April 16, 2014

World Insight Essay Series: Global Security and Health Implications of the Crisis in Mali

By: Bowie Daniel Hall

The Mali of 2004, when Oumou Sall Seck was elected as the first female mayor in the country’s north, offered the hope of stable democracy and economic development, bearing little in common with the country since an insurgency took hold in January 2012. “Life in northern Mali before the rebels and Islamic extremists arrived was calm; we lived together harmoniously in a community of various languages and backgrounds, including people of Tuareg, Sonraï, Bambara and Peul ethnicities […] and our cultural diversity enriched us,” the mayor explains.[1] Any semblance of harmonious diversity in northern Mali has been supplanted by military clashes between government forces, Tuareg separatists, and Islamist groups including Ansar Dine, the Al Qaeda in the Islamic Maghreb-linked group enforcing its harsh interpretation of sharia law.[2] Complicating matters, in March 2012 Malian soldiers staged a coup d’état, ousting the existing government while opening a window of uncertainty during which Tuareg militias, then allied with Ansar Dine, gained effective control over the main cities of northern Mali.[3] The southern part of the country remains in the hands of the country’s weakened central government as it awaits military support authorized by the U.N. Security Council in December 2012. Meanwhile, the situation on the ground as the crisis in Mali reaches its first anniversary is already stark: “[a] Taliban-style rule of stonings and amputations has been imposed, […] 400,000 civilians have fled their homes, and, the United Nations says, 600,000 children under the age of five are threatened by severe malnutrition.”[4] U.S. foreign policy as President Obama enters his second term in office should focus on places like Mali, which seem to get little serious media and policy attention until it’s too late. While the evolving humanitarian crisis and widespread allegations of violations of jus cogens, the fundamental norms of international law, within Mali should trouble all states as a matter principle, they should particularly concern the youth of the world who stand to inherit the potential consequences—particularly in terms of global security and health—long into the future.

The historical depiction of the now Ansar Dine-controlled northern Malian city of Timbuktu as the “essence of remoteness”[5] is not only intellectually outdated, but also belies the realities of security and health in a globalized world. The fate of landlocked, impoverished Mali affects everyone from Timbuktu to Times Square. While the famed city of medieval Islamic scholarship and trade in gold and salt now faces destruction of its UNESCO-protected mosques[6] and emergence as a hub of trafficking of “small arms, narcotics, migrants and hostages” which now characterizes northern Mali,[7] this contrast represents only part of a wider security problem. There is serious potential for expansion of hostilities from the rebel-controlled region of Mali that is already larger than France or Texas[8] through porous borders across North and West Africa.

“If unchecked, the Mali crisis threatens to create an arc of instability extending west into Mauritania and east through Niger, Chad and Sudan to the Horn of Africa and the Gulf of Aden, characterized by extended spaces where state authority is weak and pockets of territorial control are exercised by transnational criminals,” argues U.N. High Commissioner for Refugees António Guterres.[9] This extent of instability reaches far beyond the scope of a civil war or regional conflict; it is a global security threat. In a globalized world, one country, let alone a half of a continent, falling victim to strife echoes across the geopolitical landscape.

Highlighting the transnational security risk stemming from Mali is the fact that the crisis there was in part a spillover effect of the Libyan Arab Spring. The downfall of the Libyan regime that had employed many Tuareg fighters allowed Tuareg rebels in Mali, “[h]ighly motivated and equipped with box-fresh weaponry looted from the arsenals of Libya’s late Colonel Muammar Gaddafi—including vehicle-mounted rocket launchers, antiaircraft guns and surface-to-air missiles,“[10] to outmatch Malian forces. Just as the revolution in Libya impacted Mali, the conflict in Mali could easily spread further. Extensive, porous borders through the harsh climate of the Sahara and Sahel make the huge region difficult to control.. Furthermore, regional political instability already abounds with nearby Arab states dealing with ongoing civil uprisings, bordering Guinea and Côte d’Ivoire “still struggling to emerge from recent crises,”[11] and regional power Nigeria coping with its own insurgency led by the extremist Boko Haram group. Showing their resolve to operate across borders, northern Mali’s Islamists “have already threatened to bomb the capitals of any African nation that contributes troops to the planned military force”[12] now authorized by the U.N. Security Council. Fadiala Sidibe, police commissioner in the Malian city of Mopti, says, “[t]heir target is Western civilization,” adding that “[t]hey want to impose Islamic sharia law all over West Africa.”[13]

As dangerous as the prospect of the Malian crisis spilling over across Africa is to global security, the insurgency’s links with worldwide networks of like-minded groups could mean expanded risks of direct terror attacks around the world as extremists transform northern Mali into “a vast [Al] Qaeda enclave and training ground.”[14] Local extremists openly advertise intentions of striking globally. Oumar Ould Hamaha, lieutenant to the emir of an Al Qaeda-linked cell in Gao, Mali threatens, “[i]f they bomb us, we are going to hit back everywhere.”[15] These threats seem more realistic when one considers the rebels’ “deep pockets from ransoming Western hostages and taking their cut in West Africa’s booming cocaine trade to buy more guns and easily bribe recruits” [16] Many of the aspects which allowed Taliban-controlled Afghanistan to become a haven for militants are present in Mali, which could likewise turn into the base for global terror operations.

