The Politics of British Medical Humanitarian Aid: Ngos, the State and the Military, 1988-2014
Total Page：16
File Type：pdf, Size：1020Kb
The Politics of British Medical Humanitarian Aid: NGOs, the State and the Military, 1988-2014 A thesis submitted to The University of Manchester for the degree of Doctor of Philosophy in the Faculty of Humanities 2019 JENNIFER A. CHAPMAN SCHOOL OF ARTS, LANGUAGES AND CULTURES Table of Contents Abbreviations ............................................................................................... 4 Abstract ......................................................................................................... 6 Declaration .................................................................................................... 7 Copyright Statement .................................................................................... 7 Acknowledgements ....................................................................................... 8 Introduction .................................................................................................. 9 Historiography .......................................................................................... 13 Methodology ............................................................................................ 25 Chapter Breakdown: British Medical deployments ................................. 32 Chapter One: The 1988 Armenia Earthquake: British Disaster Response under Thatcher’s Neoliberal Agenda ...................................... 37 Introduction .............................................................................................. 37 Remembering the 1970s ........................................................................... 42 Neoliberalism in Britain and Internationally ............................................ 49 The Growth of the British NGO sector .................................................... 54 The British Response to the Earthquake in Armenia 1988 ...................... 56 Prioritising development: the British Aid sector in the 1980s ................. 64 Conclusion ................................................................................................ 74 Chapter Two: Rethinking Famine: The British response to the 1998 Sudan famine and the demedicalisation of malnutrition treatments .... 77 Introduction .............................................................................................. 77 From Thatcher to Blair ............................................................................. 81 Famine in Sudan ....................................................................................... 87 Responding to a Complex Emergency ..................................................... 98 Rethinking Famine ................................................................................. 103 An Evolving Medical Response ............................................................. 108 Conclusion .............................................................................................. 116 Chapter Three: Medicine as a tool for peacebuilding and state-building: The Humanitarian Intervention of Kosovo, 1999 ................................. 118 Introduction ............................................................................................ 118 The Kosovo Crisis .................................................................................. 122 The Humanitarian Response................................................................... 126 Medicine and Peacebuilding .................................................................. 136 Health and State-building ....................................................................... 141 2 Conclusion .............................................................................................. 146 Chapter Four: The Loss of Humanitarian Space and the Consequences for Aid Recipients during the Iraq War, 2003 ...................................... 148 Introduction ............................................................................................ 148 Pre-war Humanitarian Planning ............................................................. 152 From Liberators to Occupiers, The invasion and its aftermath .............. 162 Medical Humanitarian Aid and the role of the Military Medic ............. 172 Conclusion .............................................................................................. 180 Chapter Five: A Government-Led Response: Britain and Sierra Leone Ebola Outbreak, 2014 .............................................................................. 184 Introduction ............................................................................................ 184 The British military and securitisation of the outbreak .......................... 187 British NGO Response ........................................................................... 197 NHS Staff and the Treatment of patients ............................................... 204 Research and Vaccines ........................................................................... 213 Conclusion .............................................................................................. 219 Conclusion ................................................................................................. 222 Bibliography ............................................................................................. 232 Primary Sources ..................................................................................... 232 Archives .............................................................................................. 232 Interviews............................................................................................ 232 Annual Reports ................................................................................... 233 Newspaper, television and radio reports ............................................. 233 Government Debates, Reports, Speeches and Press Releases ............ 238 Grey Literature and situation reports .................................................. 240 Secondary Sources ................................................................................. 250 Word Count- 83,297 3 Abbreviations CAFOD Catholic Agency for Overseas Development CJIATF Combined Joint Interagency Taskforce CMAM Community-based Management of Acute Malnutrition CPA Coalition Provisional Authority CTC Community Therapeutic Care DEC Disasters Emergency Committee DEERF DfID Emergency Ebola Response Fund DfID Department for International Development EEC European Economic Community ESRC Economic and Social Research Council ETC Ebola Treatment Centre FCO Foreign and Commonwealth Office GNP Gross National Product GOS Government of Sudan HBP Health as a Bridge for Peace HOC Humanitarian Operations Centre ICRC International Committee of the Red Cross IMF International Monetary Fund INGO International non-governmental organisations INSARAG International Search and Rescue Advisory Group IV Intravenous JEEAR Joint Evaluation of Emergency Assistance to Rwanda JFS Joint Funding Scheme KFOR Kosovo Force KLA Kosovo Liberation Army MSF Médecins Sans Frontières MUAC Mid-Upper Arm Circumference NATO North Atlantic Treaty Organization NERC National Ebola Response Centre 4 NGO Non-Governmental Organisation NHS National Health Service NMCG NGO-Military Contact Group OCHA UN Office for the Coordination of Humanitarian Affairs ODA Overseas Development Administration ODI Overseas Development Institute ODM Overseas Development Ministry OLS Operation Lifeline Sudan ORHA Office of Reconstruction and Humanitarian Assistance PHE Public Health England PPE Personal Protection Equipment RSLAF Republic of Sierra Leone Armed Forces RUFT Ready-to-use therapeutic food SMART South Manchester Accident Rescue Team SPLM/A Sudan People’s Liberation Movement/Army TBSA Total body surface area TFC Therapeutic Feeding Centre UK-EMT UK-Emergency Medical Team UMEER UN Mission for Ebola Emergency Response UNDAC United Nations Disaster Assessment and Coordination Team UNDP United Nations Development Programme UNMIK United Nations Mission in Kosovo WFP World Food Programme WHO World Health Organisation 5 Abstract This thesis tells a unique story of Britain’s medical humanitarian response and its politicisation, as the British government attempted to promote its position within a changing international global order. It examines the networks, debates and negotiations that took place between different actors within the British aid sector, and examines their impact on norm-setting and aid delivery. From a sector that is often articulated in terms of human need, this thesis traces the movement of medical humanitarianism into the heart of global politics and its manipulation as a tool of the British state. Literature that champions France, as the primary medical actor, has led to the marginalisation of Britain’s medical response within humanitarian narratives. The focus of medical humanitarian aid, throughout this thesis, offers a lens through which the relationships between actors within the British aid sector can be explored. By drawing together the work of modern historians, oral histories and grey literature, this thesis showcases the unique nature of British medical humanitarianism. Through the investigation into the impact, and growth, of medical responses, this thesis eschews the institutionally-dominated narratives of British humanitarianism. Rather, it brings to the forefront the key role of smaller, medically-focused organisations, individual aid practitioners and research bodies, often overlooked in current historiography, and