Authors: Adam Fifield
Not surprisingly, some figures changed.
So, based on the latest information, did UNICEF and its partners really achieve 80 percent child immunization in 1990?
No, but they came very close.
Globally, they reached 76 percent coverage for the third dose of DPT, 76 percent for polio, 73 percent for measles, and 81 percent for tuberculosis—so, overall, about 76.5 percent. That’s up from between 16 and 21 percent in 1980. Among developing
countries and countries “in transition,” according to a recent WHO analysis, the rates were very similar: 74 percent for DPT, 74 percent for polio, 72 percent for measles, and 82 percent for tuberculosis.
The total result is still astounding, a near quadrupling of immunization coverage for children under age one in the span of ten years. And it happened despite a major global recession, despite a surging population, despite plunging incomes, despite wars, despite widespread cuts in health services.
The impact was simply colossal. The number of measles cases plummeted from 4,211,431 in 1980 to 1,374,083 in 1990 (even though the number of new births went up by fifteen million during the same period). Pertussis cases fell from nearly 2,000,000 to 476,374. The incidence of diphtheria was cut by two-thirds and polio by half (polio cases would ultimately drop by 99 percent). These ancient, fatal diseases had stalked children for thousands of years, routinely and relentlessly laying claim to the weakest and most vulnerable. The antidisease campaigns of the 1950s and 1960s had temporarily held off some of these pervasive scourges, but now, across the globe, they were being beaten back with overwhelming force.
The revised immunization numbers also show stunning progress during that period in individual countries, many of which—even if they didn’t hit 80 percent—made huge, historic leaps. Bangladesh, once widely considered a development “basket case,” did not provide any of the four vaccines in 1980. By 1988, coverage rates had not climbed very much, hovering between 13 and 26 percent. But by 1990, in the space of just two years, they
all shot up to 65 percent or above; the tuberculosis immunization rate hit 86 percent. Bangladesh did not make 80 percent in total, but it does not seem to have fudged any numbers either.
And how did India fare in the new calculation?
India also pulled off a remarkable feat, pushing its estimated DPT3 coverage from 6 percent to 70 percent, its best-performing category. Tuberculosis and polio coverage both topped out at 66 percent, and measles made it to 56 percent. In each category, though, a glaring gap of 20 to 30 percentage points yawned between the old estimates and the new ones.
Grant can’t be held accountable for the overall changing quality of data, of course. But what if he knew that some statistical corners were cut—and effectively let it happen? Nyi Nyi insists that he and Grant did not allow any tweaking of numbers, not on the part of UNICEF staff anyway (he notes that a few countries may have boosted their figures but that this was often out of UNICEF’s control). The former UCI taskmaster says that the figures available at the time showed that the goal was indeed reached. “We would never cheat,” he says. “We would never even dream of it just to say we have achieved it.”
Several UNICEF staffers say they believe some finagling of data occurred, whether it was committed by the countries themselves, UNICEF staff, or both. Most people don’t think it was widespread.
“There are two ways of looking at this,” offers LaForce. “One way is to really shake your finger and say, ‘tut, tut, tut’ … I think Jim was way beyond that. Jim recognized the importance of that 80 percent in terms of opening up a whole new set of doors.”
He adds that the indomitable UNICEF chief “has always been one of my heroes” and calls the immunization gains that were actually realized—even if they fell short of 80 percent—“absolutely astonishing … one hell of an achievement.”
Whether or not the goal was met in full, it was important for Grant to be able to say he had made it. It was important for fund-raising. It was important for kindling political will. It was important for maintaining the morale of the millions of people around the world who had answered his call to put children first. By saying he had made it, he would save more lives, it was as simple as that. It was a moral and strategic consideration. The inveterate marketer in him knew he couldn’t say,
We almost did it. We were this close!
It had to be:
We did it!
“That sounds like a rocket-propelled grenade.”
On the outskirts of Sarajevo, sitting in the cramped confines of an armored personnel carrier, they listened as a firefight seethed around them. Jim Grant, Jon Rohde, Alan Court, and a few others were part of a UNICEF delegation visiting the former Yugoslavia as it fell into bitter, internecine violence. A French crew was manning the carrier, which was part of a larger convoy. Earlier, they had been able to pop their heads out of metal hatches and look around, but then the shooting began. Now the hatches were closed, and as the bulky vehicle lumbered along, the group couldn’t see anything. They could hear bullets pinging off the sides of the carrier. Then came a sudden, screeching
whoosh!
