Elihu D Richter , Yael Stein
The Jerusalem Center for Genocide Prevention
The core value of medicine and public health is respect for individual human life, and dignity. Genocide—the intent to destroy a group defined by its ethnic, racial, religious or national or political origin in whole or in part, represents the most extreme assault on this core value. Scholars tell us that there are early warning signs of genocide. Epidemiology, the core discipline of public health, tells us that if adverse effects are predictable, they are preventable.
What can we in public health and epidemiology do to predict and prevent genocide and promote respect for human life and dignity?
Our first responsibility is to obey Medicine's oldest aphorism. Do No Harm. Leaders of Medicine and Public Health violated this aphorism in the extreme when promoting Eugenics and Social Darwinism. Getting rid of sickness in individuals mutated into getting rid of sick individuals, then into getting rid of groups of sick individuals--"Racial Hygiene" in Nazi Medicine, and later "Ethnic Clensing". Ironically, many active members of the Nazi party, including many commanders of concentration and death camps, were themselves medical professionals – who were convinced these acts were in fact promotion of public health by protection of the "master race".
Second, epidemiologists should ensure that standards which guide those guiding rapid investigation of reports of communicable disease outbreaks are applied to reports of atrocity crimes. These systems need to be insulated from political pressures and use a priori criteria and defined protocols. Epidemiologists need to recognize the role of repression and suppression biases —i.e shooting the messengers and burying the victims—in producing non-reporting underreporting atrocitly crimes but also have to be aware of the tendency of victims groups to inflate numbers of victims; [i]
Third, public health professionals should work to promote application of precautionary strategies to genocide prediction and prevention. Precautionary strategies are based on the principle that it is better to be safe than sorry and that an ounce of prevention is better than a pound of cure. In the case of genocide, a precautionary strategy encourages cost-effective interventions directed at the early warning signs, notably hate language and incitement. These strategies mean that there is a Responsibility to Prevent. Responsibility to Prevent advances the locus of intervention to an earlier stage of intervention than that implied by Responsibility to Protect.
Fourth, we in public health should be vigilant against the hijacking of medical metaphors to dehumanize and demonize– highly specific early warning signs of genocide and genocidal massacres and terror. To promote proactive precautionary interventions, epidemiologists should set up surveillance networks modeled after the systems for monitoring and reporting warning signs of epidemic diseases for monitoring hate language in state sponsored media, textbooks, and places of worship. They should identify their sources, and map their distribution and spread and evaluate interventions. [1] Interventions against hate language and incitement are an excellent example of a proactive application of the Precautionary Principle.
Fifth, epidemiologists should strengthen surveillance for rape, now ever more than before being used as weapon of genocide, and promote aggressive political and public interventions to protect women. There is also the need for surveillance and action to stop kidnapping of children and their forced recruitment as child soldiers, the most brutal form of child labor.
Sixth, we in public health should aim to broaden classic definitions of genocide to include ecocidal scenarios with varying degrees of destructive intent, starting with the willful destruction of habitat and life support systems and, reproductive capacity to destruction resulting from wanton or willfully negligent industrial practices. Public health organizations have a responsibility to protect whistleblowers calling attention to these problems. But we have to recognize there is legitimate controversy as to the inclusion and exclusion criteria for such scenarios and whether they should be considered as crimes against humanity.
Seventh, public health professionals should promote Positive Deviance-- cooperating in building on successes to advance our core value: promoting life and respect for life. In all scenarios of conflict and violence, public health and medicine are bridges for overcoming barriers. Access to clean water, food, air and shelter and medical care are core human rights which mandate cooperation between professionals in public health, no matter what the political barriers are.
Eighth and perhaps most important, health and medical professionals have a responsibility, as individuals and groups, not to be passive or complicit bystanders, but to speak out publicly on genocidal threats and their early warning signs. Genocide results from human choice and bystander indifference. One lesson of the Holocaust is that: silence makes one a complicit bystander to genocide. There is no ethical case for the position that speaking out on such threats, if based on evidence of genocidal threats, or compelling evidence that such evidence is being suppressed, is somehow a slide down the slippery slope to politicization . Not to speak out is to slide down that slippery slope. There is no action more important to promoting the core value of medicine and public health: respect for individual human life and dignity.
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1. A case in point of a failure to adhere to proper standards of investigation was the UN’s sloppy investigation of the genocidal mass murders, rapes and plundering in Darfur, This sloppy investigation had the effect of manufacturing doubt concerning the results of a far more rigorous investigation by the US State Department, a study that did find that there was a pattern of organized intent to destroy a population “in whole or in part”.
[1] We have published the Timeline of the incitement of Radio Milles Des Collines as a forerunner to the Rwandan genocide.
Richter ED, Stein Y, Barnea Burnley A, Sherman M. Can we prevent Genocide by preventing Incitement? Case Western Reserve University archives.
http://hdl.handle.net/2186/ksl:riccan00/riccan00.pdf
Notes:
Our timeline itemizing Iranian state hate language (dehumanization, demonization, delegitimization, disinformation, and denial) is an example of an attempt to quantify temporal fluctuations in frequency and intensity.
Stein Y, Pileggi T, Barnea Burnley A, Richter ED. More "Mein Kampf": A Chronology of Statements of Incitement and Hate Language by Ahmadinejad and other Iranian Leaders.
http://www.genocidepreventionnow.org/HomeIssue5Winter2011/GPNISSUES/Issue4Fall2010/tabid/90/ctl/DisplayArticle/mid/473/aid/143/Default.aspx
Richter ED, Barnea A. Tehran's Genocidal Incitement against Israel. Middle East Quarterly. Summer 2009, pp. 45-51
http://www.meforum.org/2167/iran-genocidal-incitement-israel
A second example is the Kedar-Yerushalmi study of jihadist incitement in American mosques carried out by the NY PD.
Kedar M, Yerushalmi D. Shari'a and Violence in American Mosques. Middle East Quarterly. Summer 2011, pp. 59-72
http://www.meforum.org/2931/american-mosques
A third are the studies of incitement and education for peace in Textbooks in various Mideastern countries, by Arnon Groiss, IMPACT-SE.
Palestinian Textbooks: From Arafat to Abbas and Hamas. IMPACT-SE. March 2008
http://www.impact-se.org/docs/reports/PA/PA2008.pdf
Peace and the "Other" in Tunisian Schoolbooks: A Concise Final Report. IMPACT-SE. November 2009.
http://www.impact-se.org/docs/reports/Tunisia/Tunisia_Final2009.pdf
A fourth is the current project to assess Incitement in Palestinian and Israeli textbooks sponsored by the US State Department.
Last Updated on Friday, 17 June 2011 00:55
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