country. Of course, some journalists disregard this, but they are so few in number that their reports draw little attention. Compare, for instance, the amount of coverage on Afghanistan with that given for several years on the war in Vietnam.

The French physicians who have been on permanent duty in Afghanistan for the last four years have become key eyewitnesses, and in spite of their lack of experience in journalism, they have been able to make up somewhat for the negligence of news reporting. I use the word "negligence" because, if a small organization like ours can succeed in maintaining more than 20 physicians on permanent duty in four provinces in Afghanistan, despite government acts of violence against them, the news media could do likewise. The Russians cannot tolerate the fact that we are there to witness what is happening, and we have therefore become their target. In 1980 and 1981, four MSF hospitals were deliberately destroyed by MI-24 helicopters. Two other hospitals in the region of Panjshir, which are operated by another French organization, Aide Medicale Internationale, were destroyed in the same way. May I add that one of the hospitals had a big red cross clearly visible on its roof.

Also, on several occasions, the physicians themselves have been pursued by Soviet soldiers who had in their possession photos of the doctors that they showed to the people they questioned. All the doctors have managed to get away except one, Dr. Philippe Augoyard, who was captured in January 1983. But we do not think that the Russians will try that type of operation again, as it proved disastrous for their image in Europe-especially of course in France. Rather than discouraging new recruits, which was probably the goal, the Augoyard case let physicians in other countries know about our work. Such incidents result in a bad press that affects the Soviets in other spheres. At the present time, only 50 percent of our medical teams are French; the remainder are Dutch, English, Belgian, Swiss, Scandinavian, and other nationalities. If, for example, a Dutch doctor were arrested in Afghanistan, the anti-Soviet publicity would certainly influence the ongoing debate over the installation of American missiles in Europe.


Now we come to the question of the final outcome of the Soviet strategy. The examples given above concerned Kampuchea and Ethiopia. The reason for this is that Afghanistan is not a very good example to illustrate Soviet anti-guerrilla warfare, precisely because the results have so far been unsuccessful. The towns of Afghanistan, the main bases for Soviet intervention, are poorly controlled. Not a week goes by without word of an attack against the government or against communist-bloc embassies in Kabul. In response, the heavily commercial districts in big cities such as Herat and Kandahar were reportedly severely bombed and nearly destroyed by planes because they had gone over to the resistance-just another example of the Soviet terror strategy and massive destruction, which can be contrasted with the house-by-house taking of the Algiers Casbah by the French army in 1970, with little loss to property or human life. The Soviet strongholds of Bamiyan, Ghazni, Gardez, and Khost are completely encircled by the Mujahedeen. In Bamiyan, for example, a garrison composed of 200 Russians and 200 Afghans has its post high up on a peak; supplies reach the garrison by helicopter. Helicopters are therefore gaining in importance for the Soviets as a means of transport between towns because communication links are not at all under control, although efforts have recently been made to improve them.

The puppet government of President Babrak Karmal has also attempted psychological warfare, by trying to play on local antagonisms among the Pushtun tribes. But the government has not been very successful at this, particularly since the death in 1981 of Faiz Mohammed, Minister for Tribal Affairs, who was killed by a group he was trying to bribe.

The cease-fire agreements that have been made have worked as much in favor of the resistance fighters as they have in favor of the government leaders, and they are based more on a balance of power than on a successful psychological warfare strategy. This is currently the case in Panjshir.3

The number of armored vehicles that have been destroyed by resistance forces is incredibly large, considering their outdated weaponry and suicidal tactics (such as leaping onto tanks with homemade gasoline bombs). We counted more than 600 vehicles destroyed in the areas where we work, which, when extrapolated, comes to a total figure of some three to four thousand for the entire country. This figure is generally found to be so unbelievable that, whenever I mention it, I never fail to have with me a set of slides to document what I am saying.

The economic blockade has also not succeeded. The border areas are as easily accessible as they were before it was imposed; our medical teams need only three days to reach the central province of Hazarajat. Our movement is not restricted, as people generally think; we travel by car or truck, and only during the day.

