No More Killing Fields, Part I

THE OPEN MIND
HOST: Richard D. Heffner
GUEST: Dr. David A. Hamburg
TITLE: “No More Killing Fields”
VTR: 4/9/02

I’m Richard Heffner, your host on The Open Mind. And my guest today is the distinguished author, physician, psychiatrist, educator, Dr. David Hamburg, who for a decade and a half presided over one of our nation’s most prestigious philanthropic institutions, the Carnegie Corporation.

Now, Dr. Hamburg has spoken here before about his twin interests in the healthy development of our children and in the development of world peace that he pursued at Carnegie. In both areas he has emphasized prevention as means of avoiding what he calls “rotten outcomes.”

Indeed, along with the late Cyrus Vance, once America’s Secretary of State, my guest co-Chaired the distinguished Carnegie Commission on Preventing Deadly Conflict.

And now Dr. Hamburg has written his own personal approach to the Commission’s work. Evocatively titled, “No More Killing Fields.” We record this program, of course, on April 9th, 2002 … and though we can’t begin to guess whether deadly conflict and still more killing fields will or will not continue to mar the day you watch and listen to us, as they do this day, we still can hope that Dr. Hamburg and his colleagues will have already made real progress in identifying how prevention and negotiation may ultimately keep us from self-destruction.

Indeed, in “No More Killing Fields” my guest mentions conversations about these matters with our mutual friend, the late Dr. Jonas Salk, of the Salk vaccine fame. And I want to ask Dr. Hamburg today, how large a role the training they both received as physicians may have played in developing a mutual interest in immunization in international conflict through the preventive medicine of negotiation.

In truth, my question to him is whether this aspect of the medical model is a plus in looking at the killing fields around us. Is that a fair question?

HAMBURG: Yes, it is and I think it is. Cy Vance thought it was, too, and his opinion means much more. And many of the scholars and practitioners associated with the Commission and it’s many, many publications and inquiries in international meetings, have felt in general that this was a useful orientation. With respect to Jonas, specifically, I have the highest regard for him. And was fortunate to count him as a friend. I was working with the care of patients who had very severe polio in the 1950s in the very fine unit that the University of Illinois had at that time. And during that period, the vaccine became available. And it was so vividly poignant because then a dollar’s worth of vaccine was more than millions of dollars we were spending on the iron lungs, and so on. And I didn’t know him then. Of course, he did the heavy lifting, he created the vaccine. All I did was to, to appreciate the significance, the profound impact of, of prevention in a situation that was otherwise desperate. And it was in a way, from killing fields with polio to, to productive lives. And the main reaction of those who were parents in my patients was, “Well thank God for my children.” And I hope that the message that I’m trying to get across in this meeting … in, in this book may be “Thank God for our children and our grandchildren.” If these kinds of principals and practices can be pursued.

HEFFNER: And your guess about the value of negotiation here? The value of vaccinating us against our self-destruction.

HAMBURG: Well, I … this is … we do take in the Commission a very comprehensive approach, and forgive me to take … if I take a moment to sort of back off …

HEFFNER: Please do.

HAMBURG: … and say what was the framework. The … I had worked on these matters intensively throughout the Cold War and was in a very fortunate position to be able to get some insights and do some useful things during that time, in a non-governmental way. At least in a sense that I was based in a non-governmental organization. Now, of course, Cy Vance, who was directly involved in a governmental way during some part of that time, and of course, also he made a huge contribution to the first Camp David before, during and after the Camp David, it was a long, hard process. And he had also been sent into some very difficult situations, given a very weak hand by his government or by the UN. “Go in, Cy, and do a miracle and get us out of this thing. Going to Croatia, or Bosnia and so on. So, we, we did come to feel that there was a usefulness to it. But when you think about the public health approach, it requires a lot of things. It requires a lot of research, for example, to develop a vaccine. Once you get it, you stick it in, it’s simple. But, but to figure out how to do it, as we’re now seeing with AIDS over the last ten years, to figure out how to do it, is very difficult. So there are institutions of research that can contribute mightily, but it takes them a while to do so.

