Tuesday, October 18, 2016

Hezbollah and Healthcare in Lebanon

"Continuing Tradition: Hezbollah and Healthcare in Lebanon"
by Jessi Donnelly
File: Supporters of Lebanon’s Hezbollah leader Sayyed Hassan Nasrallah wave Hezbollah flags as they listen to him via a screen, Aug. 16, 2013. (REUTERS/Ali Hashisho)

Since October 1997, Hezbollah remains identified by the U.S. Department of State’s Bureau of Counterterrorism as a “foreign terrorist organization.”[1] In the West, that designation represents fear, intolerance, and danger. And yet, Hezbollah provides millions of dollars towards Lebanese social care each year. Though Hezbollah’s funding comes from sources such as drug cartels, nearly 50% of all spending, or $250-500 million dollars are spent yearly on social services including hospitals and healthcare.[2] There is a disparity in the two images of terror and health.
Hezbollah, according to Joseph Alagha in his book Hizbullah’s Identity Construction, has evolved “based on an ideological, social, political, and economical mixture in a special Lebanese, Arab, and Islamic context.”[3] As a deeply rooted Islamic group, though extremist and prone to acts of terror, Hezbollah’s humanitarian work for the people of Lebanon is deeply rooted in the centuries old practice of social service and zakat among Muslims as a part of the larger narrative of Islamic faith. Scholarly discourse on Hezbollah has focused more intently on this complexity overtime, allowing for a more insightful view of the organization’s activities beyond its axiom of terror.
Early scholarly discussions of Hezbollah were intent on analyzing its impact as one of the “few terrorist organizations” to have “global reach.”[4] Daniel Byman, a professor of Security Studies at Georgetown University, wrote in 2003 for Foreign Affairs, “Given the organization’s record of bloodshed and hostility, the question is not whether Hezbollah should be stopped; it is how.”[5] Hala Jaber, in The Brown Journal of World Affairs, argued that Hezbollah had become “a synonym for terror.”[6] The consensus was that the radical Islamist group was an immense threat negatively impacting the Lebanese people and would continue to do so until being wiped out by anti-terror forces. However, even just years later, upon further scholarship, the discussion about Hezbollah changed into one focused on understanding the inherent complexities of an organization focused on both militant action and social welfare.
 “Hezbollah – Lebanon’s Party of God – is many things,” Matthew Levitt explained in his book, Hezbollah: The Global Footprint of Lebanon’s Party of God.[7] Levitt highlighted these different “multiple identities” that Hezbollah assumes, arguing that the organization is “one of the dominant political parties in Lebanon, as well as a social and religious movement catering first and foremost (though not exclusively) to Lebanon’s Shi’a community.”[8] Levitt’s work focused on Hezbollah’s thirty years of history and in particular, its history of global attacks and acts of terrorism. This perspective was perhaps due to his area of expertise as a terrorist and intelligence expert employed by the government as a counterintelligence advisor.  However, his point that Hezbollah has multiple identities is compelling, despite his focus on their identity as a terrorist organization.
Hezbollah’s history, beginning in the 1980’s, is popularly and not altogether incorrectly understood as one of terrorism, as Levitt suggested. It is understanding the complexity of the group that has gained academic focus in recent scholarship. Augustus Richard Norton’s Hezbollah: A Short History emphasized the evolution of the group over time in his succinct history. Norton, an anthropologist who studied the Middle East for three decades, suggested that it is imperative to understand Hezbollah from several perspectives. Understanding should come from the individual level of popular support from Shi’i Muslims in Lebanon, and also at the transnational level where the organization can be viewed as one of political force and militant action.[9] By looking at the history of Hezbollah from these sometimes counterintuitive perspectives, Norton argued, the complex placement of the organization is made clear and becomes more than “the greatest guerilla group in the world.”[10]
 In reality, the organization also serves as a social service organization for Lebanon. As Brian R. Early argued in his article, “Larger than a Party, Yet Smaller than a State,” Hezbollah is also “Lebanon’s largest non-state provider of healthcare and social services” and shouldn’t be simply dismissed as simply a terrorist organization.[11] Early’s work emphasized the alternative identities that Levitt’s work mentioned, and discussed the importance of Hezbollah’s relationship with the Lebanese state. Further, Early contended that Hezbollah has intentionally worked to assume the identity of an “Islamic welfare state” and used millions of dollars of funds provided by Iran to ensure a “complete social welfare system within the Shi’ite communities” within Lebanon.[12] This alternate identity, one of social service, seems oppositional to that of a terrorist identity, and yet, the proof is undeniable that Hezbollah is more than simply a group of extreme terrorists.
