By Marius Smith

It has recently emerged that the CIA set up a vaccination campaign in Pakistan as part of a covert operation to monitor Osama Bin Laden’s compound there and obtain a DNA sample from one of his relatives.  Although plenty of people would argue that the end justifies the means, jeopardising the health of vulnerable children is clearly overstepping the line.

Since the news broke last week, there has been plenty of speculation that people will become even more suspicious of vaccine campaigns. Mark Leon Goldberg’s piece on how the news might affect attempts to eradicate Polio in Pakistan is particularly compelling.

On another note, the respected French medical NGO, Medecins San Frontieres, has lashed out at the CIA for further undermining trust in impartial organisations trying to save lives around the world: in recent years, an average of 95 aid workers have been killed each year, and another 57 kidnapped.  The last thing humanitarian organisations needed was another wedge driven between them and those they are trying to help, especially in a country as combustible as Pakistan.

This news also highlights less-discussed issues: first, how common these types of operations are, and second, how non-humanitarian organisations such as the CIA often botch them.

It was just an aberration, right?

Some of those commenting on this story have expressed the hope that the vaccination plan was a “one-off crazy scheme” or an “aberration”, but it is nothing of the sort.  In fact, it is an expansion of the US Government’s long-standing policy of using aid for strategic, military purposes.

Since the early 1990s, western military forces – and especially US Forces – have increasingly conducted aid operations in both conflict and non-conflict situations.  The trend is strongly linked to the end of the Cold War, when the US and its allies were hard-pressed to justify their huge military budgets.  If military chiefs and their political masters could find ways to make their soldiers useful in between conflicts, the thinking went, then they could at least minimise budgetary cuts.

The early 1990s were the heyday for military aid.  US forces and their allies provided assistance to the Kurds of Iraq after the 1991 Gulf War and the people of Bangladesh after the devastating cyclone in the same year; they later intervened to open humanitarian corridors in Somalia, and to provide aid to Rwandan genocide survivors in Congo. Not long after that, they found themselves in Serbia, and then Kosovo.  By and large, western forces found themselves lionised as heroes not for their bravery under fire, but for their ability to save lives. It’s a reputation that lives on to this day: a few years ago, a student told me that she planned to apply to the military because she wanted to “make a difference”.

In some instances, such as Bangladesh and Congo, military forces directly provided aid, while in others they worked so closely with aid organisations that the line between the two was difficult to see.  Perhaps the greatest blurring came in Kosovo when CARE Canada signed an agreement with the Canadian Government to effectively spy on Serbian forces for NATO (for an explanation of this episode, see David Rieff’s book A Bed for the Night, p221).

In the aftermath of the 11 September 2001 terrorist attacks, military chiefs took the next logical step and incorporated humanitarian aid as a weapon of war.  After the initial invasion, the US and its allies formed “Provincial Reconstruction Teams” (PRTs), which were military-commanded units with embedded civilians specifically designed to achieve military goals (the original teams had 79 military personnel and three civilians).  The US realised that it did not have the manpower to patrol the entire country, so the PRTs were designed to pacify the population using aid and development, particularly in the country’s least secure regions.  Each PRT designed its own programs, but in short they included uniformed soldiers delivering aid projects such as building schools, digging wells and conducting medical clinics.  Not surprisingly, humanitarian organisations found it hard to build trust with locals, who struggled to tell the difference between an aid worker and a soldier.

When the US invaded Iraq in 2003, the PRT model was exported there too. Now, as the war on terror has moved from large-scale conflicts to small-scale anti-terror operations, the military aid model has again been adapted for military purposes, and extended to the CIA.  No one should be surprised by this development, and nor should they be surprised when it happens again.  As a result, the number of needy citizens willing to trust aid agencies is only likely to shrink.

OK, but if the military saves lives, isn’t that a good thing?

A utilitarian would probably scoff at these concerns and hail the CIA for both capturing Bin Laden and saving kids’ lives.  In the words of a CIA official speaking off the record, “this was an actual vaccination campaign conducted by real medical professionals”.  The only problem is that the vaccination program was apparently botched.  According to the Guardian, the CIA engaged a Pakistani doctor to administer a Hepatitis B vaccine made by Pakistani company Amson. According to the company’s leaf insert, it should be administered in three separate doses over six months, however the Guardian claims that the children in the poorest part of Abbottabad received only the first dose before the team moved closer to Bin Laden’s house in the more upmarket part of town.

It is not surprising that the vaccination campaign did not work, because it was undertaken with the wrong motive: the humanitarian imperative of vaccinating children took a back seat to the operational imperative of catching Bin Laden.  This illustrates why military forces or the CIA should be engaged in humanitarian activity as rarely as possible: even if the CIA genuinely wanted to help the children of Abbottobad, that aim was thrown out as soon as the operational imperative required it.

Moreover, organisations such as armed forces and intelligence agencies simply do not have the expertise to deliver aid to a level that recipients deserve.  The reason is pretty simple: MSF’s doctors train to treat the kind of problems that arise in complex emergencies, such as dysentery and malaria, while military doctors train to treat problems that arise in military emergencies, such as trauma.  When the US military arrived in Congo after the 1994 Rwandan genocide, it brought a water pump capable of delivering 57,000 litres a day for relatively small military units.  Three private organisations brought pumps with capacities (see p 75) of 3.5 million, 750,000 and 600,000 litres per day, which were much more useful in assisting 800,000 refugees.  Certainly military aid can be successful in certain circumstances, most notably in non-conflict situations where it can utilise its natural strengths, such as airlift capacity. That’s why military operations after the 2004 tsunami were successful.  It is difficult, however, to imagine the appropriate environment for a successful CIA-led aid operation.

Still, the CIA operation in Abbottabad wasn’t some one-off event; it was simply the latest misuse of aid for military purposes and, like so many others, it failed to actually help the supposed recipients.  Even if the vaccination campaign also failed in its real goal of getting a DNA sample from the Bin Laden compound, you can bet that the CIA is analysing the campaign to figure out how similar operations can be used to fight terrorists in the future – regardless of the impact on innocent bystanders.

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