Dr. Sheri Fink's first book, War Hospital, tells the story of a group of young doctors trapped along with 50,000 others in Srebrenica, Bosnia-Herzegovenia, during the Bosnian war in 1992. Lacking surgical training and ample supplies, the doctors faced extraordinarily trying circumstances. David Rieff calls War Hospital "a fascinating account of what it is to try to uphold (or fail to uphold) one's medical oath in the midst of genocide."
Sheri Fink earned her M.D. and Ph.D. from Stanford University, and she has acted as a humanitarian aid worker with the International Medical Corps in conflict zones in the Balkans, the north Caucasus, southern Africa, Central Asia, and most recently Iraq. Her writing has appeared in the Washington Post, International Herald Tribune and Wall Street Journal, among others. She lives in New York.
You spent part of the spring and summer of this year working in Iraq. What was your function there? How were you and your fellow Western aid workers perceived by the Iraqis? Talk about some of your experiences.
I went to Iraq for three months this spring with the emergency response team of International Medical Corps, a non-governmental organization (NGO) that focuses on medical assistance in conflict and disaster zones. I worked to meet needs in the health and water/sanitation sectors in southern Iraq. There, water treatment plants and sanitation systems had failed, leading to poor water quality and an upsurge of serious diseases in children. Also, looters had stripped hospitals, clinics and warehouses of critical medicines and medical supplies. We worked closely with Iraqi colleagues to fix water treatment systems, bring in and distribute needed medications and supplies, and many other related tasks. When we discovered that women nurses, already in extremely short supply, were being kept at home due to security concerns, we organized shuttles to bring them to work. For the most part, I felt welcomed. However, I also sensed that some Iraqis were afraid to work openly with us.
You’ve stated that humanitarian workers, whose jobs
depend upon remaining neutral, are often “used” and
politicized by governments. To what extent is this happening in
In War Hospital, humanitarian workers in Bosnia discovered that they were serving as a cover for international inaction (on political, diplomatic or even military fronts) to put an end to the war and war crimes. In Iraq, humanitarians have been extremely wary of being used, but this time in the opposite way--some argue they're being "co-opted" by the military coalition as a part of a "hearts and minds" campaign to win over the Iraqi population. You've touched on a subject of heated debate among aid workers today. Some agencies refuse to accept funds from any government involved in the war. Others don't see a problem with this. Why do most aid agencies take pains to distinguish themselves from governments or militaries? For two main reasons. One is the fear of aid workers becoming targets. Another is the fear of not being able to provide humanitarian assistance impartially and independently to all who need it. Those who want to read more about this topic can find a discussion in the epilogue to War Hospital, which I wrote while working in Iraq, and also a recent Wall Street Journal op-ed, which can be found on the warhospital.net website.
In one of your radio interviews, you mentioned that a key difference between the Red Cross and MSF is that MSF tends to be an advocate, whereas the Red Cross workers are not allowed to talk about what they witness. What are some successful examples of MSF’s advocacy in various parts of the world?
It's always difficult to judge the effects of one organization's advocacy on larger policy decisions by political leaders. Still, I can think of several examples where MSF's "witnessing" has made a difference--for example the testimony of Doctors Without Borders staff members who witnessed the fall of Srebrenica, Bosnia, in April, 1995 has helped bring to justice some of the perpetrators of the massacre of roughly 8000 men and boys. MSF (known as Doctors Without Borders in the U.S.) has taken a number of stances on issues related to health care and human rights. A current campaign involves the demand for access to essential medicines for people suffering from diseases such as AIDS and tuberculosis. The fact that life-extending medicines are unavailable to millions of sick men, women and children, particularly in sub-Saharan Africa and South America, is clearly the defining moral issue of our time. Why aren't we doing more to fix this situation?
What was it about the Srebrenica story that inspired you to write this book as opposed to continuing your medical work?
There is so much about this story that compelled me, from the character development that the war forced in each of the doctors, nurses and aid workers, to the conflicts they experienced between duty to their patients, desire to end the war, and the need to save their own lives. I found analogies to the doctors' dilemmas in everyday life here in the U.S. Most of all, the backdrop of the story--the siege and ultimate destruction of the United Nations-declared "safe area" of Srebrenica and the killing of most of its adult male population--is a historical event that bears deep examination. "The tragedy of Srebrenica will haunt our history forever," wrote U.N. Secretary-General Kofi Annan. When the survivors entrusted me with the stories of the worst days of their lives, telling those stories became my responsibility. Even after five years of research and writing, I'm still finding new and thought-provoking aspects to the Srebrenica war hospital story.
In the epilogue of War Hospital, you state that the US intelligence community was aware in 1993 that “attempted genocide” would likely happen in Srebrenica but that the government did not act. How much responsibility does the US have for what took place? What should the government have done?
