Advanced Search

Please click here to take a brief survey

MSF’s Top Ten - How Disconnection Affects Public Health
Ethan Zuckerman, 23 Dec 08


It’s hard to look forward to something as difficult and sad as Medicine Sans Frontieres top ten list of global humanitarian crises. I noted last year that this appears to be the season for top ten lists, and that these lists range from the positive to the extremely disconcerting. MSF’s list is certainly discomfiting, but it’s also a very helpful reminder of what stories we should be paying attention to.

Two of MSF’s top ten focus on Somalia and the ethnically Somali portion of Ethiopia. MSF reports a massive refugee crisis in Somalia, connected to ongoing instability and violence. Unfortunately, MSF is able to provide little help within Somalia - the situation is simply too dangerous for their staff. Three staff were killed by a roadside bomb in Kisamayo, and MSF pulled its international staff out of the country in early 2008 - their local staff continues to work despite a high degree of risk.

Eastern Ethiopia, a region that’s majority Somali-speaking, is facing a severe food crisis. Many of the people who live in this region are pastoralists. An ongoing conflict between the Ethiopian government and rebels have made much of the region inaccessible, which is preventing herds from reaching water and food. Here MSF is constrained from acting not so much by violence, but by an uncooperative Ethiopian government, which has put major hurdles in front of the organization and which forced an MSF project to close in the region.

(While I’ve complained in the past about how little attention is paid to Somalia, the rising threat of piracy has helped attract some attention to that country’s problems. But news from the Somali region of Ethiopia is almost nonexistent - try a search for “Jijiga”, the regional capital, on Google News, or within the New York Times, where most results are from the second World War. A paper from Dr. Abdi Aden Mohamed - whose views are clearly anti-Ethiopian and pro-independence for the region - gives a sense for how isolated this region is: “… 3. There is no electricity any where in the region and most of the people in the region have never seen a Television or Cinemas. 4. No communications like postal services, and most of the people have not seen or used up to now telephones, faxes etc., because there aren’t any in the region. 5. There are no roads in the region except dirty dusty ones and trails created by the nomads and their herds.”

The difficulty MSF is having in reaching Somalia and the Somali region aren’t just coincidental - the disconnection of these areas helps explain why they are in such dire straits. Political and military strategist Dr. Tom Barnett offers the maxim “disconnection defines danger”. Countries that are tightly integrated into global communication, financial, trade and military systems tend not to fail catastrophically in meeting the needs of their people. The idea is not unrelated to Dr. Amartya Sen’s assertion than functioning democracies don’t experience famines - they’re able to access markets and seek help from other nations to avert this sort of catastrophe. (If you’re as disconnected as North Korea, you’ll find your neighbors using food aid as a carrot to try to coax better behavior from you.) This helps explain why Burma, still recovering from Cyclone Nargis, makes MSF’s list. It’s not a surprise that MSF hasn’t been able to send international staff into Burma - the military government has refused to issue visas, leaving the task of providing critically needed medical care to local staff.

I’d always assumed that MSF’s purpose in publishing this list was to fundraise. Oddly, there’s no link to giving information on their site - if you’re in the US and want to support their important work, you can find a link on the Doctors Without Borders site. The idea of disconnection suggests another reason - MSF can’t work in many of the places on their top ten list without better security for their doctors, or international support in obtaining visas. Without more “connectivity” - in Barnett’s sense - these are largely crises they have to watch from afar and help with only indirectly. Top ten lists, whatever else they’re good for, are a way of directing attention, and attention is a necessary precursor to connection.

This piece originally appeared on Ethan Zuckerman's personal blog, My Heart's In Accra.

Bookmark and Share


Does anyone have the feeling that our communication, here and now, appears to be convoluted and confused because many too many of us do not yet recognize that the family of humanity literally lives within a modern version of an ancient edifice, the Tower of Babel? The new leviathan-like, distinctly human construction is not made of stone, but instead built out as a "house of cards". This colossal, artificially designed structure is noticeably pyramidal in shape, organized as a patently unsustainable pyramid scheme, and named the global political economy.

For the people who are the primary beneficiaries of such a scheme, the global economy is effectively an object of idolatry. Nothing else really matters. These people are the self-proclaimed Masters of the Universe among us. They could not care less about the natural world, life as we know it for the children and future generations, the integrity of Earth. You can readily recognize the idolaters as the leading, self-righteous elders of my "Not So GREAT GREED GRAB Generation". Endlessly consuming and hoarding resources as well as power-mongering are regarded as religious rituals.

Any thoughts?

Steven Earl Salmony
AWAREness Campaign on The Human Population,
established 2001

Posted by: Steven Earl Salmony on 23 Dec 08

Post A Comment

Please note that comments will remain open for only 14 days after the article is posted. While previous comments will remain visible, attempts to post new comments after this period will fail. This helps stop comment spam, so your forebearance is appreciated.

The Worldchanging comments are meant to be used for further exploration and evaluation of the ideas covered in our posts. Please note that, while constructive disagreement is fine, insults and abuse are not, and will result in the comment being deleted and a likely ban from commenting. We will also delete at will and without warning comments we believe are designed to disrupt a conversation rather than contribute to it. In short, we'll kill troll posts.

Finally, please note that comments which simply repost copyrighted works or commercial messages will be summarily deleted.

Yes No







MESSAGE (optional):

Search Worldchanging

Worldchanging Newsletter Get good news for a change —
Click here to sign up!


Website Design by Eben Design | Logo Design by Egg Hosting | Hosted by Amazon AWS | Problems with the site? Send email to tech /at/
Architecture for Humanity - all rights reserved except where otherwise indicated.

Find_us_on_facebook_badge.gif twitter-logo.jpg