Kunduz

Many years ago, after my fellowship, I looked into volunteering for Doctors Without Borders. It was as the war in Bosnia was heating up. I had no dependents at the time, and knew that, as a surgeon, the greatest demand might be in a war zone. I mentioned that I knew two Slavic languages. As it worked out, I did not end up as a volunteer. But, I have followed the activities of both MSF (Doctors Without Borders) and EMERGENCY, a similar group. So, it greatly disturbed me that a US airstrike had repeatedly hit a MSF hospital in Kunduz, Afghanistan (http://edition.cnn.com/2015/10/07/asia/doctors-without-borders-afghanistan-airstrike/index.html?eref=edition).

As a physician, I take seriously the responsibility of caring for all, even at some risk to myself. I have worked in inner city hospitals where I have been threatened by some gangs, but, excused that due to the drug induced impairment of those who threatened me. And, I have known that many would not have wanted to harm me, knowing that they might later need my services.

International law protects hospitals, both military and civilian, from deliberate attack. Physicians should provide impartial care, and thus, might provide care to both civilians and combatants. Like my experiences in the inner city, those who wage war are at risk of injury, and so they want hospitals and physicians who will care for them. That is why the events of last week are so disturbing. Despite the coordinates of the MSF hospital being provided, there were several bombing runs targeting the hospital reported. Hence, MSF is asking for an investigation of a possible war crime (http://www.motherjones.com/politics/2015/10/us-bombing-afghan-hospital-war-crime).

The US has bombed hospitals before (http://thinkprogress.org/world/2015/10/08/3710486/hospitals-bombed/), and is not alone in this (http://www.theguardian.com/global-development/2015/oct/05/kunduz-hospital-bombing-latest-long-line-attacks-msf-staff; http://www.bbc.com/news/world-asia-34444053). Civilians have increasingly become the victims of war during the last century.

I hope the truth about this event will come out. And, that a hospital can be rebuilt for the people of the region.

Carol for the absent

Polish tradition says that an extra place should always be set at the Christmas Eve table for the absent or the needy. It was always a time to welcome people into our home. Very often, when I was growing up, these were foreign students a long way from home. This morning, I found a carol that addresses the empty seats at the table. Those we have loved and lost:

http://spuscizna.org/music/k-absent.html

This evening, my family will be joining other relatives for a Christmas Eve dinner. There will be empty seats for those we have lost.

WWIII?

Seventy five years ago, on September 1, 1939, World War II began with the invasion of Poland. Seventeen days later, the Soviets invaded from the east. Appeasement had not worked to contain Hitler in his quest to dominate Europe. It only encouraged him to become bolder in his land grabs. And in the abuse and murder of people in the occupied lands.

Once again, there have been years of appeasement, which seem to be emboldening another leader. Thirteen years ago was the second Chechyn war was underway (http://www.telegraph.co.uk/news/worldnews/vladimir-putin/10679121/Ukraine-crisis-We-confront-Vladimir-Putin-now-yet-appeased-him-before.html). The, in 2008, Russia tried to take over Georgia and succeeded in controlling a part of the country (http://www.washingtonpost.com/opinions/mikheil-saakashvili-the-west-must-not-appease-putin/2014/03/06/db9e0c82-a4a9-11e3-8466-d34c451760b9_story.html). Similarly there has been a separatist part in Moldova which has been supported by Russia. And then, annexation of Crimea. And now, a war in Ukraine.

Like the expansions of Germany in the 1930s, where Hitler argued that he needed to protect ethnic Germans in the annexed parts of neighboring countries, Putin argues that these expansions have been to protect Russian speaking populations in those countries. All of the countries which were part of the former Soviet Union have significant Russian speaking populations. And similar to the Anschluss, when Austria was annexed to Germany, Putin has said that Ukraine is not a separate nation (https://www.youtube.com/watch?v=k410KneBpbY). Putin has also said that the fall of the Soviet Union was one of the major tragedies of the twentieth century. 

It appears that the former KGB agent wishes to restore the Soviet Union. And, so far, the world has allowed him to work toward this aim, imposing only economic sanctions for the support of the separatists in eastern Ukraine. Nevertheless, until recently, Russia denied that it was supporting the separatists. Until it became apparent that Ukraine was regaining territory that had been controlled by the separatists.

