Georgian Peacekeeping Mission

By LT CDR Uri Tabach

Despite the advances in medical technologies in the West, it is extremely difficult to apply and/or deliver these technologies to conflict zones under the auspices of the UN peacekeeping mission. The most difficult challenge is the delivery by UN medical personnel of appropriate technology which is easily transferable and can be operated by trained professionals. Such transference involves overcoming political, religious, ethnic, cultural and bureaucratic obstacles.

The UN Observer Mission in the Georgian-Abkhazian conflict, despite excellent military leadership, experienced disastrous medical consequences due to political maneuvering, the lack of quality of key personnel, and clearly defined responsibilities. Local misunderstanding of mission purposes led to unrealistic expectations of available medicine and equipment.

Nevertheless, the UN observer mission in Georgia helped avert a full scale armed conflict. Especially in medical emergencies and other life threatening situations, mission personnel would pull together and overcome personal, political and cultural differences in order to prevent loss of human life.

Due to my experience in dealing with the Former Soviet Union, I was selected to be a US Navy representative to the United Nations Military Observer Mission in Georgia (UNOMIG). UNOMIG's mission was to observe, monitor and prevent an armed conflict between the Georgian government headed by the former Soviet Minister of Foreign Affairs, Edward Shevernadze, and the break away Republic of Abkhazia. As a consequence of the collapse of the Soviet Union and a proclamation of the Georgian independence, the conflict erupted in August, 1992. The resulting unrest and the killings continue to this date despite the presence of the international military observers and the Russian military peacekeepers. This conflict covered a vast area along the shore of the Black Sea and the Caucuses Mountains involving a variety of different nationalities that lived in that area. The initial outbreak of hostilities produced a 250,000 refugee population consisting mostly of Georgians, Mingrelians, Russians, Armenians, Greeks and Jews. A majority of refugees are concentrated on the Georgian side, living in make-shift refugee camps. The number of killed and injured on both sides varies depending on the source. It is, however, very clear that this once popular Soviet resort and prosperous farming community is in total ruins.

Over the past four years, the infrastructure of the self-proclaimed Republic of Abkhazia has been in total devastation, partially due to the economic blockade imposed upon them by the Russians. Most of the Abkhazian territory is scorched and its population lacks the most basic necessities. The collapse of the Soviet Union, combined with a lack of a functional economy, deep rooted ethnic rivalry, civil and territorial wars, and a strategically important location (Caspian Sea oil reservoir) has brought unrest and instability to the neighboring regions in the Caucuses: Dagestan, Armenia, Azerbaijan, Ingushatia, Chechnia, and Ossetia.

To resolve the conflict, the United Nations Security Council deployed an international-UNOMIG contingency (unarmed) and a Coalition of Independent States-Peace Keeping Forces (CIS PKF) consisting solely of Russian troops (armed) to the area to maintain law and order until a peaceful settlement could be reached. Unfortunately, the UN Security Council's good intentions were very difficult to enforce. Difficulties arose because the UNOMIG and the CIS PKF lacked a clear understanding of their responsibilities, of the local culture, of a knowledge of the deeply rooted historical reasons that led to the conflict, of the national interests of the countries involved in settling the conflict, and of the unfriendly terrain.

The UNOMIG includes several components. It reports to the UN HQ in New York via the representative of the UN Secretary General who resides in Georgia's capital, Tbilisi. UNOMIGs military HQ is located in Abkhazia's capital, Sukhumi. The civilian support HQ operates out of the former KGB Black Sea resort compound located in the town of Pitsunda near the Russian border. Two UNOMIG Sector HQs are in the bordering towns, one on each side of the Cease Fire Line (CFL). Also, two Team Bases are located on each side, reporting directly to their respective sector HQ. The distances between the military contingency patrolling the area of responsibility (AOR) and the civilian UN support base is enormous. Communications between the civilian and military UNOMIG personnel were troubling because of the broken down infrastructure, the non-existence of safe roads, isolated hostile territories and poorly functioning equipment.

