High-risk mission
in Northern Caucasus
by Eric Reumann

"After the Novi Atagi tragedy and the abduction of our medical delegate, Geraldo, some people wanted us to pull out from the northern Caucasus definitively. We had to fight to stay on," says Pierre Reichel with passion. First as a translator and then as an ICRC delegate, he has worked for most of his career in conflict zones in the former Soviet Union. On 17 December 1996, a band of gunmen slipped into the grounds of the hospital run by the ICRC in Novi Atagi - a village some 30 kilometres south of Grozny - and murdered six delegates while they slept and injured a seventh. Reichel was on his first mission in the northern Caucasus at the time. Previously, he had been in Tajikistan and Nagorny-Karabakh. A sad new stage began for him and the rest of the ICRC staff in the region: "after Novi Atagi".

Deeply shocked by the murders, the ICRC decided to withdraw all of its delegates from Chechnya, Ingushetia and Daghestan to Nalchik, the capital of Kabardino-Balkaria, a republic situated more than 100 kilometres east of Chechnya. Inevitably, all assistance programmes came to a standstill. A painful debate followed over what to do next. Should they abandon the victims of Chechnya's war? And if not, how could they assist them without taking disproportionate risks? "Some of us volunteered to stay," recounts Pierre Reichel. "We had to be firm to bring everyone round. We were convinced that, even at a distance, we could still do something." Little by little, they managed to overcome the initial reluctance. The small group based in Nalchik began to construct the basis for a 'remote-controlled' assistance operation.

A different approach 

An alternative working method, seriously restricting the movement of the delegates, was set up after the murders. Delegates could no longer travel to the field to identify the obstacles and problems; they had to rely on some 200 local staff members employed by the ICRC in the region.

Assistance programmes in the area became the responsibility of the ICRC's local employees based in Grozny, Nazran and Khasavyurt, as well as regional sections of the Russian Red Cross. Despite the difficulties that this situation presented, hospitals Nos. 4 and 9 in the Chechen capital were re-equipped and supplied and a blood bank set up. Until fighting broke out again in 1999, pumping station No. 1, maintained by the ICRC, remained Grozny's main source of drinking water, providing 1,600 cubic metres of water daily for more than 20,000 residents. Twenty bakeries run by the Russian Red Cross, with the support of the ICRC, were able to ensure the most vulnerable inhabitants of Chechnya's main towns - essentially invalids and retired Russians with no family support network - received a daily loaf of bread. A similar system was developed in Ingushetia, where the Russian Red Cross continues to distribute bread to displaced people. Until last September when the conflict erupted, the Russian Red Cross's visiting nurses were able to work. Hundreds of sick or disabled people benefited from competent medical care in their homes.

In the absence of expatriate delegates, it fell to local employees to explain the new role of the ICRC in the region. They are justifiably proud of undertaking this difficult task, but admit that it is a heavy responsibility. "When the delegates were on the spot, it was easier," says Tamerlan Tsougaev, who looks after the Grozny office's vehicle fleet. "We could always refer back to them, and people didn't challenge their decisions so easily. Personally, I would welcome the return of the delegates." Most of the local staff in the region are inclined to agree.

ICRC activities on the increase

On 30 March, ICRC President Jakob Kellenberger was the first foreign guest received by the newly elected president of the Russian Federation, Vladimir Putin. This meeting has paved the way for an extension of ICRC activities in Chechnya, in cooperation with the Russian Red Cross. Since then, several surveys have taken place in Chechnya, namely in Gudermes and in Grozny, followed by medical assistance and relief distribution.

At the same time, a programme of visits to people detained due to the conflict is under way.

A huge dilemma 

The abduction of Geraldo Cruz Ribeiro, ICRC medical delegate, in May 1999 once again shattered any illusions of security. The expatriate staff was drastically reduced. The incident re-ignited the debate of whether to continue working in the northern Caucasus, where different groups had not the slightest respect for humanitarian workers.

At the same time, the increasingly marked deterioration of the situation in the region signalled an imminent return to hostilities. This made a humanitarian presence all the more vital. Once again, the desire to bring assistance to the victims overrode any initiative to pull out. It meant, though, that the delegates in Nalchik had to submit to draconian security measures. Staff was once again restricted severely to only six expatriates working in the northern Caucasus. Local police officers accompany them wherever they go. Their movements are strictly limited to travelling between the office and their residences and, of course, to making the indispensable trips to the field. Gone are the evenings spent with friends or acquaintances in the region.

Home care in Kabardino-Balkaria

Three sharp knocks on the door. Then: "Philippa Antonina, Philippa Antonina, you have guests." A long silence, furtive footsteps, the door half opens. A wizened face with a tuft of silver hair appears. Nurse Zoya Pavlova enters and immediately takes hold of the fragile old lady's arm to help her back into the single room that makes up the little apartment. In a corner, a metal bed. Near the window, a table and chair. It is more than humble, almost spartan. This is the home of Philippa Serebakova, a 90-year-old retired biologist, whom Zoya Pavlova visits and cares for regularly as part of the visiting-nurses programme of the Red Cross of Kabardino-Balkaria, a republic in the northern Caucasus, a little more than 100 kilometres east of Chechnya. A dozen nurses take care of 15 patients each. The programme is financed by the ICRC, but it is run by Nina Lisenko, president of the local branch of the Russian Red Cross. "The social and economic crisis has meant that many elderly people can no longer turn to their families," explains Zoya. This shortcoming says a lot about the state of decay in the northern Caucasus, where the family support system is a sacred tradition.

