Preface - 麻省理工学院人工智能研究专业

Preface

Jennifer M. Welsh, Paul H. 明智的 & Jaime Sepúlveda

R ussia’s invasion of Ukraine last February initiated a brutal conflict be-

tween the armed forces of the two countries, with devastating conse-
quences for the Ukrainian population. The numbers are staggering: 沿着
with the thousands killed or injured, 5.9 million Ukrainians have been internally
displaced, 7.9 million have fled into neighboring countries, and many others have
sought refuge by living underground. Relief organizations estimate that 17.7 米尔-
lion people in Ukraine are in urgent need of humanitarian assistance.1 In the clos-
ing months of 2022, Russia began bombarding the country’s power grid, 水
supply, and other key facilities with the aim of turning the cold and dark of win-
ter into another weapon of war. For humanitarian actors on the ground, 这是
but another grim episode in a conflict that had already witnessed blatant violation
of basic principles of international humanitarian law through denial of access to
imperiled civilians or indiscriminate attacks on both populations and critical in-
基础设施, 包括 (at the time of writing) seven hundred attacks on health
care.2

In truth, 然而, the massive wave of air and missile attacks launched on
Ukrainian cities in late autumn of 2022, along with the continuing systematic as-
sault on health care, was an extension of the war strategy already employed by the
Russians and their Syrian allies during Syria’s protracted civil war. During the fi-
nal battle over Syria’s second largest city, Aleppo, in the latter half of 2016, 更多的
比 31,000 Syrian civilians died through the combined effects of explosions, bar-
rel bombs, field executions, and chemical attacks. As aid convoys were attacked
in the Aleppo countryside–denying humanitarian assistance to thousands in
need–and hospitals and marketplaces were routinely hit during the siege of the
城市, former UN Secretary General Ban Ki-Moon declared that Aleppo had become
a “synonym for hell.”3

而且, whereas the conflict waged in Ukraine has attracted intense dip-
lomatic and media attention, there are many forgotten crises unfolding outside
the glare of the spotlight, where populations suffer systematic violence or are de-
nied life-saving humanitarian assistance. 十一月 2022, vital medical sup-
plies finally began arriving in Tigray–the first delivery of aid to Ethiopia since

我

D
哦
w
n
哦
A
d
e
d

F
r
哦
米
H

t
t

:
/
/

d
我
r
e
C
t
.

米

我
t
.

e
d
你
d
A
e
d
A
r
t
我
C
e
–
p
d

我

F
/

1
5
2
2
6
2
1
1
5
3
0
6
d
A
e
d
_
e
_
0
1
9
8
8
p
d

乙
y
G
你
e
s
t

哦
n
0
9
S
e
p
e
米
乙
e
r
2
0
2
3

fighting resumed in late summer between the current Ethiopian federal govern-
ment and the former ruling party in the country, the Tigray People’s Liberation
Front. The humanitarian crisis facing the Tigray region is of epic proportions,
with five million people currently at imminent risk of starvation. Elsewhere, 这
sociopolitical and economic crisis in Venezuela continues, as mass migration,
hyperinflation, and the impact of COVID-19 have exacerbated the conditions for
the most vulnerable, including women and girls. This case, along with other Latin
American contexts with high rates of violent death and sexual and gender-based
暴力, demonstrates that many of the world’s deadliest places are not in fact
zones of formal armed conflict, as defined by international lawyers. 反而, 他们
are “situations other than war,” as the International Committee of the Red Cross
refers to them, featuring extreme political and criminal violence that is in many
cases both organized and deliberate.4 These situations pose additional challenges
for humanitarian actors, including which international legal frameworks are ap-
plicable and what responsibilities should be exercised by international organiza-
tions such as the United Nations.

These snapshots of contemporary violent conflict point to the enormous
strain being placed on traditional humanitarian strategies and actors, and partic-
ularly on the delivery of effective health responses. Much of global humanitarian
action has been rooted in international humanitarian law, which contains obli-
gations to distinguish between civilian populations and combatants, and to ver-
ify that objects to be attacked are neither civilians nor civilian objects, 包括
sites subject to special protection, such as medical and humanitarian personnel,
their means of transport and equipment, and their facilities. Yet today’s warring
parties–whether nonstate armed groups or state militaries–routinely dismiss or
override this normative framework through strategies and day-to-day battlefield
decisions that put both civilian populations and humanitarian health workers at
风险.