At the same time, you must have institutions that take the research and are able to apply it. And in the main that’s either our medical profession in a more traditional sense, or the institutions of public health in a larger sense … state and city public health departments, and so on.

And then you also need in the case of the, of cigarettes, to jump to that prevention, the media played a very large role. There were a number of years in which the media did much more than the physicians did to, to publicize the damage done by cigarettes and the desirability of getting off cigarettes. And then the behavioral scientists came in with techniques that helped you to get off cigarettes.

All I’m saying is there are a number of pivotal institutions that play a role and that, that are salient to the task at hand, and can, if they wish, and if they’re adequately supported, prevent the rotten outcomes in diseases. And I give some examples of that early in the book.

And so, too, in preventing deadly conflict, we decided that governments are still important and intergovernmental organizations, especially the UN are still important. But it’s not enough. If it had been enough, we would not have had the catastrophes of the 20th century, the bloodiest century in all of history. Mainly in the first half of the century, but there was plenty to be done later, as well. It was terrible.

So, we then extended the range of pivotal institutions and it’s, I think it’s well accepted now, it wasn’t so well accepted when we first started, and that is the Institutions of Civil Society. And we interpret that quite broadly. We include the media and the business community and the scientific community and the education community, and the religious institutions, and non-governmental institutions that focus on conflict … like the Carter Center, say. Probably the best known one.

And so, we say, all of those institutions had a role to play. And I’ve tried to give in the book examples from each one. Positive examples. There aren’t a lot …[laughter] … there are a lot of negative examples, but there are some positive examples. And I choose the positive examples deliberately, not to be Pollyannaish, but to say, if it happened once, it can happen again. We can learn from the positive examples. But my point is simply that this, in my book particularly I reach out into a range of pivotal institutions, that goes far beyond the traditional ones. I think additional diplomacy is fine. Done by governments on a bilateral basis, many good things have happened; many bad things have happened. But clearly it has not been enough, historically, to do what needs doing now.

HEFFNER: David, let me ask whether these, these means that you conjure up, whether they are peculiar to, endemic too, only democracies, of whether you think you can see the construction of such means, of such institutions in non-democratic nations.

HAMBURG: They largely pertain to democracies. But to some extent they pertain beyond democracies. We, we supported … Carnegie supported, during my Presidency a, a major study by scholars primarily at UCLA on the question of what they called, “The Grand Coalition”, which would be to establish democracies plus, particularly Russia and China. Russian may or may not be a democracy one of these days; I think it’s edging toward it. And China is edging toward it, too, but at a much slower rate.

But, but on the whole I think this is a task for the established democracies, which, of course, is an expanding community. But, let me say about this just … there’s such a basic point for me, that I shouldn’t take it for granted, you know.

I’m very delighted to be on this program because it’s such a thoughtful and serious program over the years. And one of the things that has struck me … you recently sent me the volume that you and Elie Wiesel did on the whole series of interviews that, that Elie had done with you.

And what’s so important about that is Elie has, of course, magnificently documented the Holocaust, whatever else he’s done. And, and I’m saying in this book we are in a world still pre-disposed to Holocaust-like situations, as the large scale killing of people just because they’re people, because they have some identification or other. And, in any case, the, the capacity for mass slaughter is actually greater now, than it’s ever been …

HEFFNER: You mean our ability to …

HAMBURG: Yeah, our ability …

HEFFNER: … to create killing fields.

HAMBURG: …partly because there are lots more weapons, partly because many of the weapons and even conventional weapons are more destructive than they used to be. And partly because the capacity to incite violence is so much greater with all the techniques of the telecommunications world.

So you can incite violence and hatred. You can do much more damage and there are all kinds of cleavage lines that exist in the world … ethnic, or religious, or nationalistic, or whatever. And therefore I’m saying that in the next … in, in this century, as we go along that it’s … we cannot take war as a sort of naturally occurring phenomenon that has to be expected, like, like wind or snow or even blizzards and tornadoes and, and so forth.

