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A Holocaust survivor tells her story | DW Documentary

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A Holocaust survivor tells her story | DW Documentary

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[DW Documentary]. (2018, January 29). A Holocaust survivor tells her story | DW Documentary [Video]. YouTube. Retrieved October 3, 2022, from https://www.youtube.com/watch?v=ciBQFItYc7E&feature=youtu.be

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A Holocaust survivor tells her story | DW Documentary

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Life after Genocide: Mental Health, Education, and Social Support of Orphaned Survivors

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Life after Genocide: Mental Health, Education, and Social Support of Orphaned Survivors

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Ng, L. C., Ahishakiye, N., Miller, D. E., & Meyerowitz, B. E. (2015, April). Life After Genocide: Mental Health, Education, and Social Support of                    Orphaned Survivors. International Perspectives in Psychology, 4(2), 83–97. https://doi.org/10.1037/ipp0000031

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Int Perspect Psychol. Author manuscript; available in PMC 2016 Apr 4.

Published in final edited form as:

doi: 10.1037/ipp0000031

Abstract

Thousands of orphaned survivors of the 1994 Rwandan Genocide against the Tutsi were not only exposed to extraordinarily severe forms of violence, but also many of these children took on the responsibility of caring and providing for other child survivors. This study describes the poverty, educational attainment, social support and mental health of orphaned heads of household (OHH) fourteen years after the genocide, and analyzes how violence exposure during the genocide and post-genocide stressors contributed to symptoms of posttraumatic stress disorder (PTSD) and distress. Participants were 61 members of an OHH community organization who were interviewed in 2002 about their genocide experiences and who provided a follow-up assessment of post-genocide risk factors and PTSD and distress symptoms in 2008. Almost all of the OHH in this study reported low social support, high levels of poverty, and high rates of PTSD and distress symptoms. Lower educational attainment predicted PTSD symptoms and partially mediated the association between exposure to genocide violence and PTSD. Distress was predicted by lack of social support and witnessing family members harmed during the genocide. Results suggest that public health and community efforts to improve educational outcomes and to strengthen and expand social support networks may improve mental health outcomes of OHH.

Keywords: Post-genocide stressors, Rwanda, PTSD, distress, orphans

Armed conflicts have devastated entire societies and left millions of children disabled, homeless, orphaned or separated from their parents ( The United Nations Children's Fund, 1996). One such group is child survivors of the 1994 Rwandan Genocide against the Tutsi. During the Rwandan Genocide, hundreds of thousands of people were brutally murdered ( Republic of Rwanda, 2014). Survivors of the genocide were exposed to extreme levels of physical and psychological violence including rape, torture, mutilation, and witnessing their family members and loved ones being attacked and murdered. Studies have reported that 94% of people in Rwanda during the genocide experienced at least one genocide event including witnessing the murder of family members, having their property and homes destroyed, and having their lives threatened ( Pham, Weinstein, & Longman, 2004). Virtually every child survivor witnessed violence and believed they would die during the genocide ( Dyregrov, Gupta, Gjestad, & Mukanoheli, 2000). Many children lost most, if not all, of their family members, and took on the responsibility of caring and providing for other child survivors ( Schaal & Elbert, 2006). Indeed, in 2001, seven years after the genocide, it was estimated that 37% of households in Rwanda were headed by children, a higher rate than any country in Sub-Saharan Africa, and possibly the world ( The United Nations Children's Fund, 2003).

Given these experiences, it is not surprising that psychological distress is highly prevalent in survivors of the Rwandan Genocide. Estimates of probable posttraumatic stress disorder (PTSD) diagnoses in orphaned survivors in Rwanda range from 29% to 79% ( Dyregrov et al., 2000; Neugebauer et al., 2009; Schaal, Dusingizemungu, Jacob, & Elbert, 2011), with those who were between the ages of 11 and 20 during the genocide being at the highest risk for PTSD ( Munyandamutsa, Nkubamugisha, Gex-Fabry, & Eytan, 2012). In addition to PTSD symptoms, a substantial proportion of survivors of the Rwandan Genocide have been found to have distress symptoms, including depression and anxiety ( Cohen et al., 2009; Munyandamutsa et al., 2012). Almost half of youth heads of household have been reported to meet the clinical cut-off for depression ( Boris et al., 2008).

The range in mental health symptoms reported by orphaned survivors likely can be explained in part by the number and nature of experienced genocide events, with witnessing the attack of a parent being the Rwandan Genocide experience that has been found to be most strongly predictive of PTSD symptoms ( Neugebauer et al., 2009; Schaal et al., 2011; Schaal, Weierstall, Dusingizemungu, & Elbert, 2012). However, mental health problems in survivors have not been wholly explained by genocide exposure.

In addition to direct effects, survivors of war may experience indirect effects of exposure to violence on PTSD and depression because violent conflict may disrupt the lives and social support networks that individuals need to survive and cope with stress. Daily stressors, such as poverty and limited access to education and social support, may partially mediate the relation of violence exposure to mental health. War may result in a host of daily stressors, which in turn negatively impact mental health ( Fernando, Miller, & Berger, 2010; Miller & Rasmussen, 2010). War can destroy people's homes, livelihoods, families, and communities, as well as a society's economy and infrastructure, thereby increasing poverty and isolating people from social services such as clean water, medical care, and education. The social ecological model of child development proposes that disruptions in these aspects of the environment put children at higher risk for poor mental health outcomes including PTSD and depression ( Bronfenbrenner, 1979). Thus, living through a genocide may not only result in increased risk for poor mental health directly, but may also result in secondary adversities that may mediate the association between genocide events and psychological difficulties ( Bolton, 2001b; Saltzman, Layne, Steinberg, Arslanagic, & Pynoos, 2003).

These secondary adversities and daily stressors may be particularly challenging for children orphaned by the genocide. In convenience samples, researchers have found that many orphans in post-genocide Rwanda felt overwhelmed by daily tasks and the hard labor required to meet their basic needs, and regularly went without food ( Boris et al., 2008; Schaal & Elbert, 2006). These studies also found higher rates of PTSD in children living in orphan-headed households than those living in orphanages ( Schaal & Elbert, 2006). The researchers posited that the reason for this difference was because those living in the orphanages tended to have better psychosocial environments such as better access to food, shelter, education, and medical services, and less responsibilities and stress than those living in orphan-headed homes ( Schaal & Elbert, 2006).

A major secondary adversity in Rwanda, where almost every family lost members during the genocide, may be the decimation of social support networks. The disintegration of social bonds has been hypothesized to be an important factor in hindering psychological adjustment ( Scholte et al., 2011). Orphans in Rwanda have been found to have a severe lack of social support, most notably support from an adult ( Thurman et al., 2006). This was especially true for orphaned heads of household (OHH), who reported that unlike their younger siblings or housemates, they had no one to turn to for advice or assistance ( Ward & Eyber, 2009). Other studies have found that OHH experience a great deal of social isolation and lack of trust ( Boris et al., 2008).

Finally, researchers have found that orphans in Rwanda had worse educational outcomes than their non-orphaned peers, independent of the genocide experience ( Akresh & De Walque, 2008). Moreover, children who were in Rwanda at the time of the genocide had worse educational outcomes than those who were not ( Akresh & De Walque, 2008). Thus, in attempting to access education, orphaned survivors of the genocide shoulder a double burden of experiencing the genocide and being orphans. Lack of access to education that can result from genocide and orphanhood may be a proximal cause of increased psychological difficulties.

While mental health outcomes, specifically traumatic stress and distress symptoms, often co-occur, they may be differentially predicted by genocide exposure and post-genocide risk factors, such as daily stressors. Research on war affected populations has found that genocide exposure primarily predicts PTSD, while daily stressors have been found to predict only depression ( Cohen et al., 2009), or both depression and PTSD ( Heptinstall, Sethna, & Taylor, 2004; Schweitzer, Melville, Steel, & Lacherez, 2006). Understanding more about the ways that potentially modifiable post-genocide risk factors differentially predict PTSD and distress may offer insight into appropriate avenues for intervention for one or both of these conditions.

This study describes the poverty, educational attainment, social support and mental health of OHH, and analyzes how violence exposure during the genocide and post-genocide risk factors contribute to mental health outcomes 14 years after the Rwandan Genocide. It was hypothesized that violence exposure during the genocide and witnessing family members being attacked would positively predict PTSD and distress symptoms. In addition, the study hypothesized that after accounting for these genocide experiences, poverty would further exacerbate these symptoms, while social support and educational attainment would mitigate them. Post-genocide risk factors that were found to predict PTSD or distress after accounting for genocide experiences were tested to determine whether they partially mediated the association between genocide experiences and PTSD symptoms.

