Medical doctor, humanitarian, and writer Samantha Nutt takes a damning look at conflict and instability and offers the steps that should be urgently taken to give peace the upper hand.

PUBLISHED Nov. 21, 2011, THE HILL TIMES

Samantha Nutt was completing her master’s at the London School of Economics 16 years ago, focusing on public health and international development, when she had the opportunity to go to Somalia with UNICEF to help with humanitarian relief efforts.

As a then 25-year-old medical doctor, Ms. Nutt said she thought she could save lives, but she was wrong.

“The reality was that … everywhere you turned there were drugged-up trigger-happy young men armed with Kalashnikov rifles. Somalia was unbelievable, in the sense that it was easier, relatively speaking, in many parts of the country to get access to a weapon than it was to get access to clean drinking water,” Ms. Nutt, the founder of international humanitarian organization War Child Canada, told The Hill Times recently in an interview about her new book Damned Nations: Greed, Guns, Armies and Aid.

“When you’re confronted with that, you realize immediately that you can keep running programs until forever and a day, but, fundamentally, the same problems were going to keep recurring unless you did something about the failed political situation, unless you did something about the proliferation of arms, unless you did something about all the unemployed young men who were willingly joining these militias,” Ms. Nutt said.

Now 42, Ms. Nutt said the experience helped her realize that there’s more to development than simply giving money to international non-government organizations during crises or sending old shoes and bikes to those who don’t have them.

Ms. Nutt, an Order of Canada recipient who is a staff physician at the Women’s College Hospital and an assistant professor of medicine at the University of Toronto, has since been to numerous war zones and countries affected by conflict, including Iraq, Afghanistan, Congo, Sierra Leone, Uganda, Ethiopia and Sudan. She’s been in the middle of cross gunfire and car ambushes. In 2004, trapped in a Congolese hotel near the Rwandan border with a film crew and under fire by rocket-propelled grenades in an armed conflict between rebels, Ms. Nutt thought she would die.

Ms. Nutt said it was one of the most dangerous situations she’s been in and although she doesn’t go out into the field as often as she used to (she has a six-year-old son and is married to Ontario Liberal Minister of Children and Youth Services Eric Hoskins) she said the incremental success she’s seen over the years inspires her to continue her work.

The Q&A has been edited for length and style.

Why did you want to write this book? 

“For me, the book represents a culmination of, I guess, 16 years of wrestling with some questions around what are the factors that lead to violence and instability, how do we contribute or exacerbate those situations, what are we doing right and what are we doing wrong and where do we go from here, what might we do differently?”

In your introduction you wrote, “on the question of volunteering overseas and whether that’s an appropriate way to ‘do’ relief and development, I’ve devoted a considerable number of pages in the book to the exploration of this issue and why it must be approached thoughtfully and carefully.” What is your approach to development?

“Any successful development program begins with questions, not with answers. It begins by being on the ground and having strong ties to local communities, being prepared to ask the questions, being prepared to listen to the answers. The best development programs are iterative, and they’re driven from the ground up. And they’re driven by the knowledge and the experience of insiders, people on the ground who are living with these circumstances as opposed to the assumptions of outsiders and that has been, I think, the overarching lesson for me.”

You also wrote, “collectively, we are so often implicated in horrific acts of violence around the world, while our personal interventions rarely do more than maintain the status quo.”  Why do you say that? 

“The reason why I say that is that we focus overwhelmingly on short-term interventions when we see a crisis or conflict that’s in the news. … By focusing so overwhelmingly on those short-term needs we can unwittingly contribute to a number of different challenges. One is that we can create cycles of dependency. We can often arrive and set up parallel structures to governments that are unaccountable to people. We can create an environment where you’re heavily reliant on the skills and experience of internationals as opposed to national staff and investing in those capacities, and so these are just some of the ways that we can undermine local economies by shipping our surplus t-shirts, by sending our shoes.

“… If you really want to undo the legacy of war and poverty that locks many countries into this cycle of violence and ongoing instability, the way that you do that is through longer-term investments that are strategically targeting structural deficits that we see around education, around women’s literacy, around access to justice, breaking the climate of impunity, around economic opportunities particularly for young people so that you’re able to give them alternatives to joining the militia and continuing on with criminal gangs and other activities.”