In a somewhat drastic shift from her earlier argument, Hala Jaber’s later work, Hezbollah, highlighted the programs created by Hezbollah’s Health Committee including hospitals and schools. As Jaber noted, Lebanon lacks state welfare programs and almost all citizens lack medical insurance.[13] To meet this social need, the Health Committee “opened more than forty health centers and clinics in South Beruit, Lebanon” and other health centers throughout the country since the 1980’s.[14] Jaber’s book, written towards a general audience and based on interviews conducted with Hezbollah leadership, argued that Hezbollah is intentionally shifting to be seen as more moderate and less extremist. Joseph Alagha also argued that Hezbollah shifted ideological focus to that of a “pragmatic political focus.”[15]
In his work, The Shifts in Hizbullah’s Ideology: Religious Ideology, Political Ideology, and Political Program, Alagha posited that Hezbollah began with a radical religious identity, but over time has intentionally transformed its ideology from rigorously Islamic exclusivism to a more compromising liberal stance as it began program of “enrollment in Lebanese domestic political life.”[16] Despite or perhaps because of this shift, Alagha pointed out that Hezbollah considers an important aspect of “its religious task” to be the necessity of “providing medical care and hospitalization.”[17] The religious ideology behind Hezbollah’s updated methods of engaging in zakat (through creation of healthcare) no less complicated than their position. While the social welfare work is religiously based, it also serves as a legitimizing point that Hezbollah is more than a destructive force. Further, as Alagha pointed out, it also maintains their past legitimacy as an Islamic group while they shift their ideology from radical to increasingly liberal.[18]
As these realizations about Hezbollah’s shifting nature materialized, the discussion about Hezbollah changed. It was no longer enough to label Hezbollah as simply an organization of extreme terror. Rather, voices in the conversation began to question Hezbollah’s identity as a legitimate political organization. The conversation became even more interesting when prominent voices from within Hezbollah itself contributed monographs for consideration. In Hizbullah: The Story from Within, Naim Qassem asserted that Hezbollah should be seen as legitimate and as “primarily” an Islamic political party and further, as a “moderate” social movement in Lebanon, rather than a terrorist organization.[19] Further, he contended it must be understood “the Party’s practical path is interconnected with the principles of the faith it carries.”[20]
These statements, perhaps somewhat outlandish in light of previous scholarship, make more sense when it is made clear that Naim Qassem is a Shi’i scholar and politician from Lebanon. He is also second in command of Hezbollah as it’s acting secretary general. The importance of Qassem’s work however, rests in its international publication and wide consideration as a book offering “exceptional insight into the principles, objectives, and worldview” by academic reviewers.[21] With inside voices such as Qassem contributing to the legitimate conversation regarding Hezbollah, it was perhaps impossible to consider the discourse anything but complex. It seemed acceptable to consider Hezbollah’s non-military actions as a genuine reason to not dismiss its other identities.
One aspect of scholarly discussion focused on how Lebanon and its people responded to the increasingly complex multiple identities of Hezbollah. Kevin Simon, in “Hezbollah: Terror in Context,” found that as much as 38% of Lebanon considered Hezbollah favorably and to be a moderate political party.[22] Further, Simon argued that the specific reason Hezbollah is so popular is due to its “very successful implementation of social services.”[23] By spending upwards of 50% of its funds, gained legitimately through zakat donations or illicitly from drug trades, Hezbollah has become “indispensable” to the Lebanese people.[24] The focus was no longer on Hezbollah’s identity as a terrorist organization, but rather as its identity as a provider of healthcare, social programs, and welfare as a complex, political organization.