The economic aspects of security in Mali threaten to propagate the crisis there. In the words of former U.N. Secretary General Kofi Annan, “no one in this world can feel comfortable, or safe, while so many [around the world] are suffering and deprived.”[17] As routine food shortages and desertification exacerbate poverty, an already poor government loses financial resources to control its territory, and, eventually, the world faces what consequences may evolve. Susceptibility to illicit activities, bribery, and influence from extremists increases in places like Mali. Though it would be an oversimplification not supported by quantitative academic research to suggest that economic development alone is a panacea for terrorism and other global security concerns, [18]  the situation in Mali reflects broader trends of “incomplete democratization processes marked by social exclusion, and a growing population of young people with poor employment prospects.”[19] If such young people are swept away by waves of violence rather than pursuing more economically productive activities, the crisis in Mali will worsen before it improves. Poverty is a reason to pay attention to rather than neglect a country or region of the world. Mali now requires large-scale investments in intervention and peacekeeping forces as well as development initiatives to avert the existing and potential global security risks. No part of the world, especially not the United States, is immune from instability in Mali.

As worrying as the potential global security fallout from Mali has become, it is compounded by pressing health concerns spurred by the humanitarian crisis. From the perspective of the universally-endorsed Millennium Development Goals (MDGs)[20], specifically those focusing on health, this is by definition a global issue. Especially endangered by the crisis are women and children, who “bear the greatest burden in the midst of war and long-term disasters,”[21] contravening the MDGs of reducing child mortality and improving maternal health. So too does the crisis complicate the MDG of combatting HIV/AIDS, malaria, and other diseases as the jobs of healthcare practitioners, public health officials, and aid workers become more dangerous and complicated. Mali, along with Nigeria, the Democratic Republic of Congo, Burkina Faso, Mozambique, and Côte d’Ivoire, accounted for 60% of the estimated 655,000 people killed in 2010 by malaria[22]—a treatable disease with proper resources. The availability of these resources across Mali is at risk as hostilities continue. Malaria, HIV/AIDS and other epidemics in Africa are not only “African problems”; they are issues of major global concern. “From the point of view of health, there is really nowhere on the planet that is remote, and no one from whom we are disconnected[;]” argues Barry R. Bloom, former dean of the Harvard School of Public Health, “[h]ealth problems and disease do not respect national borders.”[23] The globalization of health means that viewing public health in the United States or elsewhere as insulated from that of Mali, especially in terms of communicable diseases, is no longer realistic. In the words of Judge Chistopher Weeramantry, former Vice President of the International Court of Justice, “[m]icrobes know no national barriers, and the traditional distinction between national and international health regimes is obsolete.”[24] When conflicts cause mass migrations of people and disrupt the normal provision of healthcare, as in Mali, the transnational nature of public health is amplified.

The crisis in Mali is of particular global health concern both because of its scope and because of the array of diseases present in Mali. Access to basic healthcare and preventative medicine has been disrupted by the conflict as porous borders, extensive overland trade routes, and growing refugee populations threaten to distribute the health crisis transnationally. Such situations are fundamentally precarious since complex humanitarian emergencies “frequently result in catastrophic public health emergencies as coping capacities are exceeded by need, placing vulnerable populations at greatest risk of epidemic diseases.”[25] These diseases are already a widespread problem in this part of the world. In addition to managing HIV/AIDS and malaria epidemics, Mali is part of Africa’s “meningitis belt,” where epidemics of this disease “constitute an enormous public health burden.”[26] Furthermore, schistosomiasis, onchocerciasis, trachoma, lymphatic filariasis, and soil-transmitted helminths are endemic in the county.[27] The risk of new or existing strains of diseases rapidly spreading is a reality exemplified by the severe acute respiratory syndrome (SARS) crisis, which spread within months from Hong Kong to infect some 10,000 people in 37 countries around the world.[28] The health vulnerabilities created by the crisis in Mali are a problem facing everyone.