Method

Participants

Participants in this study were 61 OHH members of a Rwandan association of orphaned heads of household who participated in both time points of a longitudinal study conducted in 2002 and 2008 ( Ng, Ahishakiye, Miller, & Meyerowitz, In Press). The association is a local nongovernmental organization that advocates for services for members including housing and educational assistance. All of the participants were double-orphans, meaning that both of their parents had died. The mean age of the 61 participants who completed the follow-up assessment was 13.81 (SD=5.31) at the time of the genocide and 34 (55.74%) were men.

Procedure

In 2002, approximately 8 years after the Rwandan Genocide, with training and support from two of the authors, the association collected demographic information and genocide testimonies of 100 association members. The semi-structured interview protocol was designed and approved by the association board and a non-profit umbrella organization of local Rwandan Genocide survivor associations. Interviewers were also association members. Participants were selected by the association board to represent OHH from a wide range of geographical areas and to have roughly equal numbers of males and females. Participants were approached and asked if they wanted to give testimony of their genocide experiences. Interviews were conducted in Kinyarwanda in participants' homes, in village locations that were selected by the participants, or in the association headquarters in Kigali City. Audiorecordings were translated and transcribed into English by a native Kinyarwanda speaker. Three of the genocide testimonies could not be located and so data on genocide experiences were only available for 97 participants.

In 2008, a follow-up study was conducted to collect data on mental health problems and risk factors from 99 of the original 100 participants (one of the 2002 participants asked to remain anonymous and was therefore not included in the follow-up). All study methods were approved by the association board and the University of Southern California Institutional Review Board. Interviewers sought out participants at their last known village or address. If the original participants could not be located, interviewers asked neighbors or friends for information about their possible whereabouts, and attempted to locate them. Once located, the purpose and procedures of the follow-up study were explained and participants gave informed consent. Sixty-three of the original participants were located and 61 agreed to participate in the follow-up. Of the remaining 36 people who could not be located for the follow-up, information was available about the presumed whereabouts of 12: one had joined the military, two were away at jobs and school in other countries, seven had relocated and could not be found, and two were under psychiatric care. Results of attrition analyses using logistic regression to predict follow-up completion found no significant differences in the completers and non-completers (see Table 1 ).

Table 1

2002 Variable

Total

Completed Follow-Up

Lost to Follow-Up

OR (SE)

p

N

Estimate

N

Estimate

N

Estimate

For the 2008 follow-up study, interview questions and measures were developed by some of the authors in collaboration with the association board and were selected from existing validated measures. To assist with measuring constructs in culturally appropriate ways, five focus groups that ranged in size from six to 12 OHH were convened from each area of the country to gather information about their day-to-day lives, experiences, and mental health concerns, and to evaluate the face validity of standard measures and assess their cultural appropriateness. After revisions and approval by the association board, measures and interview protocols were forward- and back-translated between English and Kinyarwanda by native Kinyarwanda speakers to ensure accuracy. Six association members were selected as interviewers by the association board, and participated in a week-long training on semi-structured interviewing conducted by some of the authors and the association project director. Interviews, which were conducted in Kinyarwanda, were audio recorded and translated into English by native Kinyarwanda speakers.

English transcripts of the 2002 and 2008 interviews were coded using content analysis ( Neuendorf, 2002) by four blinded research assistants to obtain quantitative measurements of genocide events and post-genocide risk factors. In order to code the transcripts efficiently, sequential overlapping coding, also known as a "not fully crossed" coding design, was used ( Hallgren, 2012; Neuendorf, 2002). Therefore, every interview was randomly assigned to two coders, with six possible combinations of coders. In cases where discrepancies or missing information remained even after coders independently checked their own coding, items were reviewed and final decisions were made based on a close reading of the interview. Interrater reliability for each pair of coders was calculated using two-way mixed average-measures Intraclass Correlation Coefficients (ICCs). ICC consistency was calculated as absolute agreement for binary items and as consistency for ordinal items. The mean ICC, weighted by the number of transcripts coded by each pair, and range of ICC scores are reported below in the measures section.

Measures

Demographics

Participants' Gender and Age were obtained from the 2002 interviews.

PTSD Symptoms

PTSD Symptoms were assessed in 2008 using an adapted version of the Impact of Events Scale-Revised (IES-R) ( Weiss & Marmar, 1997). The IES-R is a twenty-two item self-report questionnaire that measures PTSD symptoms, scored 0="Not at all" to 4="Extremely." Although the IES-R was not developed for use in Rwanda, it has been used in post-genocide Rwandan samples ( Dyregrov et al., 2000). The scale score was calculated as the mean of the items. There was disagreement about the translation of item 17 (I tried to remove it from my memory) and so this item was dropped from the scale, resulting in a 21-item scale with excellent internal reliability (Cronbach's alpha=.91).

Distress Symptoms

Distress Symptoms were measured in 2008 using a locally-derived Symptom Checklist that was developed for this study using responses from focus groups of OHH to measure different forms of psychological distress in Rwandan OHH, including depression, anxiety, and behavioral problems. The Symptom Checklist is a 26-item scale that asks participants to indicate how intense the severity of a particular symptom was over the past two months. Severity ranged from 0="Not at all" to 4="Extremely" and the scale score was the mean. Internal reliability of the scale was excellent (Cronbach's alpha=.91). The original scale consisted of 36-items, but four items were dropped because of poor translations and two items had very low to no endorsement, and so they were also dropped from the analyses. After determining that the missingness of the Symptom Checklist items for the 39 participants not interviewed at follow-up were missing completely at random (MCAR) by analyzing them using Little's MCAR analysis in SPSS 19's Missing Values program (Little's MCAR Test χ ²= 507.12, DF=468, p=.10) ( IBM Corp., 2010), scale reduction through reliability analysis was used to improve the internal reliability of the measure. Reliability analysis revealed that four additional items had corrected item-total correlation scores ≤ .20 and were dropped from the scale.

Genocide Violence Exposure

Genocide Violence Exposure was coded from the 2002 genocide testimonies. Codes were developed from the Rwandese Children's Exposure to War Scenes Measure ( Dyregrov et al., 2000), which assesses exposure to events that were common during the Rwandan Genocide. In order to ensure that the codes were comprehensive and specific to OHH in this study, additional items were added that were relevant to the sample ( Layne et al., 2010; Netland, 2001, 2005). Example genocide events include reports of having your home destroyed, being attacked, being beaten, being raped, witnessing people being killed, and seeing dead bodies. In total, 41 different genocide experiences were coded 1=reported, and 0=not reported (see Table 2 ). The sum score of all 41 items was the total score for Genocide Violence Exposure. The weighted mean ICC was .97 and the range was .95 to .99.

Witnessing Family Attacked

Witnessing Family Attacked was coded from the 2002 genocide testimonies. If participants mentioned witnessing their mother, father, or siblings being attacked, they received a score of one, otherwise they received scores of zero. The weighted mean ICC was .93 (range = .78 to 1.00).

Return to School

In the 2002 interview, participants were asked whether they had returned to school after the genocide, and this was coded as a binary (0=No, 1=Yes) variable. The weighted mean ICC was .96 (range = .82 to 1.00).

Educational Attainment

Educational Attainment was coded from participant responses during the 2008 interviews in which they were asked to identify the highest level of education they had attained. Responses were coded into seven ordinal categories ranging from 1=Less than Primary School to 7=Graduate School. If no information was available about educational attainment, it was coded as missing. The weighted mean ICC for Educational Attainment was .97 (range = .93 to 1.00).

Social Support

Social Support was measured in 2008 using the mean of an adapted version of the Medical Outcomes Study Social Support Scale ( Sherbourne & Stewart, 1991). The 6-item questionnaire asked participants to rate their perceived social support over the past two months (e.g., "Are there people in your life whom you can trust?") on scale from 1 ("Not at All") to 5 ("A Lot"). Cronbach's alpha was .83.

Poverty

Poverty was measured using the mean of a scale created from variables coded from the 2008 interview that assessed lack of resources. Nine binary (0=No, 1=Yes) items indicated lack of resources, including being unemployed, lacking food, not having water in the home, and not having electricity in the home. Mean weighted ICC of the coded scales was .95 (range = .90 to .97) and the Cronbach's alpha was .71.

Analyses

To determine whether the follow-up sample of 61 participants differed significantly from the 39 original participants who were not included in the follow-up, logistic, anova, and X ² tests were run in which each of the variables assessed in 2002 predicted participation in the follow-up study. To assess whether the covariates Gender and Age, Genocide Violence Exposure, and post-genocide risk factors predicted PTSD and Distress Symptoms, nested regressions were run in which Gender and Age were entered in model one, Genocide Violence Exposure and Witnessing Family Attacked were added in model two, and Return to School, Educational Attainment, Poverty, and Social Support were entered in model three. Fisher's r to z transformation was used to compute the average R ² and adjusted R ² values across imputations ( Harel, 2009), and Wald tests were used to assess whether including the new set of predictors improved the overall fit of the model.