The U.S. undoubtedly shares the responsibility. We are bound by
our signature on the Genocide Convention to "prevent and punish"
the crime of genocide. As if that weren't enough, we owed Srebrenica
a special debt of protection because in 1993, two years before the
genocide, we and the other members of the United Nations Security
Council designated the town a "safe area" and largely
disarmed its inhabitants. In his 1999 report on the fall of Srebrenica,
United Nations Secretary General Kofi Annan called on all governments
"which contributed to the delay in the use of force" to
accept their share of responsibility for allowing the genocide in
Srebrenica to occur, and for each government to investigate its
role in the fall of the town. The U.S. has not yet conducted such
an investigation, and I believe that it is time for a congressional
inquiry into what the U.S. knew about the Bosnian Serb attack and
when it knew it. Intelligence experts believe that the U.S. has
critical imagery and signals intelligence that it has not released,
not even to the war crimes tribunal in the Hague.
What should our government have done? Many historians believe that the wars in former Yugoslavia could have been prevented with early, concerted diplomatic efforts by United States and European negotiators. War Hospital shows that even after the wars began, there were many missed opportunities for the international community to intervene. The proof, it seems, is in the pudding. Weeks after the fall of Srebrenica, more than three years into the Bosnian war, NATO began a concerted bombing campaign against Bosnian Serb military targets, Operation Deliberate Force. Two weeks later, the campaign ended, followed by a ceasefire and peace talks in Dayton, Ohio. The war was over.
Is there any analogy between the inadequacy of humanitarian relief in Srebrenica and the ineffectiveness of various humanitarian programs and sanctions throughout the ‘90s in Iraq?
Srebrenica's problems had far more to do with a failure of international protection than a failure of humanitarian relief. Still, it's fair to say that whenever Serb forces blocked aid convoys to Srebrenica as part of their war strategy, civilians suffered from deprivation of basic foodstuffs and medicines. As part of a response to that war strategy, the UN imposed economic sanctions in Serbia. Some aid workers did see a certain analogy here, arguing that sanctions hurt Serbian civilians more than the Serbian government they were aimed at influencing. Whatever anyone might think of sanctions, which are certainly controversial, research leaves no doubt that in Iraq the period of sanctions, particularly before the initiation of the UN's oil-for-food program, correlated with an increase in malnourishment and disease, especially among children.
Do you believe that the use of force was the best option for the people of Iraq (as it would have been for the people of Bosnia)?
I met many in Iraq who wished we would have used force years earlier to remove the tyrant who killed, maimed, and oppressed hundreds of thousands of them. I also met many in Iraq who were angry and deeply suspicious about the U.S.-led intervention. In the end, only the people of Iraq can answer your question. I hate war, and no matter how good or bad the reason for unleashing force, it will unavoidably have its ugly and tragic consequences. Leaving the particular case of Iraq aside, in general I believe that military force must remain an option for our country, particularly in the case of countering other military forces that are targeting civilians. Waging war is evil, but sometimes it's the much lesser evil.
You recently visited Srebrenica in a bit of a reunion of some of the characters in War Hospital. How has it changed?
Srebrenica is truly, as its inhabitants call it, "the end of the earth." The area is extremely depressed. Much of the war damage hasn't been fixed. However, there have been some positive changes. In the 1995 peace agreement, Srebrenica was left in the Serb Republic (Republika Srpska) entity of Bosnia, but the unity of Bosnia as a country was maintained, and all citizens have the right of return. The area, which had zero Muslim returnees when I first visited in 1998, now has several thousand who've ventured back to the town where they suffered so much. They've rebuilt one of their destroyed mosques, several inhabitants have opened shops and restaurants with the help of small grants from international agencies, and a number of men have been elected to the city council (with the votes of dispaced Muslims allowed to vote in their former home districts). There is also a beautiful memorial garden and cemetery dedicated to the memory of the thousands killed in 1995. This year, for the first time, a Bosnian Serb governmental representative attended the annual memorial ceremony (where more than 600 of the dead, recently identified using DNA-matching techniques, were buried). After years of official denial, Bosnian Serb military and governmental representatives have finally begun acknowledging their crimes in Srebrenica, including at the war crimes tribunal in the Hague. This is a very positive, optimistic sign for the future, because it is providing a unified vision of historical truth for young Bosnians of all ethnicities.
What remains to be done in Bosnia to bring those responsible for this massacre to justice? Do you feel this is a priority of the Western powers?
First, arrest the two most notorious fugitives, former Bosnian Serb President Radovan Karadzic and Bosnian Serb General Ratko Mladic, thought to be hiding in the region. This is a job both for both local governments and international troops, including Americans serving in Bosnia. Second, all governments, local and international, must cooperate with the International Criminal Tribunal for the Former Yugoslavia. For the U.S., this means turning over requested documents, allowing former government representatives to testify with maximum transparency, and also allowing the tribunal to finish its work rather than imposing an artificial end-date.
You’ve proven to be a highly skilled journalist and are also well trained as a physician. Your journalistic aptitude seems like a valuable asset for an aid worker because of your ability to bear witness to the troubled places of the world. What kind of projects do you see yourself undertaking in the future? If you were to start your own NGO, what would it be like?
Thanks for the compliment. While it would be tempting to focus for a while on lighter, fluffier subjects (a book on wedding cake, anyone?), I'm dedicated to writing about the intersections of medicine, science, human rights, humanitarianism, and civil rights, globally and locally. I did start an NGO once--it was called Students Against Genocide (SAGE), and it ran for about five years in the 1990s.
Photo of Dr. Fink by Teun Voeten