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A tale of two countries: Q and A with Professor Jennifer Leaning

Fall 2008 ]

On May 2, Cyclone Nargis hit the coast of Myanmar, devastating the low-lying Irrawaddy delta with 120 miles-per-hour winds and a 12-foot tidal surge. Ten days later, an earthquake measuring 8 on the Richter scale struck China’s mountainous Sichuan Province. Both events left thousands dead, missing, injured, and homeless, and focused the world’s attention on the actions of China’s and Myanmar’s governments.

What lessons might be drawn from these terrible events? For an analysis of the responses of these two very different nations and the world community, the Review turned to Jennifer Leaning, professor of global health and population at the Harvard School of Public Health and co-director of the Harvard Humanitarian Initiative. HHI’s role in relieving human suffering in war and disasters is “to train leaders in the field, and to examine with scientific rigor how humanitarian response is delivered,” Leaning says. “It is through analytic, population-based inquiry that we can identify more effective ways to deliver humanitarian aid.”  

The need for research and training is urgent, Leaning says. She has witnessed crisis and conflict in many parts of the world, including Somalia, Kosovo, Rwanda, the Chad-Darfur border, and Afghanistan.

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Q: How does the Chinese government’s response compare with that of Myanmar’s leaders?

A: In China, there was, in general, a rapid, robust, and open response. The Chinese people and government should be given strong acknowledgment and respect for this competent and fast-moving job. The army was mobilized and able to reach the affected area in a matter of hours, which is remarkable in a region that is relatively inaccessible even on a good day.

Within the first week, the Chinese rescued 28,000 people from the rubble. The government sent out medical teams in helicopters to pick people up and bring them to triage sites for stabilization and then, from that place, send them out to receive more thorough care.

Although there appeared to be an initial attempt by the Chinese government to keep the disaster quiet, cell phone traffic and local use of the Internet made it impossible for them to maintain control over the information flow. Then the government apparently made a virtue of necessity and began to use the Internet and cell phone communication to describe what it was doing and to mobilize the entire nation. At the highest level of government, they showed they cared.

Premier Wen Jiabao visited the disaster site within just several hours. When he arrived, he was open and accessible to local people and the press. He got very close to the disaster site, which wasn’t safe because there were frequent strong aftershocks in the area. This rapid appearance of a senior government official as part of the organized response stands in marked contrast to what we have seen in other disasters, including Hurricane Katrina in the United States.

Government leaders made it quite clear to the outside world that they were in charge. Offers of help came in from around the world within a matter of hours. The Chinese government was very courteous, but they wanted to wait to assess what they needed before allowing outside resources to flow into the country.

In contrast, Myanmar is an authoritarian government that proved afraid and suspicious of any hint of intrusion from the West. It was difficult for the international community to get any information to use in assessing the needs of people left stranded in the cyclone’s wake. For several weeks the government refused to grant visas for international humanitarian workers. It accepted supplies but insisted on distributing them.

Those terms were not acceptable to the international humanitarian community. This community has a lot of expertise in how to identify those in need, how to take care of people fairly. Many major donor governments were reluctant to give substantial amounts of goods and cash without knowing whether their donations would be distributed through a proper channel. Offers of help were blocked by Myanmar’s government, and outside aid during the first few crucial weeks was greatly diminished because of this stand-off.

Eventually the government let in small teams from India and Thailand, and then specific teams from countries within the region. A few international experts were also eventually permitted entry. But in general, the potential for massive amounts of aid was aborted. Because of this denial of access for humanitarians who could have conducted rapid health assessments in affected areas, we do not know the full impact of the cyclone.

Q: What can and should the international community do when a government refuses aid for its people, as in Myanmar?

A: The government of Myanmar’s actions caused much consternation around the world, both within the international relief community and at the government level. The debate about how to approach Myanmar intersected with a separate, ongoing discussion about norms of sovereignty and the needs of people worldwide; it has been taking place at the United Nations and is working its way through policy circles.

There is a doctrine in international circles called the Responsibility to Protect, or “R2P,” which states that the sovereignty of the state is not the highest value in determining states’ collective behavior toward an individual government. This doctrine states that at a certain point of extremity, the international community has a responsibility to intervene against the sovereign government to act on behalf of the people who are suffering under its jurisdiction. This doctrine was written in response to problems in the late 20th century, with ruthless governments killing segments of their populations.

