International Environmental Security: Climate Change, Water Wars, and Other Scary Stuff

By Sumita Strander

Christopher King, the current dean of academics at the United States Army Command and General Staff College, gave a talk at Dartmouth on Thursday entitled “International Environmental Security: Climate Change, Water Wars, and Other Scary Stuff.” In this talk, King discussed the relationship between environmental problems and security.  He used this relationship to claim that paying attention to environmental issues is in the best interest of every nation, which thus makes it a priority for their militaries. King described his own efforts to introduce this priority to the United States’ military. He connected environmental concerns (such as disease and lack of water) to the principles of life, liberty, and pursuit of happiness that are found in the United States Constitution. His ultimate claim was that “providing life-sustaining conditions was a basic human pursuit.”

One problem that exists, King said, is that environmental concerns have a heavier impact on developing nations. In other words, “how do we get developed nationals to find it in their ‘National Interest’ to act?” A question like this one, he argued, deems this a public policy issue.  This heavier impact, he argued, is mostly due to the stress of increasing populations. That is, all areas of the world will continue to experience problems related to the changing environment, but these problems will be harder for places with the added pressure of an increasing population. KIng cited the country of Afghanistan and the Nile River Basin as two examples.

Afghanistan, he claimed, is the third-fastest growing country in the world and is the seventh-worst failed state. Additionally, it is included in the list of the ten countries with the worst environmental conditions. King used this to make the point that failure of state correlates with the presence of environmental issues.

Similarly, the Nile River Basin has a population of about 265 million that is expected to grow significantly in the near future, to roughly 697 million in the year 2050. The demand for water in response to this increasing population will then far exceed the supply of water at that time.

Throughout his talk, King included scientific information correlated to environmental issues, particularly emphasizing climate change. He concluded by restating the significance of environmental issues to increasing peace and security. He recommended that the nation focus more on analytical research in order to make plans addressing environmental security. Finally, King emphasized the importance of collaboration, as the Department of Defense is just one aspect of the government, and real action relies on the coordinated efforts of several invested groups and individuals.

Ukrainian Energy and the Arctic

By Tyler Stoff

The geopolitical situation in Ukraine may not seem especially connected to current concerns in the Arctic region, but the energy crisis emanating from Europe causes the two to be linked. This is what energy researcher Adam Pearson, a Transatlantic and Konrad von Molkte Fellow at the Ecologic Institute, explained during his presentation at the Dickey Center entitled “The Energy Crisis in Ukraine: What it means for the U.S., Europe and the Arctic.”

Pearson divided his talk into three sections. First, he supplied an overview of the geopolitical crisis and recent Russian intervention in Ukraine. Explaining its roots in the Russian stranglehold on natural gas in Europe, he noted how Russia cut off Hungary’s supply of natural gas in 2009 for thirteen days prior to the current dispute between Ukraine and Russia, which is over the amount of money owed for the consumption of natural gas. Feeling opposing pressure from the European Union and Russia, Ukraine first signed a free trade pact with the EU before changing course and moving closer to Russia. This precipitated the riots that brought down Ukraine’s highly centralized, corrupt government.

Though Pearson noted that Ukraine’s east is supportive of closer ties with Russia due to its ethnic and cultural heritage, he stated that “Ukraine was annexed by Russia” in reference to the Crimea’s move from Ukrainian to Russian control. Though Western observers frequently state that Russia’s increased aggression in response to fears of NATO’s possible expansion into Ukraine are overblown, Pearson responded that every European Union member state has joined NATO, and Ukraine’s free trade pack with the EU was a possible precursor to EU membership. In actuality, several EU member states have not joined NATO, but it is true that all former Eastern Bloc states that have become EU members have also joined NATO.