Mediation analyses were conducted to assess whether significant post-genocide predictors of mental health outcomes mediated the association between Genocide Violence Exposure and mental health. The covariates of Gender and Age were included in the mediation analyses. The significance of the indirect effects was tested using sgmediation with 5,000 bootstrapped samples with case resampling to account for bias in the standard error of the indirect effect. Bootstrapping has been found to provide the most accurate confidence intervals for indirect effects, particularly with small sample sizes ( Preacher & Hayes, 2004, 2008). All analyses were conducted using Stata version 12 ( StataCorp, 2011). Multiple imputation using 50 imputations was used to impute missing data from the 61 participants.

Results

Genocide violence exposure and witnessing family attacked

Of the 61 participants, genocide exposure data were available for 58 (genocide testimonies were missing for three participants). Results of X ² tests assessing differences in endorsement of each of the Genocide Violence Exposure items between the 58 participants who completed the 2008 interview and the 39 who did not indicated that of the 41 different Genocide Violence Exposure items, endorsement rates differed between the samples for only two, such that participants who completed the 2008 follow-up were more likely to have been threatened with death ( X ²=3.96, p<.05) and shot ( X ²=5.86, p=.02). There were no differences between the samples in the total Genocide Violence Exposure Scores (t=1.07, p=.29) or Witnessing Family Attacked ( X ²=.40, p=.53) (see Table 2 ).

The 58 participants reported experiencing an average of 11.43 (SD=4.27) of 41 different Genocide Violence Exposure events, and 60.34% of participants witnessed at least one family member being attacked, with 32.76% witnessing their mothers being attacked, 25.86% witnessing their fathers being attacked, and 44.83% witnessing a sibling being attacked. Most of the participants (89.66%) reported that they were threatened with death, 68.97% reported being physically attacked or assaulted, and 44.83% reported being injured during the genocide. In addition, 98.25% of participants reported that they had witnessed people being massacred, killed, or attacked and 72.41% reported seeing dead bodies. Sexual violence was witnessed by 41.38% of participants and experienced by 8.62% of participants (four women and one man) (see Table 2 )

PTSD symptoms

PTSD Symptoms were highly prevalent (see Table 3 ). The mean PTSD Symptoms score was 2.29 out of 4 (SD=.85), with 82% of participants having scores at or above 1.5, which has been found to be the IES-R cut-off with the best diagnostic accuracy for assessing PTSD in Vietnam veterans ( Creamer, Bell, & Failla, 2003). For seven of the 21 items, more than 60% of participants responded that they experienced the symptom "A lot/Quite a bit" or "Extremely," with the most frequently endorsed items being "You didn't understand how the genocide could have happened" (70.49%; mean=2.97, SD=1.21), "Anything reminds you of the genocide" (73.77%; mean=2.93, SD=1.09), and "Picturing the genocide" (65.57%; mean=2.85, SD=1.38).

Table 3

Continuous Measures

Possible Range

Actual Range

N

Mean (SD)

Social Support

1 - 5

1 - 3.83

61

2.04 (.56)

PTSD Symptoms

0 - 4

0 - 3.90

61

2.29 (.85)

Distress

0 - 4

0.15 - 3.27

61

1.37 (.79)

Distress symptoms

Distress Symptoms were also elevated in the follow-up sample (see Table 3 ), with more than 40% of the sample indicating that they felt "Quite a bit" or "Extremely" on each of the following items: anxious (67.21%; mean=2.77, SD=1.44), sad and depressed (59.01%; mean=2.67, SD=1.36), scared (45.90%; mean=1.95, SD=1.43), lonely (44.26%; mean=1.82, SD=1.62), and isolated (40.99%; mean=1.95, SD=1.70). More than 40% of participants reported that they experienced headaches (47.54%; mean=2.10, SD=1.59) and nightmares (40.98%; mean=1.95, SD=1.47) "Quite a bit" or "Extremely."

Return to school and educational attainment

By 2002, more than 70% of participants reported that they had returned to school following the genocide and by 2008, 43.75% had completed secondary school, with 27.08% continuing on to higher education (see Table 3 ).

Poverty

In 2008, almost one-third of participants were cultivators (29.51%) and 45.90% of participants were unemployed with no source of income. Less than 20% of participants had permanent employment (19.67%). Participants reported great difficulty accessing food and water, with 94.83% reporting not having enough food and 41.67% regularly eating fewer than two meals per day. Only 13.11% of participants had a source of water in their homes (see Table 3 ).

Social support

Social Support was low for almost all participants, with 81.97% of participants rating themselves on average as having "none" or "very few" people in their lives who provide social support (see Table 3 ).

Prediction of PTSD symptoms

Table 4 provides correlations between all study variables. Results of the nested regressions indicated that PTSD Symptoms were linearly and positively predicted by Genocide Violence Exposure ( β =.36, p=.009), but that when post-genocide factors were added to the model, the model fit improved, and Genocide Violence Exposure was no longer a significant predictor of PTSD Symptoms ( β=.17, p=.26) (see Table 5 ). In the final model, Educational Attainment was the only significant predictor of PTSD symptoms ( β=−.47, p=.05). The final model accounted for 23% of the variance in PTSD symptoms.

Table 4

1

2

3

4

5

6

7

8

9

1. Male

---

2. Age

.07

---

3. Genocide Violence Exposure

−.17

−.06

---

4. Witnessing Family Attacked

−.18

−.32**

.32**

---

5. Return to School

.13

−.45***

.03

.19

---

6. Educational Attainment

.22

.01

−.31*

−.11

.55***

---

7. Poverty

−.17

−.31*

.41**

.14

−.02

−.55***

---

8. Social Support

.15

.04

−.32*

,05

−.07

.06

−.30*

---

9. PTSD Symptoms

−.15

.05

.35**

.10

−.17

−.41**

.36**

−.20

---

10. Distress Symptoms

−.32*

−.06

.29*

.27*

−.28*

−.44**

.46***

−.35**

.73***

Table 5

Predictor

PTSD Symptoms

Distress Symptoms

Model 1

Model 2

Model 3

Model 1

Model 2

Model 3

β, B (SE)

p

β, B (SE)

p

β, B (SE)

p

β, B (SE)

p

β, B (SE)

p

β, B (SE)

p

R ²

.04

.17

.33

.10

.19

.46

Adjusted R ²

.01

.11

.23

.07

.14

.38

Wald Test

4.07 p=.02

2.57, p<.05

3.15, p=.05

5.48, p=.001

A mediation analysis was conducted to assess whether Educational Attainment mediated the association between Genocide Violence Exposure and PTSD Symptoms (see Figure 1 ). Gender and Age were included as covariates. Results indicated that Genocide Violence Exposure predicted PTSD Symptoms (Path c; B=0.08, SE=0.02, p=.002). When Educational Attainment was added as a mediator in the model, Genocide Violence Exposure predicted Educational Attainment (Path a; B=−0.15, SE=0.05, p=.005) and Educational Attainment predicted PTSD Symptoms (Path b; B=−0.14, SE=0.06, p=.03). This indirect effect was significant, as the indirect effect estimate's 95% bias-corrected bootstrapped standard error confidence intervals (CIs) did not contain zero (B=0.02, 95% CIs=0.002-0.05). After including Educational Attainment as a mediator, Genocide Violence Exposure was reduced but still predicted PTSD Symptoms (Path c′; B=0.06, SE=0.02, p=.02). Therefore, Educational Attainment partially mediated the association between Genocide Violence Exposure and PTSD Symptoms.

While we hypothesized that Educational Attainment would mediate the association between Genocide Violence Exposure and PTSD Symptoms, it is also possible that PTSD Symptoms mediate the association between Genocide Violence Exposure and Educational Attainment. To assess this possibility, follow-up mediation analyses were conducted. Results indicated that the indirect effect was significant (B= −0.05, 95% CI= −0.13 to −0.005), supporting this alternate hypothesis.

Prediction of distress symptoms

Results of the nested regressions indicated that in models one and two, Gender predicted Distress Symptoms ( β=−.31, p=.02; β=−.27, p=.03 respectively), such that women reported greater distress than men (see Table 5 ). However, in the final model, Gender no longer significantly predicted Distress Symptoms ( β=−.12, p=.29). Genocide Violence Exposure was trending towards significance in model two ( β=.23, p=.07), but when post-genocide factors were added in model three, it was not significant ( β=−.03, p=.80), and there was better model fit (Wald Test=5.48, p=.001). In contrast, Witnessing Family Attacked was not significant in model two ( β=.17, p=.22), but was significant in model three after the post-genocide risk factors were included ( β=.26 p=.04). In addition, Social Support negatively predicted Distress Symptoms ( β=−.30, p=.01). No other predictors were significant in model three. The final model accounted for 38% of the variance in distress.

Although Witnessing Family Attacked was not significant until Social Support was added to the model, mediation analyses were conducted to assess whether Social Support was acting as a suppressor of the association between Witnessing Family Attacked and Distress Symptoms. Results of suppression analyses that included Gender and Age as covariates indicated that the indirect effect was not significant, since the 95% bias-corrected bootstrapped CIs contained zero (B=−0.03, 95% CIs= −0.19 to 0.11), so suppression was not present.

