History

HISTORY, HEALTH AND HOPE

Ronald McCoy

Introduction

The origins of warfare are layered over with speculation, but it seems likely that the early weapons of war, such as spears, bows and arrows and slings, preceded warfare chronologically and were fashioned by groups engaged in hunting.

Although aggression is part of human nature, organised violence does not seem to have been biologically programmed into early man. It is generally accepted that warfare emerged around 6,500 B.C., at the transition when some wandering hunter-gatherer groups opted for settled village life in Western Asia and were attacked by nomadic hunter-gatherers, who were attracted to the accumulation of food and other surpluses in newly settled villages, in the same way that uncertain access to oil reserves has caused wars in the twentieth and twenty-first centuries.

A sense of territory emerged among later societies, when population growth and increasingly complex agricultural societies encouraged the growth of cities with elaborate, walled defences and citadels, the forerunner of today’s gated communities.

Military aspects of society became clearer with written history. In lower Mesopotamia, two of the most important and earliest pictorial representations of warfare, dating back to 2,500 B.C., depict the mode of warfare. They show kings leading their followers in battle in disciplined, military formations of chariots and infantry, armed with spears, daggers, javelins and sickle swords. Later came the single arc-bow, followed by the composite bow, which became the dominant weapon of the battlefield because it had an effective range of 250 – 300 yards.

Warfare in the ancient empires of Egypt, Assyria, Persia, India and China was usually caused by specific internal circumstances, economics, geography or external threats. Warfare profoundly influenced each civilization. The military successes of these ancient

empires were mainly achieved not so much by particular armies or weapons or by advances in bronze and iron, but through superior administration, organization, economic capabilities, and inspired leadership, as well as the ability to borrow and learn new ideas, techniques and innovations from their neighbours and incorporate them into their own armies. Julius Caesar said that two things created power – soldiers and money – and that they depended upon one another.

Since the dawn of civilization, organized violence has been the ultimate way by which human societies settled their differences. The First World War, which killed 20 million, unleashed an unprecedented application of technology to the battlefield, resulting in a high casualty rate. The power of the rifle, the machine gun, and field artillery drove both sides to shelter in trenches, resulting in trench warfare. Towards the end of the war,

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mustard gas, bombs, grenades, mortars, light machine guns, tanks and planes came into play.

The Second World War was more destructive and bloody, killing 50 million. The war fostered advances in science and technology and the production of jet aircraft, guided missiles and the prototype of the computer, all of which revolutionized war. Scientists in the Manhattan Project harnessed nuclear fission to produce three atomic bombs.

The first atomic bomb was detonated in a test, named Trinity, in the New Mexico desert on 16th July 1945. The other two were dropped on Hiroshima and Nagasaki on 6th and 9th August, instantly destroying the cities and killing 200,000 people, a victor’s war crime that went unpunished. The scientists realized that humankind now had the ability to destroy itself. The Bhagavad-Gita has a line: Now I am become Death, the destroyer of worlds.

The Second World War, which ushered in the nuclear age, soon gave way to an ideological Cold War, which spawned the doctrine of nuclear deterrence and ‘mutual

assured destruction’ and triggered an insane nuclear arms race. It was only by good fortune, not good management of nuclear deterrence, that the world survived.

Physicians for Social Responsibility

In 1950, the US Federal Civil Defense Administration distributed 16 million copies of a booklet, Survival Under Atomic Attack, with widespread media support. That same year, American medical organizations, including the American Medical Association, actively participated in civil defence planning. Physicians were trained in leading medical schools to organize civil defence activities in their neighbourhoods. The Journal of the American Medical Association and the New England Journal of Medicine published articles which advised physicians on how to prepare for a nuclear attack.

A group of physicians in Boston, led by a cardiologist, named Bernard Lown, was moved to make a strong medical, moral, humanitarian, and legal case for the abolition of nuclear weapons. In 1951, they founded Physicians for Social Responsibility (PSR), based on the premise that health professionals would not be able make any meaningful response in the aftermath of a nuclear attack and therefore nuclear weapons had to be abolished. PSR’s objective was to educate the public and decision-makers about the inhumanity and catastrophic consequences of nuclear war. Public health academics were in the forefront of this new organization, but most prominent was its charismatic leader, Bernard Lown, who had emigrated as a boy from a Lithuanian Jewish community. Lown’s strong social conscience always impelled him to speak up against social injustices and anything he considered was wrong. It was not surprising that he was accused of being a communist during the McCarthy era.