Following the political background of Ukraine, Pearson detailed its energy situation and that of the rest of Europe. One quarter of Europe’s natural gas comes from Russia, and much of it passes through Ukraine. Europe’s reliance on natural gas is increasing, and “this is going to get worse over time,” Pearson said. Russia could easily cut gas lines to Ukraine and, by extension, all of Europe. While alternative energy sources such as renewables hold promise for electricity, natural gas is the primary source of heating in Europe. “The EU does not have a slam dunk for the heating sector,” notes Pearson, and Europe cannot easily lessen its reliance on Russian gas. Alternatives such as fracking for natural gas in Western Europe are also not possible due to legal and geologic factors. Pearson did state that the Russian economy is completely dependent on oil and gas exports, but Europe’s inability to wean itself off of those exports and thus impose far-reaching sanctions means Russian behavior is unlikely to be altered.

For his final section, Pearson moved to the Arctic, explaining that China and India are now trying to increase their involvement in the Arctic Council, a body that addresses Arctic issues. Russia sees the Arctic Ocean as the United States sees the Gulf of Mexico. Russia is torn on the efforts of China and India to become involved in Arctic affairs because of both its interests in

preserving the Arctic for energy exploration exclusively by regional nations such as itself, and its interests in maintaining good relationships with China, a major trade partner. Russia has been a cooperative member of the Arctic Council, and the United States has largely prevented the Ukrainian situation from interfering with its diplomatic successes with Russia there.

In his concluding remarks, Pearson emphasized that Ukraine needs capable governance and monetary support to remain intact. Arctic cooperation between the West and Russia may have been slightly strained by events in Ukraine, but it will return soon. Sanctions may only accelerate Russian economic partnerships with Asian nations. Though Pearson did not make direct links between the Arctic and Ukraine beyond its possible effects on diplomacy with Russia, the possibility of lessened Russian claims in the Arctic in response to better ties with China cannot be ignored.

Robert A. F. Thurman on Buddha

By Lydia Cash

On Thursday, October 23, 2014, Robert A. F. Thurman, a recognized worldwide authority on religion and spirituality, Asian history, philosophy, Tibetan Buddhism, and His Holiness the Dalai Lama, gave a lecture entitled “Buddha: Scientist, Realist, Educator, Social Reformer.” As stated on his website, Robert Thurman advocates for the relevance of Eastern ideas to our daily lives. He has become a leading voice for the value of reason, peace and compassion. He was also named one of Time magazine’s 25 most influential Americans and has been profiled by The New York Times and People Magazine.

In his lecture, Dr. Thurman spoke on Buddha’s movement as a 2500-year-old community, culture, and educational institution, which has been appropriated as a “world religion.” By showing Buddha’s movement as a series of scientific discoveries and realist principles, Dr. Thurman explained Buddhism’s departure from “religious trappings,” instead emphasizing its core principles as adaptable on a scientific basis to all levels of modern education and research systems, combining science and technology. For example, Buddha’s realistic worldview embraces relational causation, or the idea that everything in the universe has a cause. Buddha’s cardinal mantra was that the one who realizes and enters reality knows that there are causes to everything, and realizes how to interfere with these causes and therefore overcome them. According to Dr. Thurman, this worldview depends on the fact that wisdom and knowledge free the mind.

One of Dr. Thurman’s most interesting points was that the Buddha discovered relativistic physics, evolutionary biology, and sophisticated depth psychology 2500 years before modern scholars. In terms of relativistic physics, Buddha discovered a deep reality beyond conceptual capture, and viewed the mind as a subtle energy more powerful than subtle matter. According to Dr. Thurman, this idea was a precursor to modern quantum physics. In terms of evolutionary biology, Buddha used karma (causation) to determine causal processes that determine the variety of life forms, including the presence of the mind in nature and hypothetical descriptions of mental and physical causal processes. Buddha also discovered sophisticated depth psychology, analyzing the subconscious and defining the enlightened person as one who has become fully conscious of the subconscious, reshaping its drives and instincts.

