Dear Kara: War, What is it Good For? One Man's Journey (PROFILE)

(PHOTO: Paul Giannone in a room with unexploded ordinances in Angola/P. Giannone)(HN, 5/28/12) - Monday is Memorial Day in the United States.  Around the world other countries also celebrate their version of honoring the fallen; such as Remembrance Day in Commonwealth countries (Australia, Barbados, Bermuda, Canada, India, Kenya, Mauritius, New Zealand, South Africa and the UK) on November 11th; and similar ceremonies take place in France, Belgium, Germany, Ireland, Israel, Italy, the Netherlands, and Poland.

Though, these days come once a year and help us to remember the brave and courageous  who died in the pursuit of justice, freedom and truth in the past - we must remember that war continues to exist with us in the world today.  It remains a factor - more so than ever in global history - all around us as conflict, indiscriminate killing, and terrorism. 

According to statistics gathered from Wars Around the World at least 51 global nations and armed guerilla groups are engaged in 335 active `hot' war.  This is more wars than the entire world has countries in it.

Africa, currently has 24 countries involved in hostile actions; with places such as Libya, Mali, Nigeria, Somalia, Sudan, South Sudan being the hottest spots.  In Asia, 14 countries are engaged in confrontations including Afghanistan, Burma-Myanmar, and Pakistan.  Europe has experienced battle almost continuously since ancient times, and currently has 8 nations involved in confrontation.  The Middle East, on daily newspapers front pages every day, has 8 countries battling warfare in hotspots such as Iraq, Israel, Syria, Turkey, and Yemen.  And the Americas, the most peaceful of world regions has 5 nation's including Colombia, and Mexico on the hot list.

But where has war in the world gotten us?  As a 1969 Vietnam protest song called "War" sung by vocalist Edwin Starr asked, "War, What is it Good For?"

HUMNEWS asked this question to the author of a poignantly honest and sometimes disturbingly real memoir `Dear Kara: One Man's Journey From War to War'.  Paul Giannone wrote the book as a lifelong letter to his daughter Kara who was born in 1993. A 26-year career emergency responder, planner and public health administrator Giannone began his professional work as a US Army Public Health Advisor in Vietnam 1969-1970 where he did two tours of duty.

From there, he then went on to years of working in conflict zones as a health worker including Iran (before the US embargo related to hostages was imposed in the late 1970's), Afghanistan, Sudan, Cambodia, Albania, Pakistan, and Sierra Leone among other nations.

EARLY YEARS

Giannone grew up in the small upstate New York town of Auburn. When Paul was 11, his father died of brain cancer and the family was plunged into instantaneous poverty. His mother had to work in factories just to keep the family going, finally seeing Paul enter college.  But, feeling no direction and flunking out he joined the Army - as many did - in 1969.

He didn't want to shoot anyone, and so joined the medical corps in the civil affairs unit of the Army instead. As a kid, Giannone played toys and guns and watched John Wayne movies - which, as Paul says, "Didn't show American soldiers screaming. Then you get to Vietnam and that's not the case."

What Giannone saw in the Vietnam war were high caliber bullets being used which essentially "tear your body apart".  And he learned he was "good at getting things done in difficult  situations".

(PHOTO: An An Duong boy injured in Vietnam fighting/P. Giannone)

AFTER VIETNAM

Seeing the impact of war on humanity up close and personal in Vietnam changed Giannone. When he returned to the United States in 1971 he vigorously pursued his Bachelor of Science degree in Community Health Services from the State University of New York at Brockport, graduating with honors in 1974. He then went on to achieve a Masters Degree in Public Health with a concentration in Population and Family Planning from the University of Michigan, Ann Arbor in 1976.

Giannone's first work assignment out of graduate school was in Iran as an analyst for the University of Iran's, all Iranian, disease control team. He had wanted an oversees appointment so that he could 'see the world differently' than he had seen it in Vietnam which he thought was "a political fluke not to be repeated".

But what he saw in Iran "shocked me" says Paul. "The US government was not paying attention to the people on local levels in villages and towns. I would actually observe the Shah's government fomenting dissent among the people there, encouraging conflict.  It was disturbing."

