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In Counterinsurgency, Hospitals are the Commanding Heights

by Christopher R. Albon on May 21, 2008

al-sadr-hopsital.jpgIraqi forces swept unopposed into Baghdad’s Sadr City today after a compromise with firebrand cleric Moktada al-Sadr. Most commentary focused on the impressive showing of the Iraqi Army, which conducted the operation largely independently. However, I (and also Dr. iRack from Abu Muqawama) noticed something else:

By late Tuesday, Iraqi troops had pushed deep into the district and set up positions around hospitals and police stations, which the Iraqi government was seeking to bring under its control.

A primary target for Iraqi forces seems to have been the facilities providing health services in the area. In the recent weeks Al-Sadr’s militia has tried to use ownership of these services to gain support amongst the population. Now with Iraqi forces firmly in control of Sadr City’s hospitals, it is a race against time to expand and improve available health services to win the support and loyalty of local residents.

Dr. Irack put it well: “[counterinsurgency] is a contest to influence and control the population”. The provision of health services is a low cost, yet powerful, approach to winning that contest. Those providing health services have a significant advantage in winning hearts, minds, and legitimacy in the population. By providing services, the government is aligning itself with the population’s interest. From then on, insurgent attacks are not simply a strike by one side against another, but an attack  against the providers of the population’s health. In turn, the population is more willing to cooperate with local security forces in routing out insurgents and sympathizers. If in counterinsurgency populations are the battlefields, then hospitals are part of the commanding heights.

Christopher R. Albon is a political science Ph.D. specializing in armed conflict, public health, human security, and health diplomacy.

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