A few weeks ago, I had the pleasure of attending a talk given by Colonel Peter Mansoor. Col. Mansoor is a member of Petreus’ inner circle and has been influential in the development of the US Army’s counterinsurgency doctrine. Mansoor is also an architect of the surge strategy in Iraq and recently published Baghdad at Sunrise: A Brigade Commander’s War in Iraq, an analysis of counterinsurgency in Iraq from a mid-level officer.
During the questions and answer section I asked the Colonel what was the role of providing health and social services in modern counterinsurgency doctrine. He took the (very reasonable) position that the primary concern of civilian populations is security. That is, without security, nothing else matters. However, once a certain level of security has been established, the population looks for the provision of services (including health services). In this ’second stage’, of counterinsurgency the provision of health services plays a major role in winning hearts and minds. Mansoor’s position is that Iraq was just barely in this second stage.
I agree with Mansoor, but believe the effect is more nuanced. The two stages (security and services) are not firmly separated. Rather, as the population gradually feels less security needs, people begin to look for the provision of services.
Christopher Albon is a Ph.D. candidate specializing in armed conflict, public health, human security, and health diplomacy.
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Dear Col. Mansoor: C O N G R A T U L A T I O N S. We, the citizens of the United States can only hope to learn the truths behind the “disastrous war of choice” from leaders like you. It should be warning to legislators not to rubber-stamp ideology. So many of the great military leaders were “fired” early on or “forced” into retirement throughout this mess by the incompetence of the so-called “experienced” in this administration. I have read many of the books already published and will soon read yours. Even though I am a 76 year young woman, when I read in the first weeks, of our fighters writing home for the proper lubricants to clean their firearms I was devastated. Having come from a long family line of machine tool workers I saw what would come in the years ahead for our military. The comments of Rumsfield “go with what you have and not with what you wished you had.” It Spoke words as to how and what supplies would be forthcoming to our troops. Again incompetence.
“Their legacy will be their blood stained fingerprints forever ingrained on the pages of history.” (My words.) Keep up your good works.
Sincerely, Mary
This is a pivotal question and, like many in medicine, is ultimately unknown. But we should see “security” as 2 separate states: a physical state, and a state of mind. These are different but related, and the relationship is not by any means 1:1. Physical security allows health services on large scale, and this in turn contributes to mental security.
After 9/11, it was hard to make an argument that the average man on the street in America or Europe faced any significant personal or family threat of terrorism. The main trauma threat remained, and still is, death or serious injury in a motor vehicle collision. But did Americans quit driving?
Mental security is thus only loosely related to physical security. But mental security is the necessary – sine qua non – ingredient to trust-building, reconciliation, and meaningful political and economic progress. This is where health services influence the process.
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