HEFFNER: Why do you say we “can’t.” What do you mean by that?

HAMBURG: I mean that it’s so dangerous, that it could mean actually the extinction of humanity. I mean that much. There was a debate during the Cold War, when we were at a very close point to a nuclear war. In the scientific community about whether a full scale nuclear war would eliminate humanity altogether or whether maybe it would leave a small ring in the Southern hemisphere. Maybe ironically apartheid South Africa would escape the radiation effects. But the total … the various effects were such that there was a serious question whether humanity could survive. That’s quite a debate to have.

Now, we’re not in the Cold War now. On the other hand, if you look ahead two or three decades, we could get into a multi-polar situation, in which multiple countries had weapons of mass destruction; some of which were much less responsible than others. Even we and the Russians learned something about how to become responsible with each other. I was involved in that, the crisis prevention approach. But I don’t know that all the nations that have weapons of mass destruction are going to be responsible. Furthermore, the killing in the 1990s … large scale killing … I mean look in Rwanda, it was roughly speaking one in ten people about, in a few months time. And that was with so-called “light” weapons, “light” weapons. But even the “light” weapons and small arms are more destructive than they used to be and much more widely available. The world is plastered with so-called “light” weapons.

So I’m, I’m saying that I think we can’t afford to be complacent or take it as a phenomenon of nature anymore because at best, if we go the path that we’ve been one, there will be very little decency to live for.

HEFFNER: Wow. That’s all I can say when you, when you finish saying that. And it’s strange for me to hear that from you. Because “No More Killing Fields”, when I first understood the title, when I first knew what your title was, I thought, “Well, that’s David Hamburg; it’s that goodness in that man. Please, no more killing fields.” You think there will be more? I’m not asking you now whether we’re going to destroy ourselves, if there are more killing fields.

HAMBURG: Well, I think there will be more killing fields. In the very beginning of this I, I say, and I should say I am freer to speak for myself in this than the Commission was. Furthermore, the Commission sponsored the widest array of prevention relevant material ever generated to my knowledge. There are 75 reports, monographs and books that have been put out by the Commission to try to get around the contours of this very complex problem, and very necessarily comprehensive approach. And, and I try to draw on all that, I can’t make a grant synthesis, but try to illuminate the potentially strongest pillars of prevention for the future.

And I say, the time, Richard, that has to be measured is at best decades and probably generations … and I hope by the end of this century we’ll be at a point where it will be virtually impossible to have more killing fields. But I think in the next few decades, if we take, you know, some of the Cambodian analogy, that there will, unfortunately, be other killing fields.

HEFFNER: You say, “virtually impossible.” Impossible on what level, in what way? Because we will have structured negotiations, preventive action in such a way that it just won’t happen?

HAMBURG: Yes. We will have structured a system so far reaching in its effects that it will greatly diminish the likelihood of large scale armed conflicts. Now I …

HEFFNER: Does that presuppose, David, if I may interrupt …

HAMBURG: Sure.

HEFFNER: … does that presuppose the domination of the rest of the world by a few democracies that can think in these terms, that have the ability and the willingness to do so.

HAMBURG: I would much prefer that it be the community of … the enlarging community of democracies, it would be, of course, the familiar West European and American and Canadian, etc. But also now Japan. Also, more and more Eastern Europe. India, of course. South Africa. It’s an expanding community and I hope that it would continue to expand.

Now let me say, that’s an important part of what this book is about. I say more than the Commission was able to say on this subject. It isn’t just negotiation, negotiation and mediation … third party intervention deals with, with already when there’s tension building pretty strongly, or even you’re close to a crisis or close to the brink. And that’s important. And the earlier it can be done the better. And the more skillfully it can be done, the better. That’s important. That’s what we call preventative diplomacy.

