First, Do No Harm

“If Auschwitz were operating today,” said Rony Brauman, the former head of the Nobel Prize-winning Doctors Without Borders, “it would probably be described as a humanitarian emergency.” It was the tired perspective of a tired humanitarian.

In the public imagination, “humanitarians” emerged from the chaotic and bloody 1990s as saintly antidotes to the ethnic chauvinists, dictators and other spoilers who got in the way of the “end of history.” College applicants declared their aim of becoming “relief workers.” Hundreds of millions of dollars poured into humanitarian organizations, which put the money to noble--if not always efficient--use, tackling crises in Bosnia, Burundi, Rwanda, Sierra Leone, East Timor, Kosovo, Sudan, Chechnya and the like. And by the end of the decade, even Western governments were latching on to the appeal of the humanitarian epithet. War, it seemed, was obsolete; henceforth, the just, bloody battles fought by the West would be sanitized and spruced up as “humanitarian interventions.”

For all of the presumed righteousness of the humanitarian enterprise, detractors have long abounded. Some government officials turned up their noses at those they envisaged as Scandinavians in Nelson Mandela T-shirts engaged in squishy and expendable “social work.” But none have been as critical as the humanitarians themselves: the men and women who worked within nongovernmental organizations (NGOs) and suffered their bureaucratic foibles and donor-driven turf warfare. Those, like Brauman, who found themselves proffering food, shelter and medicine when confronted with mass murder, rampant disease, starvation and enormous refugee flows, suffered grave existential doubts, knowing that the source of misery was political rather than humanitarian. Nongovernmental groups could attempt to treat symptoms, aid workers knew, but only powerful governments could tackle causes.

David Rieff, a journalist and author of four previous books, including “Slaughterhouse: Bosnia and the Failure of the West,” has become a category of critic unto himself. He spent the last decade roaming the world’s conflict zones and refugee camps, often with the aid of the aid givers themselves, making himself the most forceful and, in the nongovernmental aid world, influential exposer of the institutional contradictions, hidden agendas and confusion of roles among those who have enlisted in what fellow critic Alex de Waal has called the “Humanitarian International.”

Rieff understands that life is hard for low-paid relief workers (whom he calls “the last of the just”), that political support and financial resources are often spare and that their day-to-day choices are unenviable. But these realities must not shield the self-styled altruists from criticism. Rieff is an outsider’s insider, one who can identify the perverse consequences of and the dangerous hubris behind humanitarian intrusions in needy societies but who doesn’t bring the defensiveness of a stakeholder.

In his provocative new polemic, “A Bed for the Night: Humanitarianism in Crisis,” Rieff offers us the big picture--and oh, what a dispiriting picture it is. Rieff writes that the apparent “triumph” of humanitarianism in the 1990s--the decision by frustrated aid workers to urge governmental intervention and of governments to dabble in humanitarian work--has proved “both morally and operationally, to be a poisoned chalice.” The meaning and mandate of humanitarian relief work has been so distorted by mission creep that the aid industry stands “verging on cognitive and moral meltdown.” The rescuers, Rieff suggests, are in dire need of rescue, less from the world’s evil-doers than from themselves.

Rieff argues that relief workers emerged from the 1990s punch-drunk and transformed into politicized advocates. In Bosnia and Rwanda, aid organizations saw they were being manipulated and degraded by timid Western statesmen. In Bosnia, beginning in 1992, the United States and Europe used the delivery of humanitarian aid as an alibi to avoid military action. Unwilling to stop genocidal attacks on civilians but under pressure to “do something,” the major powers gave the United Nations more than a million dollars a day to feed civilians under threat or in flight. Then they gallingly turned around and said they could not undertake much-needed military action because doing so would interfere with the life-and-death feeding operations.

But the worst was yet to come. As Rieff writes, “If Bosnia turned humanitarianism on its ear ideologically, Rwanda broke its heart.” During the genocide, while about 800,000 Rwandans were murdered, the United States blocked military action. More egregiously, because the Clinton Administration feared it would eventually be called upon to rescue embattled UN peacekeepers, U.S. officials demanded the withdrawal of the armed blue helmets. The few relief workers who remained lacked the means to stem the extermination campaign. Indeed, NGOs were powerless even to protect their Rwandan employees. Most of the Tutsis who had worked for humanitarian organizations (and those who worked for Western embassies, for that matter) were murdered. Once relief workers finally got geared up to offer help, they supplied assistance not to the victims of the genocide but to the victimizers, the genocidaire who had fled Rwanda and been struck by a fatal wave of cholera. Again, the bystanders to genocide cited their relief efforts as proof of their generosity. But this time, by tending to the refugees’ humanitarian needs, Western governments and aid agencies helped the killers regroup for more murderous attacks. Rieff quotes one aid worker who was deployed at the height of the emergency and who realized only upon returning to the United States, “Hey, I’ve been busting my butt for a bunch of ax murderers!”

Here, according to Rieff, many humanitarians (a term he never actually defines) decided they had had enough of neutrality in the face of mass murder and enough of putting “Band-Aids on malignant tumors.” If NGOs did not become advocates, they would become accomplices. Since only states could properly stem the carnage, aid workers began to call for and work with state power. The long-standing notion of “humanitarianism against politics” was replaced by a politicized humanitarianism.

