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On Medical Neutrality
May 21, 2013 7:47 AM   Subscribe

In 2011, the CIA reportedly hired a doctor in Pakistan to conduct espionage while giving vaccinations to children. In response, Pakistan expelled Save the Children from the country. The New England Journal of Medicine comments on military operations masquerading as humanitarian relief.

Don't miss the audio interview on that page too.
posted by painquale (41 comments total) 25 users marked this as a favorite

 
On a tangentially related note, and to put this in context of the bigger problem of oppressive governments subverting the neutrality of medical care professionals or otherwise denying people access to medical care for political reasons:

Security Forces Barring Protesters from Medical Care

It's awful, but it seems like the days of all sides at least having the decency to let their enemies tend to their wounded are long gone, if they ever existed at all outside of the romanticized tales of honor and glory we used to tell ourselves to make combat seem noble.
posted by saulgoodman at 8:01 AM on May 21, 2013 [1 favorite]


In 2011, the CIA reportedly hired a doctor in Pakistan to conduct espionage while giving vaccinations to children. In response, Pakistan expelled Save the Children from the country.

This is a line in the sand the US Govt. should really regret crossing. It will result in the deaths of thousands of innocents least able to protect themselves: children, the elderly, and the disabled. Disgraceful.
posted by leotrotsky at 8:07 AM on May 21, 2013 [34 favorites]


I think it was in longtime CIA operative Robert Baer's autobiography that I picked up the idea that it was flatly illegal for actual CIA personnel to pose as clergy, journalists or aid workers. I could be mistaken on that, 'cause I'm operating on memory early in the morning, but I remember that being a thing.

Guess the same rules don't apply when it's the people the CIA is trying to work through.
posted by scaryblackdeath at 8:12 AM on May 21, 2013


This is a line in the sand the US Govt. should really regret crossing.

It takes a tough man to make a tender chicken.
posted by three blind mice at 8:15 AM on May 21, 2013


The behavior of US armed forces in combat is actually far worse than the case of DNA testing. Additionally, the United States has been systematically executing first responders after drone strikes:
Further, those interviewed stated that the fear of strikes undermines people’s sense of safety to such an extent that it has at times affected their willingness to engage in a wide variety of activities, including social gatherings, educational and economic opportunities, funerals, and that fear has also undermined general community trust. In addition, the US practice of striking one area multiple times, and its record of killing first responders, makes both community members and humanitarian workers afraid to assist injured victims.
Coincidentally, it's another Terror Tuesday, so at some point today Obama will probably be deciding who to execute without trial this week.
posted by tripping daisy at 8:17 AM on May 21, 2013 [11 favorites]


This is appalling.
posted by orange swan at 8:21 AM on May 21, 2013 [1 favorite]


Bullshit on both sides of this coin.
posted by Windopaene at 8:23 AM on May 21, 2013


In addition, the US practice of striking one area multiple times, and its record of killing first responders, makes both community members and humanitarian workers afraid to assist injured victims.

Oh holy shit. Oh I hope there's a special circle of hell. It is beyond unconscionable to kill first responders or use international medical aid as a cover for political gain. Bin Laden was not a good dude, but his death is far from worth the thousands of lives it's going to cost across the world because medical care is no longer getting where it's needed.

I am joining a Global Health graduate program in the fall. I will almost certainly be going to undeveloped, unstable areas at some point my career. At this point, I'm more afraid of my own government's stupidity getting me killed than I am of the locals per se.
posted by WidgetAlley at 8:24 AM on May 21, 2013 [12 favorites]


it seems like the days of all sides at least having the decency to let their enemies tend to their wounded are long gone, if they ever existed at all outside of the romanticized tales of honor

Please don't assume that all countries tolerate war crimes just because your country tolerates war crimes. It's cynicism in defense of barbarism.

The reason why the Geneva conventions have been such a widespread success is that there's actually very little military advantage to be gained from bombing a hospital, torturing a prisoner or impersonating a doctor. The CIA was not "doing what needs to be done" to win the war; the overall effect of this campaign on the war was likely negative. From the article: "the ploy appears not to have worked." It's shocking that the CIA was willing to hurt so many people so badly for such trifling gains.
posted by justsomebodythatyouusedtoknow at 8:34 AM on May 21, 2013 [26 favorites]


Then, instead of giving the doctor who helped us get Bin Laden part of the $50M reward, we let him get arrested by the Pakistanis, and he's now rotting in one of their prisons (as far as I know).
posted by whatgorilla at 8:53 AM on May 21, 2013 [2 favorites]


we let him get arrested by the Pakistanis, and he's now rotting in one of their prisons