The UNOMIG consisted of 124 officers from 22 different countries and belonging, at different levels, to six religious groups. Linguistic and cultural differences combined with a variance in the military and civilian mentalities and a strange and hostile territory made mutual understanding of the mission somewhat arduous. Consequently, even when the equipment functioned properly and the parties were in the right place, it was still likely that the parties did not sufficiently understand the English language, creating a perfect environment for Murphy's Law to prosper. Some of the officers and the civilian employees came to the Mission not because of their military and/or linguistic achievements, but because they are "cousins" of some "Minister of Ideological Induction" in their respective country. Furthermore, in some cases, the pay and the living conditions for some of the UN employees mentioned above were much better and safer in Georgia then in their own country.

The military component of the UNOMIG consisted of two major groups. The officers from the NATO countries served for six months, mostly in key positions. The rest served for one year and it was difficult for them to secure postings in the leadership positions. Once again, it was not necessarily the officers' talents and/or experiences that dictated the assignment at the UNOMIG, but rather political intrigues and pressures from the participating countries, thus forcing the Chief Military Observer (CMO) to appoint "westerners" to leadership roles. Internally, this created animosities among the UN officers and civilian personnel.

The UNOMIG civilian staff consisted of career UN employees, mission specific employees hired by the UN specifically for this mission, and local hires. The UNOMIG had a well trained and equipped German Medical Team, consisting of two medical officers and four medics. One of the doctors operated out of the Sukhumi HQ and the other one out of the Sector HQ on the Abkhazian side. There were two well-equipped ambulances, but because of the vast AOR and mountainous terrain, the ambulances were not always capable of performing their intended mission. The most appropriate vehicle for medical assistance at this mission would have been a helicopter. All parties agreed that the helicopter is a necessity in the mission. Unfortunately, once again due to bureaucracy and politics, the mission remains without a helicopter to this day, and therefore, without proper medivac capabilities for medical emergencies.

The Russians have a helicopter available at their base. However, when a soldier was seriously wounded by a mine in a mountainous area and needed to be evacuated by helicopter, the Russian pilots were found to be so inebriated that they could not even walk out of their quarters and navigate themselves to their own helicopter on the ground. UNOMIG officers, referred to as United Nations Military Observers (UNMOs), had to put the wounded soldier on the hood of their vehicle and drive for six hours through the mountain passes until they were able to reach a local hospital. In another incident, the Russian Force Commander, a Major General in command of all the CIS PKF, was seriously injured in a car accident. Once again the helicopter crew could not medivac him to the military hospital in Russia. This time, the Russians did not have any fuel to operate their helicopter. As a result, the UNOMIG ambulance and its German crew had to transport the General to Russia. Fortunately, this time the trip was only four hours long. Presently, the UN has contracted a Ukrainian helicopter and its crew to be deployed to the area. However, this most needed asset has been sitting in Russia for several months awaiting country clearance and proper visas, among other things, before it can be operational in Georgia/Abkhazia. It is unfortunate, but somewhat understandable that a helicopter contract between the UN and the Ukrainian government would be a very political issue. However, UNOMIG had just as much trouble getting first aid kits for their patrol vehicles. At one point, one of the more aggressive and dedicated German doctors demanded an adequate supply of the First Aid Kit Boxes for the UN patrol vehicles. After six months of his perseverance and reasoning, the Mission received the long awaited First Aid Kit Boxes. Correct, that is exactly what they were, First Aid Kit Boxes --just boxes, nothing inside of them.

The German medical crew rotated medical officers from the former East German Armed Forces and the former West German military. The West German doctors were highly trained professionals who did everything by the book, and were very much aware of the budget constraints, as well as the potential legal problems of treating the locals. The former East German medics, on the other hand, were not as friendly or neat as their new countrymen. They had difficulty understanding that there was a limit to the medical supplies when it was needed for a patient, even if the patient was a local bandit. After all, in their eyes the UN has plenty of items to waste, and in certain way it did. The former East German medics would not act in a friendly manner when treating the local population; in fact, they were outright rude. On the other hand, they did not make polite excuses why they could not help local people with their health problems.

When UNOMIG personnel brought a local to the Russian field hospital, the Russians always treated them, and in most cases they would do an outstanding job by improvising for some of the essential medical supplies. Most of the Russian physicians had experience in the Afghanistan war. Once, a local nine year-old boy picked up a flair which was connected to a trip-wire. Naturally, the flair exploded in his hand, ripping off his fingers and palm. UNMOs took the boy to the Russian military hospital where the Russian surgeon amputated the boys hand. All of the boy's arm functions remained in tact, with almost no damage to his arm's skeletal/muscular structure. Some of the western physicians examined the boy several months later and concluded that the surgery was skillfully performed despite the field conditions.