If the Sahel region’s “19 million people [living] on the edge of malnutrition” and“[m]ass rape, amputations and killings”[29] in Mali were not enough to attract serious attention in more fortunate parts of the world, the realities of global insecurity and health risks mean that the crisis there cannot be ignored. What happens in Mali poses a risk to people in all countries, and especially to the youth of the world who stand to gain or lose the most from the conflict’s long-term effects. Ten years from now Mali could return to being an example of tolerant democracy where women like Oumou Sall Seck can be elected mayor, or it can be a bastion of intolerance harboring terrorists. For the second Obama administration, both supporting the U.N. Security Council’s mandate to intervene in Mali and focusing its major foreign policy efforts on countries facing similar challenges should be priorities. The global security and health hazards which can erupt from impoverished, superficially isolated places impact even the wealthiest of countries in a globalized world.

 

 

 

References

Annan, K. (2002, 19 March). Investing in the World’s Future. United Nations press release of the Secretary General’s statement at the International Conference on Financing for Development. Retrieved from http://www.un.org/ffd/pressrel/19a.htm.

Bloom, B. (2008). Preface. In Skolnik, R., The Essentials of Global Health (pp. xiii-xiv). Sudbury, MA: Jones and Bartlett Publishers. P. xiii.

Callimachi, R. (2012, December 31). Al Qaeda In Mali: Islamist Fighters Carve Out New Country. Huffington Post/Associated Press. Retrieved from http://www.huffingtonpost.com.

Cavendish, J. (2012, March 22). Mali: Big Trouble in a Poor Country Awash in Post-Gaddafi Weapons. Time. Retrieved from http://www.time.com.

Crumley, B. Mali’s Crisis: Is the Plan for Western Intervention ‘Crap’? Time. Retrieved from http://www.time.com.

Dixon, R and Labous, J. (2012, April 4). Gains of Mali’s Tuareg rebels appear permanent, analysts say. Los Angeles Times. Retrieved from http://www.latimes.com.

Gasseer, N. A., Dresden, E., Keeney, G. B. and Warren, N. (2004), Status of Women and Infants in Complex Humanitarian Emergencies. Journal of Midwifery & Women’s Health, 49: 7–13.

Gladstone, R. (2012, December 20). U.N. Council Votes to Help Mali’s Army Oust Islamists. The New York Times. Retrieved from http://www.nytimes.com.

The Washington Post Editorial Board. (2012, December 9). Terror central in Mali. The Washington Post. Retrieved from http://www.washingtonpost.com.

Guterres, A. (2012, September 4). Why Mali Matters. The New York Times. Retrieved from http://www.nytimes.com.

O’Dempsey, T. (2009). Refugee Health. In Gil, G. V. and Beeching, N, Eds., Lecture Notes: Tropical Medicine, (pp. 365-372). 6th Ed. West Sussex, UK: Wiley-Blackwell.

Piazza, J. (2007). Global Poverty, Inequality, and Transnational Terrorism: A Research Note. Perspectives on Terrorism, 1(4).

Sall Seck, O. (2012, December 28). Save Mali Before It’s Too Late. The New York Times. Retrieved from http://www.nytimes.com.

Smith, R. D. (2006). Responding to global infectious disease outbreaks: Lessons from SARS on the role of risk perception, communication and management. Social Science and Medicine, 63(12), 3113-3123.

Townsend, M. (2012, 15 December). The Observer. Retrieved from http://www.guardian.co.uk.

U.S. Agency for International Development/Neglected Tropical Disease Control Program. (2007). Success Story: Governor of Bamako Motivates Others to Participate in the Neglected Tropical Disease Control Program in Mali. Retrieved December 31, 2012 from http://ntd.rti.org/publications/index.cfm?fuseaction=throwpub&id=254.

United Nations Development Programme. The Millennium Development Goals: Eight Goals for 2015. Retrieved December 31, 2012 from http://www.undp.org/content/undp/en/home/mdgoverview.html.

Weeramantry, C. (2005). Foreword. In Aginam, O. (2005). Global Health Governance: International Law and Public Health in a Divided World (pp. xi-xii). Toronto: University of Toronto Press. P. xi.

World Health Organization. (2012). Meningococcal meningitis: Fact sheet N°141. Retrieved December 31, 2012 from http://www.who.int/mediacentre/factsheets/fs141/en/.

World Health Organization, Global Malaria Initiative. (2011). World Malaria Report 2011 Fact Sheet. Retrieved December 31, 2012 from http://www.who.int/malaria/world_malaria_report_2011/WMR2011_factsheet.pdf. P. 1.

York, Geoffrey. (2012, December 20). Mali’s Neighbours fear spread of terrorism from Islamists. The Globe and Mail. Retrieved from http://www.theglobeandmail.com.