Then, nearly seventy five years to the day after the start of WWII, while many in the US were enjoying the start of their Labor Day weekend (which was placed in September to separate it from the May Day celebrations of labor in much of the rest of the world, including, especially communist countries), Russia invaded Ukraine. This was south of where most of separatist activity has been. Yet, he calls these troops "volunteers." "Volunteers" with tanks--two columns of tanks. 15,000 Russian troops are now reported to be in Ukraine (https://www.youtube.com/watch?v=OSUeewx4qL8).

The Russians have routed Ukrainian forces in several areas and have begun arresting Ukrainians in areas they took over and deporting them to unknown locations (http://wiadomosci.gazeta.pl/wiadomosci/1,114881,16542864,Jaceniuk__Putin_rozpoczal_wojne_w_Europie__chcemy.html?entry=1231554#MT). In addition, they fired on Ukrainians leaving an area in which they were previously encircled via a "safe" corridor.

And, to discourage other nations from supporting Ukraine, Putin reminded the world over the weekend that Russia is a "nuclear superpower." (http://www.ibtimes.co.in/putin-warns-west-we-are-nuclear-superpower-dont-mess-us-607925) He has also begun referring to the area in eastern and southern Ukraine as "Novorossiya," a term which was used in the time of Catherine the Great.

Similarly, as Kazakhstan has expressed more nationalistic sentiments, especially regarding the space launch facility which Russia rents from them, Putin has warned them that they may be next in his efforts to reconstitute the Soviet Union (http://hotair.com/archives/2014/08/29/putin-youre-next-kazakhstan/). But, these countries are not falling into line as Putin might have expected (http://belarusdigest.com/story/belarus-ukraine-and-kazakhstan-building-alliances-against-moscow-15829). Rather they are starting to form alliances against Russia. 

While the West is not obliged to come to the defense of any of these countries, the Baltic nations of Lithuania, Latvia and Estonia, as well as most of the countries of what once was communist controlled Eastern Europe, are members of NATO. NATO has been shoring up its support of its easternmost members since it realized that it was in a poor position to defend them should they be attacked from the east (http://www.newrepublic.com/article/116967/nato-no-position-protect-eastern-europe-russia). Here, too, appeasement was in play in 2009, when the US backed down on a missile shield defence for Poland.

In addition, the restrictions on food imports, imposed by Russia in reaction to economic sanctions imposed by the West for the Russian support of separatists in eastern Ukraine, are punishing average Russians with increasing food prices (http://www.bbc.com/news/world-europe-28849726). These could drive Russians to lose support for their government, especially its territorial claims, or could increase solidarity against the world, as shortages did for the Russians under previous rulers.

So, now, we have a Russia, emboldened by appeasement which is threatening NATO members with nuclear attack should they dare oppose Putin's plan for reconstituting the Soviet Union. And, already, it is apparent that Russia will continue on its expansionist path, regardless of the desire for peace by the leaders of the West (http://www.forbes.com/sites/marcelmichelson/2014/08/29/it-is-time-to-face-it-we-are-at-war-with-russia/). 

So now, we are faced with the decision, as put succinctly by Ben Judah, to Arm Ukraine or Surrender (http://www.nytimes.com/2014/09/01/opinion/arm-ukraine-or-surrender.html?_r=0). The world must decide whether Russia will become the dominant power on the Eurasian landmass or the West will draw a "line in the sand" or, in this case, the fields of Ukraine. Neither path will be easy for the world. 

Warsaw Uprising

Seventy years ago, on August 1, the Warsaw Uprising began. It was the largest military effort by a resistance group. It has been said that more Jews fought in the Warsaw Uprising of 1944 than in the Ghetto Uprising of 1943.

The Polish fighters were so effective that the Germans began to retreat, especially as they saw the Soviet Red Army nearing Warsaw.  Once they realized the Soviets would not come to the aid of the Poles, the Germans regrouped and defeated the outgunned Poles. The Germans began systematic massacres of civilians. By the end of the Uprising 200,000 civilians had been killed. Forty thousand were killed on August 8 in the Wola Massacre alone. Another 50,000 are said to have fled. Over eighty percent of the city was leveled.

Yet the Warsaw Uprising was carried out with limited outside support. Only one American airdrop of supplies was allowed by the Soviets. The Polish pilots with the British Air Force were too far away in Italy. Nevertheless, the British made over 200 flights to help the Polish Home Army in 1943 and 1944. When a British mission did finally arrive in December, to help the Poles in Warsaw, they were promptly arrested and imprisoned by the Soviets.