Shawn Flannigan and Mounah Abdel-Samad continued this focus in their article, “Hezbollah’s Social Jihad: Nonprofits as Resistance Organizations.” Flannigan and Abdel-Samad also claimed that Hezbollah’s popularity within Lebanon stemmed directly from its social services and health support. Further, they argued that the motivating factor of these provided services was based on “social jihad” that was “integral to Hezbollah’s struggle against Israel and the West” which had been one of the organization’s founding ideologies.[25] Further, like the earlier sentiments of Alagha and Haber, Flannigan and Abdel-Samad agreed that Hezbollah intentionally used their healthcare and social programs to increase their political legitimacy. They suggested, “Hezbollah’s health and social services primarily benefit Lebanon’s Shi’ite population and are typically not advertised to the Lebanese population at large except following an Israeli attack.”[26] While the zakat is fundamental to Hezbollah, its successful politicizing of welfare programs indicates a highly complex nature, previously unearthed by scholarly analysis.
Hezbollah and its connection to healthcare in Lebanon had morphed into its own topic of discourse in the academic world. James B. Love, in his work, “Hezbollah: A Charitable Revolution,” argued that the social service and healthcare programs of Hezbollah are a driving force behind its success.[27] According to Love, in accordance with both Haber and Alagha, this was a strategic move by the organization to meet both its religious and political ideological needs. Love stated, “Hezbollah established a solid popular support base by leveraging the needs and injustices of the Lebanese Shi’a.”[28]
In addition, and most importantly to the academic discourse concerning Hezbollah, Love connected this strategic move to the Islamic institution of zakat, noting that it is both a means of legitimizing the organization and as a possible means of funding.[29] In addition to adhering to the third pillar of Islam, Hezbollah has created social welfare programs to receive additional funding from Muslims. This funding can then be funneled back into healthcare or perhaps into other activities. Love concluded his work with a warning that the danger of Hezbollah is that its “model” could be perpetuated by further jihadi movements and “unique, proven, and exportable.”[30] Hezbollah’s legacy as a terrorist organization may very well take on new meaning for future discourse if Love’s premonition is correct.
The history of Hezbollah is indeed one of terrorist acts and militant Islam. Its ideological basis as a religious organization however, evolved into multiple identities, as Levitt suggested. However, the initial analysis that Hezbollah was nothing more than a radically dangerous Islamic organization focused on terror dismissed its complexity. Scholarly discourse, which had at first simply focused on the threat of Hezbollah as organization with a global reach as the “A-team of terror” left much of the organization’s outreach unanalyzed. Yet, relatively quickly, the academic world shifted its discussion from security and Hezbollah as terror to one of prominent social service. The dichotomy of terror and health was one worth exploring and the complexity of the situation was, and continues to be, one of legitimate scholarship.
The importance of understanding Hezbollah’s multiple identities cannot be understated. It will never fully be free of its terrorist mantle and more importantly, that history should not be forgotten. Yet, Hezbollah is also the force that provides healthcare to 500,000 Lebanese.[31] The intention behind that healthcare provision is both religious, as a means to engage in zakat, the third pillar of Islam, and also political as a means to “increase its popularity and prove its competence while simultaneously highlighting the ineffectiveness of the Lebanese government.”[32] It is both charitable and intentionally political. By understanding the complexity of Hezbollah and its social, political, and military identities within Lebanon and worldwide, scholars will further provide further illumination into the popularity of these organizations. Particularly in the West, it is imperative to understand the motivations and intertwined religiously political nature of “state-less governments” such as Hezbollah. 

Alagha, Joseph. Hizbullah’s Identity Construction. Amsterdam: Amsterdam University Press, 2011.
Alagha, Joseph. The Shifts in Hizbullah's Ideology: Religious Ideology, Political Ideology, and Political Program. Amsterdam: Amsterdam University Press, 2006.
Byman, Daniel. "Should Hezbollah Be Next?" Foreign Affairs 82, no. 6 (2003): 54-66.
Early, Brian R. “’Larger than a Party, yet Smaller than a State’: Locating Hezbollah’s Place Within Lebanon’s State and Society,” World Affairs 168, no. 3 (2006): 115.