After being evacuated from Iran, Paul learned that  the Vietnamese “boat people” exodus from Vietnam was headline news.  Paul volunteered for the U.S. Indochinese Refugee Program because he wanted to do whatever he could to help a people that he had grown to love.  He also wanted to see if he could find the Vietnamese public health staff he had worked with in Hue City.  Paul became Director of refugee screening operations in Singapore designed to determine what country the “boat people” would be resettled.  Paul saw the refugee program evolve before his eyes as the program was  dealing less with refugees and more with economic migrants.  Data collected by Paul and others indicated that the program was rampant with immigration and welfare fraud and more ominous was the program was actually resettling North Vietnamese civilians, former NVA infantry, Viet Cong and political party members.  This information was reported to President Reagan at the White House and the reaction was that his immediate supervisor was fired and they were told by the Secretary of State Haig to cover the story up.

Paul went on to work with “real” refugees in Africa and then home to upstate New York.  Paul was demoralized.  Two times he had volunteered to his government to help Vietnamese.  First as a soldier and later as a civilian and both times he was lied to and betrayed. Giannone began writing the first part of his book in 1982.    It was just my complete feeling that the reasons for the Vietnam War and then how the US was dealing with the boat people” For two months, he cranked out his thoughts and then just put them away. 

Giannone then set about to use his public health skills for a global greater good, working for humanitarian organizations such as CARE, the American Red Cross and Family Health International - running emergency response and refugee relief operations in Singapore, Sudan, Albania, and Pakistan; AIDS/HIV intervention research in Thailand and the Philippines; family planning research and institutional capacity building in Egypt, Kenya, Turkey and Pakistan; and disaster response in the US among other work.  

(PHOTO: Paul Giannone in teh Rwanda jungle with staff/P. Giannone) In the meantime, Paul's daughter Kara was born in 1993 and though his heart was at home, he was often missing for important events in her life over the years, as war zones and those in need of help kept calling worldwide. He began writing his book again for Kara in case he was killed in a war zone.

WHAT DID YOUR WORK IN GLOBAL PUBLIC HEALTH TEACH YOU ABOUT THE STATE OF OUR HEALTH SYSTEMS?

Generally in public health we need systems. Often  developing nations lack strong management systems, and a collective and sustained effort is often hard to accomplish.  Ironically, as compared to war, which many use as a way to galvanize opinion and consensus - public health is a really great unifier of people.  We can all get behind the idea that we need to address the pandemic flu or polio, for instance.

TRAVELLING THE WORLD FROM ONE WAR ZONE TO ANOTHER, WHAT DID YOU LEARN ABOUT THE WORLD AT LARGE THAT THE PUBLIC CAN LEARN FROM YOU?

To all the places I went,  I went as a manager or a coordinator and my lens was that of being a public health worker - and an American.  I have learned that all people around the world want to have dignity and work; and they all love their children and respect the elderly.  They all want to survive and keep their families safe. Most people want to give back to the world, and many of them have some form of community service that they do.  With human beings, that's what keeps them going as I've seen it. 

A while back I saw some data  indicating that American citizens believe that 27% of the US government budget goes to foreign aid in other countries and that's why some people say we shouldn't be helping those in need around the world.  Yes, we definitely need to be helping our own, but in reality the figure on US foreign aid is more like 1% and if we can help people help themselves, we have to do it.  None of the people I ever met wanted handouts.  

AS A PUBLIC HEALTH OFFICIAL, WERE YOU ABLE TO OBSERVE THE IMPACT OF CONFLICT MORE GENERALLY?  WHAT DID PEOPLE TELL YOU?

(PHOTO: In traditional dress with colleagues in Sudan/P. GiannoneI was in Taliban controlled Afghanistan in the late 1990's, working with women who were a credit to their gender and a credit to the human race. They stood up as best they could to survive and it was an amazing thing to watch.  In our CARE refugee camp in Albania we had women coming in for colds or coughs to our clinics telling us they had been gang-raped while leaving Kosovo. There, I had a little girl come up to me to say that she was there because she knew that with the Americans present she wouldn't raped. 