On August 15, the same Soviet Foreign Minister Vyacheslav Molotov sent an emissary to inform American Ambassador Averell Harriman that the Soviets would not support the Poles. So, the Red Army was waiting for resupply across the Vistula river, as they watched the city burn.

There was only one attempt at providing help to the Polish insurgents allowed. It was made by Poles serving under General Zygmunt Berling in the Red Army.  Many of these men were taken prisoner in 1939-1940 under the terms of the Molotov Ribbentrop Pact and spent two years in gulags. They were freed only after the Germans reneged on the agreement and invaded Soviet territory in July, 1941, when they actually invaded the eastern part of Poland previously ceded to the Soviets. After that point, the Soviets needed soldiers and freed the Polish prisoners. Some made it out with the Anders Army under British command, while others were too late to join General Wladyslaw Anders and then joined the Berling Army in the hopes of liberating their homeland.

The Soviets gave orders on August 23 not to help the Poles, rather the arrest and disarm them. The attempt to help the Poles in Warsaw occurred on September 14. Only 900-1200 made it across the river. There was no artillery or air support provided. No further attempts were made after September 19. General Berling was relieved of his command and ordered to return to Moscow, perhaps for his disobedience in this matter.

Even with the limited outside support, the Poles continued to fight until October 2, when they finally surrendered. The Uprising had lasted 63 days. The combatants were taken as prisoners of war, since it was felt that they fought as an organized military unit. Even the women combatants were given that distinction. Earlier, even Polish soldiers were deemed "bandits" since they served a country which the Germans felt did not exist since 1939, after the joint invasions from the west by the Germans on September 1, 1939 and the east by the Soviets on September 17, 1939. The two powers had divided Poland in accordance with the Molotov Ribbentrop Pact of August, 1939.

During the years of communism, the history of the Warsaw Uprising was suppressed by the Soviets, who painted the partisans of the Home Army as Nazi sympathizers, despite the fact that they were the largest resistance movement in Europe. For years after the war, they arrested, imprisoned and often executed former members of the Home Army. Since the fall of communism, this history is again remembered.

Photo courtesy "Sąd najwyższy s5" by Spens03 - Own work. Licensed under Creative Commons Attribution-Share Alike 3.0 via Wikimedia Commons - http://commons.wikimedia.org/wiki/File:S%C4%85d_najwy%C5%BCszy_s5.jpg#mediaviewer/File:S%C4%85d_najwy%C5%BCszy_s5.jpg

The intersection of medicine and war

Had another blog published on Physicians Practice:
http://www.physicianspractice.com/blog/when-war-and-medicine-combine-physician-reflects

Things continue to heat up

Reading the news about Ukraine continues to scare me. The countries of the victims of MH17 send more police and even troops to help with the investigation. It was revealed that the man who likely fired the rocket that downed the passenger plane (http://www.ibtimes.co.uk/igor-strelkov-key-mh17-crash-suspect-linked-massacre-3000-bosnian-muslims-1992-1458304) is a veteran of both the Soviet and Russian armies, and is thought to be a covert agent of Russian military intelligence (GRU).

Russia is moving more powerful weapons close to the border. It may also be delivering more powerful weapons to the separatists. US intelligence is reporting that rockets are being fired from within Russia across the border into Ukraine.

NATO is placing more troops in Poland (http://rt.com/news/175292-nato-poland-supply-base/). Poland is buying more weapons, as it and the Baltic countries are increasingly concerned that, despite being members of NATO, the alliance will be reluctant to engage Russia in their defence. Those in Brussels have acknowledged that defence of the eastern countries now in NATO would be difficult. Perhaps that is the reason for the new base being proposed in Poland.

Even as I watch from the comparative safety of the US, I remember that a Russian AWACS plane flying along the coast interfered with air traffic control at LAX. The world is now not that big. Regional conflicts can spread quite quickly.

The Russian bear seems to be wanting to reclaim the territory it lost in "the worst disaster of the twentieth century," as Putin described the breakup of the Soviet Union. It is nearly the 75th anniversary of the start of World War II, as the Germans and the Soviets invaded and divided Poland under the Molotov-Ribbentrop Pact. I hope that we are not seeing the lead up to World War III.

IPPNW weighs in

Since my last two blogs have dealt with Ukraine, here is IPPNW's opinion:
http://peaceandhealthblog.com/2014/07/22/crisis-in-ukraine/