Easing World Pain

The Open Doorby Edited by Kevin M. Cahill, M.D.The Center for International Health and Cooperation (New York City). 133p $25

With civil wars exploding around the world, the essays in The Open Door come at an opportune moment. Originally given as annual addresses before the Royal College of Surgeons in Ireland (co-publisher with the Center for International Health and Cooperation), they represent the thought of some of the preeminent statesmen of the 1990’s. Boutros Boutros Ghali, Cyrus Vance and John Hume are just three of those whose lectures appear here in written form. But the contributors also include a missionary priest involved in disaster relief in Africa and a physician - Kevin Cahill, the editorwho has played an active medical role in several of the developing nations in which these conflicts have been taking place. They bring to the collection a pragmatic concreteness that balances the more theoretical views expressed in the other essays.

The essay that readers may find most universal as a statement on how to respond to conflict is that of John Hume, a Nobel laureate for peace because of his many years of involvement in efforts toward peace in Northern Ireland. In "Peace and the Healing Process," he uses the word healing in a political sense. Above all, he emphasizes that no healing can come about through violent means, because force simply "generates more force, creating the vicious cycle of an eye for an eye.’" Not surprisingly, in this context he quotes the words of Martin Luther King Jr.: "Violence as a way of achieving justice is both impractical and immoral."


For Mr. Hume, the healing process must be based on an acceptance of the fact that differences are inevitable, butin his viewthey can be accommodated by dialogue leading to eventual agreement. Although he writes from the perspective of the conflict in Ireland, his words have a global application, as does his belief in the power of dialogue. As an example of the way in which the latter can lead to agreement, he points to South Africa and the work there of Nelson Mandela and F. W. de Klerk, whose efforts led to an agreement far more successful than observers might have thought possible in the early 1990’s.

In his own essay, Boutros Boutos Ghali, former secretary general of the United Nations, describes what he considers the three tasks of peacekeeping at the turn of the century. The first is peacekeeping itself which, he insists, must begin through preventive diplomacy before conflict surfaces. Should conflict nevertheless eruptas it does far too oftenpeacekeeping continues in the form of protecting humanitarian relief shipments and, if necessary, military intervention. Finally, once conflict ends, it takes the form of fostering commercial, cultural and educational projects that can build bridges between the opposing parties. Interwoven in these peacekeeping measures are development and democracy. As he puts it, "Without development there can be no democracy," and without democracy lasting development is not possible. Then, in turn, peace is not possible either.

Kevin Cahill looks at peace and conflict from his firsthand experience as a physician who has seen the devastating results of conflict in Latin America and Africa. He argues that health issues should be a central aspect of a nation’s foreign policy. AIDS is a primary case in point. With half the armed forces in seven African nations infected with H.I.V., from a military point of view "the fundamental foundation of these nations is fragile indeed," resting as it does on a group of people whose life expectancy is short.

But it is the worldwide land mine crisis that Dr. Cahill sees as the most telling instance of the relationship between health and foreign policy. Over 100 million mines are buried in over 60 countries. Not only because of the death and maiming they causemostly among civiliansbut also because of their economic consequences, their use has wreaked long-term damage in poor countries, causing the abandonment of already limited amounts of arable land because of the life-threatening risks to farmers. The sowing of mines thus represents the military aspect of foreign policy at its most degraded.

The extensive levels at which mines and other forms of armaments are bought and sold are major components in the conflicts that form the background from which the contributors in The Open Door write. Former U.S. Secretary of State Cyrus Vance, in fact, points to arms sales as a central aspect of the frequency and destructiveness of continuing eruptions of conflicts. "The United States and other arms exporting nations," he writes, "persist in viewing such transfers [of weapons] as commercial opportunities rather than as potential threats to regional and...our own security." Commerce and monetary gain can easily take precedence over what does and does not promote peace. Sensibly, he calls for a treaty that would limit the sale of armsa step that could bring the concepts of prevention and productive dialogue closer to achievable goals.

Amid the proliferation of late-20th century conflicts that continue into the new millennium, the emergence of larger and more sophisticated nongovernmental operations has helped to stem the tide of resultant human suffering. Aengus Finucane, C.S.Sp. ministered to refugees during the Biafran war and founded Irish Concern, a charitable relief organization. He is consequently in a position to write about the work of N.G.O.’s in providing relief efforts in parts of the world where conflicts have raged. Their growth over the past three decades in size and sophistication has been notable.

However, this very growth has been a mixed blessing, having led to what he terms an "erosion of ethos." Work formerly done by volunteers now often depends on the services of highly salaried professionals. By the same token, the increase in operating expenses has led to greater bureaucratization, along with more dependence on donor governmentsand therefore a lessening of autonomy. As Father Finucane observes, when it comes to N.G.O.’s, bigger is not necessarily better. But he never doubts that the need for themwhether in situations of actual conflict or simply as part of a world in which over a billion people exist on the equivalent of a dollar a dayis greater than ever.

The reader is not told why the book is entitled The Open Door. But given its overall theme of conflicts around the worldthe struggle to prevent them, what to do when they burst forth, and how to assist in the aftermaththe implication is clear enough: The door to peace and reconciliation, and the binding up of wounds, must always remain open.

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