Book
Review:
Mobilizing Physicians
to Eradicate a ScourgeLandmines:
A Global Health Crisis
IPPNW Global Health Watch Report Number 2International
Physicians for the Prevention of Nuclear War (1997)
100 pp., US$10 
Reviewed by Kevin Cahill, MD Landmines: A Global
Health Crisis is a concise summary of a complex epidemic that currently destroys
lives and limbs in seventy countries on all continents. This new report, part
of a series of occasional policy papers issued by IPPNW, is strengthened by up-to-date
maps, charts, and tables detailing the areas most affected by antipersonnel mines,
hidden deadly weapons that kill and maim long after wars are finished and forgotten.
(In fact, ceasefires are usually associated with a rise in landmine induced injuries,
as innocent civilians try to return to homes and fields contaminated with explosives.)
The book’s appendices are also well organized, with a thorough bibliography,
the addresses of organizations cooperating in the current struggle to legally
ban landmines, the texts of international treaties, and suggested approaches and
protocols for physicians who might wish to become involved in the growing campaign
to eradicate this terrible scourge from the earth. In recent years, physicians
have been among the leaders of this movement, one founded in a revulsion at the
massive civilian trauma caused by landmines. Over a hundred nations have now pledged
themselves to a comprehensive ban on the use, stockpiling, production and transfer
of antipersonnel mines. Sadly, the United States has thus far refused to sign
the treaty and, having lost a unique opportunity for global moral leadership,
remains in the unenviable company of Iraq, China, India, and other landmine-producing
nations. The Nobel Peace Prize award to the international movement to ban landmines
further isolates the U.S. Administration’s position. In light of the
role physicians have -- and are -- playing in this international effort, it is
surprising that the authors of the report limit -- and underestimate -- the potential
role of their medical colleagues. For example, on pages 60-61, the authors state: “doctors...are
not involved in the diplomatic and political decisions concerning their (landmines)
inclusion in national arsenals, nor in considering treaties and protocols to control
their use or ban them all together...” But is this true,
and if so, why? Why do we create artificial barriers that restrict the scope of
any citizen’s involvement? The landmine crisis is, in fact, one of the prime
examples of the absolute need for physicians to transcend our self-imposed professional
constraints. In Preventive Diplomacy: Stopping Wars Before They Start
(Basic Books, 1996) contributors including the Secretary General of the United
Nations, his predecessor, the former Secretaries of State of the U.S., England,
and Sweden, the President of the World Court, and others, argued forcefully for
the centrality of health in defining foreign policy. In each chapter the authors
utilized the methodology of public health, and the semantics and metaphors of
medicine, to clarify and strengthen the soft discipline of diplomacy. As physicians,
we must no longer shy away from topics and causes that have been, by tradition,
viewed as non-medical activities. The medical profession can apply to
public policy issues the wisdom and insight that comes from clinical care of the
sick and wounded, from the unique privilege of sharing in the pains and sufferings
of our fellow man. No other profession is as protected as medicine. We must learn
to use our contacts -- very often our patients -- to extend the principles and
goals that medicine once effectively brought to the anti-nuclear weapons movement.
When the UN wished to use photographs I had taken in an amputee project for landmine
victims in Northern Somalia, I suggested that rather than use my amateur images
we invite photojournalists and photographic artists to expand our horizons. Although
I could not expose this group to the very real dangers of Northern Somalia, I
could invite them to become partners in our “cause” by offering their
own vision of the landmines crisis. Each photographer received two of the
prostheses we had used in Somalia and were told--most for the first time--that
there were a hundred million mines in the earth and that mostly women and children
were blowing up. Their contributions formed the basis for a major art exhibit,
entitled Silent Witnesses (Routledge Press). The collection has been seen by hundreds
of thousands of visitors in Geneva, Vienna, Oslo, across Canada, and, for six
months, in the main lobby of the United Nations. Its visual impact may well be
as important as the carefully argued logic of this truly excellent IPPNW report.
Kevin M. Cahill, M.D. is President of the Center for International
Health and Cooperation and is the editor of Clearing the Fields: Solutions
to the Landmine Crisis and of A Framework for Survival: Health, Human Rights,
and Humanitarian Assistance in Conflicts and Disasters.
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