Rightly so.
posted by justsomebodythatyouusedtoknow at 8:56 AM on May 21, 2013 [3 favorites]


This is a line in the sand the US Govt. should really regret crossing. It will result in the deaths of thousands of innocents

So business as usual.
posted by five fresh fish at 9:01 AM on May 21, 2013


I'm betting we lied to him, but maybe he fully understood the risks.
I also don't know his situation and if he realized the consequences.
I'm just not ready to throw him under the bus with the CIA, but maybe he deserves such.
posted by whatgorilla at 9:02 AM on May 21, 2013


Oh holy shit. Oh I hope there's a special circle of hell. It is beyond unconscionable to kill first responders or use international medical aid as a cover for political gain.

And then when people actually bring these things to light....

Recently, Bill Gates was on NPR talking about polio and he pretty much blamed distrust of the US government as the primary reason polio hasn't been eradicated.
posted by cjorgensen at 9:07 AM on May 21, 2013 [5 favorites]


the doctor who helped us get Bin Laden

Nope. Afridi's campaign of faking vaccinations to steal genetic material from children (!) did not even succeed; he never made it into bin Laden's compound. This cockamamie scheme was about as successful as the CIA's plan of assassinating Castro with an exploding cigar.

Co-conspirator Leon Panetta's claim that this scheme was beneficial has little credibility.

I'm just not ready to throw him under the bus with the CIA

He's responsible for the deaths of thousands of children. He violated the Hippocratic oath and the Geneva conventions while spying for a foreign country (the US). What do you have to do to get sent to prison?
posted by justsomebodythatyouusedtoknow at 9:16 AM on May 21, 2013 [10 favorites]


He's responsible for the deaths of thousands of children. He violated the Hippocratic oath and the Geneva conventions while spying for a foreign country (the US). What do you have to do to get sent to prison?

He was a patsy and the people responsible for planning this, recruiting him, paying him, training him, running the DNA tests, and so on and so forth are somehow safe in their jobs and, not only that, barring any judicial recourse, they are encouraged to continue perpetuating this kind of thing. The nefarious cherry on top is that the faceless bureaucrats in the CIA are the ones who are truly responsible and didn't seem to care enough about keeping him out of jail.
posted by dubusadus at 9:22 AM on May 21, 2013 [2 favorites]


“No good man will ever reproach another who endeavors to defend his country, whatever be his mode of doing so"

-Machiavelli

"In times of war, the laws fall silent"

-Cicero

"Among these forbidden means are…the appointment of subjects to act as spies…or even employing agents to spread false news."

-Kant

"Human activity cannot be judged morally good…simply because the subject’s intention is good"

-John Paul II

"Some of the moral judgments are easy to make: not providing assets with child prostitutes or drugs when they demand them as the price for continued cooperation; not deploying a “Trojan Horse” device that would likely kill innocent victims when it disrupts technical systems in the target country; not authorizing a terrorist recruit to prove his worth to the group by killing people; not tricking a potential asset into believing his child is seriously ill but can be treated in exchange for information; and not allowing a terrorist attack to occur in another country in order to protect a well-placed source who disclosed the plan."
posted by clavdivs at 9:26 AM on May 21, 2013 [1 favorite]


and didn't seem to care enough about keeping him out of jail.

Plausible Deniability?


"According to Dawn News, appearing before the court of Frontier Crimes Regulation’s commissioner to appeal against 33-year imprisonment to Afridi, Abdul Lateef Afridi and Samiullah Afridi said the prime charge against him was having links with a defunct organisation, Lashkar-i-Islam.

They said that the prosecution however did not produce any evidence in this respect.

Afridi, a former agency surgeon, was picked up allegedly by an intelligence agency in May 2011 on suspicion of helping CIA trace Osama bin Laden by carrying out a fake vaccination campaign in Abbottabad.