In subsequent emergencies in Kosovo and Afghanistan, Rieff tells us, aid groups worked in dangerously collaborative fashion with states. In Kosovo, when NATO bombed the Serbs in the spring of 1999, he claims that humanitarianism had “all but begged for the chance to be used as a moral warrant for warfare.” In Afghanistan, U.S. officials anxious to win over public opinion dropped precision-guided munitions along with (imprecisely guided) meals-ready-to-eat. U.S. forces also tried to coordinate their efforts with the relief and refugee groups. As Secretary of State Colin L. Powell said in October 2001, “The NGOs are such a force multiplier for us, such an important part of our combat team.”

In this original but overly tidy synopsis of the last decade, Rieff suggests that Afghanistan marked the end of the era of independent humanitarianism. He argues that Oxfam, CARE, the International Rescue Committee, the office of the U.N. High Commissar for Refugees and other aid agencies are increasingly becoming tools of governments, and he fears aid givers and war fighters will henceforth be indistinguishable. A skeptic that anything governmental can ever be humanitarian, he urges NGOs to return to neutrality, whatever its imperfections. CARE should not be building human rights monitoring into its refugee camp contracts. Aid agencies should not be pulling out of Zimbabwe on human rights grounds. Politicians should play politics, while the humanitarians should supply macaroni and tents. “Let humanitarianism be humanitarianism,” Rieff concludes. “Let it save some lives, whatever the compromises it has to make along the way, and let it tend to the victims .... [I]s that really so little?”

As is true of most of Rieff’s critiques, his plea here for humility and mission retrenchment will inject a valuable degree of self-consciousness into organizations known for their ad hoc and reactive decision-making. Instead of forever “fighting the last war,” as they have been prone to do, Rieff urges them to pull back and respond not merely to short-term need but also to long-term sustainability.

But while the critiques can be helpful and often quite brilliant, they contradict one another and leave readers groping for a take-away. Having criticized the aid groups for operating while Western governments did nothing in Bosnia and Rwanda, he then seems to bash them for operating while Western governments did something in Kosovo and Afghanistan. He seems to be suggesting that humanitarianism once was, and again can be, apolitical. Yet he would be hard-pressed to offer historical examples of pristine, apolitical humanitarian work. Was the Red Cross really neutral in World War II when it went ahead and inspected concentration camps and then kept silent? Was it an act of neutrality for the United Nations to give the Bosnian Serbs 70% of its relief deliveries in return for access to Muslim territory? And, in Afghanistan, before the Taliban’s fall, which organizations were behaving neutrally: those that supplied food to agents of the Taliban regime or those that stomped back home to protest the persecution of women?

When confronting most crises, whether historic or contemporary, aid agencies generally muddle along on a case-by-case basis. They weigh insufficient information, extrapolate somewhat blindly about long-term pros and cons, and reluctantly arrive at decisions meant to do the most good and the least harm. By choosing to be involved, most of these organizations have long ago eschewed the possibility of neutrality. And surely the best test of their performance is not a cookie-cutter demand that they avoid consideration of human rights but Rieff’s worthy (and not at all neutral) inquiry as to whether they have “kept a single jackboot out of a single human face.”

Part of the confusion in “A Bed for the Night” stems from the fact that Rieff claims to be taking aim at aid workers when in fact it is Western governments that are the main target of his ire. It is the United States and its allies that have most contributed to the blurring of roles, by first leaving aid workers to tackle political problems and then, belatedly, undertaking humanitarian tasks for geopolitical reasons. While Rieff blames the aid organizations for pulling governments into humanitarianism, he knows that it was not a humanitarian summons that led Western governments to bomb Yugoslavia or Afghanistan; it was the major powers’ strategic concerns.

It is true that many Western relief workers welcomed these bombing campaigns, which enabled them to intensify their relief efforts. But the views of NGOs neither influenced NATO planning nor rendered the aid workers more vulnerable to retaliation than they would otherwise have been as NATO nationals. The NGOs may wish to do more to distance themselves from governments. But they will be powerless to stop determined governments from appropriating the humanitarian mantle.

Rieff sounds sorry when he writes, “What Afghanistan demonstrated was that humanitarianism was too important a matter to be left to humanitarians.” But if he regrets Western military involvement in humanitarian missions, he need not worry. The Kosovo and Afghanistan interventions are exceptional, and it is unlikely that NATO will spend the coming decades clamoring to assume roles traditionally performed by Doctors Without Borders.

The tragic reality is that American and European leaders are generally determined to steer clear of those causes that are “merely” humanitarian. The vast majority of NGOs thus operate in obscurity, with neither television cameras nor Western soldiers present to confuse or attempt to control them. Today’s sufferers of AIDS, genocide and politically induced famine can be heard wishing out loud for Al Qaeda operatives to infiltrate their neighborhoods so that the mighty might cast a glance or a buck their way.

Under such circumstances, it should not be surprising that humanitarianism will remain in a state of perpetual crisis. What is surprising, in light of the impossibility and thanklessness of the tasks they face, is that the humanitarians remain at all.