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DOCTORS WITH BORDERS: HIERARCHIES OF HUMANITARIANS AND THE SYRIAN CIVIL WAR

  • Rania Kassab Sweis (a1)

Abstract

In humanitarian studies, it is typically the white western doctor who stands apart as the cultural prototype or universal figure through which global aid is delivered to vulnerable groups. This article, by contrast, examines the experiences of members of a prominent Syrian-American global medical aid organization. The members of this organization provide life-saving emergency care to millions of Syrians affected by the ongoing civil war, both inside Syria and in surrounding refugee camps. Drawing on over four years (2014–18) of intermittent interviews and observations with these doctors, I suggest that they are positioned precariously within a global “hierarchy of humanitarians” that deems their lives less worthy of mobility and protection than others. In critically analyzing the unequal politics of humanitarianism that exists around the Syrian war, this research complicates our understandings of the givers of global aid, as well as the medical humanitarian encounter itself in times of war.

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Author's note: I wish to express my deepest gratitude to many people who have contributed to this work. First, my wholehearted thanks go to the doctors of “MRS” for sharing their time and stories with me. Without their generosity and continuous hospitality throughout the years, this research could have never been conducted. The fieldwork upon which this article is based was supported by various grants from the University of Richmond. Preliminary conclusions were revised and strengthened thanks to comments provided by brilliant colleagues at several conferences and workshops, including the 9th European Spring School on History of Science and Popularization in Menorca, Spain in 2017, the American Anthropological Association's Annual Meeting in 2018, the Anthropology Brown Bag Series at the College of William and Mary in 2019, and the Contested Identities: Race, Nation, and Conflict Workshop at the University of Richmond in 2018. I especially want to thank Nadia Guessous, Atiya Husain, Faedah Totah, Andrea Wright, Sara Pappas, Lidia Radi, Sa'ed Adel Atshan, Omar Dewachi, and two blind reviewers at IJMES for sharing valuable feedback on various iterations of the work and for helping me think through the findings. Finally, and as always, I am grateful to my partner Patrice Rankine, who is an extraordinary intellectual cheerleader and endless source of encouragement.

1 All of the names in this article have been changed in order to protect the identities of research subjects in line with professional institutional review board protocols.

2 For more on the philosophical concept of “bare life,” see Agamben, Giorgio, Homo Sacer: Sovereign Power and Bare Life (Stanford, Calif.: Stanford University Press, 1995). With respect to global medical humanitarianism, see Redfield, Peter, “Doctors, Borders, and Life in Crisis,” Cultural Anthropology 20 (2005): 328–61.

3 Redfield, “Doctors, Borders, and Life in Crisis,” 336–37.

4 Adia Benton, “African Expatriates and Race in the Anthropology of Humanitarianism,” Critical African Studies, 10.1080/21681392.2016.1244956.

5 Fassin, Didier and Pandolfi, Mariella, “Introduction: Military and Humanitarian Government in the Age of Intervention, in Contemporary States of Emergency: The Politics of Military and Humanitarian Interventions (New York: Zone Books, 2010), 1011.

6 Fox, Renée C., “Medical Humanitarianism and Human Rights: Reflections on Doctors Without Borders and Doctors of the World,” Social Science & Medicine 41 (1995): 1607–16.

7 Fassin, Humanitarian Reason.

8 For anthropological work that examines humanitarian government and specifically the politics and personal motivations of global aid workers, see Malkki, Liisa, The Need to Help: The Domestic Arts of International Humanitarianism (Durham, N.C.: Duke University Press, 2015); and Naguib, Nefissa, “Middle East Encounters 69 Degrees North Latitude: Syrian Refugees and Everyday Humanitarianism in the Arctic,” International Journal of Middle East Studies 49 (2017): 645–60. For more on the nuances and relations between humanitarian aid workers and aid recipients, see Sweis, Rania Kassab, “Saving Egypt's Village Girls: Rights, Humanity, and Gendered Vulnerability in a Global Youth Initiative,” Journal of Middle East Women's Studies 8 (2012): 2650; and Sweis, Rania Kassab, “Children as Biologial Sufferers? The Paradox of International Medical Aid for Homeless Children in Cairo,” Childhood 24 (2017): 502–16.

9 Fassin, Humanitarian Reason. I am using Fassin's definition of “humanitarian government,” which he describes as the deployment of moral sentiments in contemporary politics. Drawing on the work of Michel Foucault on the art of government, humanitarianism in Fassin's articulation at once manages, regulates, and supports the existence of human beings.

10 Fassin, Humanitarian Reason, 240.

11 Ibid., 241–42.

12 Nefissa Naguib “Middle East Encounters 69 Degrees North Latitude,” 652.

13 For an overview of Syria's geopolitical landscape, including intimate accounts from Syrians themselves, see Pearlman, Wendy, We Crossed a Bridge and It Trembled: Voices from Syria (New York: HarperCollins, 2017), xlivxlv.

14 Feldman, Ilana and Ticktin, Miriam, eds., In the Name of Humanity: The Government of Threat and Care (Durham, N.C.: Duke University Press, 2010), 8.

15 Ibid., 15.

16 Amani Massoud, “A Brief History of Field Hospitals in Tahrir Square,” Al Masry Al Youm, 12 December 2011.

17 See Redfield, Life in Crisis, 1–2; and Benton, Adia and Atshan, Sa'ed, “Even War Has Rules: On Medical Neutrality and Legitimate Non-Violence,” Culture, Medicine and Psychiatry 40 (2016): 151–58.

18 Benton and Atshan, “Even War has Rules,” 153.

19 Hamdy, Sherine F. and Bayoumi, Soha, “Egypt's Popular Uprising and the Stakes of Medical Neutrality,” Culture, Medicine and Psychiatry 40 (2016): 223–41.

20 Omidian, Patricia and Panter-Brick, Catherine, “Dignity Under Extreme Duress: The Moral and Emotional Landscape of Local Humanitarian Workers,” in Medical Humanitarianism: Ethnographies of Practice, ed. Abramowitz, Sharon and Panter-Brick, Catherine (Philadelphia, Pa.: University of Pennsylvania Press, 2015), 24.

21 See Dewachi, Omar, Ungovernable Life: Mandatory Medicine and Statecraft in Iraq (Stanford, Calif.: Stanford University Press, 2017) for an ethnographic and historical study of medicine in Iraq, including intensive violence and harassment against doctors in the aftermath of war.

22 “Syria's Civil War Explained from the Beginning,” Al Jazeera, 9 April 2017.

23 “The Failure of UN Security Council Resolution 2286 in Preventing Attacks on Healthcare in Syria,” Syrian-American Medical Society, January 2017, p. 2. Press Release.

24 Malkki, The Need to Help, 24.

25 Ibid., 4.

26 Fassin, Humanitarian Reason, 231.

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DOCTORS WITH BORDERS: HIERARCHIES OF HUMANITARIANS AND THE SYRIAN CIVIL WAR

  • Rania Kassab Sweis (a1)

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