However, he was not convicted on that charge".
posted by clavdivs at 9:34 AM on May 21, 2013


Yeah, this has been terrible. There have always been conspiracy theories flying around about international aid workers. Before, one was able to to be righteously indignant, "Really? You're going to refuse to give your kids polio drops because you're afraid that these people are 'foreign agents'?" The CIA's use of aid workers becoming public has made a lot of social development work a lot harder. Think: "Oh those aid workers were telling us to get polio drops and we know aid workers are CIA agents. Polio drops must be terrible for us and our kids. They are probably an evil plan to sterilize our men."
posted by bardophile at 9:38 AM on May 21, 2013 [2 favorites]


Yep. The remaining polio-endemic countries are Nigeria, Afghanistan and Pakistan, none of whom are big fans of Western (and especially American) interference in their countries' affairs. All have had polio eradication campaigns disrupted or suspended due to public mistrust, with religious leaders warning their communities that the campaign is actually a plot to either sterilise or transmit AIDS to the population. Meanwhile, people in those countries are being crippled or killed by a preventable disease, and the risk of the disease spreading back out to the (increasingly unprotected) wider world climbs ever-higher.

These populations' mistrust of the vaccination campaigns is the biggest obstacle to finally eradicating one of the most horrifying diseases on the planet, protecting literally billions of people from its effects. Years of careful effort has been spent trying to defray these fears, with genuine progress being made, and then the CIA decided to prove them right. We'll have to see how it plays out, but in all likelihood whoever gave that order and whoever knowingly followed it will have the permanent disabling or deaths of millions of people on their hands. It almost makes me want to believe in hell.

In happier news: India -- which not too long ago had the highest rate of transmission in the world, and was one of the four remaining countries with endemic transmission -- has now been free from polio for two years and three months (previously). And they're using the infrastructure developed for the polio eradication campaign to go after other diseases.
posted by metaBugs at 9:44 AM on May 21, 2013 [13 favorites]


Yup What Bill Gates said and on preview beaten to the punch. But I'll say it again anyway..

This certainly sucks on multiple levels - dirty spy games, Pakistani kids not getting their polio shots and dying as a result, folk not trusting doctors on other fronts, aid workers getting killed.

But the critical and potentially catastrophic impact is that a reservoir of polio remains in the wild amongst people who remain free to travel to countries where polio has been eradicated and whose populations have grown complacent enough about polio to either not vaccinate their kids or not follow through with full vaccination schedules.

Once there it jumps around, or backwards and forwards between the unvaccinated and the partially vaccinated, and before you know it you've got a mutated pathogen that existing vaccines can't beat.

Ie this shit can come back to bite everyone in the arse.
posted by Ahab at 9:47 AM on May 21, 2013 [10 favorites]


Well, I travel on a Canadian Passport so as a Mossad agent I should probably have something to say about this. Give me a moment to put on my tennis outfit.
posted by srboisvert at 9:48 AM on May 21, 2013


Washington gets explicit: its 'war on terror' is permanent.
Senior Obama officials tell the US Senate: the 'war', in limitless form, will continue for 'at least' another decade - or two.
posted by adamvasco at 9:51 AM on May 21, 2013 [2 favorites]


and on that note, remember that line from Kurtz in 'Apocalypse Now'

"We went back there, and they had come and hacked off every inoculated arm...but they had the strength... the strength... to do that. If I had ten divisions of those men, our troubles here would be over very quickly. You have to have men who are moral... and at the same time who are able to utilize their primordial instincts to kill without feeling... without passion... without judgment... without judgment! Because it's judgment that defeats us."
posted by clavdivs at 10:06 AM on May 21, 2013 [1 favorite]


And yet, after everything they have done, America still takes the moral high-ground on any fucking issue going these days. Seriously, they bang on about corrupt regimes and kill first responders? Use medical personelle as spies and undercover operatives? Jesus H Christ.
posted by marienbad at 10:08 AM on May 21, 2013 [6 favorites]


And yet, after everything they have done, America still takes the moral high-ground on any fucking issue going these days. Seriously, they bang on about corrupt regimes and kill first responders? Use medical personelle as spies and undercover operatives? Jesus H Christ.

Yeah, but that Hugo Chavez was a thug I tell ya.
posted by AElfwine Evenstar at 10:40 AM on May 21, 2013 [5 favorites]


clavdivs: "Afridi, a former agency surgeon, was picked up allegedly by an intelligence agency in May 2011 on suspicion of helping CIA trace Osama bin Laden by carrying out a fake vaccination campaign in Abbottabad."

I'm confused - Was it fake in the sense that he was giving a saline solution and saying it was polio vaccine? Or was he actually vaccinating these children and trying to collect DNA evidence on the side?

If he was genuinely vaccinating these children, I don't see how he could be blamed for the death of thousands of children like it's being stated above.

Note that nobody in this thread is blaming the people who are killing doctors and expelling aid organizations from countries because they think since one guy was a spy, now they are all spys, children be damned. Increase operational security? Why, if we can take our children hostage to make the imperialists feel bad?
posted by gertzedek at 12:16 PM on May 21, 2013


The nefarious cherry on top is that the faceless bureaucrats in the CIA are the ones who are truly responsible and didn't seem to care enough about keeping him out of jail.