Adding to these pressures are two worrying trends: 第一的, the increasing roll-
back of political commitments to upholding humanitarian principles by UN
member states and signatories of the Geneva Conventions in a context of grow-
ing geopolitical rivalry. And second, the ongoing impact of counterterrorism
policies developed by governments and international organizations that have in-
advertently created new obstacles for humanitarian health by constraining the
provision of services in areas controlled by nonstate armed groups. There are also
new constraints and challenges more specific to the humanitarian health field that
call for further reflection and examination, including the increasing attention on
fostering local ownership in humanitarian health delivery, the need to consider
the impact of digital technology and data in caring for victims of violent conflict,
and the immediate and long-term effects of infectious disease in conflict zones.
While pandemics have featured in conflict settings for some time, the global scale

我

D
哦
w
n
哦
A
d
e
d

F
r
哦
米
H

t
t

:
/
/

d
我
r
e
C
t
.

米

我
t
.

e
d
你
d
A
e
d
A
r
t
我
C
e
–
p
d

我

F
/

1
5
2
2
6
2
1
1
5
3
0
6
d
A
e
d
_
e
_
0
1
9
8
8
p
d

乙
y
G
你
e
s
t

哦
n
0
9
S
e
p
e
米
乙
e
r
2
0
2
3

152 (2) Spring 2023Jennifer M. Welsh, Paul H. 明智的 & Jaime Sepúlveda

of COVID-19 and its impact on both deeper conflict dynamics and civilian popu-
lations (including migrants) are likely to shape broader policy discussions of hu-
manitarian health in the coming decades.

在此背景下, we have co-led a multiyear initiative through the Ameri-
can Academy of Arts and Sciences to critically interrogate and creatively reimagine
strategies for preventing civilian harm and delivering critical health services in ar-
eas plagued by violent conflict.5 As co-editors with diverse scholarly backgrounds
and varied policy experience, our work has been based on a central premise:
that innovative approaches are best derived from a deeper, transdisciplinary un-
derstanding of the changing political, 军队, 合法的, and health dimensions that
are dramatically redefining humanitarian action across the globe. Our collabora-
tive work has brought together legal and security experts, health professionals,
政策制定者, artists, leaders of humanitarian organizations, and representa-
tives of conflict-affected communities to address a range of pressing challenges.
Our in-depth research projects have included examination of the political and se-
curity dimensions of pandemic response in areas of weak governance and violent
冲突 (drawing lessons from the Ebola outbreaks in West Africa and the Dem-
ocratic Republic of the Congo), as well as the humanitarian health challenges re-
lated to major migrant flows, with a particular focus on those seeking relief from
criminal and political violence in Mexico and the countries of the Northern Tri-
angle of Central America.6

All our activities have been organized around a set of interrelated principles:
1) interdisciplinarity, with an emphasis on integrating long-siloed scholarship and
deliberations; 2) ongoing, substantive dialogue with practitioners and victimized
communities in the field; 和 3) sustained engagement with disciplines that help
shape local and global norms, including the arts and other arenas of talent and ex-
pertise beyond traditional academic spaces.

In developing this issue of Dædalus, we convened authors and relevant experts
in small workshops organized around specific themes to both enhance the qual-
ity of their essays and generate ideas and momentum for broader policy changes
in humanitarian health delivery. The volume reflects the most significant cross-
cutting issues that have emerged from our collaboration with the contributors, 作为
well as our consultations with humanitarian health practitioners over the last four
年. The collection also illustrates our belief in the fundamental role that the arts
play in shaping norms and public understanding of humanitarian needs. By lever-
aging the American Academy’s network and connecting with artists in conflict-
affected areas, we have included a series of artistic works within the volume.

