Human disasters born of armed conflict will continue to plague Sub-Saharan Africa. When the American people demand engagement, the U.S. military, especially the Army/Air Force team, responds effectively and efficiently when local order has collapsed or when local authorities resist relief efforts. The better that Army planners and leaders understand the nature of African conflict and the better they've prepared before such conflicts occur, the greater the likelihood the Army can fulfill the public's expectations at minimum cost to other efforts. Why Rwanda Happened. Human disasters in Sub-Saharan Africa are characterized by widespread famine and disease, and often by large refugee movements which overwhelm precarious systems of public health and provision. They are almost always the direct or indirect result of organized violence combined with economic stagnation and disintegration, population pressure, ecological decay, and regional conflict. Some are deliberately engineered by a regime or local authorities to punish opponents, derail a separatist movement, or undercut support for an insurgency. Others are accidental, occurring when authority collapses. Because of its combination of a history of primal violence, intra-elite struggle, a weak economy, proximity to conflict-ridden neighbors, and a lack of outside interest, Rwanda was especially vulnerable to human disaster. In many ways, the crisis of 1994 was the inevitable result of 50 years of misrule, repression, and violence.

The media generally tend to focus in particular on the failures of U.N. peacekeeping operations. In Walking the Tightrope, Jair Van Der Lijn draws a different conclusion. He argues once a peace agreement has been signed, the efforts of the U.N. peacekeeping operations do contribute to durable peace. By analyzing the U.N. peacekeeping operations in Cambodia, Mozambique, Rwanda, and El Salvador in a structured focused comparison, this book shows how U.N. operations do have a contribution to make.

This paper explores some of the key factors behind Rwanda key successes, including unique institution-building that emphasized governance and ownership; aid-fueled and government-led strategic investment in people, infrastructure, and high-yield economic activity;re-establishment and expansion of a domestic tax base; policies to reduce aid dependency by attracting private investment and bolstering exports; and a purposeful strategy to harness the economic power of gender inclusion.

Colonel Pat Proctor’s long overdue critique of the Army’s preparation and outlook in the all-volunteer era focuses on a national security issue that continues to vex in the twenty-first century: Has the Army lost its ability to win strategically by focusing on fighting conventional battles against peer enemies? Or can it adapt to deal with the greater complexity of counterinsurgent and information-age warfare? In this blunt critique of the senior leadership of the U.S. Army, Proctor contends that after the fall of the Soviet Union, the U.S. Army stubbornly refused to reshape itself in response to the new strategic reality, a decision that saw it struggle through one low-intensity conflict after another—some inconclusive, some tragic—in the 1980s and 1990s, and leaving it largely unprepared when it found itself engaged—seemingly forever—in wars in Afghanistan and Iraq. The first book-length study to connect the failures of these wars to America’s disastrous performance in the war on terror, Proctor’s work serves as an attempt to convince Army leaders to avoid repeating the same mistakes.

Many patients who present to district (first-referral) level hospitals require surgical treatment for trauma, obstetric, abdominal or orthopedic emergencies. Often surgery cannot be safely postponed to allow their transfer to a secondary or tertiary-level hospital but many district hospitals in developing countries have no specialist surgical teams and are staffed by medical, nursing, and paramedical personnel who perform a wide range of surgical procedures often with inadequate training. The quality of surgical and acute care is often further constrained by poor facilities, inadequate low-technology apparatus and limited supplies of drugs, materials, and other essentials. The mission of the team responsible for Clinical Procedures in the World Health Organization Department of Essential Health Technologies (EHT) is to promote the quality of clinical care through the identification, promotion and standardization of appropriate procedures, equipment and materials, particularly at district hospital level. WHO/BCT has identified education and training as a particular priority, especially for non-specialist practitioners who practice surgery and anesthesia. It has therefore developed Surgical Care at the District Hospital as a practical resource for individual practitioners and for use in undergraduate and postgraduate programs in-service training and continuing medical education programs. The manual is a successor of three earlier publications that are widely used throughout the world and that remain important reference texts: General Surgery at the District Hospital (WHO 1988), Surgery at the District Hospital: Obstetrics Gynecology Orthopedics and Traumatology (WHO 1991), Anesthesia at the District Hospital (WHO 1988; second edition 2000). This new manual draws together material from these three publications into a single volume which includes new and updated material, as well as material from Managing Complications in Pregnancy and Childbirth: A Guide for Midwives and Doctors (WHO 2000).