You wrote that you don’t tell your mom where you are and she doesn’t ask. Does she still worry?

“She does. She won’t even read the book she’s told me. It’s tough. As a parent myself now, I can really appreciate that. I think if my son woke up one day and said, ‘Mommy, I want to do what you do and go to war zones,’ I might have to handcuff him to the bed.

“The thing is, I didn’t choose war. When I made the decision in the ’90s to go with UNICEF in Somalia I was interested in health and human rights and women’s issues. I never in a million years would’ve thought I would even do more of it after that, but once you’re confronted by war, once you see the devastation of war and how it destroys people’s lives, you’re different after that. You just are. I could not then pretend that I was capable of doing anything else, I think.”

Your opening chapter talking about your experience in Bukavu at the Orchid Hotel was pretty scary. How do you feel about going through that?

“That was a tough one. We almost died in the Congo for sure. We could’ve died in the Congo. I think that ultimately I’m acutely aware of how lucky I am. At the end of the day, I have a Canadian passport, I’m able to come and live here and be here and enjoy a life of relative peace and privilege by any measure of it. Living in Canada is a real privilege and I don’t think we often appreciate that.

“And so, while people will say to me all the time, ‘Well, that was dangerous, and you’ve been shot at, you’ve been this, you’ve been that, in a scheme of things, when you think about what millions of people around the world have to endure every single day, and every single night—women in the Congo who can’t walk two blocks without being raped repeatedly, people who fall asleep every night with the crackle of automatic gun fire and explosions and don’t know and look at their children and don’t know how they’re going to be able to protect them from that—I mean, that is an inescapable horror and an awful, awful thing. I’m aware of that all the time, and it feels always very indulgent to me to even say, ‘Poor me, it was a close call in the Congo.’ Close call is a lucky thing because I made it out and most people don’t have that.”

You wrote that a vigorous debate about the balance between war and peace is “long overdue.” What should MPs and the Canadian government be talking about?

“A number of issues, most of them I get into in the book: the balance between military versus aid spending; the militarization of aid in terms of having larger portions of our aid spending is being administered by the military through Hearts and Minds initiatives. We should be operating within a particular framework even around things like the responsibility to protect doctrine. …

“We need to look at why Libya and why not Darfur where three years into the crisis, as tens of thousands of people were dying, Canada wouldn’t even commit and other nations wouldn’t even commit one helicopter that was requested for the mission, never mind that still three years into it, they had half of their requested and approved number of 26,000 peace keepers deployed to the region. …

“These are important questions that also relate to how we’re seen in the world and how we’re received in the world. If the questions aren’t being asked and debated at the Parliamentary level then where will they be asked and debated?”

Do you think the environment is conducive to having this discussion, as opposed to the last 10 years that you wrote about where dissent has been shut out? 

“… I was really disturbed by a lot of the debates around Iraq. Principally, it was the assumption that if you weren’t for the war, that you had to by extension be for Saddam, because you were prepared to let him stay in power and all this kind of stuff. The space between just seemed to disappear. It is possible to be completely opposed to a vicious tyrannical dictator like Saddam Hussein—which I fiercely was—and also feel there wasn’t a legitimate case for war. And so, that’s the legacy that we’ve been dealing with over the past 10 years.

“I also think that in the context of minority government situation, it’s very difficult for foreign policy issues and aid policy issues to take centre stage. … Now that we are in a different political situation where we do have two very different visions of what Canada should be in terms of the opposition and the elected government, I think now is a great time to be having this discussion and debate.”

What do you think of the government’s move to focused aid on the Americas to 20 countries where they think it will be better used?

“I’m critical of it. … We look at our presence on the world stage through a very NATO-driven lens where our weight is not so much felt as a moral power, but as a military power through our NATO experiences. That is changing public perceptions around what Canada’s trying to accomplish and what our priorities are. It’s changing our brand, essentially.”

What do you think the government’s role is in terms of foreign aid, in light of William Easterley’s book The White Man’s Burden, and Dambisa Moyo’s Dead Aid? Should Canada be involved? 