Which to me means it will be much harder to recruit the next operative (or whatever you call such a person).
posted by cjorgensen at 12:18 PM on May 21, 2013 [1 favorite]


If he was genuinely vaccinating these children, I don't see how he could be blamed for the death of thousands of children like it's being stated above.

Because he erroded a basic trust and countries are kicking out aid workers. Going forward many will die that didn't need to.
posted by cjorgensen at 12:20 PM on May 21, 2013 [3 favorites]


If he was genuinely vaccinating these children, I don't see how he could be blamed for the death of thousands of children

His actions got Save The Children kicked out of the country. Save the Children is now unable to vaccinate children as it once did. In the short term, some of those unvaccinated children will get polio. In the long term, efforts to wipe out polio have been kicked in the teeth. Polio will now remain endemic, and future generations of Pakistani children will get polio. This were foreseeable consequences of his actions. They are banned by international law because they are easily foreseeable consequences.

nobody in this thread is blaming the people who are killing doctors and expelling aid organizations

Let's blame everyone that is to blame. Pakistani paranoiacs, American spymasters, Afridi himself -- all of them. They are severably responsible; it is fair to arrest and punish any one of them even if others get off scott free. Don't ask why Afridi is in prison; ask why other guilty parties are free.
posted by justsomebodythatyouusedtoknow at 12:39 PM on May 21, 2013 [8 favorites]


They hate us for our freedom.
posted by crayz at 12:47 PM on May 21, 2013 [1 favorite]


IIRC, he was not completing the vaccination series, which is one of the things that put the Pakistani intelligence services on to him. So yes, as well as being a spy, he was doing fake vaccinations. Can't say I'm the least bit sorry if he's still rotting in jail.
posted by tavella at 1:16 PM on May 21, 2013 [5 favorites]


The CIA has been discrediting USAID for decades in this way. Many countries reject USAID support because it is considered almost as replete with CIA operatives as State is. But many more countries just accept this as the cost of business. I imagine these medical operations will go the same way, where the US implicitly says well, if you want to save your children, you'll have to accept a certain percentage of spies. Kind of like it does with mercury levels domestically, I suppose.
posted by chortly at 2:48 PM on May 21, 2013


Related post.
posted by homunculus at 5:39 PM on May 21, 2013


Taliban Calls Off Attacks On Polio Vaccine Workers In Afghanistan
posted by homunculus at 5:41 PM on May 21, 2013 [2 favorites]


It could easily be that the results of this will kill more people than died on 9/11.

I'm so over the United States. Can we tear it all down and get a new one, please?
posted by lupus_yonderboy at 11:59 PM on May 21, 2013


Sorry yonderboy, it don't work that way.

I'm confused - Was it fake in the sense that he was giving a saline solution and saying it was polio vaccine? Or was he actually vaccinating these children and trying to collect DNA evidence on the side?

Not sure. It's Pakistan were truth is always for sale. I don't know, wasn't my OP. But I would have run him, in a passive way. I doubt we will know the details.

How about this, let them care for thier own children, do they send us aid, no, they provide intelligence to us, sketchy at that.

It may be illegal to run clergy and the press, but it was done, I'm thinking of the soviet era. The poster above is right concerning Baers' assertion about running such folk. (though legallity may be a question
posted by clavdivs at 7:59 AM on May 22, 2013


"How about this, let them care for thier own children, do they send us aid, no, they provide intelligence to us, sketchy at that." clavdivs at 7:59 AM on May 22 [+] [!]


No, because infectious disease can spread to our population once again if any link in the chain of herd immunity is broken. I guess we as a country would just be getting a type of blow-back if we do get outbreaks of polio again, though.
posted by RuvaBlue at 1:01 PM on May 22, 2013


no. how no because you say so and some" immunity chain" which I get but begs the question. weak answear, again, did we fund this enterprise, how much aid do we and others give...yeah ALOT.
posted by clavdivs at 7:56 AM on May 24, 2013


1 killed, 1 wounded in fresh attack on polio workers in Pakistan
posted by homunculus at 5:23 PM on May 28, 2013


Pakistani militants shoot dead two polio vaccination workers: Murders raise to nearly 20 the number of health workers killed on campaign to help rid Pakistan of endemic disease
posted by homunculus at 7:43 PM on June 16, 2013 [1 favorite]


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