A modern nurse Nightingale

How do you quantify a war? Politicians will learn lessons from the diplomacy employed, the distinctions drawn in international law. Military men will tot up the losses in manpower and machinery. Economists will measure the drop in GDP, the cost to restore infrastructure. ‘Collateral damage’ has to be one of the world’s most flexible euphemisms, yet in what it hides it can be the most sinister. In addition to the quantifiable, it provides an umbrella for damage that cannot be calculated.

Alison Criado-Perez is someone whose job it is to deal with collateral damage. She is a nurse with Medecins Sans Frontieres, the humanitarian aid organization whose sole purpose is to step in when other medical safeguards have failed. As the name suggests, MSF follows human need, irrespective of borders and independent of political influence.  As we speak, its 26,000 medics are providing care in over 60 countries, though the frontiers of race and religion, creed and political conviction are as real as the physical in the work of MSF. Part of their work is in providing relief from natural disasters, but the human suffering they deal with is, as often as not, the result of human folly.

Last week, Alison returned from three months on the Libyan-Tunisian boarder, leading a series of medical projects around the refugee camps and evacuating Libya’s war wounded. Though the scale of the humanitarian crisis in and around Libya is still largely unquantified, it cannot be doubted that ‘crisis’ is no exaggeration. ‘Displaced people’ is another euphemism that subsumes the personal, and the numbers are beyond any human scale. Of a population of just over 6 million, 500,000 have fled the country, a vast number  into the Tunisian hinterland.

The resulting camps that have sprung up mirror the pattern of every mass displacement, though in many ways the indignity is greater. Libya may not be a rich country by European standards, but to most intents and purposes it is an economically developed state, and its people are used to a standard of living not dissimilar to our own. It is not, despite the title of its ostensible ruler, much of a military nation. Of the human collateral damage, Alison found the vast majority to be “young guys like you who are at university, or truck drivers who said they had never thought of taking up arms.” The images that blaze from our TV screens every night seem dehumanized in comparison, like most aspects of this conflict.

I ask how the Tunisians have reacted to the vast influx of refugees, and it becomes very clear that our concerns with the ‘mission creep’ of the NATO coalition and the Arab reaction are not shared on the ground. “The solidarity of the Arab world is amazing. They’re providing everything for the camps, and building latrines.” From the United Arab Emirates, to the Sudanese, to the Tunisians themselves, the support for the refugees has been “remarkable”. This last group, with whom Alison had the most contact, come in for special praise. “They provided food, they provided clothing, they say they are ‘our brothers’. They obviously feel they’ve been through a revolution which was luckily for them fairly peaceful, with about 50 people killed. I think that’s a thing that inspires them to help the Libyans with their revolution, because they’re so happy with the outcome of theirs.”

This brings up an uncomfortable point. MSF is a non-political organization, and in its history has only once taken sides in a military conflict, in response to the Rwandan genocide in 1994. Throughout our conversation numerous examples of manifest abuses of the pro-Gadaffi forces become apparent. In Misrata, NATO troops can’t do anything about the shelling because it’s being done from behind hospitals or schools. Two of Alison’s team went into the city to see what the conditions were like, and found the hospitals themselves had been shelled and were in the process of being abandoned. Elsewhere, the retreating rebel forces were chased into the refugee camp across the Tunisian boarder, where a child was hurt in the discharge. These are just the tip of the iceberg – news outlets tell us of many more every day. The more one thinks about it, the more one realizes that Gadaffi is simply unfit to govern, and the more inconceivable it becomes that he can stay in power.

I ask how she can reconcile the seemingly irreconcilable – stand by and watch the wanton destruction of a civilization, before quietly spending months picking up the pieces. I expect the response to be anger, but the mark of a true humanitarian is one who can reply ‘upset’.  It is telling that on numerous occasions, both regime and rebel troops were treated side-by-side, in the same hospitals and on the same wards, and were evacuated from Misrata on the same boats. This is the beauty of organizations such as MSF: “You’re neutral, when you’re nursing people you just get on, you see a human being and you do all you can to help them, regardless of their political persuasion.”

Alison has her own thoughts on the meaning of collateral damage. As in all war-zones, she tells a story that speaks louder than a statistic. A colleague providing psychological support to the refugee children in the camps showed her a drawing, which she recalls with profound simplicity.

“There were great big machine guns pointed at a person, and at a child’s house, with windows. At each window there was a face, and each face had red pouring out of it. These are things that children should never see, and they only could have drawn because they have seen it.” As with the thousands of young men that have been physically maimed in the carnage, these children will remain mentally so far beyond the life of this conflict. This is the collateral damage that will linger long after Gadaffi is gone, long after Misrata has rebuilt its hospitals and life has returned to normal for the Tunisians.

Whether you think the political or the humanitarian crisis is the story, I am once again reminded that only when a conflict is witnessed and humanized can we understand its significance. The most poignant moment of the conversation came at its end: “I came back and found England to be very pleasant and green and peaceful, and that was ok.” The understatement here speaks as loudly the sound of human folly.

James Cross