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and what weapons and methods they can use are not unlimited. Second, states have responsibilities toward those affected by war, including providing or allowing the delivery of humanitarian assistance, such as medical and food aid. Unlike war abolitionists, IHL takes war as a given and attempts to ameliorate the effects of war. It does not have the broad societal-changing goals of human rights. It is focused on the moment, the situation on the ground, and people in immediate need.

      Over the decades, the ICRC has developed a set of principles to which most humanitarians aspire.9 Of the seven core principles, four are the most important—humanity, neutrality, impartiality, and independence.10 Humanity is of obvious importance—it is the core impetus, the reason behind the actions. Neutrality, impartiality, and independence form the superstructure of classical humanitarian action. Neutrality means not taking sides in a conflict. Impartiality requires the provision of assistance to all in need. Independence entails acting without any state guiding your actions. The ICRC strictly adheres to these principles, and most other nonstate humanitarian organizations also take them as core principles, although this has become harder to do. UN and other state-based humanitarian organizations, while professing adherence to these principles, have obvious problems with independence, since they are acting on behalf of states. Further, neutrality can be difficult to achieve if the UN has taken sides in a conflict. International humanitarian organizations (IHOs) use these principles as a protective cloak, hoping that combatants will perceive them as not involved with one side or another and not threatening them in any way, and thus having no reason to fear or harm them. While this may work to a certain extent, it is by no means a sure path to security for humanitarian workers and access to those in need.

      The developments in 1949 coincided with other developments in the UN and elsewhere. In particular, the UN created the Office of the UN High Commissioner for Refugees (UNHCR)11 in 1950, and the Refugee Convention followed in 1951. The latter created a framework to provide for the rights of a significant population of those affected by war—refugees. It outlined the responsibilities of states toward refugees, including the principle of nonrefoulement—no forcible repatriation. UNHCR had an initial budget of $300,000 and a three-year lifespan. In the ensuing decades, it dramatically expanded its remit and global presence.12

      The 1990s saw UNHCR expand its presence substantially while changing the nature and scope of the organization. The number of refugees globally reached its peak in 1993 in the context of war in the Balkans and Somalia. Its experience in Bosnia changed the organization as it became involved in the midst of a conflict rather than on the edges.13 Its personnel were put in harm’s way and it was much more difficult for it to operate—it now had to negotiate with combatants to gain access to affected populations in the middle of fighting, and frequently the combatants were not willing to accommodate UNHCR. The UN also had a peacekeeping mission in Bosnia, but it had a weak mandate, and although it included protecting humanitarian aid efforts, it routinely failed in its mission.14 Thus, humanitarianism became the perfect vehicle for the international community, which was under pressure to respond but which did not want to commit troops. At the same time, UNHCR began acquiring a wider remit as it began assisting internally displaced persons (IDPs). While undoubtedly helping many people inside Bosnia, UNHCR’s actions also helped European states, which wanted to keep IDPs from becoming refugees and making their way to Germany and other western European countries. The right to seek asylum thus became the “right to remain”15 and “preventive protection,”16 and humanitarians became involved in “‘containment through charity.’”17 High Commissioner Sadako Ogata suspended UNHCR operations in Bosnia until it received better cooperation from all the combatants and peacekeepers. However, because Ogata was going to remove “the international community’s symbol of concern,”18 UN Secretary-General Boutros Boutros-Ghali ordered UNHCR to stay. Although they were myth before, Bosnia fundamentally exposed the mismatch between lofty humanitarian principles—in particular independence—and the reality of state-based humanitarian action.

      Rwanda proved another turning point for UNHCR and other IHOs as genocide and complete and utter failure on the part of the international community to stop the genocide or address the aftermath created untenable situations and dilemmas for all IHOs. The North Atlantic Treaty Organization (NATO) intervention in Kosovo19 brought humanitarianism further into the political fold. This process was complete by the early years of the new century as humanitarians became “force multipliers”20 in Afghanistan and Iraq, and humanitarianism became just one more tool in the “War on Terror.” The “War on Terror” has also eliminated the distinction between combatant and noncombatant, on which the principle of neutral and impartial assistance is based. As the United States and its allies pursue those they deem terrorists around the world, its adversaries become “evil,” thus losing the protection (in the eyes of the United States) of the Geneva Conventions—and fundamental human rights norms more generally, such as the prohibition on torture—and the notion of the battlefield has disappeared as the entire world becomes a battlefield.21 This creates problems for humanitarians.22

      From Classical to Rights-Based Humanitarianism

      Indeed, humanitarians frequently end up in the middle of the most violent conflicts around the world, with little political or other support. They must negotiate access to populations affected by war and may find that they become part of the conflict, targeted by various actors in the conflict or manipulated as pawns.23 Further, fundamental understandings of what the practice of humanitarianism entails have changed. Through the 1970s, humanitarianism, for the most part, was conceptualized and practiced along the lines of classical, bed for the night humanitarianism—delivering food and medical aid in the midst of conflict—although Conor Foley notes how even during the Biafra crisis in 1967 humanitarians acted in very political ways.24 The move to rights-based humanitarianism—along the lines of the peacebuilding version identified above—has led to a situation where humanitarians frequently look at the root causes of conflicts—including human rights abuses—and the broader rights of those displaced or otherwise affected by war. IHOs will more frequently engage in advocacy for the protection of human rights, including calling for the use of the military to protect human rights. And, instead of international humanitarian law, international refugee law, and international human rights law being viewed as separate realms, they are now seen as interrelated, providing broader, more robust legal analysis.25 At the same time, particularly as a result of the experience in Rwanda, the “do no harm”26 model is being embraced, as IHOs become more reflective about the broader implications of their work.27

      From Palliation to Power

      In its most basic sense, humanitarianism is palliation. According to the World Health Organization, “Palliative care is an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.”28 In the medical sense, palliative care “intends neither to hasten or postpone death.” It “provides relief from pain and other distressing symptoms” and “offers a support system to help patients live as actively as possible until death.” The “illness,” the symptoms of which humanitarians treat, is not the malnutrition and diseases from which those affected suffer. Rather, it is war and violent conflict itself. Thus, whereas palliative care “affirms life and regards dying as a normal process,” humanitarianism as palliation affirms life but also regards war as a normal process. It takes the world and its illness—war—as it is and helps those affected by the illness—refugees, IDPs, and others—to stay alive, hopefully until the war ends and localized illness is cured, or until the illness—war—ultimately kills them. It treats the symptoms rather than effecting a cure. While many millions of people have been saved by humanitarianism, it must seem for some caught in the midst of conflict that the refugee camp is akin to a hospice, with humanitarians keeping refugees alive and comfortable until the war—either directly through an attack by armed forces or indirectly through malnutrition and war-associated disease—kills them. They thus become what has been described as the “well-fed dead.”29

      This description

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