In 1959, the Joint Congressional Committee on Atomic Energy declared that a 1,446-megaton nuclear attack on the United States was a “realistic possibility.” PSR responded by graphically describing in clinical detail the aftermath of a nuclear war, drawing on the

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documented experiences of Hiroshima and Nagasaki. In 1962, a series of articles describing the medical consequences of thermonuclear war were published in a single

issue of the prestigious New England Journal of Medicine. David Nathan, Jack Geiger, Victor Sidel and Bernard Lown, all from the Boston PSR group, were the authors.

They analysed the attack and documented the health effects of nuclear explosions in clinical detail. They described the effects of heat, blast and radiation at various distances from the hypocenter of a one-megaton nuclear explosion. They charted the location of medical facilities and showed that most of them would be destroyed, together with their health professionals. They predicted that severe traumatic injuries and massive burns, combined with life-threatening radiation exposure, would kill 1.3 million people and injure 1.25 million in the Boston area alone and that approximately one million of the injured would subsequently die. The authors concluded that any response from health professionals would be futile and that civil defence efforts would be meaningless. It was argued that physicians had an ethical responsibility to help prevent the use of nuclear weapons. The articles received worldwide attention and PSR membership grew rapidly.

PSR’s initiatives kindled medical studies on the health effects of atmospheric nuclear testing which showed increasing levels of strontium-90, a component of radioactive fallout, in the deciduous teeth of children in the United States and Europe. Public protests led to the signing of the Limited Test Ban Treaty in 1963, which banned nuclear testing in the atmosphere or undersea. It stopped atmospheric testing, but more than one thousand nuclear tests were then carried out underground in the next two decades.

The miraculous avoidance of a nuclear catastrophe in the 1962 Cuban missile crisis and the Limited Test Ban Treaty had the effect of tranquillising and persuading most Americans, including some physicians, that nuclear war was a remote possibility. Subsequently, PSR lost support and momentum and its level of activism declined.

In the meantime, the nuclear arsenals of the United States and the Soviet Union continued to grow and the deployment of tactical nuclear weapons in Europe increased the risk of a nuclear confrontation between NATO and the Soviet Union in the late 1970s. In 1979,

Helen Caldicott, an Australian paediatrician working in the United States, was elected president of PSR and she revitalized the organisation. With the support of other knowledgeable physicians, she organized a series of medical symposia in major US cities and projected what she called “a bomb run on them,” describing the likely consequences of a nuclear attack on each city and the problems of providing medical care for survivors. Public awareness and fear were rekindled and membership in PSR grew rapidly, reaching 20,000 members.

International Physicians for the Prevention of Nuclear War

That same year, in 1979, Bernard Lown reached out to a fellow cardiologist in Moscow, Eugueni Chazov, who like Lown was researching the causes of sudden death in myocardial disease. Lown’s contention was that they were doing nothing to prevent a cause of sudden death that was threatening millions – nuclear war. He invited Chazov to

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join him in developing a joint medical protest against nuclear weapons. As personal physician to Leonid Brezhnev, Chazov felt confident enough to accept the invitation.

In December 1980, three American physicians (Bernard Lown, James Muller and Eric Chivian) and three Russian physicians (Eugueni Chazov, Leonid Ilyin and Mikhail Kuzin) met in Geneva. They agreed on guidelines for organizing an international group of physicians, with the overarching principle that discussions would be limited to issues of nuclear war only and would avoid sensitive issues concerning conventional arms, nuclear power and human rights.

As a result of that meeting, International Physicians for the Prevention of Nuclear War was founded, the only international medical organization dedicated to preventing nuclear war and abolishing nuclear weapons. It is now a non-partisan federation of national

medical groups in 60 countries, representing tens of thousands of doctors and medical students.

IPPNW’s mission can be described in medical terms as offering a diagnosis, which describes the reality of nuclear annihilation from nuclear weapons and nuclear policies, and a prescription for cure: the abolition of nuclear weapons.

IPPNW received the Nobel Peace Prize in 1985 in recognition of its ability to bring together physicians linked by the common bond of medicine and its ability to speak with a single voice, ethically and with authority in the name of humanity. The award proved to be contentious. There were many accusations that IPPNW was a “communist front.”

Bernard Lown’s eloquent Nobel Peace Prize acceptance speech had strong moral undertones: “We physicians who shepherd human life from birth to death have a moral imperative to resist with all our being the drift toward the brink. The threatened inhabitants on this fragile planet must speak out for those yet unborn, for posterity has no lobby with politicians…. We physicians have focused on the nuclear threat as the singular issue of our era. We are not indifferent to other human rights and hard won civil liberties. But we must be able to bequeath to our children the most fundamental of all rights which preconditions all other rights: the right to survival.”

