As this issue goes to press, we have just heard the tragic news of the latest incident in London, following bombings in Kabul and Manchester within the last week – to list but a few of the incidents around the world under the banner of terrorism. It therefore seems fitting that this issue focuses on two different – but related – aspects of the ‘global war on terror’.
First up, we have a special forum section, devoted to issues around ethics, national security and global health. This is followed by two articles that focus on the longer-term disabling impacts of war and conflict.
Lisa Eckenwiler and Matthew Hunt introduce the forum section, which followed a meeting on these issues held in Geneva, in 2016. They further discuss these issues in their article ‘Health and security: ethical principles for counterterror policy and practice in protection crises and beyond’. In it, they raise the important – and much debated – point that counter-terror strategies, when deployed domestically, can create or foster xenophobic policies and rhetoric, which in turn can themselves foster resentment, leading to alienation and further violence. To address these issues, they call for global security actors to abide by a set of ethical principles. These are further addressed in Ryoa Chung’s article ‘The Securitization of Health in the Context of the War on Terror, National Security and Global Health: the Conflict of Imperatives’. In the conclusion to the article, Chung makes the point that ‘… [we] might not always have undefeatable arguments for promoting human security over legitimate national security concerns when the stakes are exceptionally high’. The question remains – and is highlighted by recent events – when are the stakes seen as ‘exceptionally high’ by world leaders and national security forces, and what do they see as proportionate responses?
In the final article of the forum, ‘Which Will Trump: Human Rights and Professional Ethics, or Torture Redux?’, Jonathan Marks discusses these issues from the perspective of what constitutes ‘proportionate’, and the extent to which the Trump administration (further) challenges the boundaries of acceptable conduct. Interestingly, he chooses to focus on the roles and responsibilities of physicians in torture. As he reminds us, torture is of course prohibited under international law, and he argues that physicians need to be reminded – and empowered – to play their part in upholding these laws.
The effects of torture are discussed in the article by Amanda C de C Williams and Kirstine Amris, ‘Treatment of persistent pain from torture’. In it, they make the point that pain is often interpreted as somatic, as survivors of torture are believed to have long-term psychological problems, over and above physical pain, resulting in much of the literature focusing on psychosocial and other psychological issues, such as post-traumatic stress disorder. As they note, attitudes can be complicated by a range of factors, for example: ‘The torture survivor who is a refugee and asylum seeker has additional problems which complicate presentation, assessment and treatment: uncertainty about civil status; unstable accommodation or homelessness; isolation from family, community and even others speaking the same language; anxiety about family and friends in the country s/he fled; poverty; racism and hostility in the host society’. However, they raise the point that assuming these views apply to all torture survivors may only pathologize – and depoliticize – them further. This in turn leads to the misplaced view that providing mental health services will largely meet their needs, without consideration of rights, which may in turn lead to greater exclusion. Williams and Amris discuss a range of physical symptoms resulting from specific mechanisms of torture, but note how few studies there are into effective treatments for the range of symptoms. They conclude by noting that without acknowledging the broader context for torture, treatment for pain and other sequelae may well fail.
This broader context can include issues of justice and reconciliation, which is a theme picked up in the final article, by Niro Kandasamy, Karen Soldatic and Dinesha Samararatne ‘Peace, justice and disabled women’s advocacy: Tamil women with disabilities in rural post-conflict Sri Lanka’. In the article, they discuss how women with conflict-acquired physical disabilities resulted in shifting identities that enabled them to become ‘agents of peace’, fostering cross-ethnic dialogue and creation of safe spaces in post-conflict Sri Lanka. Using narratives of the women themselves, they build up a nuanced picture of the intersections of gender, disability and ethnicity, and how these new identities in turn led to empowerment of the women.
The article highlights how finding a common link, even with multiple and previously conflicting identities, can foster peace and reconciliation. It is this lesson we need to learn and apply on a much wider scale to find a way to shift the current narratives and find a way to peace and security for all.
Leonard Cheshire Disability and Inclusive Development Centre, University College London, London, UK
[email protected]
Simon Rushton
Department of Politics, University of Sheffield, Sheffield, UK