“I think the response to poorly managed aid is not to just cut off aid. The response to poorly managed aid is to manage aid well. So how do you do that? … Yes aid is an imperfect response. There are things that we can do though to make our aid much more effective and I get into these recommendations in the book.

“The flavour now of our aid is to do a smaller number of projects with much bigger budgets … and there are a huge number of problems with that. One is that it allows corporations to have a much more direct influence over work of international organizations because some of the organizations are receiving funding for corporations which erodes more than anything else the role of the NGO as incubators of social movement and social justice. There’s that piece of it.

“The other thing around consolidation of the aid money is that it ends up stifling innovation because it rewards a fairly elite group of large organizations and it basically wipes out all of the smaller to medium-sized organizations that often are doing the more innovative work that has a strong grassroots connection at the local level. … Aid can be managed well and it can be very successful.”

What do you think of Canada’s military remaining in Afghanistan in a non-combat role until 2014? Is Canada doing anything good there?

“I think there is a tremendous need for training and a tremendous need for capacity building at the local level. I think that this is consistent with the kind of activities that we have been involved in militarily in the past around training of civil society groups and training of military and training of police. I do see that as a legitimate and necessary role for our military in terms of the training piece of it.

“I also do think though that some of the training has drifted into areas that are outside of what the scope of the military involvement ought to be. I also think that there is a real risk within that … for our soldiers. It’s a risk for civilians who are killed on those projects at a higher rate than on any other programs and it’s also a risk for our aid workers because it blurs the line.

“I think we also have a tremendous reputation for civil society training. We have a great and vibrant and functioning public service and I think it’s something that people don’t often appreciate here in Canada. I’ve worked around the world in places where the bureaucracy has failed and where corruption is widespread and our civil service is one of Canada’s most laudable assets and we used to be heavily involved in civil service training internationally. We are less so now, but I do see that again as a really important role that we could play.”

You wrote that  “there is a simple way for the Armed Forces of NATO countries to responsibly contribute to aid and development globally: through United Nations peacekeeping missions.”  How do you feel that our role has diminished?

“Disappointed. Very disappointed. I know that peacekeeping has become a pejorative term in defense circles and I feel it hasn’t kept pace with our counter terrorism and counter insurgency role but you know we’ve off loaded so much of the peace keeping missions around the world to poorly funded, poorly equipped, poorly trained African Union troops that still could benefit from that experience and support and investment in those missions. … Peacekeeping missions are fraught with difficulties and I get into some of these in the book, but at the same time, if wealthy countries aren’t prepared to champion reform, then what is the alternative? The alternative is we’re just going to leave people and leave these missions understaffed and under-resourced while people die. We saw that in Darfur.”

How do you measure success? 

“On a personal level, I measure success based on where we start and where we end up. When I look to field programming that I’ve been involved with all around the world I see situations where six or seven years ago you had a local women’s organization in Afghanistan that had no international funding or support, no staff, that had all the right ideas and a very strong community network but really didn’t have the training or the experience to be able to run programs. Then with concerted effort and over time, … they are fully literate, they are trained in a vocational training in a vocation of their choice that’s tied to market needs, they are starting revolving funds, they are supporting one another, they are hiring other women, all of their kids are now in school. You see that and you’re in awe of it, because it’s astonishing. At the same time, it’s also what ends up becoming so frustrating and so disappointing when you know it’s working and it’s not able to continue.”

Do you see that a lot? 

“Yes. And we’re going to see that more in Afghanistan in the years ahead because we’re going to see a drop in global interest and a subsequent drop in aid funding, and successes while they may be lost, they will certainly not continue at the rate we’ve seen.”

Why is your book important? 

“I hope that my book is important and I hope that what it does more than anything else is challenge assumptions around the factors that lead to war and what we’re doing, and what is and what isn’t working and how we might do things differently. … I hope, ultimately, that it starts a conversation, even conversations around the dinner table, conversations in classrooms that people will turn around and say whether they agree with it or don’t agree with it. At least we’re thinking of these issues and that’s a huge step forward.”