Discussion

Fourteen years after the genocide, OHH in this study reported considerable ongoing difficulties, including low social support, high levels of poverty, and high rates of PTSD and distress symptoms. The 60% of participants who reported in 2002 that they witnessed their family members being attacked during the genocide reported more distress in 2008 than participants who did not witness their family members being attacked. Additionally, participants who reported less social support in 2008 reported more distress. Although poverty was clearly a problem for these OHH, it did not directly predict distress or PTSD symptoms.

While exposure to genocide events reported in 2002 had a positive dose-response relationship with PTSD symptoms in 2008, this association was partially mediated by lower educational attainment in 2008. Education emerged as one of the most potentially valuable protective factors following the genocide. Despite the many difficulties facing these survivors, 90% of them managed to complete primary school (6th grade), while 46% completed secondary school (12th grade). Education may be beneficial because it may offer hope and the possibility of a brighter future to OHH. In addition, going to school is one of the primary normative experiences for children, and for OHH who are suddenly thrust into the adult roles of caregiver and breadwinner, education may offer an opportunity for success in a developmentally appropriate everyday role, as well as providing access to concerned adults. Indeed, education certainly appears to be extremely important to many of the OHH in this sample, who on average achieved higher educational levels than similarly aged youth in Rwanda ( Akresh & De Walque, 2008).

The difference in education between Rwandan youth overall and the OHH in this sample may stem in part from the fact that the OHH in this sample were members of a grassroots community organization dedicated to assisting OHH, and may therefore have had better access to education than other youth in Rwanda. Moreover, qualitative interviews revealed that many participants received educational assistance from the Rwandan government's National Assistance Fund for Survivors of Genocide (Fond d'Assistance pour les Rescapes du Genocide: FARG). It seems that the assistance it provided may have been essential to helping the OHH with pursuing their educational goals, and in turn, that educational attainment may have resulted in lower PTSD symptoms years later. Programs that help orphaned survivors of war access education by providing transportation, uniform fees, school materials, and assistance with applying to and paying for higher education may reduce PTSD symptoms.

While many OHH in this study succeeded in gaining education, almost none reported having substantial social support. Despite this limited range, social support was still a highly significant predictor of distress. Social support as measured in this study refers to the perception of having someone to turn to when things bother you, when you are sick, and when you need advice or help making decisions, and having someone around whom you trust, feel close too, and who understands your feelings. OHH who have even one person in their lives who provides this support may indeed be much better off than those who report having none. For war-affected populations, efforts to strengthen and expand social support networks, such as promoting community groups of others with shared experiences, developing mentoring networks, and continuing efforts to reconnect fragmented families may also decrease distress. The goals of social support interventions may not need to be lofty, because the results suggest that even a small change may be beneficial. Indeed, there is some evidence that distress decreases in Rwandans receiving interventions designed to improve social cohesion and bonding ( Brown et al., 2009; Scholte et al., 2011).

While the findings are consistent with studies which have found that psychological distress in war-affected populations is often more associated with daily stressors than with war exposures ( Miller, Omidian, Rasmussen, Yaqubi, & Daudzai, 2008; Miller & Rasmussen, 2010), post-genocide risk factors and mental health symptoms were both assessed in 2008, and therefore directionality cannot be inferred. Results of the follow-up mediation analyses found that PTSD symptoms may also mediate the association between genocide violence exposure and educational attainment. While further research is needed on the directionality of the association of these variables, the results of this study support the association between PTSD symptoms and education and between distress and social support.

For many war survivors, public health interventions that improve social support and education may significantly reduce distress and PTSD symptoms, but for some survivors, particularly those who have witnessed their family members and loved ones being harmed, interventions for mood and anxiety disorders may also be beneficial. In addition to increased understanding of the efficacy of interventions for depression and anxiety, research is needed on the effectiveness of existing local community-based approaches to addressing risk factors and mental health needs. Not only may these approaches be more culturally-relevant for war survivors, but they may also be more sustainable than imported interventions.

Limitations and strengths

This study has a number of limitations. The findings may not be generalizable to other OHH in Rwanda because the participants were members of an orphan organization, were selected by the organization leadership and, thus, were not a random sample of OHH. Additionally, the fact that all participants in this study had given genocide testimony may have had an impact on the mental health outcomes reported here, as studies have found that providing narrative accounts of traumatic experiences can reduce PTSD symptoms (Bisson & Andrew, 2009). Therefore results must be interpreted with caution. The study has a small sample size, which may mean the analyses are underpowered. Although coding of the genocide testimonies was reported in a more naturalistic and personal way than a checklist approach, genocide experiences were reported retrospectively with little prompting, and may not be complete. While the process for translating assessment instruments involved having measures reviewed and approved by OHH in focus groups and by board members, and having the measures forward and back translated by native Kinyarwanda speakers and approved by a different set of OHH, the measures did not undergo formal pre-testing and cognitive interviewing as suggested by the World Health Organization ( World Health Organization, 2014). Finally, educational attainment was used as a continuous variable, and while using ordinal variables coded into five or more categories as continuous variables has been supported in the literature ( Beauducel & Herzberg, 2006; DiStefano, 2002; Rhemtulla, Brosseau-Liard, & Savalei, 2012), it is possible that this created some bias in the parameter estimates.

Despite these limitations, this study also has a number of strengths. The use of two time points allowed for prediction of risk and outcome variables from reported genocide exposure and a long separation between the reporting of distressing information about the genocide and the collection of information on mental health. Additionally, the study not only used a standardized measure with strong established psychometric properties (IES-R), but also a measure developed locally for this population (Symptom Checklist), to assess mental health symptoms, thereby increasing the likelihood of cultural relevance and appropriateness of the assessments ( Bolton, 2001a; Jayawickreme, Jayawickreme, Atanasov, Goonasekera, & Foa, 2012). Finally, this study was conducted with the full collaboration and participation of an association of OHH, which helped increase the cultural relevance and sensitivity of the study and ensured that the questions being asked were meeting the specific needs of their membership.

Conclusion

These results provide support for the hypothesis that education and social support may play important roles in mental health of genocide survivors, and may even contribute more to PTSD and distress symptoms than war exposures. While experiences that occurred during the genocide cannot be altered, these post-genocide factors may be targets of change for interventions and may be used to identify individuals at higher risk of poor mental health outcomes. Results suggest that public health and community efforts to improve educational outcomes and strengthen and expand social support networks may improve mental health outcomes of OHH. In addition, secondary and tertiary interventions such as depression and anxiety interventions may be beneficial for a subset of OHH who have witnessed harm to family members. Taken together, these findings highlight possible directions for post-genocide psychosocial and public health intervention programs to improve the mental health of OHH in Rwanda. The resilience shown by these young survivors in obtaining education and raising their families even after facing horrifying genocidal experiences suggests that such interventions may be valuable and welcomed.

Acknowledgments

We wish to thank the Rwandan Association des Orphelins Chefs de Ménages, for their commitment to unifying, strengthening, and bringing hope to children orphaned by the 1994 Rwandan Genocide against the Tutsi. This project was funded by grants from the Rosenzweig-Coopersmith Foundation and the Office of the Provost at the University of Southern California to Dr. Meyerowitz. Dr. Ng's time was partially supported by the National Institute of Mental Health (#s 5T32MH093310 and 5R34MH084679).

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Life after Genocide: Mental Health, Education, and Social Support of Orphaned Survivors

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Thousands of orphaned survivors of the 1994 Rwandan Genocide against the Tutsi were not only exposed to extraordinarily severe forms of violence, but also many of these children took on the responsibility of caring and providing for other child survivors. ...

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[Then & Now]. (2021, January 27). How The Holocaust Happened [Video]. YouTube. Retrieved October 3, 2022, from https://www.youtube.com/watch?v=RPCKzgITCRI&feature=youtu.be

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The Holocaust, Genocides, and Mass Murder of WWII: Crash Course European History #40

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The Holocaust, Genocides, and Mass Murder of WWII: Crash Course European History #40

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[CrashCourse]. (2020, April 10). The Holocaust,Genocides, and Mass Murder of WWII: Crash Course European History #40 [Video]. YouTube. Retrieved October 3, 2022, from https://www.youtube.com/watch?v=iQeDvnapdlg&feature=youtu.be

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The Holocaust,Genocides, and Mass Murder of WWII: Crash Course European History #40

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[United States Holocaust Memorial Museum]. (2014, January 13). The Path to Nazi Genocide [Video]. YouTube. Retrieved October 3, 2022, from https://www.youtube.com/watch?v=sRcNq4OYTyE&feature=youtu.be

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Jones, A. (2016, December 16). Genocide: A Comprehensive Introduction (3rd ed.). https://www.mcmsnj.net/cms/lib07/NJ01911694/Centricity/Domain/155/Textbook.pdf (Original work published 2006)

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Boats and boating--Equipment and supplies

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Effects and Aftermath of the Holocaust. (n.d.). Holocaust Encyclopedia. Retrieved October 3, 2022, from https://encyclopedia.ushmm.org/content/en/article/the-aftermath-of-the-holocaust

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In 1945, when Allied troops entered the concentration camps, they discovered piles of corpses, bones, and human ashes-testimony to Nazi mass murder. Soldiers also found thousands of Jewish and non-Jewish survivors suffering from starvation and disease. For survivors, the prospect of rebuilding their lives was daunting.