Grant was the one who identified the grenade’s nerve-jangling sound, as though naming the song of some rare bird.
“Very good, sir!” said a French crew member. “You recognize it.”
Court was impressed and puzzled. He leaned toward Grant. “How did you recognize it?” he asked.
“You forget,” Grant replied, perhaps smiling and raising his eyebrows, “I used to be in the infantry in the Second World War. I recognize those sounds.”
He then added that it looked like their current situation “could get a bit hairy.”
The violence had erupted after four of Yugoslavia’s six republics—Croatia, Slovenia, Macedonia, and Bosnia and Herzegovina—declared independence in 1991 and 1992. There were three main sides to the conflict: the Bosniaks, who were Muslims; the Croats, who were Catholics; and the Serbs, who were Orthodox Christians. In the Bosnian republic, a proudly multicultural society, all three groups had, until recently, lived in relative harmony for the past several decades. But Serbian nationalists, urged on by the vitriol of leaders Slobodan Milošević and Radovan Karadžić, wanted to prevent the breakup of the Serb-dominated Yugoslav federation and to create a “Greater Serbia.” Fighting broke out in Slovenia and Croatia in 1991 and spread into Bosnia in 1992. Much better armed than any of the other factions and backed by the Yugoslav army, Serbs began taking over much of Bosnia, leaving a blood-soaked path in their wake. As the violence escalated—the worst in Europe since World War II—acts of revolting, confounding brutality were committed by all sides. Women and girls were systematically raped, families were herded into concentration camps, and children were mutilated and murdered in front of their helpless parents. Everyone suffered immeasurably, but it
was the Bosnian Muslims who bore the unforgiving brunt of the mounting atrocities, as Serbian forces began a calculated campaign to expel and exterminate them. The Serbian leaders were bent on genocide, or, as it was euphemistically called, “ethnic cleansing.”
The city of Sarajevo, a sweeping, pretty patchwork of red terra-cotta roofs, pointed minarets, and blocky modern buildings, lies in a basin ringed by the Dinaric Alps. The looming, knuckled mountains—once known for their beauty—became suddenly synonymous with doom. It was in those mountains that Serbian snipers took up their positions. During the medieval-like, nearly four-year siege of Sarajevo, which began in April 1992, the snipers deliberately targeted noncombatants, picking off children and women, killing people as they crossed the street or sat in their living rooms. Nowhere was safe. Death rained down not only in the form of bullets, but also mortar bombs, which were sent screaming into hospitals, schools, libraries, crowded squares. Many families holed up in their basements. The Serbs even shelled funerals held for their previous victims.
This purposeful slaughter was, shamefully, allowed to happen. No one did anything to stop it. When Grant and his convoy arrived in September 1992, the UN was already drawing criticism for not halting the sniper and mortar attacks. UN airlifts were bringing critical relief into the city and other areas, and many aid workers were heroically distributing it. The blue-helmeted UN peacekeepers protected aid convoys but did little else. The crux of it wasn’t their fault—peacekeepers act at the
behest of the UN Security Council, and the Security Council had set a very limited mandate and low troop levels for Bosnia. The troops were ordered not to take sides. UN peacekeepers were regularly fired on with apparent impunity, and by 1995, 167 of them would be killed. The residue of failure that clung to the peacekeeping operation would only grow thicker and would, many people believe, help pave the way for the shocking Srebrenica massacre in July 1995. Led by the “Butcher of Bosnia”—the deranged and sadistic military commander Ratko Mladić—Serbian forces would easily overrun a meager Dutch UN peacekeeping force in this so-called UN safe haven and proceed to methodically torture, kill, and maim more than eight thousand Muslim men and boys. The unadulterated horror of Srebrenica was an embarrassing low point for the UN: the world body’s first of four principal aims forged in the ashes of World War II—to “save succeeding generations from the scourge of war”—suddenly seemed hollow and meaningless. It wasn’t that they had tried and failed. They never really tried in the first place—they had been ordered not to. NATO air strikes would finally end the slaughter.
