Militarizing health? Or "health-erizing" the military?

Well, I had my first comment on this blog, and it was smart and well appreciated! I even liked the teaser sentence: "addressing the Maslowian Hierarchy of Needs via legitimate organs of the Westphalian State, rather than create opportunities for the emergence of illegitimate power structures". Wow, who wouldn't be intrigued? I have often thought about, and at one point invested a bit of time toward a lit review on, Maslow's Heirarchy of Needs as it applies to the application of "smart power". The Army teaches us the PMESII model of assessing the current operational environment (Political, Military, Economic, Social, Infrastructure and Information). We invest huge amounts of energy and money to build economies and teach others how to have legitimate governments. Obviously these are important. But you can't go to work in your new government job and then spend your salary buying dinner if you are sick. And you'll notice that Maslow's Heirarchy of Needs is buried in the "S" portion of the analysis...deeply buried. I'd like to do an analysis that would describe the cost-benefits of public health system building vice building other governance structures. And obviously in practice it's not an either or situation, but it might be a worthwhile consideration that would modify our practices. What to do first and what sector should be focused on? Seems likely that first we would start with Maslow's Heirarchy of Needs and then over time shift focus or expand focus to other sectors. But maybe not. And, separately, I wonder if burying "health" in such an ambitious analysis describes what the military thinks of health care?

Now, on to today's topic, which is not unrelated. I was reading Defense Secretary Gates' transcript in the Jan-Feb 2008 issue of Military Review called "Beyond Guns and Steel:Reviving the Nonmilitary Instruments of American Power". This transcript was of a speech Secretary Gates delivered in November 2007. The speech is worth a read and has been languishing in a deep pile on my desk for a while, obviously. Secretary Gates discusses the need to invest in the foreign diplomatic efforts of the government. In it, he describes the military's use of anthropologists. Anthropologists are now being hired by the military to help describe and "translate" important cultural aspects of tribes in Iraq and Afghanistan, for example. (Their work is reaching more broadly than this, but this gives an idea). The professional field of anthropology has reacted very negatively to this trend, labeling the woman who is the primary proponent of this activity and saying that she is "militarizing anthropology". In his speech, Secretary Gates says that an unnamed person's response to this accusation is "...we're really anthropologizing the military." Ahhhh!! I like that.

In the same vein, the debate about DoD's role within the US Government's global public health engagement has a side-discussion that says that DoD is "militarizing public health". Global public health practitioners are all a twitter. Those that despise the military for whatever reason can repeat this mantra as some kind of justification for not working together.

DoD has been engaged in public health works around the world for.... at least decades (good topic for another post). To think that DoD will suddenly stop engaging in the world via delivery of health services is counter-factual and a denial of history. However the role that DoD plays can be shaped, and that's where I liked the idea of "health-erizing the military." In other words, perhaps its time that the other agencies help DoD understand that it has a talent. That helping peoples in other lands develop their public health systems might sometimes be an appropriate use of DoD resources, and an activity that will create healthier populations abroad and at home, legitimize governments, boost economies and hopefully give a good impression of America. It's not an either-or world: that there is still enough world for both USAID and DoD and the Dept of State to do good. Instead of complaining, why not grab the bull by the horns and give it a little shake? I can only hope that the incoming political appointees will reach out and grab ahold.