After liberation, many Jewish survivors feared to return to their former homes because of the antisemitism (hatred of Jews) that persisted in parts of Europe and the trauma they had suffered. Some who returned home feared for their lives. In postwar Poland, for example, there were a number of pogroms (violent anti-Jewish riots). The largest of these occurred in the town of Kielce in 1946 when Polish rioters killed at least 42 Jews and beat many others.

With few possibilities for emigration, tens of thousands of homeless Holocaust survivors migrated westward to other European territories liberated by the western Allies. There they were housed in hundreds of refugee centers and displaced persons (DP) camps such as Bergen-Belsen in Germany. The United Nations Relief and Rehabilitation Administration (UNRRA) and the occupying armies of the United States, Great Britain, and France administered these camps.

A considerable number and variety of Jewish agencies worked to assist the Jewish displaced persons. The American Jewish Joint Distribution Committee provided Holocaust survivors with food and clothing, while the Organization for Rehabilitation through Training (ORT) offered vocational training. Refugees also formed their own organizations, and many labored for the establishment of an independent Jewish state in Palestine.

The largest survivor organization, Sh'erit ha-Pletah (Hebrew for "surviving remnant"), pressed for greater emigration opportunities. Yet opportunities for legal immigration to the United States above the existing quota restrictions were still limited. The British restricted immigration to Palestine. Many borders in Europe were also closed to these homeless people.

The Jewish Brigade Group (a Palestinian Jewish unit of the British army) was formed in late 1944. Together with former partisan fighters displaced in central Europe, the Jewish Brigade Group created the (Hebrew for "flight" or "escape"). This organization that aimed to facilitate the exodus of Jewish refugees from Europe to Palestine. Jews already living in Palestine organized "illegal" immigration by ship (also known as ). British authorities intercepted and turned back most of these vessels, however. In 1947 the British forced the ship Exodus 1947, carrying 4,500 Holocaust survivors headed for Palestine, to return to Germany. In most cases, the British detained Jewish refugees denied entry into Palestine in detention camps on the Mediterranean island of Cyprus.

With the establishment of the State of Israel in May 1948, Jewish displaced persons and refugees began streaming into the new sovereign state. Possibly as many as 170,000 Jewish displaced persons and refugees had immigrated to Israel by 1953.

In December 1945, President Harry Truman issued a directive that loosened quota restrictions on immigration to the US of persons displaced by the Nazi regime. Under this directive, more than 41,000 displaced persons immigrated to the United States. Approximately 28,000 were Jews.

In 1948, the US Congress passed the Displaced Persons Act. The act provided approximately 400,000 US immigration visas for displaced persons between January 1, 1949, and December 31, 1952. Of the 400,000 displaced persons who entered the US under the DP Act, approximately 68,000 were Jews.

Other Jewish refugees in Europe emigrated as displaced persons or refugees to Canada, Australia, New Zealand, western Europe, Mexico, South America, and South Africa.

I was 18, but I was, in fact, only 13 because those years were nothing. Those were erased from my life.
-Madeline Deutsch

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In 1945, when Allied troops entered the concentration camps, they discovered piles of corpses, bones, and human ashes-testimony to Nazi mass murder. Soldiers also found thousands of Jewish and non-Jewish survivors suffering from starvation and disease. For survivors, the prospect of rebuilding their lives was daunting.

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United Nations. (n.d.). United Nations Office on Genocide Prevention and the Responsibility to Protect. Retrieved October 3, 2022, from https://www.un.org/en/genocideprevention/genocide.shtml

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Genocide - Impacts of Genocide. (2017, January 24). Beyond Intractability. Retrieved October 3, 2022, from https://www.beyondintractability.org/special/genocide-impacts-of-genocide

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Between Vengeance and Forgiveness: Facing History After Genocide and Mass Violence The rise of collective violence and genocide is the twentieth century's most terrible legacy. Writing with informed, searching prose of the extraordinary drama of the truth commissions in Argentina, East Germany, and most notably South Africa; war-crime prosecutions in Nuremberg and Bosnia; and reparations in America, Minow looks at the strategies and results of these riveting national experiments in justice and healing.

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Genocide Timeline. (n.d.). Holocaust Encyclopedia. Retrieved October 3, 2022, from https://encyclopedia.ushmm.org/content/en/article/genocide-timeline

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This is a timeline noting the major conceptual and legal advances in the development of "genocide." It does not attempt to detail all cases which might be considered as genocides, but rather how the term becomes a part of the political, legal, and ethical vocabulary of responding to widespread threats of violence against groups.

1900: Raphael Lemkin
Raphael Lemkin, who would later coin the word "genocide," was born into a Polish Jewish family in 1900. His memoirs detail early exposure to the history of Ottoman attacks against Armenians (which most scholars believe constitute genocide), antisemitic pogroms, and other histories of group-targeted violence as key to forming his beliefs about the need for legal protection of groups.

1933: Rise of Adolf Hitler
With the appointment of Adolf Hitler as Chancellor on January 30, 1933, the Nazi Party took control of Germany. In October, German delegates walked out of disarmament talks in Geneva and Nazi Germany withdrew from the League of Nations. In October, at an international legal conference in Madrid, Raphael Lemkin (who later coined the word "genocide" ) proposed legal measures to protect groups. His proposal did not receive support.

1939: World War II
World War II began on September 1, 1939. Germany invaded Poland, triggering a treaty-mandated Anglo-French declaration of war on Germany. On September 17, 1939, the Soviet army occupied the eastern half of Poland. Lemkin fled Poland, escaping across the Soviet Union and eventually arriving in the United States.

1941: A crime without a name
On June 22, 1941, Nazi Germany invaded the Soviet Union. As the German forces advanced further east, SS, police, and military personnel carried out atrocities that moved British Prime Minister Winston Churchill to state in August 1941: "We are in the presence of a crime without a name." In December 1941, the United States entered World War II on the side of the Allied forces. Lemkin, who arrived in the United States as a refugee in 1941, had heard of Churchill's speech and later claimed that his introduction of the word "genocide" was in part a response to Churchill's statement.

1944: "Genocide" coined
Nazi leadership embarked on a variety of population policies aimed at restructuring the ethnic composition of Europe by force, using mass murder as a tool. Included among these policies and involving mass murder were the attempt to murder all European Jews, which we now refer to as the Holocaust, the attempt to murder most of the Roma (Gypsy) population of Europe, and the attempt to physically liquidate the leadership classes of Poland and the former Soviet Union. Also included in these policies were numerous smaller scale resettlement policies involving the use of brutal force and murder that we now refer to as a form of ethnic cleansing. In 1944, Raphael Lemkin, who had moved to Washington, DC, and worked with the US War Department, coined the word " genocide" in his text Axis Rule in Occupied Europe. This text documented patterns of destruction and occupation throughout Nazi-held territories.

1945-1946: International Military Tribunal
Between November 20, 1945, and October 1, 1946, the International Military Tribunal in Nuremberg tried 22 major Nazi German leaders on charges of crimes against peace, war crimes, crimes against humanity and conspiracy to commit each of these crimes. It was the first time that international tribunals were used as a post-war mechanism for bringing national leaders to justice. The word "genocide" was included in the indictment, but as a descriptive, not legal, term.

1947-1948: Creating an international convention on genocide
Raphael Lemkin was a critical force for bringing "genocide" before the nascent United Nations, where delegates from around the world debated the terms of an international law on genocide. On December 9, 1948, the final text was adopted unanimously. The United Nations Convention on the Prevention and Punishment of Genocide entered into force on January 12, 1951, after more than 20 countries from around the world ratified it.

1950-1987: Cold war
Massive crimes against civilian populations were all too common in the years after World War II and throughout the Cold War. Whether these situations constituted "genocide" was scarcely considered by the countries that had undertaken to prevent and punish that crime by joining the Genocide Convention.

1988: US signs the Genocide Convention
On November 4, 1988, US President Ronald Reagan signed the UN Convention on the Prevention and Punishment of Genocide. The Convention had strong supporters, but also faced ardent opponents, who argued it would infringe on US national sovereignty. One of the Convention's strongest advocates, Senator William Proxmire from Wisconsin delivered over 3,000 speeches advocating the Convention in Congress from 1968-1987.