And the Commission sponsored a lot of new work, genuinely new research … it almost … it’s roughly analogous to some of the immunological research that made, made the vaccines possible, and it, it tells a lot about how early and how well to do preventative diplomacy. That’s fine. But, but I also say that fundamentally you need systems within countries and in regions that are capable of dealing with grievances, that are capable of meeting basic human needs. And, and so I basically am saying you need international cooperation for democratic development. And I mean democratic development both the political sense and the economic sense. You need marks-based economies with appropriate regulations so they don’t run wild. And you need democratic institutions, including very strong civil societies.

Why? Because those two taken together and I think they belong together, provide the best opportunity that we have for people everywhere to feel reasonably satisfied, not to build tremendous grievances. If they do build strong grievances, there are mechanisms readily available.

Look, in a democracy you not only have an independent judiciary and all of that, but you also have habits of negotiation and mutual accommodation that develop even from childhood, so you learn the things … there’s a give and take … and there’s a compromise and that informal part is, is perhaps as important as the formal. But it is, I do try to make a strong case for, for international cooperation for democratic development.

Why international cooperation? Because nobody can do it along. Not even the US and certainly not the UN. Those are two important constituents. But it needs to be quite extensive. And as I say, I hope it will get more extensive with more democracies to contribute.

HEFFNER: You know here in the book I get this notion that it is the fairness, the essential fairness that is characteristic of democracy ….

HAMBURG: MmmHmmmn.

HEFFNER: … that looms so large in this matter.

HAMBURG: Yes.

HEFFNER: In your thinking.

HAMBURG: Yes. If I had to have a bumper sticker, one of my bumper stickers would be “A Culture of Fairness.” That would be one of my bumper stickers. Fairness in all aspects of life, within countries and between peoples to the maximum extent possible. The dignity of every human being, what we now mean by “human rights” that, that’s at the core of it and the only way I know to develop and protect for the long term that outlook is through democratic institutions.

HEFFNER: I said to begin with I don’t know what our viewers are going to be living with when they see what we’re saying today. But we know what we’re living with.

HAMBURG: Yeah.

HEFFNER: What’s your sense of the possibility of containing the struggles that come before September 11th, but perhaps, let’s focus on what is going on in the Mideast and on September 11th.

HAMBURG: Well, let me say first … that September 11th was a great, huge stimulus which could paradoxically do a lot of good in the world. It may or may not. But it, it brings home the very fundamental realization that anybody, anywhere can do immense damage.

No matter per people near or far, that we have a situation which is unprecedented. And it doesn’t have to take an intercontinental missile, not at all. They can bring in a nuclear weapon, say, on a ship or a van. There’s so many way, we needn’t go into it. But that is fundamental and September 11th brought that home, certainly to us as it never has been and I think to much of the world. That could happen anywhere. The Russians know they could have a nuclear weapon in Moscow or St. Petersburg set off. And the Brits know it could be in London; and the French know it could be Paris; and so on. So that this is … and certainly the Indians from their experience, they know it could be Deli, it could be whatever in their conflicts. So all over the world, everybody is vulnerable and I think this, this awareness was reflected in the shock people felt and the initial cooperation the United States got in responding to it, it was sort of ‘there, but for the grace of God, go I.”

Alright, that’s one thing. Now that can be a stimulus and I have a … I, I added a chapter. It was scattered before, but I added a chapter before going to publication, called “Preventing Catastrophic Terrorism”. In order to make it clear, some of the lessons at least that grow out of that experience.

But now you, you come to the Middle East. The Middle East is a perfect case for prevention. So is Norhtern Ireland. We have these dreadful situations that go on and on and on for decades, where early on nobody thinks about prevention, it’s out of the question. Now it’s true that it was a different world forty or fifty years ago, we didn’t have a lot of the insights and the attitudes and the machinery and the institutions that can, to some degree, help us with prevention. We didn’t have that then. We had some.

I have a chapter in here, you know, “Could World War II and the Holocaust Been Prevented?” I got wonderful help from great historians like Gordon Craig of Stanford and Fritz Stern of Columbia to try to figure that out. And my old mentor, Fritz Redlick(CHECK SPELLING) from Yale was very helpful in that. And I can plead “Yes”, even with the limited tools I had available they could have been … and Winston Churchill thought that. But certainly with today’s tools they could.