[1] Sall Seck, O. (2012, December 28). Save Mali Before It’s Too Late. The New York Times. Retrieved from http://www.nytimes.com.

[2] Gladstone, R. (2012, December 20). U.N. Council Votes to Help Mali’s Army Oust Islamists. The New York Times. Retrieved from http://www.nytimes.com.

[3] Dixon, R and Labous, J. (2012, April 4). Gains of Mali’s Tuareg rebels appear permanent, analysts say. Los Angeles Times. Retrieved from http://www.latimes.com.

[4] The Washington Post Editorial Board. (2012, December 9). Terror central in Mali. The Washington Post. Retrieved from http://www.washingtonpost.com.

[5] Guterres, A. (2012, September 4). Why Mali Matters. The New York Times. Retrieved from http://www.nytimes.com.

[6] Supra. Dixon, R and Labous, J. (2012, April 4).

[7] Supra. Guterres, A. (2012, September 4).

[8] Callimachi, R. (2012, December 31). Al Qaeda In Mali: Islamist Fighters Carve Out New Country. Huffington Post/Associated Press. Retrieved from http://www.huffingtonpost.com.

[9] Supra. Guterres, A. (2012, September 4).

[10] Cavendish, J. (2012, March 22). Mali: Big Trouble in a Poor Country Awash in Post-Gaddafi Weapons. Time. Retrieved from http://www.time.com.

[11] Ibid.

[12] York, Geoffrey. (2012, December 20). Mali’s Neighbours fear spread of terrorism from Islamists. The Globe and Mail. Retrieved from http://www.theglobeandmail.com.

[13] Ibid.

[14] Supra. Gladstone, R. (2012, December 20).

[15] Supra. Callimachi, R. (2012, December 31).

[16] Crumley, B. Mali’s Crisis: Is the Plan for Western Intervention ‘Crap’? Time. Retrieved from http://www.time.com.

[17] Annan, K. (2002, 19 March). Investing in the World’s Future. United Nations press release of the Secretary General’s statement at the International Conference on Financing for Development. Retrieved from http://www.un.org/ffd/pressrel/19a.htm.

[18] Piazza, J. (2007). Global Poverty, Inequality, and Transnational Terrorism: A Research Note. Perspectives on Terrorism, 1(4).

[19] Supra. Guterres, A. (2012, September 4).

[20] United Nations Development Programme. The Millennium Development Goals: Eight Goals for 2015. Retrieved December 31, 2012 from http://www.undp.org/content/undp/en/home/mdgoverview.html.

[21] Gasseer, N. A., Dresden, E., Keeney, G. B. and Warren, N. (2004), Status of Women and Infants in Complex Humanitarian Emergencies. Journal of Midwifery & Women’s Health, 49: 7–13. doi: 10.1016/j.jmwh.2004.05.001. Abstract.

[22] World Health Organization, Global Malaria Initiative. (2011). World Malaria Report 2011 Fact Sheet. Retrieved December 31, 2012 from http://www.who.int/malaria/world_malaria_report_2011/WMR2011_factsheet.pdf. P. 1.

[23] Bloom, B. (2008). Preface. In Skolnik, R., The Essentials of Global Health (pp. xiii-xiv). Sudbury, MA: Jones and Bartlett Publishers. P. xiii.

[24] Weeramantry, C. (2005). Foreword. In Aginam, O. (2005). Global Health Governance: International Law and Public Health in a Divided World (pp. xi-xii). Toronto: University of Toronto Press. P. xi.

[25] O’Dempsey, T. (2009). Refugee Health. In Gil, G. V. and Beeching, N, Eds., Lecture Notes: Tropical Medicine, (pp. 365-372). 6th Ed. West Sussex, UK: Wiley-Blackwell.

[26] World Health Organization. (2012). Meningococcal meningitis: Fact sheet N°141. Retrieved December 31, 2012 from http://www.who.int/mediacentre/factsheets/fs141/en/.

[27] U.S. Agency for International Development/Neglected Tropical Disease Control Program. (2007). Success Story: Governor of Bamako Motivates Others to Participate in the Neglected Tropical Disease Control Program in Mali. Retrieved December 31, 2012 from http://ntd.rti.org/publications/index.cfm?fuseaction=throwpub&id=254.

[28] Smith, R. D. (2006). Responding to global infectious disease outbreaks: Lessons from SARS on the role of risk perception, communication and management. Social Science and Medicine, 63(12), 3113-3123.

[29] Townsend, M. (2012, 15 December). The Observer. Retrieved from http://www.guardian.co.uk.

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