When IPPNW’s First World Congress was held in 1981 in Airlie, Virginia, it was attended by 80 physicians from 12 countries. Since then, increasingly larger congresses have been held, first annually and then biennially.

At the Seventh World Congress in Moscow in 1987, with Chazov’s influence, the IPPNW Executive Committee was invited to meet with President Gorbachev. Earlier that year, Bernard Lown had impressed Gorbachev at a forum in Moscow, when Lown acclaimed Gorbachev’s initiatives of glasnost and perestroika, appealed to him to continue the Soviet moratorium on nuclear testing, and concluded: “Survival depends on

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protest, not resignation. Each of us must speak for generations yet unborn. We shall succeed as we empower millions of people with our vision of a world free of nuclear weapons. Only those who see the invisible can do the impossible.”

Gorbachev then leaned across and scribbled in Russian on Lown’s script: “I agree with everything you say, Dr Lown.”

In the meeting with the Executive Committee, Gorbachev declared: “We share the aims of your movement, and take them into account in shaping our foreign policy…You are not a political organization – you are concerned for the survival of all human beings. This overrides all other programmes.”

Gorbachev told the Executive Committee about new proposals that he believed the Soviet Union should support: no nuclear weapons by the year 2000; a continuing moratorium on nuclear tests; and a new system of security, universal and collective.

He went on to say: “We have a deep conviction that the only basis for international relations is a peaceful relationship and peaceful competition. We see a common European home, common security in the Asia-Pacific region, common security with our friends in the Warsaw Pact, all following a strictly defensive policy.”

A few years later, Gorbachev fell from power and the Soviet Union was dismantled. The world now is in great need of an ‘American Gorbachev.’

A wider IPPNW agenda

By the time of the 1987 Moscow Congress, new affiliates from the Third World were becoming more visible and IPPNW was concerned that nuclear disarmament had little relevance for countries where poverty, hunger and disease had become another means of mass destruction. Lown’s idea of a satellite for peace attracted generous support and soon materialized with the launching of a small satellite which brought free and effective

communication to every part of the globe. Initiated by IPPNW, SatelLife has since become a private project.

There were also concerns about the deterioration of the global environment. Bernard Lown’s creativity produced the IPPNW “triangle” – a model focusing on nuclear weapons which showed the three-way interdependence of disarmament, development and the environment. The triangle showed that refusal to abandon spending on nuclear weapons prevented nuclear states from participating effectively in development, and that their nuclear weapons industries secretly caused untold damage to the environment. Nuclear disarmament was seen as a path, not only away from a nuclear holocaust, but also towards global justice and ecological survival.

In 1988, IPPNW worked with the Institute for Energy and Environmental Research and established a commission to study the health and environmental effects of nuclear weapons production, testing and deployment. This collaboration produced three

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influential books: Radioactive Heaven and Earth, Plutonium: Deadly Gold, and Nuclear Wastelands.

World Court Project

IPPNW actively participated in the World Court Project, the brain-child of Harold Evans, a New Zealand lawyer and magistrate, who persistently advocated seeking a legal opinion from the International Court of Justice (or the World Court) on the legality of the use or threat of use of nuclear weapons. He was supported by the International Association of Lawyers Against Nuclear Arms (IALANA) and the International Peace Bureau (IPB).

At the 1991 Tenth Anniversary World Congress in Stockholm, Eric Geiringer, a member of the New Zealand affiliate, sought and received the support of IPPNW to proceed with the initiative, but it was a few years before it was finally considered by the ICJ, which gave its Advisory Opinion in 1996.

The ICJ unanimously concluded: “There exists an obligation to pursue in good faith and bring to a conclusion negotiations leading to disarmament in all its aspects under strict and international control.”

Eleven years after the advisory opinion, the nuclear weapon states have not pursued in good faith the elimination of their nuclear arsenals. There is widespread concern that the nuclear weapon states should do more to show good faith in fulfilling their legal obligation to comply with Article VI of the NPT and the thirteen Practical Steps contained in the Final Document of the 2000 NPT Review Conference.

IPPNW, IALANA and IPB are now initiating a move to revitalize the legal process. A World Court Coalition has been formed and is preparing a resolution for the UN General Assembly to request further advice from the ICJ on whether the nuclear weapon states are complying with their “good faith” obligation.

The threat of nuclear war

Climate change and nuclear war are the two most dangerous challenges to human and planetary survival. The effects of climate change are now sufficiently visible and palpable to persuade governments of the urgent need to reduce greenhouse gases. The threat of nuclear war, however, has not raised the same fears or roused our instinct of self-preservation, despite the existence of 27,000 nuclear weapons in a world that still resorts to war. The fear of Armageddon, most palpable in the 1980s, has receded and been replaced by complacency and a superficial understanding of the true nature of nuclear weapons.