In conclusion, Dr. Thurman introduced Buddha’s idea of the relational identity: humans do not exist in absolute, self-identities, but rather in interconnected webs in relation to other identities. According to Dr. Thurman, when people believe that they are absolute and their identities are rigid, religion, gender, color, ethnicity, and other factors become fixed and create barriers. This makes it impossible to identify with other individuals. In contrast, Buddhists see their identities as relational and transformable, and instead cultivate love, compassion, joy, and equilibrium. Dr. Thurman also referenced the idea of reincarnation as liberating, versus the “terminal lifestyle” of believing one will die at some definite point in time. In the “terminal lifestyle” individuals believe that their days will come to an end, and they will not have to suffer the problems of the future. This perpetuates a certain irresponsibility, where individuals don’t care enough or put enough effort into making the world more livable for future reincarnations. In Dr. Thurman’s eyes, this “terminal lifestyle” is a debilitating disease. Instead, humans should pursue happiness and recognize themselves as interrelational beings, which creates the responsibility to improve on one’s self and on one’s surrounding environment.

John Broderick on Public Service

By Kai Yan

On Wednesday October 15 , John Broderick, former Chief Justice of the New Hampshire Supreme Court, former dean of University of New Hampshire School of Law, and current executive director of its Rudman Center for Justice, Leadership, and Public Policy gave a speech at Dartmouth College aptly titled “Public Service is Not for Sissies”. Broderick chronicled the politics that have affected his life from the time he was a young boy to his time serving on the Supreme Court, and explained both the potential inspiration as well as the political hardship of public policy at large.

In his reflection, Broderick began by explaining how even from a young age he was inspired by the impacts of politics. In particular, Broderick’s admiration toward the progressive policies and actions of John F. Kennedy, Martin Luther King, and Lyndon B. Johnson shaped his view on the vast potential of public service. From there, Broderick committed himself to a life of public service, and in 1975 he began serving as a judge in the New Hampshire appellate courts.

While initially holding the optimistic belief that “judging seemed isolated in politics”, Broderick’s view of political and judicial independence came crashing down in February of 2000 when the entire New Hampshire Supreme Court came under public indictment and incurred impeachment hearings over the selection of a replacement court in a divorce trial. Broderick was forced to take a five-month leave from the courts before then having to testify before the house Judiciary Committee, where he was able to convince the panel not to indict him. However, despite successfully convincing the Committee and being exonerated by judicial conduct, Broderick only escaped the indictment charge by a narrow vote count in the House. Later, Broderick discovered that the pretext for many of these votes was not the selection of the divorce panel but rather backlash from deep-seated political resentment over his ruling on the previous controversial cases.

Broderick describes public service as “full of peaks and valleys”. While the peaks may be high through the passage of important reform or civil rights packages, the valleys can be dreary when even the closest of allies won’t speak up for one another and allegations are flung wildly. Broderick experienced this dark political reality first hand through the defamation of his name and reputation by the media , while even the closest members of the New Hampshire Bar failed to step up in his defense. However, no matter how low the valleys may be, Broderick concluded, we should not grow bitter or hold grudges, nor should we give up hope on politics. Instead, we should work to raise interest in important public service matters because in the end, “making a difference is much more important than making a profit”. By following this logic, we can truly see the bright side of progressive politics come into fruition.

World Outlook’s Dinner Discussion with Bruce Riedel

By Rebecca Rodriguez

On May 15, 2014, Bruce Riedel, counter-terrorism expert and former Central Intelligence Agency (CIA) analyst, discussed the future of American security at Dartmouth College. The discussion, hosted by World Outlook, allowed students to ask Riedel questions concerning terrorism, intelligence gathering, and future of foreign policy.

Riedel began the discussion with a brief talk regarding American security and its future. America, he believes, has been developing a new foreign policy, much of which is coming from the Republican Party. He predicts that because of these changes the 2016 election will feature a choice not narrow in contours. Riedel emphasized that Americans need to ask themselves what are the nation’s interests and what are we willing to fight for

Riedel then went on to address the issues and the limitations of counter-terrorism. He explained that the biggest misperception surrounding terrorism was that Al Qaeda is or has ever been a monolithic, well-organized, global terrorist organization. Until the Arab Spring uprisings in 2011, much of the organization had been driven underground; it is only recently that that the group has again gained strength. Concerning the limitations of counter-terrorism, Riedel has confidence in American capabilities however recognizes that it is particularly difficult to make progress simply because there is little information about many groups and their members. Similarly, attacks planned by few individuals, such as the Boston Marathon bombing, have short gestation periods and are therefore practically impossible to be discovered and prevented.