In Sudan - I was there to work with local officials in an area so remote they told me that the means of communications was drums and runners. We would drop in by light plane and the pilot would say something like, "See you in 4 days if you make it".  That was during the 1990's and the people there asked me why hadn't President Clinton signed the global landmine treaty - even the most remote people in the world work to keep themselves informed!  And it's not just an `oh by the way' kind of information that they seek, it's a life and death situation for them. They knew about the landmine bill and what the US was doing with it!  I'm always surprised by how much people know when I meet them in far off places.

I also learned that we don't spend enough time listening to farmers, people on the ground and local community leaders.  We as Americans, but we as the world in general.  It's part of why we  fail overseas.  We have this idea that somehow trickle-down economics is going to work in the developing world, when it doesn’t even work in America,  and somehow the aid or influence we exert will somehow find its way from Kabul or Lagos to the village level without us addressing it. It doesn't work that way.

(PHOTO: The author in Vietnam holding a baby in 1969/P. Giannone)For instance, between Iraq and Afghanistan we can't account for 6 billion dollars. We need to drop the term superpower in the US and we need to become `Super Partners'. The US is still looked at in many ways as a country to help out but I don't think our strategy should be about  `boots on the ground' anymore.  More flip-flops and sneakers, less boots.

YOU WROTE THIS AS A LESSON TO KARA BUT ITS ALSO YOUR MEMOIR, WHAT DO YOU THINK BOTH KARA AND THE PUBLIC CAN TAKE AWAY FROM IT?

The experiences that I've had have dissolved prejudices - we're just one people striving for life and organization trying to do good.

On the bad side - I have seen the bad side. Yes, there are people like terrorists. There is brutal innocent and needless killing and maiming.  There are people who use their wealth to gain while others suffer.  And for the US there is a failure in our foreign policy - we have to do what we should do and learn from our mistakes and grow.

We are experiencing more frequent, intense disasters and complex emergencies globally. Addressing these must be about building coalitions.  We must look at culture and politics in the places we work in around the world and learn.  For instance, if anyone had done research on the culture and religion of Iraq - no one would have ever have said yes to the US going in there.

YOU'VE SEEN CONFLICT FROM BOTH THE HUMAN SIDE, THE HEALTH SIDE, AND THE CONFLICT SIDE FOR YEARS.  HOW HAS THE WORLD CHANGED IN THAT TIME?

In my time the world has gotten much more violent. Finally African tribal society is changing and people are taking a better life into their own hands but it is a rough journey for them. In the Middle East we're having the Arab Spring. An advance in technology and the flow of information has led to both a positive and a negative situation.  Our number one priority should be about getting the global terrorists we're dealing with now.  Then, the economy, education, environment, healthcare - we have to deal with these. They are no longer nice to have's they are have to haves.

(PHOTO: Landmine areas in Cambodia/P. Giannone)

And there's a new war we don't seem to be picking up on here in the US - we're fighting for how we spell "democracy" -  either with a big `D' or a little `d'.  The last 3 to 4 years people are talking about rewriting the constitution, dropping the separation between church and state, re-writing history, controlling woman’s rights. These are dangerous roads to go down.

HOW DID KARA REACT TO A BOOK BEARING HER NAME?

Kara was very quiet about the book, but I hope she was impressed. She did just graduate from high school this weekend and I am impressed by her!  I wanted the book to give her some insight into the work I was doing and why I couldn't be there in her early years.

AFTER ALL YOU'VE DONE AND LEARNED, WHAT DO YOU HOPE YOUR LEGACY IS?

My contribution now is teaching public health professionals - particularly in the military - how you do this kind of very necessary work around the world That would be a legacy I would want to leave behind.

(PHOTO: The author) 

At 64 Paul Giannone resides in Atlanta, Georgia with his wife Kate and daughter Kara.  He is currently the Deputy Director, Global Disease Detection and Emergency Response in the Center for Global Health at the Centers for Disease Control and Prevention. The opinions expressed in this interview and in his book ‘Dear Kara One Man’s Journey From War to War” are not endorsed by, nor are policies of the US Government, Health and Human Services and/or the Center for Disease Control.  Further the stories and events that Paul Giannone discusses occurred before he became a federal government employee.

- HUMNEWS