Unhealthy Practice

Medical Work in Conflict Zones Is Compromised

Courtesy Reuters

A Pakistani nurse administers polio vaccines in Peshawar, November 2001. (Courtesy Reuters)

For the second time in less than six months, polio vaccine workers in Pakistan have come under fire. In early April, an unidentified armed group attacked a team of Pakistani health workers administering vaccines and killed one of the police officers guarding them. The program suffered a tragic loss last December, when gunmen killed nine polio workers. Since then, the government has suspended the vaccination campaign in Pakistan’s tribal region -- a major setback to public health in a country where polio remains endemic. By the end of March, almost a quarter of a million children scheduled for polio vaccinations had not received them in that region. Meanwhile, in northern Nigeria, where polio is also endemic, vaccination efforts are strained. Last February, nine vaccine workers there were killed by gunmen associated with Boko Haram, a militant Islamist group that claims polio vaccinations are part of a Western plot against Islam.

Some observers, such as the Council on Foreign Relations Senior Fellow Laurie Garrett, persuasively argue that the CIA is partially to blame for turning health workers abroad into targets. In 2011, the CIA employed a Pakistani doctor to conduct a fake vaccination campaign in an effort to track down Osama bin Laden. News of the scheme reinforced the population’s worst suspicions about the motives behind immunization campaigns. Earlier this year, deans of a dozen of the United States’ most prestigious public health schools wrote a letter to President Barack Obama demanding that public health programs never again be used as a cover for intelligence gathering operations.

The Pakistan and Nigeria killings and the CIA’s activities illustrate the disturbing and widespread erosion of the norm of health care as an intrinsic good that must be respected and protected in conflict zones. For the CIA, the faux vaccine campaign was justified as part of the war on terror. For the gunmen, killing health care workers was rationalized inasmuch as they

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