First Do Ho Harm

Book by David Gibbs, Vanderbilt University Press, 2009, 327 pp.

David Gibbs has written a book that overthrows the fading shibboleths of the Yugoslavian conflict. He states that the U.S. was actively involved at the start of the conflict. Rather than being reluctant to intervene, the U.S. encouraged or supported ethnic groups to secede even before the war broke out in April 1992. This approach was consistent across the Bush I and Clinton administrations.

As reported by the press, both Administrations at first appeared reluctant to intervene. However, by going into primary sources not examined carefully before, the author reveals the behind-the-scenes involvement of the U.S. in both diplomatic efforts as well as the internal politics of Yugoslavia. He finds that the U.S. acted to maintain its hegemony as the sole superpower following the then-recent end of the Cold War. The U.S. acted not from disinterested motives, but out of political and economic self-interest.

How well does he substantiate this? First, he relies on published sources of very sound quality. Almost every sentence is footnoted: it is details, details, details. Second, he provides the background for what drove Yugoslavia apart as well as the foreign policies of the U.S. and Europe, commonly perceived as an American ally, but posing a threat to the U.S. position as undisputed world leader.

As is commonly known, Tito held Yugoslavia together following WWII. Although under the Soviet sphere, he managed to steer the country in an independent socialist direction. Less commonly understood, Gibbs shows from GDP data that the country prospered until the economic crisis precipitated by the oil price shock of 1973-74. This economic crisis exacerbated the political and ethnic tensions that had been dormant since WWII. Gibbs adds to this the role of the IMF (International Monetary Fund) whose policy of macroeconomic "adjustment" imposed harsh conditions on the economy in order to repay loans. The stage was set for the break-up of the country.

Gibbs argues that following the break-up of the Soviet Union, just prior to the conflict in Yugoslavia, the U.S. developed its position to be the sole leader on the world stage, interceding around the world as it saw fit. In Yugoslavia, the U.S. did not have strong military or economic links. But the U.S. did have an interest, as the author explains, in putting its stamp on the outcome. In almost all of the different parts of the war—from the Serbo-Croatian split to Kosovo—the U.S. ended up scuttling what Europe had negotiated, so that it could impose its own resolution, even if it resembled what Europe had negotiated.

Gibbs explains in fascinating detail the different parts of the conflict, the leaders of the ethnic groups, and the roles of the U.S. and Europe in supporting one side over another and in their often-opposed approaches to resolving the war. Although all is well laid out and explained clearly, the book would have benefited from a better map of Yugoslavia that shows the various secessions across the country. Perhaps in the second edition this omission will be remedied.

The question underlying the book is whether "humane intervention" should be undertaken, since, as the author explains, military intervention in the internal affairs of another nation is against international law, UN covenants, and so on. In assessing the interventions in Yugoslavia, it is critical to understand that the U.S. and Europe were acting from self-interest.

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Albert Woodward has been the director of Science and Research Services at American College of Cardiology. During 1993-1994 he served on the President's Task Force on Health Care Reform. He has published on access to health care, health insurance, and cardiovascular outcomes research.