Flanigan, Shawn T. and Mounah Abdel-Samad, “Hezbollah’s Social Jihad.” Middle East Policy 16, no. 2 (2009): 112-137.
Jaber, Hala. Hezbollah: Born with a Vengance. New York: Columbia University Press, 1997.
Jaber, Hala. "Consequences of Imperialism: Hezbollah and the West." The Brown Journal of World Affairs 6, no. 1 (1999): 163-76.
Levitt, Matthew. Hezbollah: The Global Footprint of Lebanon’s Party of God. New York: I.B. Tauris, 2006.
Love, James B. Hezbollah: A Charitable Revolution. Army Command and General Staff Coll Fort Leavenworth KS School of Advanced Military Studies, 2008. http://www.soc.mil/Swcs/SWEG/AY_2008/Love,%20J%202008.pdf
Norton, Augustus Richard. Hezbollah: A Short History. Princeton: Princeton University Press, 2007.
Salwen, Sarah. Journal of Church and State 48, no. 4 (2006): 884-85. http://www.jstor.org.libpublic3.library.isu.edu/stable/23921491.
Simon, Kevin, "Hezbollah: Terror in Context." 2012 AHS Capstone Projects. Paper 18. 2012.
U.S. State Department. “Foreign Terrorist Organizations.” Bureau of Counterterrorism. 2016. http://www.state.gov/j/ct/rls/other/des/123085.htm

[1] U.S. State Department, “Foreign Terrorist Organizations,” Bureau of Counterterrorism, 2016. http://www.state.gov/j/ct/rls/other/des/123085.htm
[2] Kevin Simon, "Hezbollah: Terror in Context,” 2012 AHS Capstone Projects, Paper 18, 2012,
[3]  Joseph Alagha, Hizbullah’s Identity Construction (Amsterdam: Amsterdam University Press, 2011), 19.
[4] Daniel Byman, "Should Hezbollah Be Next?" Foreign Affairs 82, no. 6 (2003): 54.
[5] Byman, 55.
[6] Hala Jaber, "Consequences of Imperialism: Hezbollah and the West," The Brown Journal of World Affairs 6, no. 1 (1999): 163-76.
[7] Matthew Levitt, Hezbollah: The Global Footprint of Lebanon’s Party of God (New York: I.B. Tauris, 2006), 8.
[8] Levitt, 8.
[9] Augustus R. Norton, Hezbollah: A Short History (Princeton: Princeton University Press, 2007), 4-6.
[10] Norton, 140.
[11] Brian R. Early, “’Larger than a Party, yet Smaller than a State’: Locating Hezbollah’s Place Within Lebanon’s State and Society,” World Affairs 168, no. 3 (2006): 115.
[12] Early, 120.
[13] Hala Jaber, Hezbollah (New York: Columbia University Press, 1997), 158.
[14] Jaber, 158-162.
[15] Joseph Alagha, The Shifts in Hizbullah’s Ideology: Religious Ideology, Political Ideology, and Political Program, (Amsterdam: Amsterdam University Press, 2006), 13.
[16] Alagha, 15.
[17] Alagha, 241.
[18] Ibid.
[19] Naim Qassem, Hizbollah: The Story from Within, trans. Dalia Khahil (London: Saqi Press, 2010).
[20] Qassem, 6.
[21] Sarah Salwen, Journal of Church and State 48, no. 4 (2006): 884. http://www.jstor.org.libpublic3.library.isu.edu/stable/23921491.
[22] Kevin, Simon. "Hezbollah: Terror in Context," 2012 AHS Capstone Projects, Paper 18, 2012, 3.
[23] Simon, 6.
[24] Simon, 7.
[25] Shawn T. Flanigan and Mounah Abdel-Samad, “Hezbollah’s Social Jihad,” Middle East Policy 16, no. 2 (2009): 112-13.
[26] Flanigan and Abdel Samad, 114.
[27] James B. Love, Hezbollah: A Charitable Revolution (Fort Leavenworth, KS: School of Advanced Military Studies
United States Army Command and General Staff College, 2008), 3.
[28] Love, iii.
[29] Love, 95.
[30] Love, iii.
[31] Simon, 4.
[32] Flanigan and Abdel Samad, 114.