The unique destructiveness of nuclear weapons places them in a category of their own, beyond chemical and biological weapons. Thermonuclear weaponry has the potential to render human habitat permanently radioactive and uninhabitable. The most immoral, the

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most inhumane, the most illegal weapons of war, nuclear weapons incinerate, vaporise and annihilate indiscriminately. The principles of preventive medicine dictate that the

most effective approach to the nuclear threat is to prevent nuclear war by abolishing nuclear weapons.

The threat of nuclear war will prevail as long as states possess nuclear weapons and brandish them for security. As the Canberra Commission on the Elimination of Nuclear Weapons declared: “The proposition that nuclear weapons can be retained in perpetuity and never used, accidentally or by design, defies credibility. The only complete defence is the elimination of nuclear weapons and assurance that they will never be produced again.”

When the Cold War ended, the world squandered a great opportunity to reap a ‘peace dividend’ and increase the momentum of the bilateral Strategic Arms Reduction Treaty (START) agreements to reach the goal of zero nuclear weapons. Instead, START has effectively been replaced by the 2002 Strategic Offensive Reduction Treaty (or Moscow Treaty), which does not embrace the disarmament principles of verification, irreversibility and transparency.

The 1970 Nuclear Non-Proliferation Treaty (NPT), the only legally-binding instrument for the elimination of nuclear weapons, is seriously dysfunctional. The NPT is based on a quid pro quo agreement between the non-nuclear weapon states, which have renounced nuclear weapons and are guaranteed access to peaceful nuclear technology, and the nuclear weapon states, which in turn have promised to eliminate their nuclear arsenals in good faith. The challenge has been to enforce compliance on both sides of the bargain. Failure to balance disarmament and non-proliferation commitments is causing mutually assured paralysis in the NPT process and stimulating nuclear proliferation.

Until the nuclear weapon states are seen to be unequivocally committed to elimination, there is a real danger that nuclear proliferation will spin out of control. The 2004 Report by the UN Secretary-General’s High Level Panel on Threats, Challenges and Change has

warned: “We are approaching a point at which the erosion of the non-proliferation regime could become irreversible and result in a cascade of proliferation.”

The increasing risk of nuclear war stems particularly from the military policies of the United States, as articulated in its 2001 Nuclear Posture Review (NPR) and National Security Strategy. The US reserves the right to the pre-emptive use of force and has begun to envisage the use of nuclear weapons against any non-nuclear weapon state that poses a threat with its chemical or biological weapons. Counter-proliferation has now been enshrined in US national security strategies and has had a profound influence on a new evolving nuclear doctrine.

The NPR has expanded the role of nuclear weapons beyond their core function of nuclear deterrence to a war-fighting capability. It has blurred the distinction between nuclear and non-nuclear missions and projects plans for new nuclear weapons, new missions and new

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uses for nuclear weapons, and preparations to resume nuclear testing. The US has stigmatized five non-nuclear weapon states as ‘rogue states’ and made them potential nuclear targets.

The NPR advocates a New Triad of capabilities that will consist of combining conventional and nuclear offensive strikes with missile defences and a new nuclear infrastructure for the development and eventual production of new low-yield and earth-penetrating nuclear weapons.

The new nuclear doctrine disregards previous US negative security assurances given to non-nuclear weapon states. At least, the Cold War doctrine of nuclear deterrence started from the premise that nuclear weapons must never be used except in retaliation against another nuclear weapon state.

The other nuclear weapon states – Russia, France, Britain and China – continue to modernize and upgrade their nuclear arsenals, in open defiance of the international

community and their legal obligations under the NPT. In March 2007, Britain made clear its intentions by deciding to replace its submarine-based Trident nuclear weapon system. With the exception of China, all nuclear weapon states have a First Use policy.

The Canberra Commission on the Elimination of Nuclear Weapons asserted that when any state reserves to itself the unique right to possess nuclear weapons for its own security, it leads to a highly discriminatory and unstable situation in which there is a constant stimulus to other states to acquire them for their own security.

International Campaign to Abolish Nuclear Weapons (ICAN)

Compliance with the NPT has failed dismally. Following the significant failure of the 2005 NPT Review Conference and the attempt by the nuclear powers, led by the United States, to nullify previous NPT agreements, after 35 years of diplomatic doublespeak, IPPNW Co-President Ron McCoy called on IPPNW to think outside the NPT box and explore other avenues to nuclear abolition. He called on IPPNW to lead an International Campaign to Abolish Nuclear Weapons (ICAN), as a parallel abolition initiative outside the deadlocked NPT process, similar to the Ottawa Process on landmines.