Unfortunately, humanitarian agencies were functioning less than effectively. The country had more leg prosthesis in stock then the population of the country in general. The local population would use the leg and foot prosthesis for building material. Unfortunately, there was not even a single artificial hand prosthesis to be found anywhere in the country and no means for getting one.

Some of the humanitarian aid agencies had various problems of their own. For example, they were not eager to deliver their goods and/or services to the areas of potential danger. Instead, they would contract local "actively strong" and ambitious entrepreneurs to do that job. As a result, the black market thrived and the people in need of real help were left without much hope. It was obvious that the local population was frustrated by observing the humanitarian agencies present in their towns, because the goods they delivered to the agencies were on the black market in the cities at prices beyond their reach. Unfortunately, most of the people in desperate need of help were usually very old or very young. Many children appeared to be suffering from malnutrition. The animal stock did not appear healthy at all. However, the vegetation, particularly fruits, grew everywhere, hence the vitamin supplementation should have been simple. The negative effects were most likely related to poor hygiene and parasite infestations of both humans and animals, contrary to the popular belief in the West that poor diets were due to a lack of food staples. So, instead of educating proper infant/child nutrition intake and basic hygiene tectonics, these same agencies would deliver high-tech medical equipment to the local hospital. Meanwhile, this hospital would not have essential things such as water, surgical gloves, cleaning/disinfecting material and basic drugs.

Some of the material and equipment used in the hospitals dates back to WW1. Open top IVs, leaches, fifty year-old needles and syringes are in use at these hospitals. Often bandages are washed and used again, sometimes even on a different patient. One of the hospitals, frequently visited by the UNOMIG personnel to transport a patient from the AOR, was partially a refugee camp. The hospital lawn was adopted as feeding grounds for pigs and chickens. The windows in the surgery suite were open for lighting and ventilation. The family of the patient undergoing surgery were present in the surgery suit during the surgery, in case the surgeon needed something to be purchased on the black market, and later to witness that it was put to use on that patient. A covered body of a deceased human was laying on the floor of the surgery suit, probably waiting to be transported to the morgue. In one instance the surgeon could not get out of the surgery suite because a two hundred pound pig was leaning against the door on the other side.

The physicians and the nurses at the hospital are getting paid around $25 per month and, therefore, are forced to treat only patients who can pay them money or trade goods like food or services for treatment. In one instance, a humanitarian agency operating under the UN umbrella donated two kidney-dialysis machines to one of the hospitals. The administrators and the practitioners of this hospital certainly know what these machines are intended for. Unfortunately, they have no means for correctly using them. For similar reasons, they would not be able to sell this high-tech medical equipment on the black market.

The population of the region suffers from a high rate of drug abuse. Particularly this problem affects the younger male population. The cemeteries are filled with men in their late teens and early twenties. Most of them did not die during the heavy fighting, but rather shortly after. These young men usually never had a chance to finish secondary school. Most of them had to quit their studies and go out to fight in the war. After the heaviest fighting was over, the ones that survived the war most likely went back to their burned out villages. Unfortunately, most of the former soldiers are no longer interested in their education or occupying themselves with productive labor. No social state is available to take care of its veterans. However, there is no shortage of war-scored and overly aggressive angry young men with no hope for the future. Meanwhile, for the most part of the year the area is very fertile and produces an abundance of fruits and vegetables, as well as all kinds of other vegetation. The production and the consumption of drugs becomes the main occupation for many of the young men in the region. As a consequence, this type of lifestyle leads to their demise due to overdose or a shoot-out.

Keeping in mind the above- mentioned problem and the availability of free high-tech medical equipment donated to the regional hospital by the "rich West", the following occurs: hospital administrators with the help of the local "scientists" alter the function of the kidney-dialysis machine by filling it up with something that looks like an activated charcoal. Then this new "invention" is marketed as a detoxification apparatus. According to the medical "professionals" operating the altered kidney-dialysis machine, the desire to use drugs and/or alcohol ceases to exist after three blood transfusions, but only if it is performed by them on the high-tech Western machinery, and only after their "scientific" adjustments. Unfortunately, no study nor any records of the success rate of the treatment is available for public scrutiny. Also, the price of such treatment is highly "classified" and the payment plan is difficult to understand.