Without Zoya, the old lady would not be able to live alone. She did try to go and live with her brother and his family in Stavropolski Kraļ, but her brother is blind and the toilets at the end of the garden. So she preferred to come back to Nalchik and let herself be cared for by Zoya. Lidya Antchekova, the head nurse who is accompanying Zoya on this visit, questions the old lady on the quality of the services provided. "Vsio kharacho. Everything is great. I am very happy with Zoya Dimitrievna's visits," enthuses Philippa. For the old lady confined to her room, having someone to talk to is visibly as important as the physical care she receives from the nurse. While chatting to her, Zoya has taken hold of her patient's left arm. "This side is paralysed. I try to make it better through massage." When it is time to leave, Zoya gently strokes the old lady's face and her hair, which seems a little ruffled. "I washed it yesterday," says the nurse proudly. Then Zoya and Lidya head off to visit their other patients, among whom are 87-year-old Tatiana Ignatenko and her son Vladimir, whose feet have been partially amputated owing to frostbite.

Closely guarded 

The rapid deterioration of the situation in the northern Caucasus, first in Daghestan in August and then in Chechnya at the beginning of September 1999, radically altered the priorities, although security concerns are ever present. The arrival of 250,000 civilians in Ingushetia created a humanitarian emergency requiring an immediate response. At the end of October, the conflict's brutality and the looting of its Grozny office obliged the ICRC to evacuate its Chechen staff to Nazran. On one of the trips to the Ingush border, two staff members of the local Chechen branch of the Russian Red Cross were attacked and killed and a third wounded as they travelled in cars bearing the emblem.

Despite the enormous difficulties posed by the conflict, the ICRC rapidly mounted a relief operation for 100,000 displaced people. In addition, from October, five hospitals in the region were supplied with medical materials to treat nearly 1,000 wounded. Paradoxically, the decision to resort to armed guards prompted by Geraldo's abduction gives the delegates greater freedom of movement in the region and enables them to be present in Ingushetia. Pierre Reichel and his colleagues go to Nazran several times a week to meet the Chechen and Ingush staff. He has even become accustomed to the presence of the policemen. "It took me a while to get used to the idea that it was not up to me to watch what they were doing, but up to them never to lose sight of me," explains Pierre.

Indeed, as he inspects the water distribution points installed beside the railway carriages sheltering displaced people near Karaboulak, he doesn't spare a glance for his guardian angels. The only thing that interests him is to find a good location for the showers that he plans to build close to the camp. As the conflict dragged on, the issue of hygiene became more and more pressing.

The Chechens, who come up to talk to him, are unfazed by the proximity of the armed men. Too long they have been used to the presence of all kinds of militias. What's more, they well know that foreigners are under threat and that they have to protect themselves. The Ingush authorities make it a point of honour to intercept all foreigners arriving on their territory, whether journalists or aid workers, to place a bodyguard at their sides. Despite the risks, an international presence remains essential.

Fortunately the humanitarian catastrophe that the Ingush authorities predicted when faced by the flood of Chechen civilians arriving at the republic's border checkpoints did not happen. But the problems are still many and serious. Large numbers of refugees are now suffering from pneumonia and tuberculosis.

Exodus 

To escape their lot and the miserable conditions in the temporary and overcrowded shelters, more and more displaced people in Ingushetia are moving in with family members living in other regions of Russia. The Stavropol region, in particular, is receiving a growing number of Chechens, creating new problems. In order to assist displaced and dispersed Chechens, the Russian Red Cross and the Federation have set up a network of distribution points in the areas adjoining the conflict zone. The programme falls within the Federation's existing operation for populations returning to Russia following the collapse of the Soviet Union.

Although the worst of the fighting appears to have ended, the remaining Chechens in Ingushetia do not seem in a hurry to return. One family member returns from time to time to find out what has become of their houses, but the fear and uncertainty are still too great to risk going home permanently. Clearly, only when these fears have been overcome will the real challenge for humanitarian organizations working in the region begin.

Difficult tomorrows 

One way or another, assistance must be brought to the devastated republic. For the time being, the local staff of the Grozny office, currently based in Nazran, have begun to carry out assessment missions and to distribute medical assistance. It is a first step. The priority is to develop a medical and water and sanitation programme that takes into account the bitter experiences of the past three years. Meanwhile home visiting nurses and bakery programmes have resumed in Chechnya.

Living with the reality of the security issues, the team of ICRC expatriates working in the northern Caucausus will probably remain small and, despite their reservations and expectations, the local staff will have to continue to assume the majority of the operation. As one of them called out following an interview, "Whatever happens, we will continue. After all, it's our country, not yours."