Concerning the NSA and American intelligence, Riedel acknowledged that the NSA has yet to make a compelling case for what seems to be a superfluous amount of data collection. However, he personally believes more is better in order to protect the nation’s interest. As far as the recent releases of intelligence, Riedel believes that Snowden has had the most impact as he released many methods of intelligence collection. Subsequently there has been a noticeable changed in the behavior of Al Qaeda’s communications. However, he is confident that Snowden will one day be tried and convicted.

Riedel’s following remarks concerning a regime change in Saudi Arabia, the Syrian crisis, and relations with the UAE all relate to the question of American interests. As far as Syria and Saudi Arabia, Riedel emphasized the instability and unpredictable nature of the situations, again leaving the questions up to a matter of American decisiveness. He reiterated that Americans should decide in broader terms what our interests are and where we are willing to get involved.

Bruce Riedel is senior fellow and director of the Brookings Intelligence Project, part of Brookings’ new Center for 21st Century Security and Intelligence. Riedel also serves as a senior fellow in the Saban Center for Middle East Policy.

Peter Singer on Cyber Security, Computation and the Internet

By Ariana Mercado

Peter Singer is Senior Fellow and Director of the Center for 21st Century Security and Intelligence at the Brooking Institution, and gave a presentation at Dartmouth on Monday, May 15th, 2014 on Cybersecurity and Cyberwar. This presentation discussed changes in technology, explained how they affect global security, and gave advice on what an individual can do about the growing issue of cyber security.

​Computation skills touch all aspects of society. Since the first website in 1991, there are currently over 30 trillion websites and 40 trillion emails are sent every year. In the next 5 years, internet enabled devices are estimated to reach 40 billion. All this activity and all these mediums for communication cause 98% of all military operations go through the civilian domain.

With all these amazing advantages to a more interconnected world there remain dangerous disadvantages. Every second, 9 new pieces of malware are discovered. 97% of all Fortune 500 companies admitted to having been hacked, and what Americans are most afraid of is a cyber-attack, with diplomats facing millions of cyber-attacks per day. It is estimated that in the next 10 years the number of cyber-attacks will double. 80 cyber security companies have entered the emerging industry of cyber security with a 10 fold return showing the growing demand for these services.

In addition, cyber security bureaucracies are emerging at both the local and federal level. From last year to this year the amount of times “cyber” was used in the Pentagon’s Annual Budget grew from 12 times to 147 times.

Though cyberwar is an art, 70% of business executives have made cyber security decisions with critically little academic experience in the field. Thus, Peter Singer stressed the importance of a comprehensive, holistic approach to cyber security. Cyber security is everything from the individual level to the organizational level to the global political level. All these different degrees of attacks are lumped together causing gaps in the understanding of the nature of cyber-attacks.

The Internet works on a system on trust. There are three trends to this system: 1. Cybercrime 2. Government actions on monitoring the internet. Pushes by authoritarian regimes in blocking the free flow of information (i.e. China and Russia). What can we do?

  1. Knowledge matters (don’t just leave it to the nerds),
  2. People matter (if you want to set up a response you have to understand the people behind the machines)
  3. Incentives (incentivize a solution to set up standards and regulations)
  4. History matters (prevention is always better than a cure).

“An Unprecedented Era of a New Tyranny” – Noam Chomsky Responds to Poet John Berger

By Bryan Thomson

On Tuesday, April 22nd, the Gender Research Institute of Dartmouth hosted Booker Prize-winning English poet John Berger and Noam Chomsky, an MIT professor and acclaimed intellectual as part of the ‘Times of Crisis’ lecture series.  Berger first submitted to Dartmouth an enigmatic and poetic recording on the limiting nature of capitalism in modern society, and Chomsky then reflected on what Berger stated.