There was strong support from all affiliates and ICAN was adopted by the Board of Directors as a primary IPPNW programme. ICAN will aim to build a partnership between civil society groups, like-minded governments, international agencies and the United Nations, working together to achieve a Nuclear Weapons Convention, which would ban the development, possession and use of nuclear weapons.

The aim of ICAN is to garner the support of individuals, citizen groups, parliamentarians, mayors and other civic leaders and generate a global outcry, create a nuclear taboo, and mount an irresistible mass movement that will compel the nuclear weapon states to disarm and abolish their nuclear weapons through a Nuclear Weapons Convention.

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There are encouraging signs that some influential quarters in Europe and the United States are now advocating nuclear abolition. The calls have come from the Weapons of Mass Destruction Commission (chaired by Hans Blix), the former UN Secretary General, Kofi Annan, and, most significantly, from the quartet of four senior US Cold Warriors –

George Schultz, William Perry, Henry Kissinger and Sam Nunn – who in the Wall Street Journal of 4th January 2007 called for a world free of nuclear weapons.

Ethics

The state of our disorderly world cries out for new thinking and a new ethical agenda for international relations. The world is largely being shaped by political and economic forces, backed up by military power, often compromising fundamental human security, social justice and human rights. The challenges of inequity and poverty, rampant militarism and deadly conflict, environmental damage and human rights violations require of governments a new sense of global responsibility and accountability.

So-called ‘realists’ are setting the agenda and their ‘realism’ continues to dominate thinking in international relations and to influence world politics. But where is the realism in advocating security in terms of military power and the possible use of weapons that have the capacity to end our civilization? But there is a glimmer of hope. It is gradually being recognized that we have to conceptualise ethics in world politics, rather than ethics and world politics. In other words, ethics must be integrated with politics.

We in IPPNW believe that there are human solutions to human problems. Global trends suggest that the world has reached a critical cross-roads, but trends do not have inevitable end-points or consequences. Global trends can be checked and altered by transforming attitudes and values. For physicians, who believe in the sanctity of life, a natural starting point would be the Hippocratic principle: First Do No Harm. Such a principle could form the basis of a global ethic that could impinge on scientific endeavour and world affairs, at a time when science and technology are under scrutiny and the forces of militarism and economic globalisation are creating a moral vacuum.

While moral codes shape individual behaviour and state laws constrain citizens, ethics and international law do not seem to enjoy the same application or acceptance by sovereign nation states. Ethical norms governing international relations, such as they exist, need to be redefined, strengthened and applied as ground rules for the behaviour of states, as opposed to what has come to be known as an autonomous ‘morality of states’ which in practice maintains the status quo of state sovereignty which is not always moral or just.

In practice, ethical norms are often viewed as irrelevant to foreign policy, the argument being that foreign policy cannot but pursue the national interest. Since states are largely governed by self-interest, they have a tendency to view anything that compromises national interests as being inconvenient, if not irrelevant.

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As tendencies are not inevitabilities, each state can make a choice. If we agree that foreign policy is shaped by considerations and choice, then it is possible that ethical values can contribute to foreign policy, either because decision-makers are persuaded of their importance or because electorates are so persuaded. Articulation and advocacy of ethical values by civil society and ethicists are therefore important, if there is to be change.

The creation of a global ethic as a ‘global social reality’ will depend upon what is established, not so much upon the norms accepted by states, as upon the norms embedded in institutions and practices, which represent the wider consensus of civil society throughout the world. The challenge would seem to be in establishing a consensus of universal values. It is clear that civil society has an important role and must exert its influence.

The paradox of the nuclear age is that the greater the striving for power and security through nuclear weapons, the more elusive the goal of human security becomes. For humankind to survive in an environmentally challenged and nuclear-armed world, we must learn from the mistakes of the past and forge a common, secure future. The greatest moral challenge of our times has been the unthinkable possibility of self-destruction on a global scale in a nuclear war or from climate change.

The greatest priority for collective human responsibility for the future is to ensure there will be a future and to strive against the dark forces that threaten the continuity of life itself. Such an endeavour will need political will to establish a new global ethic based on equity, justice, the rule of just law, multi-dimensional democracy, and a shared responsibility for upholding our humanity and respect for the environment.

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Talk given at the IPPNW Southeast Asia and Pacific Students Conference in Adelaide, 7 – 8 July 2007.