1991-1995: Wars of the former Yugoslavia
The wars of the former Yugoslavia were marked by massive war crimes and crimes against humanity. The conflict in Bosnia (1992-95) brought some of the harshest fighting and worst massacres to Europe since World War II. In one small town, Srebrenica, as many as 8,000 Bosniak men and boys were murdered by Serbian forces.

1993: Resolution 827
In response to the atrocities occurring in Bosnia, the United Nations Security Council issued resolution 827, establishing the International Criminal Tribunal for the former Yugoslavia (ICTY) in The Hague. It was the first international criminal tribunal since Nuremberg. Crimes the ICTY can prosecute and try are: grave breaches of the 1949 Geneva Conventions, violations of the laws or customs of war, genocide, and crimes against humanity. Its jurisdiction is limited to crimes committed on the territory of the former Yugoslavia.

1994: Genocide in Rwanda
From April until mid-July, between 500,000 and a million Rwandans, predominantly Tutsis, were killed in Rwanda. It was killing on a devastating scale, scope, and speed. In October, the UN Security Council extended the mandate of the ICTY to include a separate but linked tribunal for Rwanda, the International Criminal Tribunal for Rwanda (ICTR), located in Arusha, Tanzania.

1998: First conviction for genocide
On September 2, 1998, the ICTR issued the world's first conviction for genocide in an international tribunal when Jean-Paul Akayesu was judged guilty of genocide and crimes against humanity for acts he engaged in and oversaw as mayor of the Rwandan town of Taba.

Through an international treaty ratified on July 17, 1998, the International Criminal Court was permanently established to prosecute genocide, crimes against humanity, and war crimes. The treaty reconfirmed the definition of genocide found in the 1948 Convention on the Prevention and Punishment of the Crime of Genocide. It also expanded the definition of crimes against humanity and prohibits these crimes during times of war or peace.

While the ICTY and ICTR, other ad hoc tribunals, and the International Criminal Court have helped establish legal precedents and can investigate crimes within their jurisdictions, punishment of genocide remains a difficult task. Even more difficult is the continuing challenge to prevent genocide.

2004: Genocide in Darfur
For the first time in US government history, an ongoing crisis was referred to as a "genocide." On September 9, 2004, Secretary of State Colin Powell testified before the Senate Foreign Relations Committee that "We concluded-I concluded-that genocide has been committed in Darfur and that the Government of Sudan and the Janjaweed bear responsibility-and that genocide may still be occurring."

March 17, 2016: Genocide in Iraq and Syria
Secretary of State John Kerry announced that the self-proclaimed Islamic State (IS) had committed genocide against Yezidi, Christian, and Shia Muslim populations in areas under its control across Syria and Iraq. This is the first time in more than a decade that the United States has declared genocide. Secretary Kerry also stated that IS committed "crimes against humanity and ethnic cleansing directed at these same groups and in some cases also against Sunni Muslims, Kurds, and other minorities."

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This is a timeline noting the major conceptual and legal advances in the development of "genocide." It does not attempt to detail all cases which might be considered as genocides, but rather how the term becomes a part of the political, legal, and ethical vocabulary of responding to widespread threats of violence against groups.

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The long-term health consequences of genocide: developing GESQUQ - a genocide studies checklist - Conflict and Health

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The long-term health consequences of genocide: developing GESQUQ - a genocide studies checklist - Conflict and Health

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Lindert, J., Kawachi, I., Knobler, H. Y., Abramowitz, M. Z., Galea, S., Roberts, B., Mollica, R., & McKee, M. (2019, April 11). The long-term health consequences of genocide: developing GESQUQ - a genocide studies checklist. Conflict and Health, 13(1). https://doi.org/10.1186/s13031-019-0198-9

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Conflict and Health 13, Article number: 14 (2019) Cite this article

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Abstract

Background

Genocide is an atrocity that seeks to destroy whole populations, leaving empty countries, empty spaces and empty memories, but also a large health burden among survivors is enormous. We propose a genocide reporting checklist to encourage consistent high quality in studies designed to provide robust and reliable data on the long term impact of genocide.

Methods

An interdisciplinary (Public Health, epidemiology, psychiatry, medicine, sociology, genocide studies) and international working committee of experts from Germany, Israel, the United States, and the United Kingdom used an iterative consensus process to develop a genocide studies checklist for studies of the long term health consequences.

Results

We created a list of eight domains (A Ethical approval, B External validity, C Misclassification, D Study design, E Confounder, F Data collection, G Withdrawal) with 1-3 specific items (total 17).

Conclusion

The genocide studies checklist is easy to use for authors, journal editors, peer reviewers, and others involved in documenting the health consequences of genocide.

Background

Genocides have brought immeasurable suffering to millions of people in the 20th and the early years of the twenty-first century. [ 1, 2] They have attracted the attention of researchers from a range of disciplines, including epidemiologists, historians, political scientists, psychologists, anthropologists, demographers, and others, with genocide studies emerging as a distinct body of scholarship. Each discipline offers important perspectives on a phenomenon whose horror is beyond the imagination of most people. The impact of genocide continues long after the killing has ended, leaving lifelong scars on survivors and, potentially, their offspring. [ 2] Yet, as revealed in a recent systematic review, this research has taken a wide variety of approaches and produced heterogeneous, and, in some cases, conflicting findings, suggesting a range of consequences between severe long term impact and no impact. [ 2] This conflicting evidence leads to several conclusions.

First, genocide - as defined in the Convention on the Prevention and Punishment of the Crime of Genocide (CPPCG) adopted by the United Nations General Assembly on 9th of December 1948 as General Assembly Resolution 260 (III, article 2) - can take many forms, from the semi-organized chaos of Rwanda systematic murder of Jews by Nazis and/or their allies in the Genocide termed the Holocaust, with differences in exposures to mass atrocities (e.g. duration, types of genocidal acts). The Convention defines genocide as an attempt "to destroy, in whole or in part, a national, ethnical, racial or religious group." Genocidal acts include "killing members of the group; [and] causing serious bodily or mental harm to members of the group", and deliberately inflicting "conditions of life, calculated to bring about [a group's] physical destruction in whole or in part; imposing measures intended to prevent births within the group; [and] forcibly transferring children of the group to another group". [ 3] These definitions suggest a breadth of exposures that can be associated with genocide. Table 1 lists those events that have been designated officially by the United Nations as genocides, as well as the range of estimates of those killed and the percentages of the target populations affected.

Table 1 Genocides since World War 1

A second concern relates to methodological differences among studies. For example, studies reviewing the mental health impact of genocides have investigated a variety of outcomes, including depression, anxiety, schizophrenia [ 4, 5], suicide [ 6, 7], post-traumatic stress as well post-traumatic growth. Some studies documented a negative impact, while others found resilience or no association notwithstanding immense cruelties to which survivors had been exposed. [ 8] Some of this variability may be due to the methodological challenges inherent in conducting studies on populations affected by genocide. Some are common to any epidemiological research and include recruitment bias, measurement error, and the need to adjustment for potential confounding. Attempts to attribute symptoms to the experience of genocide may be complicated by confounding factors unrelated to the genocide, such as discrimination in another country due to migration or poverty. [ 9] Other factors, however, are specific to genocide research. One is memoralization, whereby groups valorize, marginalize, or disable acts of remembrance, or forgetting. [ 10, 11] Anthropological research has reported how some genocide survivors or children of survivors challenge the pathologizing construct of long term impact of genocides. It can be politically expedient to pathologize the long term consequences of genocide, or, conversely, to deny the long term impacts of genocides as part of an attempt to relieve the perpetrator from responsibility for having committed genocide. Disorders associated with genocide are therefore subject to the influence of various interests, institutions, and political interests.

The need for clear, transparent, and reliable reporting of research has led to important initiatives such as the Strengthening Reporting of Observational Studies in Epidemiology Statement (STROBE). [ 12] The STROBE statement, published in 2007, is an evidence-based 22 item set of recommendations for reporting observational studies (cohort studies, case-control studies, and cross-sectional studies) and has been credited with improvements in quality of reporting. [ 13] However, the STROBE statement is designed to apply to all observational studies, [ 8] and it does not adequately capture some of the key challenges inherent in post-genocide research.

Seeking to address this shortcoming, an international group of experts (JL, MZA, HJK, SG, RM, BR, MMcK, IK) with a specific interest in genocide and health worked together on a systematic review. [ 2] Important gaps in STROBE that were specific to studies of genocide and health were identified and agreement was reached that an extension of STROBE was warranted. Thus, the QUALITY ASSESSMENT TOOL FOR QUANTITATIVE GENOCIDE STUDIES (GESUQ) initiative was established as an international collaborative project to address these issues. Herein, we propose recommendations for reporting genocide and related research.