In his reflection, Berger described what he considers a new type of global tyranny.  In a similar vein as the now-infamous arguments made by Karl Marx in his Communist Manifesto and later echoed by Jalal Al-I Ahmad in his 20th century work Occidentosis, Berger sees a distinct divide between an impoverished, exporting East and a greedy, exploitational West. This dichotomous divide between classes and societies creates what Berger labels a worldwide capitalist prison, wherein the walls no longer keep prisoners from escaping, but rather stop the world’s poor from entering the protected lands of the rich. The conspiring powers, no longer governmental, but instead transnational and economic, attempt to dissuade rebellion through empty talk of human rights, growth and democracy, while in reality they desire complacency through passive uncertainty.

Though the capitalist prison presents a massive threat to sustainability and egalitarian living, Berger argues the era is no more unprecedented than any others, since every significant change is ‘unprecedented.’ He ultimately claims that, in order to break the passive acceptance of today’s tyrannical economic oppression, the world’s ‘prisoners’ must find liberty locally, “in the depths of the prison,” and thus break free of the current sedative state of being.

The lauded intellectual, linguist, logician, questionably labeled ‘anarcho-syndicalist libertarian,’ and MIT professor Noam Chomsky skyped in to reflect on Berger’s speech. In his response, Chomsky delved into the various threats to humanity that he argues, do, in fact, make this era unprecedented. Professor Chomsky summarized the state of the global capitalist structure as having, unnoticed and unquestioned, but massive, systemic failures.  The protectionist and universally harmful nature of NAFTA, Alan Greenspan’s claims that worker insecurity is beneficial for the economy and the often exorbitant returns to investors have been the forces driving the world toward collapse.  The systematic NSA surveillance is demonstrative of a government desperate to use security as a means of retaining control, not actually bettering its citizens’ lives. Even environmentally, the elites have only desired quick profits and ignored long-term concerns. Not since the Cretaceous mass extinction event have species been dying so quickly. Global issues of nuclear threat, global climate change and impulsive increases in executive power over democratic debate exacerbate the challenges of the classist struggle the world is undergoing, Chomsky contends.

The proliferation of communication technologies that have saturated virtually every rung of every society in the world now make local issues international. Berger believes our salvation can come through cyberspace – as information is empowering and allows those alive now to “stand shoulder to shoulder with the [wronged] dead.” At the end of his response, Professor Chomsky raised a call for action on the part of student groups and grassroots movements to take on the existing power structure that has allowed so many issues to arise.  Much like the Civil Rights movement in the 1960s or British Suffrage movement, modern challenges demand local and organized action.  Taken in Berger’s global, trans-generational context, Chomsky’s call for action becomes one that demands historical awareness and effective global communication.

Both Berger and Chomsky made clear their opinions that we are truly living in a time of crisis, and that such a time demands effective action.  Whether or not the reader believes in the fundamental evils and reach of a corrupt, transnational Capitalist prison, Chomsky and Berger together create a convincing argument for awareness of global affairs and current issues.  In the 21st century’s age of information, dissemination of opinions, organization of opposition and collective action on socioeconomic and multi-national issues are more feasible than ever before.

“The Game Changer” – Madeleine Albright on Russia and Crimea, Syria and the Future of US Foreign Policy

By Bryan Thomson

On April 8th, 2014, Secretary of State for the Clinton administration Madeleine Albright met Director of the Dickey Center Ambassador Daniel Benjamin to discuss her experiences in Spaulding Auditorium. After giving a glowing introduction for Secretary of State Albright, the first woman to ever hold the office, Ambassador Benjamin jumped into perhaps the most pressing issue in current global affairs – Crimea.

Secretary Albright described the situation in the Crimean peninsula as a “game changer.”  Despite efforts to cooperate with Putin and Russia after the collapse of the USSR, Russia has become consistently more hostile to America and Europe since the turn of the century. Hostilities recently culminated in the well-publicized seizure of Crimea from Ukraine. Secretary Albright, speaking as a Soviet expert, asserted that post-superpower Russia has “psychologically lost its identity” and now disappointingly sees a free Europe as inherently anti-Russian. Accordingly, Secretary Albright contends that the West must be prepared to develop multilateral sanctions to show Putin that use of force over diplomacy isn’t tolerated in the present international system.

