Education And Debate

Commentary: Life in the real world is more complicated

BMJ 1995; 311 doi: (Published 14 October 1995) Cite this as: BMJ 1995;311:1001
  1. Anthony B Zwi, senior lecturer in health policy and epidemiologya
  1. aHealth Policy Unit, London School of Hygiene and Tropical Medicine, London WC1E 7HT

    These past months have been filled with the wars in former Yugoslavia: the fall of Srebrenica and Zepa to the Bosnian Serbs, the flight of tens of thousands of Bosnian Muslims, the retaking of Krajina by the Croatians and evidence of Croatian atrocities, the flight of Croatian Serbs, wanton violence and war crimes, rape, and ethnic cleansing. The historically hesitant and inconsistent response of the West and the United Nations, enabling the Bosnian Serbs to continue with their genocidal project, has at last been placed at the top of the political agenda. Hopefully the current negotiations will lead to a lasting peace, but doubt somehow lingers.

    Gellert's important article1 is timely, relevant, and deserves to be debated widely. It raises many crucial issues which should be recognised, endorsed, and acted on by us all. Below, I focus on a few areas where further debate is merited: the role of data, improving the international response, and assessing vulnerability in order to intervene and prevent violence at an earlier stage. Hopefully, many of the other complex issues raised by Gellert will be addressed by others: through further debate we clarify the way forward.

    Data alone are not enough

    Gellert hopes for a more humane and rational world: “the introduction of a standardised protocol for decision making in humanitarian intervention, based on quantifiable thresholds which invoke specific international actions, will …

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