So when the cyclone hit Myanmar, many people in government and United Nations’ circles asked whether R2P applied. The consensus among both war and disaster responders was that it would be inappropriate to disregard the sovereignty of the Myanmar government and send in aid by force. The reasons were, first, that the doctrine of R2P had evolved and been promoted for application in a conflict setting, not in a disaster setting; second, it was unclear how much damage the government of Myanmar had done to its people by refusing outside aid. So a number of us were saying, “Let’s not activate R2P in an unclear context.”

All the answers aren’t in yet, but there are now indications that survivors in the cyclone-affected areas are getting by. My hope is that, by not invoking R2P, we at least did not make the government of Myanmar more antagonistic toward the West; and that, in the likely event that food support will be needed in the coming months, the international community will be allowed in.

Q: How has the Harvard Humanitarian Initiative been engaged with these two disasters?

A: When the news broke, we determined that there was no need for us to send relief teams to China-and that we would not arrive in time anyway. We participated in some of the awareness-raising events around Harvard and have been involved in talks about the response of the Chinese government in the context of overall disaster management. And we have a graduate of the HSPH MPH program and our Humanitarian Studies Initiative training, Dr. Emily Chan, who was deployed by Doctors Without Borders. She ran a triage health post in one of the mountain areas for about 10 days. We are working with her to get her report published in medical/public health literature. As people return to the area and contribute to reports on what happened, I think we will find more and more of our graduates and colleagues who were part of that response.

We had a senior fellow, Mihir Bhatt, an expert on disaster response in India, who, along with his team, was allowed into Myanmar. He participated in community self-help and preparedness, and in the assessment of public health and shelter issues.

My role, and HHI’s role, has been to be present at conferences and high-level meetings discussing what to do, and urging that we keep a certain level of criticism in abeyance and allow these events to play out. Countries all over the world are going to have major disasters. Odds are that they are not going to do a good job responding the first time around.

Looking ahead, climate change will make many parts of the world more hazardous and inhospitable for human populations. And even natural disasters that are not affected by climate change, such as earthquakes, will become more deadly, because as the world’s population increases there will inevitably be more people at risk.

As hard as that sounds, countries and local populations have to learn how to deal with the next disaster. And it is in that phase that we might be helpful to Myanmar, and to other countries with the misfortune to get hit by something big.

Q: Are there any lessons for the United States from these events?

A: The U.S. government and populace did the right thing, in my view. When massive disasters occur in other countries, the U.S. is very generous in the short run. This responsiveness builds goodwill, which I believe will come back to help us in international policy arenas.

The U.S. could have a major role improving disaster response worldwide. We have excellent experts in disaster warning and mitigation. There might be ways to bring together international consortia of scientists who are scanning the world for major disasters, issuing major alerts, supporting mitigation efforts in some of the poorer parts of the world-and do this completely free of politics.

Q: What long-term effects do you predict from these disasters?

A: China has shown itself, at least in the short run, to be a competent and caring government in this highly visible crisis. This is an interesting profile for China; it is not one that most people would have immediately assigned to the Chinese before this disaster response. The mobilization of resources, and the full effort that the Chinese government made in this response phase, have made people look at the country with more positive feelings on a worldwide level.

For all of China’s initial attempts to control the news media and censor the Internet, China became a much more open society with respect to this disaster. Can they put that genie back in the bottle? Now that their population has seen the power of open communication, will the Chinese people tolerate a re-imposition of whatever constraints the government may wish to reactivate?

The signs would suggest to me that China is going to be changed somewhat toward a stance of greater openness. But of course these are early days.

With Myanmar, I think the best hope we can have is that the government realizes that, at its point of extremity, it was not invaded by the West. We heard them and we stayed back. That might be marginally helpful in our future dealings with this regime. Given the ways other relatively closed societies dealt with the outside in the aftermath of major disasters-the Soviet Union after the 1986 Chernobyl disaster, for example, and the 1988 earthquake in Soviet Armenia-the government in Myanmar might be interested in making new, if hesitant, connections.

Other ways in which disasters affect people and change societies include cementing the people to their government or distancing people from it. This consequence is linked to perceptions of the government’s response, which are sometimes unfair or unfounded.

Yet an important aspect of disaster management is to recognize that perception is as important as reality. What people believe happened winds up being rooted in popular culture, and then becomes part of history. It is very important for governments to manage people’s perceptions early on.

China did a very good job, Myanmar less so. What we see in the short run in China is activation of a very strong national spirit. That nationalism is going to have significant impact on China’s role in the world. Whether the people of Myanmar are moved farther away from their government or not remains to be seen.

Photos: Myanmar, STR New/REUTERS; China, China Daily Information Corps/REUTERS; Jennifer Leaning, ©Tony Rinaldo 

Originally published in Fall 2008