Intended for healthcare professionals

Education And Debate

Health and human rights in contemporary humanitarian crises: is Kosovo more important than Sierra Leone?

BMJ 1999; 319 doi: (Published 11 December 1999) Cite this as: BMJ 1999;319:1569
  1. Peter Salama, medical coordinator emergency programmes (,
  2. Bruce Laurence, medical directorb,
  3. Monica L Nolan, medical adviser MERLIN Albaniab
  1. a Concern, Lower Camden Street, Dublin 2, Ireland
  2. b Medical Emergency Relief International (MERLIN), London W1M 1HW
  1. Correspondence to: P Salama

    In 1998, international agencies operating in Kosovo recognised that human rights violations were causing a humanitarian crisis. The language and principles of human rights were used effectively to advocate interventions that addressed the root causes of the conflict.1 As the details of the tragedy in Kosovo have become clearer, the international community has expressed some sense of vindication that the systematic abuse of human rights justified the military intervention. According to some, the NATO led intervention sets an important precedent: human rights were given priority over the rights of a particular state, a challenge to the notion of the absolute inviolability of state sovereignty.2

    This increased priority given to human rights is laudable. However, such rights, universal in scope, should not be differentially recognised; their protection must be extended beyond Europe (press release by Sergio Vieira de Mello, undersecretary-general for humanitarian affairs and emergency relief coordinator, UN Office for the Coordination of Humanitarian Affairs, 12 August 1999). The causal link between human rights violations and a humanitarian crisis must be recognised wherever it exists.3 Addressing the roots of contemporary crises requires a detailed analysis that incorporates a study of human rights, followed by multifaceted solutions supported by sustained international attention. The standard assessment of and response to humanitarian needs effectively mitigates human suffering but has virtually no role in preventing its ongoing generation.4

    In this article we draw on our collective experience in Sierra Leone to illustrate some of the links between human rights violations and health effects in that country's chronic conflict.

    Summary points

    Human rights violations have contributed to large scale humanitarian crises in protracted conflicts in Kosovo and Sierra Leone

    The politico-military intervention in Kosovo exemplifies a growing international commitment to human rights and the recognition that humanitarian responses alone are often insufficient

    Humanitarian responses …

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