Margaret Bourdeaux: Why civilians suffer more once a war is over
Margaret Bourdeaux: Dlaczego cywile cierpią bardziej po wojnie
Margaret Bourdeaux investigates the best ways to protect, recover and reconstruct health systems and institutions disrupted by war or disaster. Full bio
Double-click the English transcript below to play the video.
what it would be like
there are no rules
and there are no laws.
have disappeared.
about what this is like,
a medical student in 1999,
in the Balkans during the Kosovo War.
podczas wojny domowej w Kosowie.
od uniwersytetu medycznego
from my medical school
za niektórymi rodzinami,
that I had befriended in the camp
w powojennych warunkach.
life in this postwar setting.
was a very interesting place
było bardzo interesujące,
the war didn't break out again.
że wojna nie wybuchnie na nowo.
it was actually a lawless place,
both public and private,
zarówno publiczne jak prywatne,
of these situations and settings,
before you run into a situation
how incredibly vulnerable you are.
jak bardzo jesteście bezbronni.
when I had to cross the first checkpoint,
było przekroczenie punktu kontrolnego.
through this checkpoint
przejazd przez punkt kontrolny
right then and there,
mnie na miejscu zastrzelić,
anything illegal.
was absolutely nothing
of the families that I got to know
zagrożenia rodzin,
where there are no social institutions
w którym nie ma instytucji społecznych,
"What are we going to eat tonight?"
takie jak: "Co będziemy dziś jeść"?,
when you don't have any security systems,
gdy nie istnieją systemy bezpieczeństwa,
with the neighbor down the block
that will end my life
zakończony moją śmiercią
when there is no health system
gdy nie ma systemu opieki zdrowotnej,
had to sort through questions like,
zmierzyć się z pytaniami:
What am I going to do?"
is bleeding. What should I do?
where are the nurses?
czy mogę mu zaufać"?,
In what currency will I pay them?"
where will I find them?
are they actually counterfeits?"
the dominant feature of life,
that people have to manage
z którym ludzie muszą sobie radzić
is incredibly difficult to explain
bardzo trudno wyjaśnić
who are living outside of it.
spoza obszaru konfliktu.
I became a physician,
health policy researcher.
zdrowia publicznego na świecie.
w Harvard Medical School,
Division of Global Health.
w dziale zdrowia globalnego.
on this problem right away.
jak zredukować miażdżącą bezbronność
the crushing vulnerability
niestabilnych regionach.
of fragile settings?
we can start to think about
that are critical to survival,
I had amazing colleagues.
na wspaniałych współpracowników.
question for them.
konfliktu militarnego,
"Oh, if you work in war,
you work on refugee camps,
w obozie dla uchodźców,
mass atrocities?" --
very, very important.
why I was so passionate about this issue,
zajęło mi trochę czasu,
the public health consequences of war
wpływa na system opieki zdrowotnej,
provocative conclusion.
and disability from war
living in a conflict-affected state
has been achieved.
but of course it's not,
ale tak naprawdę nie jest,
by robbing them of their clinics,
okradając ich z klinik,
they're on the run.
są zabijani, muszą uciekać.
and yet more deadly is the destruction
i bardziej śmiertelna staje się destrukcja
and their finances.
surprising at all to me.
and somewhat dismaying,
about human suffering and war.
o ludzkim cierpieniu i wojnie.
country of Liberia.
w Afryce Zachodniej.
about this group, Doctors Without Borders,
and calling for aid and assistance.
do pomocy i wsparcia.
answered the question:
even in Liberia?
Lekarze bez Granic są w Liberii.
is an amazing organization,
to wspaniała organizacja,
emergency care in war zones.
pomocy w rejonach konfliktów zbrojnych.
skończyła się w 2003 roku,
before Ebola even struck.
in the entire country
a functioning health system,
sprawnej służby zdrowia,
uderzyło w Haiti w 2010 roku,
aid was phenomenal.
była nieprawdopodobna.
two percent of that funding
że tylko 2% tych funduszy
Haitian public institutions,
publicznych instytucji,
from the earthquake even today.
z powodu trzęsienia ziemi, nawet teraz.
in the northern autonomous region of Iraq,
północnego Iraku, Kurdystanie.
that in the last nine months,
że przez ostatnie 9 miesięcy
from four million people
liczba mieszkańców wzrosła
have experienced incredible trauma.
doświadczyło ogromnej traumy.