When asked about her own involvement in the region, Secretary Albright defended the Clinton administration’s NATO expansion, which many are now calling into question. She cited Article 5 of the NATO treaty – an attack on one member is an attack on all – as a critical deterrent to Russian aggression.  Dismissing claims that NATO acted like a charitable organization, Secretary Albright claimed the organization’s strategic mission has changed since the end of the Cold War. Now, NATO has found allies in many nations previously swallowed unwillingly into the Warsaw pact. Poland, Latvia and others, who have chosen to join NATO have not seen similar violations of their borders as has Ukraine (whose request to join was denied in 2008).

Secretary Albright also made some very straightforward comments regarding Syria. Drawing a parallel to Bosnia, Secretary Albright reminded the audience of the responsibility to protect Syrians.  When asked by an audience member about concrete actions she wished to see the US currently taking, Secretary Albright stated that the US should increase humanitarian and medical assistance to Syrian civilians, especially given the horrific reemerging cases of polio in the region.  She warned that “We are going to be asked why we didn’t do something about Syria. Not 20 years from now, but one year from now.” Unlike the confusing reports and breakneck speed of atrocities in Rwanda, Syria presents an ongoing rights violation that Secretary Albright believes the US should act on immediately.

Secretary Albright, who escaped both fascism and communism in her home country of Czechoslovakia to become one of the most influential and groundbreaking stateswomen in America, elicited a laugh from the audience when she claimed she is “an optimist who worries a lot.” True to her statement, the 90-minute conversation between Secretary Albright and Ambassador Benjamin ultimately proved the former Secretary of State to be cautiously optimistic about America’s future. Drawing on her own work across the aisle with Senator Helms (R-NC), she hopes that current Republicans and Democrats in the center will come together and make progress (or, in her own assured quip, “regain some civility and get some things done!”).  Despite recent inauspicious news, she maintains that a brokered two-state solution is possible in Israel, and that progress with Russia as a partner is still obtainable.  Though Madeleine Albright warned that the challenges of today make those in the ‘90s pale in comparison, her cautious endorsement of both America’s and the world’s capability to progress invites confidence and hope in the future.

Democracy, the Jewish State, and the Israeli-Palestinian Conflict: A Conversation with Gershom Gorenberg

By Alexandra Woodruff

On April 3, 2014, Gershom Gorenberg, expert on Middle Eastern politics, discussed the peace negotiations between the Israelis and the Palestinians currently mediated by the US Secretary of State John Kerry. The discussion, co-hosted by Dartmouth’s Nelson A. Rockefeller Center for Public Policy and the Social Sciences and the John Sloan Dickey Center for International Understanding, highlighted issues of occupation and Israel’s identity as concurrently Jewish and democratic.

Gorenberg, a historian as well as a journalist, began the discussion by contextualizing the current peace negotiations by tracing the history of Israel’s development as a nation. After dividing Israel’s history into three eras, beginning with its pre-state history, followed by “the first republic,” and the period of “the accidental empire,” Gorenberg suggested Israel might be on the verge of a fourth era: “a second republic.”

The character of this era, still to come, depends on the success or failure of the current peace negotiations. Gorenberg emphasized that if the current talks were to break down any future negotiations would find both sides worse off. Additionally, he emphasized the importance of the talks and of compromise in continuing Israeli democracy.

Gorenberg also emphasized the importance of narratives in the peace talks, and the significance of the conflict between Israeli narrative and Palestinian narrative. But he also suggested that a “reconciliation of narratives” is not the goal of the current peace negotiations. Instead, it is more important that these narratives do not prevent a successful compromise.

Gorenberg also raised thought-provoking lessons applicable beyond the Israeli-Palestinian conflict. When discussing the conflict between Israel as a democratic nation and Israel as a Jewish nation (can it be both at once? Does true commitment to one prevent the other?), he pointed to two important considerations: first, when thinking about global issues and peoples, we have a habit of imposing Western conceptions upon non-western peoples. Specifically, the concept of “Jewish” as distinctly a religion or a race is a Western concept, and thus not particularly meaningful in discussions of identity and democracy in Israel. Second, Gorenberg emphasized that adopting a pessimistic “change can’t happen” perspective is not only politically damaging, but also historically inaccurate.