The essays and artistic expressions that follow are designed to illuminate and
examine the key features of the complex challenges facing humanitarian actors
今天, but also to provide forward-looking ideas for rethinking strategies to deliv-
er humanitarian health assistance in a rapidly changing conflict environment. 我们

我

D
哦
w
n
哦
A
d
e
d

F
r
哦
米
H

t
t

:
/
/

d
我
r
e
C
t
.

米

我
t
.

e
d
你
d
A
e
d
A
r
t
我
C
e
–
p
d

我

F
/

1
5
2
2
6
2
1
1
5
3
0
6
d
A
e
d
_
e
_
0
1
9
8
8
p
d

乙
y
G
你
e
s
t

哦
n
0
9
S
e
p
e
米
乙
e
r
2
0
2
3

代达罗斯, 美国艺术学院学报 & SciencesPreface

begin with an introduction by International Rescue Committee (IRC) 总统
David Miliband and IRC Director of Policy Communications Ken Sofer, who viv-
idly depict the stark realities that give rise to the widespread need for humanitarian
协助, and particularly health services, in today’s zones of conflict.7 Our con-
tributors to the first half of the volume build on this foundation, with an analysis
of how the nature of contemporary civil wars shapes humanitarian needs, 关于-
响应, and outcomes, and a discussion of how the shift of major powers away
from counter insurgency, and back toward peer or “near-peer” conflict, is likely to
affect the context for humanitarian health delivery.

Our authors then revisit the ethical and legal principles that have long guid-
ed humanitarian action and deliberate on how the changing character of war–
including fast-moving technological developments–is undermining compliance
with these traditional norms. 同时, they ask how a set of prominent
justice-related claims, such as the imperative to decolonize humanitarian assis-
坦斯, demand reconsideration of what it means for humanitarians to act ethical-
莱. We round out the first section with a discussion of two particularly challenging
contexts for humanitarian health delivery: situations of urban conflict, 例如
those in Iraq, 叙利亚, and Yemen, where humanitarian missions have struggled to
access and meet the needs of civilian populations; and situations of intense polit-
ical and criminal violence, which create ambiguity regarding the appropriateness
of different legal frameworks for regulating efforts to protect and assist popula-
tions under threat.

The authors in the second half of this issue apply their deep policy-making and
field experience to address a set of specific ethical and operational challenges fac-
ing those who seek to provide humanitarian health relief in twenty-first-century
冲突. We begin part two with a discussion of the ongoing dilemmas and ob-
stacles confronting humanitarian health actors in engaging with nonstate armed
团体, which leverages the most recent research on both the need for and modal-
ities of working with these actors. The following essay examines both the oppor-
tunities and challenges posed by new capacities to gather and use data in human-
itarian emergencies, and the tensions that can arise concerning the need to share
data between and among humanitarians and with donor governments. Our con-
tributors then focus on the increased risks of violence against humanitarian health
workers and facilities and assess the impact of various high-profile diplomatic
efforts both to prevent such attacks and to hold perpetrators accountable.

A final set of essays takes up a prominent theme from the 2016 World Human-
itarian Summit: 即, the imperative to “localize” humanitarian assistance by
empowering and supporting local actors, including in the health care sector. 我们的
first contribution on this theme explores the role of local women’s organizations
in Jordan as frontline responders with the potential, if harnessed, to improve both
health service quality and gender equality, while the second draws on a survey of

我

D
哦
w
n
哦
A
d
e
d

F
r
哦
米
H

t
t

:
/
/

d
我
r
e
C
t
.

米

我
t
.

e
d
你
d
A
e
d
A
r
t
我
C
e
–
p
d

我

F
/

1
5
2
2
6
2
1
1
5
3
0
6
d
A
e
d
_
e
_
0
1
9
8
8
p
d

乙
y
G
你
e
s
t

哦
n
0
9
S
e
p
e
米
乙
e
r
2
0
2
3

152 (2) Spring 2023Jennifer M. Welsh, Paul H. 明智的 & Jaime Sepúlveda

international nongovernmental organizations to better understand what efforts
they have undertaken to localize health services and build critical capacity in
conflict-affected societies.

