The relief effort following the Pakistan earthquake in 2005 - which saw the unlikely spectacle of U.S. forces distributing aid alongside Islamic militant groups - has been touted as the most effective response ever to a natural disaster on this scale.
The complex operation is examined in a new report the Boston-based Feinstein International Center, which asks what impact the war on terror had on aid operations.
The quake killed approximately 75,000 people, injured 70,000 more and left an estimated 3.5 million homeless in the north of Pakistan, a key U.S. ally in its "war on terror".
The obstacles were phenomenal. For a start, how do you begin to reach so many people in mountainous terrain before winter sets in and they all freeze to death?
Another major challenge was how to coordinate such a diverse array of humanitarian actors which included Pakistani, U.S. and NATO troops, international and local aid agencies, and Islamic groups, some of them on U.S. and U.N. lists of terrorist organisations.
Quake survivors interviewed for the report were nearly unanimous in believing that all organisations had acted for humanitarian reasons rather than to promote hidden agendas. And that includes U.S. and NATO military forces, whose deployment would normally generate numerous conspiracy theories in a place like Pakistan.
But while aid officials agreed the quake response was motivated by humanitarian considerations, several thought the scale of the response was indeed motivated by considerations of the war on terror.
"There is little question that the twin objectives of rewarding a 'strategic ally' and 'winning hearts and minds' in the (War on Terror) clearly influenced the scale of the earthquake response, especially for the U.S.," the report says.
But does it really matter that the quake survivors' benefited from their country's frontline status in the "war on terror"? Well, yes it does in that it raises questions about the neutrality and impartiality of U.S. humanitarian assistance, the report says.
And there are obvious negative implications for anyone affected by a crisis in a region not deemed strategically important.
Although most aid addressed real needs, there were cases where public relations goals took over, the report adds. It cites the U.S. ambassador's insistence on bringing Chinook helicopters - a key symbol of the U.S. response - back from Afghanistan for the anniversary of the quake - "a big waste of money based only on 'hearts and minds' considerations", according to one unnamed U.S. official.
One fascinating aspect of the aid response was the high-profile role played by militant organisations.
As one U.N. official commented: "This was the first time NATO and al-Qaeda worked together, and western Christian NGOs worked side-by-side with Islamic militant groups Â? it was great."
In many cases, Islamist groups, including militant jihadi organisations, were the first on the scene. According to one local aid worker they were much more organised than civil society groups.
Many of their members had been trained at camps for Kashmiri militants in the quake zone so they knew the terrain and the people. They were accustomed to hardship and came with horses and mules that could carry supplies.
But the report suggests the war on terror fuelled suspicion between international and national aid organisations on the one hand and Islamic organisations on the other, which contributed to poor coordination between the two.
For the most part they each did their own thing, but in the first few months several aid agencies did collaborate with and deliver assistance through some of the jihadi organisations.
The U.N. World Food Programme relied quite heavily on jihadi groups' mules to transport food to higher altitudes, the report says. The U.N. refugee agency reportedly gave banned groups tents to deliver and the U.N. World Health Organisation handed over medical supplies.
The U.S. government's response to all this was remarkably low-key, the report says.
Ironically, the United States' desire not to alienate a "war on terror" ally is likely to have contributed to a "don't ask, don't tell" policy regarding groups on its list of terrorist organisations.
"Oddly enough, strategic war on terror considerations may therefore have helped preserve neutral humanitarian space for U.S. military forces to work alongside banned organisations," the report says.
It would also seem likely that the jihadi organisations themselves were trying to win over hearts and minds so the war on terror may have ended up being a bonus to the quake victims in that both sides were pulling out all the stops.
ARMY ROLE
Unlike many other natural disasters there was no significant second wave of deaths from injury, cold, food shortages, or disease. And much credit for that probably goes to Pakistan's army.
Perhaps more than anything else, the quake relief effort demonstrated the growing importance of military forces in responding to disasters, says the report's author, Andrew Wilder. This is something he expects we'll be seeing more of, partly because of the positive perception of the role international and national forces played in Pakistan.
Indeed, Wilder even says there are reports that the United Nations has recommended the Pakistan military form a standby team to respond in disasters.
But the Feinstein report cautions that integrated military-civilian responses are most likely to be successful in natural disasters. The centre's research into similar approaches in armed conflicts has shown political and military concerns tend to trump humanitarian ones.
Another lesson from the Pakistan study is that the role of the military becomes more contentious and politicised as the immediate life-saving phase of an aid operation ends and the reconstruction phase takes over.
"It is therefore important for military actors to not only develop their capacity to respond to disasters, but also to develop their capacity to exit from disaster responses and hand over responsibility to civilian authorities Â? a notable weakness of the Pakistan Army," the report says.
Although the army's response was favourably viewed, the report says it's crucial to remember that the deployment of military forces in the relief effort Â? whether Pakistani, U.S. or NATO Â? were influenced by strategic considerations.
"If this type of involvement is a harbinger of things to come, humanitarian actors may be facing a steep learning curve in terms of dealing with, and sometimes insulating themselves from, militarised relief in the years to come," it concludes.
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