Methods

First, we searched for any existing reporting guideline covering long term impacts of genocide. Second, we sought relevant evidence regarding the quality of reporting. Neither search yielded any results. Third, we identified experts (i.e., methodologists, psychiatrists, epidemiologists, and genocide experts) who could advise on potential sources of bias, from relevant genocide projects and reference documents. They were then asked for recommendations. Fourth, the group met in person and via Skype meetings to agree the wording of the statements. Stakeholders reviewed the statements and provided feedback. The final checklist and this explanatory document were drafted by the three members of the working committee. During two face-to-face and three skype meetings, members of the group discussed the input received and prepared new versions that were circulated until consensus on all items was reached.

Results

Items in the GESUQ checklist

The complete GESUQ checklist is provided in the Additional file 1. In the following sections we explain the rationale for choosing items A-H in GESUQ.

A. Ethical approval

Research on the impact of genocide must adhere to same ethical standards that guide all other research. [ 14] This includes that all research participants have the capacity to provide informed consent. As in other research, investigators should maintain the principles of approval of research by institutional review boards (IRBs) respecting not only confidentiality and privacy but the importance of expertise in genocide research within the research team, including the specific genocide-related challenges that exist. Among these challenges are extra provisions to minimize harm to human subjects (e.g. the potential for retaliation from those who perpetrated the genocide), and extra steps to provide medical resources / referral to people still suffering from lingering mental health effects. Given the particular risk of causing distress by asking questions about past events in this vulnerable population there is a need to ensure mechanisms for referral information for mental health support. These ethical questions are especially difficult in situations in which genocide perpetrators, genocide victims, and genocide bystanders are forced to live together even after the genocide (e.g. in the case of Rwanda [ 15]).

B. External validity and selection bias

In genocide studies as in other epidemiological studies, attention to sampling methods is crucial. Often in the early aftermath of genocide, health studies either comprise only convenience samples or clinical samples (populations that manifest some kind of pathology, i.e. post-traumatic symptoms) and have sought and obtained care. This is understandable given the challenges of recruitment but is likely to introduce bias as such participants go through several stages of selection and thus, both in practice and theory, may differ from participants drawn from random samples of those exposed. Random sampling should therefore be used. Where this is not possible, analyses should include appropriate weighting. This can avoid the challenge of biased estimates of the incidence and prevalence of certain disorders (e.g., Posttraumatic Stress Disorder). Given the difficulty of random sampling in many settings, alternative methods such as respondent driven sampling may be useful adjuncts. [ 16]

It is important to recognize the inevitable scope for survivor bias, both in terms of surviving the events in question and their sequelae. Consequently, and to a greater degree with genocide than many other exposures, any sample will not be representative of all those exposed.

C. Avoiding misclassification

Any flaw in measuring exposure, outcome, or covariates can overestimate or underestimate the true value of the association. [ 17, 18, 19] This is a challenge in many areas of epidemiology, but is especially so with genocide. Does exposure include direct and indirect exposure (such as the death of family members or friends, and if so, in the presence or absence of the subject)? How is the duration of exposure measured? Reporting of genocide exposure should include the nature, intensity, and length of exposure. This assessment of exposure could draw on approaches adopted in other areas of epidemiology, such as the job-exposure matrix used in occupational epidemiology. [ 20, 21] Accordingly, assessment of exposure should be quantified systematically. For example, one could inquire about direct personal experiences of genocide (e.g. whether one's relatives were killed). But in genocide research it is also relevant to assess exposure to genocide even if someone was not directly affected - i.e. there may be spillover effects of genocide in a community. [ 22] In genocide research both direct and indirect exposures are of interest. Research on the impact of genocide on subsequent generations creates additional challenges, in measuring both the nature and timing of exposure. [ 2, 5] Our guidelines seek to guide researchers to be explicit about why the exposure measurement was carried out in a certain way.

Genocide studies seek accuracy in reporting the incidence, prevalence, and burden of disease so avoiding diagnostic errors is crucial. It is essential to understand the psychometric properties of health measures used among those affected by genocide. Expressions of suffering due to genocide may differ by populations. In the area of mental health, the DSM-5 [ 23] emphasizes the need for measures that capture culturally grounded concepts of distress, [ 24] something that is largely missing from genocide studies so far.

D. Study design

Most genocide studies will, inevitably, be retrospective and observational, e.g. case-control or cohort studies. The selection of controls is a major challenge as they should resemble, as closely as possible, those who experienced the genocide without themselves being exposed. The objective of genocide studies therefore is to find an unexposed control group that resembles the exposed group as closely as possible. For example, in studies of the health effects of the Holocaust, investigators have compared Jews who emigrated to Israel before and after the Holocaust. However, even this design poses challenges, since there will be many unobserved factors that could confound the comparison being made, e.g. those who escaped before the Holocaust may have had more extensive social networks to help them escape, and stronger social networks would make such individuals more resilient to adverse mental health effects.

Research undertaken in Israel has used the National Population Register. This is a unique resource for genocide studies. [ 4] However, should such a situation arise in the future, the ability to use a similar resource will depend upon the nature of consent given at enrolment, the degree of anonymisation, and the data protection laws in place in the country concerned.

F. Confounders

If the question of interest involves identifying the causal effects of genocide experience on mental health outcomes, the investigator must identify (and control for) factors that influence the probability of both the exposure and the outcome being studied. For example, in a study of exposure to genocide and the outcome of poor mental health, socioeconomic disadvantage could be a confounder. Someone disadvantaged in this way may be less able to escape the that would make a person less able to escape the direct and indirect effects of genocide, for example because of fewer material resources. However, there is also a well-recognized association between disadvantage and adverse mental health outcomes. It is good epidemiological practice to control for confounders but it is also important not to over control. Thus, genocide is often the final end-result of many decades (perhaps even centuries) of unjust treatment of a particular group in society. Hence, a confounder such as "low socioeconomic status" may itself represent an effect of the underlying injustice which preceded genocide. For example, immediately before and during the Holocaust, many Jewish children and adolescents were excluded from studies in public schools. One would not control for "confounding" by educational attainment in this instance, because interruption of schooling is part of the exposure (the Holocaust) that we are trying to understand. Likewise, the experience of escaping from the genocide constitutes a part of the exposure.

There are several approaches to addressing these issues, including the thorough review of the literature and use of methods such as directed acyclic graphs (DAGs), [ 25] multivariable regression to help adjust for potential confounders and structural equation modelling (path analysis). [ 26]

F. Data collection methods

Data can be collected in ad hoc surveys or, in rare cases, as with the Israeli National Population Register, from routine sources, as noted above. Valid and reliable assessment of exposures and outcomes requires carefully developed instruments, which have ideally been evaluated in different cultural settings. The attributes (e.g. recall period, question/response format) and mode of administration (e.g. interviewer-, self-administered) of existing instruments are extremely varied and many have not been evaluated for use in different cultural contexts or age groups.

Discussion

In summary, there are substantial challenges in epidemiological studies of survivors of mass atrocities, crimes against humanity, and genocide. However, data are needed to better serve this population. The GESUQ guidelines are a first step to better understand the mental health impact of mass atrocities, crimes against humanity, and genocide. These proposed guidelines are specific to observational genocide research and serve as starting point for improving epidemiological research on the impact of violence on health. GESUQ was created as a guide for authors, journal editors, peer reviewers, and other stakeholders to encourage researchers to improve the quality and completeness of reporting in genocide and war epidemiology. To our knowledge, our guidelines are the first to have been proposed for use specifically in genocide studies. As with other reporting guidelines, these complement the instructions in editorial and review processes to ensure a clear and transparent account of the research conducted. Experts we contacted generally welcomed the initiative and provided constructive feedback. The checklist will subsequently be translated into other languages, and disseminated widely. Ongoing feedback is encouraged to improve it.

While GESUQ represents our best attempt to reflect the interest and priorities of stakeholders and the interested public in genocide research, we recognize that the methods used in observational health research are changing rapidly, and the availability of different types of data for such research is expanding. For example, mobile health applications (mHealth apps) are becoming widely available for smartphones and wearable technologies. While there is limited experience so far with these data sources in genocide research, we anticipate rapid growth in the near future. Additionally, health care providers in for instance Israel offer good registry data on more outcomes than government data that can be linked to Holocaust exposure without sample selection.

The nature of genocide poses some obvious limitations on the conduct of associated research. First, while we have described this instrument as one for use in genocide studies, the international community has shown a great reluctance to use the term "genocide" because of the implications, in particular the "responsibility to protect". However, the issues we have discussed in developing this instrument will be equally applicable in many situations involving large scale killings that are not subsequently labelled as genocide. Second, it will continue to be extremely difficult to collect data in real time and any attempt to do so would face a myriad of methodological and ethical challenges, as was apparent in studies seeking to quantify the death toll in post-invasion Iraq. Consideration of these issues goes beyond the scope of this paper.

Conclusions

We have created GESUQ in the form of a checklist, trying to take account of and learn from existing guidelines. While we anticipate that GESUQ will change as research methods evolve, these guidelines should encourage better reporting of research over the coming years. With implementation by authors, journal editors, and peer reviewers, we anticipate that GESUQ will improve transparency, reproducibility, and completeness of reporting of research on genocide and health and, especially, much-needed research on evidence-based interventions for genocide affected populations.