We conclude the volume with our own reflections on the key messages that
emerge from the essays. We also draw out recommendations for how to pursue in-
novative change in humanitarian health delivery in light of the profound shifts in
the nature of conflict itself, and in the normative and operational environment in
which humanitarian actors operate. 合在一起, the essays we have assembled
show that the rich and complex tapestry of norms and practices that shapes hu-
manitarian health delivery is now confronting a historic moment. While the hu-
manitarian mandate remains unchanged, the evolution of organized violence and
increasingly unstable geopolitical order have generated challenges so deep and
varied that a reconsideration of humanitarian health’s most basic tenets and prag-
matic practices seems unavoidable. Even the ethical foundation of humanitarian
health responses, we argue, will become an essential component of this rethink-
英, as both scholars and practitioners grapple with not only the growing tensions
among core humanitarian principles, but also the competing imperatives that
sometimes underpin legitimate calls for reform of today’s humanitarian system.

T he creation of this volume was a collaborative effort among many individ-

uals and institutions working toward a more robust humanitarian land-
scape. This Dædalus issue originated with the Rethinking the Humanitar-
ian Health Response to Violent Conflict project at the American Academy of Arts
and Sciences. We are grateful to the members of the project’s advisory group for
their advice in shaping the trajectory of this initiative, including Donald Berwick,
Elisabeth Decrey Warner, Marian Jacobs, Arthur Kleinman, Joanne Liu, Jane Ol-
儿子, Deborah Rutter, and Tamara Taraciuk-Broner; the consultants who helped
lay out the foundations of this project in the preliminary and exploratory meet-
英格斯, including Michael Barnett, Jocelyn Kelly, Beatriz Magaloni, J. Stephen Mor-
rison, James Orbinski, David Polatty, Anne Patterson, Leonard Rubenstein, Fer-
nando Travesi, Ronald Waldman, and Elisabeth Wood; and the American Acad-
emy of Arts and Sciences’ Committee on International Security Studies for their
oversight of this volume. We are appreciative of Dirk Druet for his leadership and
authorship of our work on pandemic and peace operations, and Ender McDuff
and David Fidler for their invaluable assistance on the project’s publication on
international cooperation in pandemic preparedness and response. We would also
like to thank our partners at the University of California campuses in San Fran-
cisco and San Diego, and El Colegio de la Frontera Norte for their collaborative
work and field research on regional humanitarian responses to pandemics in the
context of forced migration. We thank our home institutions McGill University,
斯坦福大学, and the University of California, 旧金山, for support-

我

D
哦
w
n
哦
A
d
e
d

F
r
哦
米
H

t
t

:
/
/

d
我
r
e
C
t
.

米

我
t
.

e
d
你
d
A
e
d
A
r
t
我
C
e
–
p
d

我

F
/

1
5
2
2
6
2
1
1
5
3
0
6
d
A
e
d
_
e
_
0
1
9
8
8
p
d

乙
y
G
你
e
s
t

哦
n
0
9
S
e
p
e
米
乙
e
r
2
0
2
3

代达罗斯, 美国艺术学院学报 & SciencesPreface

ing us. We are grateful to Chris Merrill and James Cuno, whose insights were
crucial for the inclusion of the creative writing and visual arts pieces in this vol-
梅. We thank the Academy team, especially David Oxtoby, Tania Munz, 彼得
罗宾逊, Melissa Chan, Michelle Poulin, Francesca Giovannini, Islam Qasem,
Kathryn Moffat, Kathleen Torgesen, Rebecca Tiernan, Jen Smith, Phyllis Bendell,
Scott Raymond, Peter Walton, and Key Bird for their support. This venture would
not have been possible without the generous support of Louise Henry Bryson and
John E. Bryson, the Malcolm Hewitt Wiener Foundation, and The Rockefeller
基础.

最后, and most important, we thank each of the writers and artists whose
work appears in this volume. This edition of Dædalus would not have been possi-
ble without your extensive research, revisions, and creative contributions.

我

D
哦
w
n
哦
A
d
e
d

F
r
哦
米
H

t
t

:
/
/

d
我
r
e
C
t
.

