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Understanding medical civil-military relationships within the humanitarian-development-peace ‘triple nexus’: a typology to enable effective discourse

Research output: Contribution to journalArticle

Simon Horne, Samuel T. Boland

Original languageEnglish
JournalJournal of the Royal Army Medical Corps
Publication statusAccepted/In press - 1 Dec 2019


King's Authors


The interface between humanitarianism, development and peacebuilding is becoming increasingly congested. Western government foreign policies have shifted towards a pro-active stabilisation agenda and Civil-Military Relationships (CMRel) will inevitably occur with increasing frequency as a result. Current debate is hampered by lack of a common language or clear and mutually understood operational contexts to define such relationships. Certainly, it may be easier for example to simply assume that the purpose of military attempts at co-operation is to ‘win hearts and minds’, rather than attempt to navigate the morass of acronyms for different types of engagement. In the healthcare arena such relationships are likely to be even common and more complex - in part as health is seen as both an easy entry point for diplomacy and so is a priority for militaries, and because health is so critical to apolitical humanitarian responses.

This paper identifies the characteristics of commonly described kinds of CMRel, and then derives a typology that describe them in functional groups as they apply to healthcare-related contexts (although it is likely to be far more widely applicable). Three broad classifications are described, and then mapped against 6 axes; the underlying military and civilian motivations, the level of the engagement (strategic to tactical), the relative stability of the geographical area, and finally the alignment between the civilian and military interests. This allows a visual representation that shows where different types may co-exist, and where they are likely to be more problematic. The model predicts two key areas where friction is likely; tactical interactions in highly unstable areas and in lower threat areas where independent military activity may undermine ongoing civilian programmes. The former is well described in the literature, and so supports the typology. The latter is poorly described, and so represents an ideal future study to validate it

In short, we describe an in-depth typology mapping the Civil-Military space in humanitarian and development contexts with a focus on healthcare, with a view to defining operational spaces and the identification of areas of synergy and friction.

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