The major threats to the UNOMIG personnel were mine warfare, abductions and ordinary banditry. The Russian troops were armed and could protect the UNMOs from being taken hostage or being looted during the patrols. Unfortunately, the Russians were not considered impartial in this conflict and quite often were targeted by the different local fighting formations. Therefore, the UNMOs did not conduct joint patrols with the Russians who were supposed to provide protection for UNOMIG. This left UNMOs as open prey to the profusion of criminal groups in the area, especially, if the UNMOs were not familiar with the local culture, terrain and did not speak Russian. Nevertheless, it was still safer to conduct patrols without Russian escort. The banditry was boundless and if local bandits spotted disoriented and confused UNMOs, they would most likely rob them of everything of any remote value. An UNMO, who was proudly serving the United Nations very far from his home-country, was looted of his watch and wallet during one of the patrols. According to this officer, he was stationary inside of the UN vehicle at a crossroad, when a local man came up to him and pointed with his right index finger to his left wrist. The UNMO did not speak Russian and understood it as an attempt to rob him of his Seiko watch. He did not feel the necessity to escalate the situation and expose himself to further unnecessary danger, and therefore, handed over his watch along with his wallet. The looter took the goods, thanked the officer and left. Surprisingly, the local authorities did not display any enthusiasm to investigate this incident. Unfortunately, other incidents were not so humorous. A gang of local thieves broke into an American accommodation and stole over $3,000.00 worth of equipment and personal belongings. Also, the bandits abducted an American officer and threatened to kill him. Fortunately, because of the Force Protection Training that all Americans receive before deployment, coupled with the personal stamina of this officer and knowledge of the Russian language, this officer was able to come out of this ordeal with just a few bruises.

The deadliest threat to the UNMOs was the constant escalation of mine warfare. Some of the mines were left from the fighting and some were continuously planted on a daily bases. Maps were never made of the mine fields and mines were planted by both sides indiscriminately. Four years ago, most of the mines planted were pressure release anti-personnel and anti-tank mines. Many of them dated back to WW II production. One UNOMIG UNMO was killed when his vehicle struck an anti-tank land mine during a patrol. After this unfortunate incident, UNOMIG obtained previously used South African Anti-Mine vehicles called MAMBAs. These vehicles were not appropriate for a mountainous terrain, but did provide good anti-mine and small arms protection for the UNMOs. Nevertheless, several UNMOs and local interpreters working for the UNOMIG were injured due to different mine incidents. The mine warfare progressed in sophistication and lethality as the conflict progressed. Fighting groups applied deadlier and more accurate techniques. Several times, remote control mines such as MON-50 and MON-100 were deployed against local authorities and the civilian population. Recently, radio controlled mines were deployed against the CIS PKF. In one case, the chief of the local Abkhazian police force found a limpet naval mine with a timing mechanism attached to the bottom of his car. Fortunately, because of the grave road conditions, his car struck a pothole causing the timing mechanism of the mine to malfunction, hence disarming the mine. The easiest way to plant a mine was to place it in one of the many potholes on the only major road in the area and preferably after the rain. The water would cover the mine which is hermetically sealed and not affected by water. Some of these potholes were unavoidable; therefore, this combination of a decay and destruction could easily result in a deadly outcome.

The best defense against the mines were not MAMBAs. The local population was invariably the best protection. The key to survival was to be friendly and understanding with as many different fractions of locals as possible. It involved diplomacy and the development of friendships with the military, security and police forces, as well as the civilian representatives in the area. Russians would usually come to the rescue, and definitely would go out of their way to assist if they personally knew you and shared some vodka during the joint meetings. Refugees and civilians would be most helpful and direct you away from the mine fields, providing they could communicate with you and not feel threatened by your presence. It was very important that the locals did not get an impression that you were sympathetic to their enemy. On the other hand, if you were misunderstood or appeared threatening to them, it would be very likely that your patrol would have an opportunity to end up in the middle of a minefield or be taken hostage by the bandits, or a local group of "Freedom Fighters".

1999, Foreign Area Officer Association
Springfield, Virginia
Maintained by LTC Steve Gotowicki.
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