16-hour days without pay.
bez wynagrodzenia.
by 25 percent;
and to short-term relief efforts.
oraz krótkofalową pomoc humanitarną.
to upadnie na pewno,
of the five million people in his region
ludzi w tym regionie,
whether they should flee
miejsca zamieszkania?
this is a frustrating topic for me,
and security systems?
i systemu bezpieczeństwa.
two arguments.
dwa argumenty.
in these settings are corrupt
w tych regionach są skorumpowani
unsavory characters
podejrzanych osobników,
in these situations.
w tych rejonach.
is absolutely true
jak najbardziej istnieją,
z jakim miałam do czynienia,
to Haiti, to Liberia --
Kosowo, Haiti i Liberię.
for their country,
dla swojego kraju,
to save their health institutions.
instytucje służby zdrowia.
who wants to help
tych dobrych ludzi,
in Afghanistan.
success stories
i nieopisanych historii sukcesu USA,
in Afghanistan
narodu w Afganistanie,
investing heavily
który w 2002 roku silnie zainwestował
Afghani health sector leaders.
afgańskich liderów służby zdrowia.
have pulled off an incredible feat
access to health care
dostęp do opieki zdrowotnej
the health status
Ministerstwo Zdrowia dokonuje rzeczy,
of Health does things
we just don't have the money.
that the current situation
we could possibly conceive of.
wydajne, jakie można sobie wyobrazić.
is that when governments like the US --
of governments
i w przypadku klęsk żywiołowych
and disaster relief worldwide.
that's just disaster relief.
pomoc w przypadku klęsk żywiołowych.
goes to international relief agencies,
organizacje humanitarne,
dostarczyć środki w odpowiednie rejony
into these areas,
system służby zdrowia,
of temporary health system, let's say,
gdy kończą się pieniądze.
when they run out of money.
naszej pracy jest jasny.
zdrowia globalnego,
community policy experts,
w monitorowaniu
in how to monitor
of health systems
and wave our arms.
they don't need us to tell them that.
nie trzeba nam tego mówić.
gdzie pracuję,
need to take their cue
Banku Światowego w Afganistanie.
in Afghanistan,
health sector leaders like these.
dla liderów sektora zdrowia.
with some support.
odrobiną wsparcia.
and make new partnerships.
wraz z NATO i politykami,
with NATO and other security policy makers
instytucji systemu zdrowia
to protect health system institutions
i innych niezbędnych instytucji
and other critical social institutions
collateral damage;
na skutek działań wojennych,
we need to engage is you,
and indeed, the world public.
the value of social institutions,
instytucji społecznych,
w niestabilnych rejonach,
in these fragile settings,
doctors are on the run in country X.
to, let's say, detect influenza."
na przykład wykrywanie wirusa grypy.
That's what I'd tell you.
institution defenders and builders.
obrońcy i konstruktorzy.
the Marshall Plan
ekonomiczne po II Wojnie Światowej.
institutions after World War II.
stanowi fundament
really serves as the foundation
organizacji praw człowieka.
human rights organizations.
in terms of creating institutions,
jeśli chodzi o budowanie instytucji,
wspierał narodziny konstytucji USA.
country was threatened,
to protect human security,
powinno zrobić to samo.
should do the same.
ABOUT THE SPEAKER
Margaret Bourdeaux - Physician, global health policy analystMargaret Bourdeaux investigates the best ways to protect, recover and reconstruct health systems and institutions disrupted by war or disaster.
Why you should listen
Margaret Ellis Bourdeaux, MD, MPH spearheads the Threatened Health Systems Project at Harvard Medical School -- an initiative that brings together public sector leaders, health care providers, academics, military strategists and private sector stakeholders to generate creative approaches to protecting valuable health system resources in countries affected by armed conflict and acute political crisis.
Bourdeaux's journey in global health began when she took a year of leave from Yale Medical School to work in refugee camps during the Kosovo War in 1999. She returned on her own after the war to trace families she had befriended in the camps and find out what had happened to them. Living in villages of Kosovo's countryside, she documented how these families struggled to care for their children, find health services and make a living in a society decimated by genocide and ethnic conflict. This experience impressed upon her the stark truth that war kills people by stripping them of their personal, community and national resources and institutions. Far more people died in Kosovo from the depleted health systems and institutions than from wounds sustained during the armed conflict.
Later experiences in Haiti, Afghanistan, Libya, Sierra Leon, Madagascar and Liberia revealed a similar pattern: armed conflict would decimate indigenous health institutions that never recovered, leaving people helpless when later crises -- earthquakes, epidemics, renewed conflict -- invariably struck. Strong, resilient health systems are the key to making war, disasters and epidemics less deadly.
After completing a joint residency in Internal Medicine and Pediatrics at the Harvard Combined Med/Peds Program, Bourdeaux was among the first graduates of Brigham and Women's Global Women's Health Fellowship. She has worked with the Office of the Secretary of Defense Policy to analyze the US Department of Defense’s global health projects and programs. She led a joint Harvard-NATO team of analysts to evaluate the impacts, challenges and opportunities international security forces have in protecting and rebuilding health systems in conflict affected states. She joined the faculty of the Division of Global Health Equity at Brigham and Women’s Hospital and Harvard Medical School in 2011.
This year she was awarded the prestigious Harvard Global Health Institute's Burke Fellowship in Global Health to investigate the responsiveness of foreign aid to health system distress and disruption. She is co-developing the first executive education course between Harvard Medical School and Harvard Kennedy School of Government for senior security policy makers on health system threat detection and response. In addition, she is launching Harvard Global Health Institute's first Summit on Threatened Health Systems in June 2017.
Margaret Bourdeaux | Speaker | TED.com