Even as early as the fall of 1992, the circumstances in Bosnia were numbingly grim. What could Jim Grant do? He had no say over peacekeeping or the anemic international response to the atrocities. But maybe—if only for a short time—he could get critical aid to more Bosnian children. In a vacuum of international apathy, maybe he could temporarily halt the bloodshed.
He wanted to reprise his Days of Tranquillity—the idea that had worked so well in El Salvador and Sudan (and had also been successfully applied, in different ways, in Lebanon, Uganda, Afghanistan, and Iraq). In 1991, UNICEF had even managed to arrange a water-based zone of tranquillity to facilitate the delivery of aid by boat to the nearby Croatian coastal town of Dubrovnik, then under heavy bombardment (the “siege of Dubrovnik” ended in May 1992; the Serbs would save most of their fury for Sarajevo).
Why shouldn’t Grant give tranquillity a try throughout the disintegrating Yugoslavia? If he could get Omar al-Bashir—a pitiless megalomaniac—to agree to put down guns in Sudan, why couldn’t he persuade the murderous Serbian president Slobodan Milošević to do the same in Sarajevo?
Many attempted ceasefires had failed in Bosnia. Grant thought his would be different, because it would be about children. As in other conflicts, children would foster a common cause. Children would be a “zone of peace.” But there are some people in the world so heartless and so devoid of conscience that not even saving the lives of innocents will sway them. As a rash of post–Cold War conflicts in Somalia, the Persian Gulf, and other places hampered new hopes for peace, Bosnia would test Grant as never before.
The task was made all the more urgent by the creep of winter in a place where many had no heat or electricity. Grant’s goal, as he described it to staff and reporters alike, was to “winterize” children through the battle-rent region.
His convoy made it through the firefight without incident and took the delegation to the fortresslike post office in
downtown Sarajevo. It was here, in the center of this battered, blackened, smoking city, that they would stay.
As they were leaving the office of Bosnian president Alija Izetbegović, after quickly securing his cooperation for a ceasefire, Alan Court noticed sharpshooters perched on the roof of the presidential palace. They were firing into the mountains.
He pointed them out to Grant. “You see these shooters shooting out?” Court said. “And no firing coming in?”
Grant looked up. “What are they doing?”
“They’re trying to attract artillery fire to impress you,” Court said. “They do that for visitors.”
Grant was flabbergasted. The returning artillery fire could kill people. He had been “very sympathetic” with the plight of the Bosnian Muslims, says Court, and believed unreservedly that they were “the good guys.” He was disappointed to see Muslim soldiers firing their guns unprovoked—even worse, doing so for his benefit. The Bosnian Muslim cause was indeed a just one—they had every right to defend themselves from the threat of annihilation. These shooters seemed to make a mockery of that right, though all the factions were guilty of such behavior. “He was horrified when he saw that everybody was playing these games,” Court recalls.
Grant had sent Court to the former Yugoslavia in August to figure out what UNICEF could do to help children there. Before Grant’s trip in September, Court got a call from Mary Cahill. She told him that Jim, now seventy years old, was not feeling well. “Get
him to take it easy,” Cahill suggested. “You’ve got to be kidding!” Court replied with a chuckle, then added: “I’ll do what I can.”
The resourceful, gangly Briton had traveled throughout the region before Grant’s visit. He told his boss he had found that most ordinary citizens—whether Muslims, Serbs, or Croats—were good; it was the leaders who were bad. He also knew from firsthand experience that the snipers were not exclusively Serbian. During one visit to a Serbian-held part of Sarajevo, he was standing on a dirt sidewalk near his unmarked car when—
Boof!
—the ground a few inches from his right foot exploded in a fist of dust. He froze. A sniper from somewhere had just tried to kill him.
“I was transfixed,” he recalls. His driver, a Croat, bolted out of the car, grabbed Court, and stuffed him headfirst through the front passenger window (no easy task—Court is well over six feet tall). His body scraped the window frame. It hurt. But he wasn’t about to complain. The driver then ran back around, jumped in, started the car, and floored the gas pedal. As the Volkswagen Golf sped away and Court tried to adjust himself in the seat, the driver explained: “Armor-piercing … every five round for standard Yugoslav Kalashnikov … armor-piercing.”