Saturday, December 6, 2008

What's mendstate?

This blog is being created to discuss trends in the 'securitization' of 'health'. What does that mean? Well, I plan to discuss the health treatment of foreign nationals (and their health systems) by our military (and by coalition partners) as part of either a security operation, a stability operation, a transition operation or a reconstruction operation. SSTR-operations (SSTRO) is the new US military acronym for something that has been around for a long time and which has other names du jour like "nation building" or "winning hearts and minds" depending upon the context. Everyone tosses these words about as if they are synonomous, which of course they aren't. But much like trying to define "terrorism," the definition and action of 'nation building' to one person could be considered 'imperialism' to another. And that leads me to legitimization. I'm pretty certain I'll touch on ideas of 'legitimate' action --or when the world's public and the American public thinks the military and the government is acting righteously. Polls show positive response to our continued delivery of aid. Using the military to deliver humanitarian medical assistance post-conflict (as an example) might be perceived as being legitmate by some. On the other hand using the military to deliver medical humanitarian aid to 'stabilize' a country might not be perceived to be legitmate by those same few who would stop to consider. In it's bid to charm the rest of the world, how will American use its instruments of national power? And, particularly, how will global public health be affected, how will America be perceived? How effective can we be in doing our good deeds?

Foreign policy, global health and national security hang together quite naturally as do an egg white and an egg yolk. But oddly enough there is scant scholarship about the matter. Part of the problem is that although these ideas form a cogent and intuitively balanced perimeter, it is really hard to know what goes in the perimeter or when you have enough in the perimeter. Measuring traditional national security policy actions tends to be most persuasive in binary terms: either we win or they win. Foreign policy is much fuzzier since probably nobody quite wins everything, in absolute. But perhaps all sides gain a bit and hopefully lose a bit less. Global public health, which one would imagine could be defined by matters of counting (as in the number of people who are diseased), is even fuzzier. Different cultures define health differently than we do in the West. Not only that, but it's just plain hard to count much of anything in the middle of a conflict. Hence describing, measuring and furthering the practices of foreign policy, global health and national security (when taken as one), becomes darn near impossible. How do we know when we have reached an end state?

And that brings me to the name of the blog which is a play on words for mending, and state, and end state. What's the end state when you are mending a state? Or even mending non-state actors? Very hard to know. But really interesting to consider.

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