Gorenberg’s remarks were introduced by the Dartmouth chapter of J-Street U, “a pro-Israel, pro-peace, pro-Palestinian group that promotes American diplomatic leadership in achieving a two-state solution as an end to the Israeli-Palestinian conflict.”

Gershom Gorenberg is a senior correspondent for The American Prospect and contributor to The New York Times, The Washington Post, and the Los Angeles Times.


“Imihigo” and Reasons for Successful HIV Management in Rwanda

By Liz Lin

On April 2nd, 2014, Dr. Jean Luc Nkurikiyimfura presented his experience as the Director of the HIV Clinic at Kigali University Teaching Hospital or CHUK (Centre Hospitalier et Universitaire de Kigali), explaining the strong positive trends the country was experiencing with regards to HIV/AIDs management. Specifically, he explains the success with committed leadership, a network of community health workers, and partnerships with international groups.

Rwanda is a small country in central Africa, about the size of New Hampshire with ten times the population. It is also a poor country with a GDP ranked 203 out of 227 countries. Dr. Nkurikiyimfura points out that for a population 11 million, health professionals are scarce: there are only 625 MDs, 8273 RNs, and 240 midwives. Yet, Rwanda has come a long way in providing for its people.

The devastating effects of civil war and genocide in the 1990s, with rates reaching 1 million Tutsi and sympathetic Hutu people slaughtered by Hutu majority in 3 months, can be further quantified by a life expectancy of 28 years in 1994. Dr. Nkurikiyimfura, going back to his home at the end of the decade, recalls the country smelling of death, with corpses still strewn about the land. Since then, the life expectancy has steadily improved to 53 years alongside a 86% reduction of malaria related death. More strikingly, 5-year mortality after birth has decreased from 186 to less than 50 per 100,000 births, not only reaching pre-genocide levels, but also reaching rates lower than the average in Sub-Saharan Africa.

Dr. Nkurikiyimfura’s HIV clinic has also had remarkable success in providing access and treatment for HIV/AIDs patients in all aspects from diagnosis, treatment, to follow-through. Prophylactic measures reduced the incidence of HIV vertical transmission, and in 2012 less than 2% of newborns had the virus compared to 11.6% in 2005. With a target demographic of children and adolescents, the clinic also educates for community change from within. Dr. Nkurikiyimfura attributes the success due to the committed leadership, citing the government to be the “least corrupt” compared to surrounding countries and effective in allocation of resources. The community-based focus, with community health workers placing an emphasis on maternal care and child health, and a triage-like system in treatment, builds a strong foundation for public health. Furthermore, community health workers create a network of personal contact to help with treatment adherence through organization of group support and home visits. Finally, the international support, especially from NGOs, is critical.

Some reasons for success may prove to be challenges in the future, speaking to the multi-faceted nature of global health. International support is the least sustainable in the long run, though critical for now. Understandably, with the poverty of the country,Dr. Nkurikiyimfura estimates 80% of the allocated money to fight HIV comes from outside sources. Right now, Rwanda has been justifying the investment, for example, from the Global Fund, with numbers. However, the long term success of combating HIV in Rwanda depends on change from within. Taking communities into context for the treatment of disease is essential: the health care structure must come from the community and not be imposed based on what outsiders might think may work. “Imihigo,” a term defining a pledge to achieve for communal good, is a concept with traditional roots. Dr. Nkurikiyimfura states traditional concepts, including “imihigo,” are key for sustainable development and continued momentum from the Rwandan people

By showing relevance and results through numbers, fighting HIV in Rwanda is a success story. A government committed to forming a strong health care system proves to NGOs and funding sources that it is committed to succeed and builds a partnership of trust in receiving the financial resources needed to effect change. The Rwandan people, pledging “imihigo,” have a strong stake to help themselves and is creating a sustainable network of community health workers and educated citizens.