Setting fire to crops and storage shelters is another anti-guerrilla tactic, but its effect is limited because less than half the amount of food that was needed before the war is needed now due to the diminished population. In addition, caravans going to and from Pakistan continue to bring fresh produce. Another striking-and ironic-example of the ambiguous effect on the economy, also from Hazarajat, is the need in Kabul for firewood, which has forced the government to deal with the resistance. The resistance fighters bring wood to government outposts and exchange it for salt or sugar from Kabul.

Despite the attempts to restrict the food supply, trends in local market prices indicate that the blockade is not working. Some prices have actually dropped since the Soviet invasion. At Jaghori, for instance, a gallon of gasoline that cost 200 to 300 Afghanis (AFS) in 1979 costs 160 AFS today. A pack of cigarettes that cost 60 AFS in 1979 now costs 28 AFS. These figures suggest that supplies are adequate to keep prices from rising. Other prices have risen, but less rapidly than those in many Third World countries, even countries that are not at war: a ser (15 pounds) of flour cost 70 AFS in 1978; it rose to 160 AFS in 1979; today it costs 180 AFS. The price of a ser of tea doubled between 1978 and 1979, from 960 to 1,920 AFS; since then it has only risen to a current price of 2,500 (less than one-third of the 1978-79 rate of increase), and even this price rise may be largely attributable to inflation.

The examples illustrating the poor short-term effect of Soviet strategy suggest a rather optimistic trend with regard to the Afghan resistance movement, but my conclusion is much less so. Everything I have said about the current situation shows that the war in Afghanistan is one in which the balance of power has not changed in four years, in spite of the fact that the two adversaries are unequally matched-on one side the world's biggest army, on the other a handful of people standing tall against the invader. There is no sign of any change soon in this state of affairs, and I do not believe that the Afghans can be beaten in the short or medium term. But Soviet strategy involves two aspects that may make the outcome in Afghanistan differ from the Western experience; one, already mentioned, is the use of mass terror, completely unlike any of the more moderate types of intervention. The second is that the Soviets can afford a protracted war in the short term for the sake of a long-term victory.

The Russians do not need smashing victories to announce to their citizenry, as Soviet public opinion does not influence Soviet policy. Catastrophes, such as that in the Salang tunnel where several hundred Soviet and communist-regime troops (and civilians) were killed, do not incite an outcry in Moscow for Soviet "boys" to come home. The Soviet army can wait it out as long as it did for the Basmachi revolt to end-and it waited for that for 20 years. It can wait even longer if necessary. The Afghan resistance will hold out for a long time, but in the end it will probably be beaten. It might not be beaten, however, if in the coming years there is a profound change in the international balance of power and in the reactions of Westerners to Soviet totalitarianism. It is not impossible that this change could take place, but only a very wise person would dare to predict the future of Afghanistan.

1 Medecins sans Frontières (Doctors Without Borders) was created in 1971 by a group of physicians who had worked in Biafra during the Nigerian civil war of the 1960s. This rapid-deployment medical organization has sent teams to conflict-torn areas in Southeast Asia, Lebanon, Chad, East Africa, Angola, Central America, and Iranian Kurdistan, often despite the opposition of host governments.

2 The Iranian government informed the United Nations High Commissioner for Refugees in 1983 that there are 1.5 million Afghan refugees in Iran; Pakistan reports 2.8 million Afghan refugees inside its borders.

3 During the summer of 1983, Ahmad Shah Massoud, resistance commander in the Panjshir Valley, negotiated a truce with the Soviets, refusing to deal with the Kabul regime (thus forcing the Soviets to implicitly recognize him). Under the truce, he resupplied the valley, opened supply lines and formed alliances with leaders in the north and as far west as the town of Herat. The truce has now ended, and Massoud has refused to extend it.



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  • Dr. Claude Malhuret is the executive director of the Paris-based Medecins sans Frontières. This article is adapted from his address to a conference on "The Soviet Invasion of Afghanistan: The Consequences for Afghanistan and the Soviet Union," held at the Russian Research Center of Harvard University on October 17, 1983.
  • More By Claude Malhuret