But this, the Middle East thing goes on and on. One personal example, very small … it occurred to me after the Six Day War, when the Isralelis had proven their courage and their ability and the old stereotype of Jews as, as weak and fearful and inevitably crushed … in the immediate wake of the Holocaust. What is Israel? It is the remnant of the Holocaust. I mean it has other means, but it is operational, as the remnant of the Holocaust. Well, I went over there and talked to some people. I had no authority then, that was before I was with Carnegie and I was a doctor, an academic scientist, what did I know? But I did, I did have some feeling for it, and essentially what I said paraphrasing Churchill and others, “In Victory, Magnanimity. “ the Six Day War was brilliant. Now you have an opportunity to lay out a piece. You don’t even have to start from scratch. You know there’s a lot of animosity toward you and in someway even more after you’ve won, but nevertheless your, your enemies know that you’re very powerful and you’re a very strong physician, you could probably get a lot of world backing. Lay out the essential elements of the peace plan and get some backing from the United States and others to help work it out. Might have failed. But it was preventative thinking, it wasn’t primary prevention in a medical sense, there had already been several wars. But it was secondary prevention in the sense that you hadn’t yet reached the kind of catastrophic war which, God knows, what, what might result. So what, what I’m saying is we chose here not to deal with what’s in the In-box of foreign ministries about today’s conflicts, many of them reflect failures of prevention.

The whole Yugoslavia thing I could go into great detail because I was involved. But it, it was very late in the day that people began even to think about prevention in Yugoslavia, let alone act on it. So these things, awful as they are have to be a stimulus to us to say, “We’ve got to do better than that. And let’s look at David Hamburg’s book and see if its, if it can help us.” By the way I want to emphasize, the intention of my book, like the intention of Commission was to stimulate better ideas, to get it out there where people would read and think about it. At least begin to think preventatively. Undoubtedly there will be better ideas.

HEFFNER: David, what in the history of mankind gives you basis, any basis for hoping that this can take place.

HAMBURG: Well, not much, but on the other hand, you know, in my lifetime, the second half of the 20th century, we have seen some remarkable things, Dick, that do provide some basis for hope. We look at how the United States responded after World War II. It seems so obvious now. It wasn’t obvious then. When, when Marshall proposed the Marshall Plan at his Harvard Commencement, such polling as there was in those days … as I understand it, never got up to 10% support in the early months. Now the people went along, “the war is over, fine … let’s get out of there.” And we de-mobilized rapidly and so forth. Marshall and Truman and Atchison and others got out … let me exaggerate, they didn’t miss a Rotary Club or a Kiwanis Club … they campaigned for this and for four years we spent about one percent of our gross national product. Not such a big deal, and it made it … a transforming influence on Europe.

Now moreover, the concept was that Europeans would play a very active part in formulating it. They wouldn’t be the passive recipients, they wouldn’t have it imposed on them. They would, they would use their brains and their ideals with us. They would have to meet democratic standards, they would have to meet free market standards. But within certain guidelines, they would go a long way to develop and we’d develop it jointly. But anyhow the Marshall Plan and NATO and the emergence, gradually, of the European Union which began back in that period, you have a set of institutions in Europe that stand very strongly for democracy, for, for human rights. You look at the way we treated Germany, Japan and Italy … they are vigorous democracies today, there are a lot of things like that that give me some hope.

HEFFNER: You have hope. I have hope that you will come back again and continue this because there’s too much here that has to be unraveled, but thank you very much for joining me today on The Open Mind.

HAMBURG: Thank you, it’s a privilege to be with you, Dick.

HEFFNER: And thanks, too, to you in the audience. I hope you join us again next time, and if you would like a transcript of today’s program, please send $4.00 in check or money order to The Open Mind, P.O. Box 7977, FDR Station, New York, New York 10150.

Meanwhile, as an old friend used to say, “Good night and good luck.”

N.B. Every effort has been made to ensure the accuracy of this transcript. It may not, however, be a verbatim copy of the program.