米

我
t
.

about the authors

Jennifer M. Welsh, 自此成为美国科学院院士 2021 and cochair of
the Academy’s project on Rethinking the Humanitarian Health Response to Vio-
lent Conflict, is the Canada 150 Research Chair in Global Governance and Securi-
ty at McGill University. Her most recent books include The Return of History: Conflict,
Migration and Geopolitics in the 21st Century (2016) and The Responsibility to Prevent: 超过-
coming the Challenges of Atrocity Prevention (2015).

Paul H. 明智的, 自此成为美国科学院院士 2018 and cochair of the
Academy’s project on Rethinking the Humanitarian Health Response to Violent
Conflict, is the Richard E. Behrman, 医学博士, Professor of Child Health and Society,
Professor of Pediatrics, Co-Director of the March of Dimes Center for Prematurity
研究, and a Senior Fellow at the Freeman Spogli Institute for International
Studies at Stanford University. He participated in two other projects at the Ameri-
can Academy: 内战, 暴力, and International Responses; and New Dilem-
mas in Ethics, 技术, and War.

Jaime Sepúlveda, 自此成为美国科学院院士 2014 and cochair of
the Academy’s project on Rethinking the Humanitarian Health Response to Vio-
lent Conflict, is the Haile T. Debas Distinguished Professor of Global Health and
the Executive Director of the Institute for Global Health Sciences at the University
加利福尼亚州, 旧金山. He is also a member of the U.S. National Academy of
药品. He has published in journals such as The Lancet, NEJM, Vaccine, Health Af-
博览会, BMJ, 科学, and Nature.

e
d
你
d
A
e
d
A
r
t
我
C
e
–
p
d

我

F
/

1
5
2
2
6
2
1
1
5
3
0
6
d
A
e
d
_
e
_
0
1
9
8
8
p
d

乙
y
G
你
e
s
t

哦
n
0
9
S
e
p
e
米
乙
e
r
2
0
2
3

152 (2) Spring 2023Jennifer M. Welsh, Paul H. 明智的 & Jaime Sepúlveda

尾注

1 The breakdown of the data as of late 2022 can be found at Relief Web: 我们. Agency for
International Development, “Ukraine: Complex Emergency Fact Sheet #5, 财政年度
(风云) 2023,” 十二月 23, 2022, https://reliefweb.int/report/ukraine/ukraine-complex
-emergency-fact-sheet-5-fiscal-year-fy-2023.

2 This estimate comes from the World Health Organization’s “Surveillance System for
Attacks on Health Care,” https://extranet.who.int/ssa/LeftMenu/Index.aspx?utm_
source=Stopping%20attacks%20on%20health%20care%20QandA&utm_medium
=link&utm_campaign=Link_who (十一月访问 23, 2022).

3 “‘Aleppo Now Synonym for Hell,’ Ban Warns in Final Press Conference as UN Chief,” UN
消息, 十二月 16, 2016, https://news.un.org/en/story/2016/12/547962#:～:text=%E2
%80%9CAleppo%20is%20now%20a%20synonym,to%20the%20UN %20press%20
corps.

4 Quoted in Igarapé Institute, “Humanitarian Action in Situations Other than War,”

https://igarape.org.br/en/hasow (二月访问 15, 2023).

5 “Rethinking the Humanitarian Health Response to Violent Conflict,” American Acade-
my of Arts and Sciences, https://www.amacad.org/project/humanitarian-health (交流电-
cessed February 13, 2023).

6 See the summary of project activities at ibid.

7 David Miliband and Ken Sofer, “介绍,代达罗斯 152 (2) (春天 2023): 13–21.

我

D
哦
w
n
哦
A
d
e
d

F
r
哦
米
H

t
t

:
/
/

d
我
r
e
C
t
.

米

我
t
.

e
d
你
d
A
e
d
A
r
t
我
C
e
–
p
d

我

F
/

1
5
2
2
6
2
1
1
5
3
0
6
d
A
e
d
_
e
_
0
1
9
8
8
p
d

乙
y
G
你
e
s
t

哦
n
0
9
S
e
p
e
米
乙
e
r
2
0
2
3

代达罗斯, 美国艺术学院学报 & SciencesPreface
下载pdf