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Skip to 0 minutes and 16 secondsIt’s a whole framework, and it takes a little while to describe it, but the major finding at the very beginning was that in all the societies at conflict that we were looking at, and mostly these were internal civil wars at that stage, in the nineties. We find this to be true and cross border wars now in many places as well, but what we found was that not surprisingly there were things that divided people, around which they were having the battle. That finding was an interesting one because if people are fighting you know they’re divided in some sense.

Skip to 0 minutes and 43 secondsBut what we began to find was people describe the divisions, the thing they were fighting about and the way it manifested themselves in their location with much more subtlety and precision than just the battle lines and so there was something to be discovered about what people call their dividers, what divided people from each other. More interesting, when we got to this point was discovering things that people in those war situations also remain connected throughout the war.

Skip to 1 minute and 8 secondsWhen we began the project we’d imagine that you would find in the war-zone people who are for war and people who are against war and what you were trying to do was to provide the aid in a way that help move people who are in favor of war over to the other side. Give them incentives to disengage from the war. We found an entirely different picture.

Skip to 1 minute and 25 secondsWe found that there are those two groups at the extremes, the anti-war people and the pro-fighters but we found that the vast population in between was ambivalent that they spent some part of their time engaged in the war and some part of their time, sometimes on a daily basis engaged in the peace, that is in the normal interactions of life in a civil war. So what we found was that when international assistance is given, its very often given much more consciously aware of the divisions than of the connectors.

Skip to 1 minute and 55 secondsMost international aid workers were not aware of these ongoing connectors as well and that therefore they give the aid in relation to the dividers and reinforce them and make them worse and by doing that ignore the existing connectors and often undetermine and weaken them so that in fact in a more subtle way we were reinforcing the divisiveness and the continued fighting in some subtle way rather than helping people continue the normal connected sides of their lives. There are two basic ways in which this occurs in we found.

Skip to 2 minutes and 32 secondsInternational assistance brings resources into an environment, obviously, and those resources that we bring - and those can be both tangible resources and intangible - such as training or advice, but those resources we bring... if you introduce resources into a resource scarce environment, where people are in war with each other, those resources become a part of that conflict and people fight over them and struggle over them, so the distribution and the allocation of those resources is one of the mechanisms by which aid.... either reinforces the dividers or connectors in that framework.

Skip to 3 minutes and 3 secondsAnd the other thing that turned out to be extremely important and very interesting to us as we had story after story and evidence after evidence on this was something we began calling “implicit ethical messages” and that is the way in which the aid is provided the way in which people interact with each other the kinds of personal conduct of aid workers, the kinds of organizational conduct, conduct of aid agencies conveys messages that either reinforce the kind of modes, means of conflict or that set out an alternative standard in some way remind people of the other ways interacting with people.

Skip to 3 minutes and 40 secondsWell health workers as all international actors or even local actors working in a conflict situation need to be aware of the fact that there’s no neutrality. That when one is providing resources meaning both the tangible and the intangible curative resources you are having an impact, you are having a non-neutral effect. You can be impartial between the two sides but the impact of that aid is playing into the conflict in one way or another.

Skip to 4 minutes and 5 secondsSo that they need to know as all aid workers do, anyone else, they need to make themselves aware of and try to analyse and stay on top of the evolving and changing dividers and connectors so that they can trace the way in which their assistance is interacting with that. The special aspect that health workers really can acknowledge is this that I just said that in many countries the access to medical and health services are accepted as something that everyone has a right to even the enemy, even the enemy’s children.

Skip to 4 minutes and 41 secondsAnd so in some ways they start a little bit ahead of many other aid workers, the workers dealing with housing or with food, because if people will accept this notion that, and its not universal to every individual, but it certainly seems to permeate many societies, if people accept this fact that healthcare is something that people should have access to , they start with a possibility of working on a connector very early in their work to give their services in a way that reinforces division would therefore be even worse than people who are struggling harder to figure out how to get food across borders, because they start with an advantage.

Skip to 5 minutes and 20 secondsThey ought to play to that advantage and really be very sensitive to how to deliver the services, how to provide the apparatus of health care, the clinic’s drugs, the expertise. To provide that in a way that does really actually bring people across lines to each other.

Managing complex situations

Mary B. Anderson is an American economist and author of the book “Do no harm: how aid can support peace - or war”.

In her video interview, Anderson explores just how subtle the difference between “connectors” and “dividers” can be.

Consider viewing the transcript at the same time as you watch the video. Make some notes about how healthcare workers can unknowingly focus on the “dividers” more than the “connectors” in a conflict setting.

Please discuss the following questions below in the general discussion:

Who or what are the dividers and connectors that may assist Dr Samoe’s healthcare team in entering the community? Negotiating access is one of the most difficult and recurrent objectives for humanitarian field workers.

Does this change the answer you gave in Step 1.15 - when you were deciding on whether you agreed with nurse Aisha or with nurse Ann? Hopefully this scenario has shown that armed conflict presents a complex challenge to healthcare workers, and that the answers are never black and white.

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Medical Peace Work

University of Bergen

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