Abbreviations

BR:

Prof. Bayard Roberts

CPPCG:

Convention on the Prevention and Punishment of the Crime of Genocide

DAGs:

Directed acyclic graphs

GESUQ:

Quality Assessment Tool for Quantitative Genocide Studies

HYK:

Prof. Haim Y. Knobler

IK:

Prof. Ichiro Kawachi

IRBs:

Institutional review boards

JL:

Prof. Jutta Lindert

mHealth apps:

Mobile health applications

MMK:

Prof. Martin McKee

MZA:

Dr. Moshe Z. Abramowitz

RM:

Prof. Richard Mollica

SES:

Socioeconomic status

SG:

Prof. Sandro Galea

STROBE:

Strengthening Reporting of Observational Studies in Epidemiology Statement

References

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Acknowledgements

The authors thank Linda Wulkau for helping to edit the manuscript.

Funding

The study was done without any additional funding.

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Authors and Affiliations

1. Department of Health and Social Work, University of Applied Sciences Emden/Leer, Constantiaplatz 4, 26723, Emden, Germany

Jutta Lindert & Moshe Z. Abramowitz

2. Women's Research Center, Brandeis University, Waltham, Massachusetts, USA

Jutta Lindert & Moshe Z. Abramowitz

3. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA

Ichiro Kawachi & Moshe Z. Abramowitz

4. Hadassah Medical School, Jerusalem, Israel

Haim Y. Knobler & Moshe Z. Abramowitz

5. Dean's Office, Boston University School of Public Health, Boston, Massachusetts, USA

Moshe Z. Abramowitz & Sandro Galea

6. Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK

Moshe Z. Abramowitz, Bayard Roberts & Martin McKee

7. Harvard Program in Refugee Trauma, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Cambridge, USA

Moshe Z. Abramowitz & Richard Mollica

Contributions

JL drafted the manuscript together with MM. All authors contributed with methodological expertise to the project. All authors contributed in writing. All authors added content and specific examples. All authors discussed the guidelines and decided upon standards. Furthermore, Jl, HYL, MA and TV provided expertise in the field of mass trauma and epidemiology. All authors revised and edited the manuscript critically for important intellectual content of the material. All authors read and approved the final manuscript.

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Correspondence to Jutta Lindert.

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Bayard Roberts is co-Editor-in-Chief of Conflict and Health. He was not involved in handling this manuscript.

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Lindert, J., Kawachi, I., Knobler, H.Y. et al. The long-term health consequences of genocide: developing GESQUQ - a genocide studies checklist. Confl Health 13, 14 (2019). https://doi.org/10.1186/s13031-019-0198-9
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Keywords

Genocide

Long term impact

Quality criteria

Mental health

Bias

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The long-term health consequences of genocide: developing GESQUQ - a genocide studies checklist - Conflict and Health

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Background Genocide is an atrocity that seeks to destroy whole populations, leaving empty countries, empty spaces and empty memories, but also a large health burden among survivors is enormous. We propose a genocide reporting checklist to encourage consistent high quality in studies designed to provide robust and reliable data on the long term impact of genocide.

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Is Russia Committing Genocide in Ukraine? (a)

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Is Russia Committing Genocide in Ukraine? (a)

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Irvin-Erickson, D. (2022, April 22). Is Russia Committing Genocide in Ukraine? Opinio Juris. Retrieved October 3, 2022, from https://opiniojuris.org/2022/04/21/is-russia-committing-genocide-in-ukraine/

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[Douglas Irvin-Erickson is Assistant Professor at the Jimmy and Rosalynn Carter School for Peace and Conflict Resolution, George Mason University, where he directs the Raphaël Lemkin Genocide Prevention Program.]
Dictator, assassin, war criminal. Russian President Vladimir Putin may soon add genocidaire to his resume.

A long line of blood runs from Chechnya, through Syria and Georgia, to Ukraine. Since 2014, in Ukraine, Russian forces have committed war crimes in the Donbas, and the repression of Crimean Tatars by Russian forces in Crimea certainly falls within the scope of crimes against humanity and has raised concerns of genocide.

Two things are different today, however. First, Putin has stated his genocidal intent in Ukraine in no uncertain terms. And, secondly, with United Nations and International Criminal Court investigations afoot, there is now a political opening for international justice after decades of inaction and global acceptance of three decades of mass atrocities and genocides committed or supported by the Russian army across the Middle East, the Caucuses, and Eastern Europe.

Genocide does not need to take the form of mass violence in order for it to be legally genocide. Article II of UN Genocide Convention outlaws the intended attempt to destroy national, racial, ethnical, or religious groups. Clearly the stated attempt to destroy the Ukrainian national group is inherently genocidal, therefore. Legally speaking, for genocide to be determined, the attempt to destroy one of the protected groups must be committed through one of the following five acts:

(a) Killing members of the group;
(b) Causing serious bodily or mental harm to members of the group;
(c) Deliberately inflicting on the group conditions of life calculated to bring about its physical destruction in whole or in part;
(d) Imposing measures intended to prevent births within the group;
(e) Forcibly transferring children of the group to another group.

Most of these five acts of genocide have been met.

There are a lot of problems with the law, and a lot of politics behind who gets accused of genocide and why. There are many reasons why genocide prosecutions might not be the best way to seek justice. Certainly, I too have argued the UN Genocide Convention is flawed instrument for justice and the legal definition of genocide a morally perverse hierarchy of social groups that suggests some are more important to humanity that others. But, let's set that aside for the moment and compare how the conflict is unfolding in Ukraine to what the law says.
The Case
It is very likely that that international courts will attempt to prosecute Russian defendants for genocide in Ukraine. If the Ukrainian government decided to prosecute international crimes in its domestic courts, not international courts, as I recently suggested could be done, then Ukraine can look to genocide prosecutions in Argentina as establishing important precedents. Argentine courts charged and secured convictions for Argentine military and political leaders committing genocide against the Argentine national group during the period of military junta rule from 1976 to 1983. These convictions are, arguably, not consistent with the jurisprudence around the international law of genocide, namely because courts in Argentina diverged from international precedents in the way they defined a "nation" as a protected group. Argentine jurists made a point of interpreting the "national groups" of the UN Genocide Convention in accordance with the legal theories of the jurists who helped write the UN convention, such as Raphaël Lemkin, and the diplomats representing member states from around the world who helped draft the treaty-not just the Americans and the British. This revealed a definition of national groups that was different from understandings of term in English, French, Dutch, and German political and legal traditions. These Western European (and North American) traditions largely view nations as large, coherent bodies of people united by common descent, history, or language, inhabiting a particular country or state, with intrinsic cultural characteristics.

Scholars have argued that the trials in Argentina did uphold a position consistent with international law, because domestic applications of international law by definition allows national courts to interpret international law according to local legal traditions, and thus "engage in flexible, culturally conscious translations of international norms." Daniel Feierstein, one of the world's leading legal theorists and the past president of the International Association of Genocide Scholars, led efforts in Argentina to interpret nations in the manner of Lemkin and many of the non-Western jurists at the UN, who believed national destruction could be achieved by seeking to destroy aspects of social diversity that were part of the fabric of national group.

Such destruction, often committed through idioms of national "purification" or eliminating internal threats, is now referred to as genocidal " reorganizing of society" or " partial national group destruction," which can be achieved through various forms of oppression, terror, and violence. The courts in Argentina accepted this reasoning, and eventually found the dictatorship committed genocide by virtue of their attempt to reshape the national identity of Argentine society by targeting for elimination leftist and urban social movements, and certain social identities perceived as subversive.

In the Russian war in Ukraine, the world is watching on live television these exact kinds of acts committed by the Russian army against Ukrainian society. The genocidal intent of the war has been clear from Putin's own statements, delivered to Russian and international audiences, before and during the war, which explicitly outline the destruction of the Ukrainian nation and ethnicity as the Russian state's policy objectives of the war.
Intent
Arguments for why the Russian war in Ukraine is not genocide revolve questions of whether or not it is possible to prove there is a Russian intent to destroy a group in Ukraine that the UN Genocide Convention protects. Such arguments ignore thousands of murders and overlook the deliberate imposition of conditions that destroy part of the Ukrainian national group, which is important because the UN Genocide Convention treats the attempt to partially destroy a protected group as genocide.

Others suggest Russia's war plan was to sweep Ukrainian President Volodymyr Zelensky from power, not wage a genocidal campaign of group selective destruction. This line of argument tends to suggest the Russians cannot be committing genocide in Ukraine because they are not making cultural and ethnic distinctions in their brutality, and are killing many ethnic Russians and Russians-speakers in Ukraine. This view, however, presents ethnic Russians and Russian-speakers as citizens of the country of Ukraine, but not members of the Ukrainian national group. Ultimately, this denies that ethnic Russians and Russian-speakers in Ukraine can see themselves as a full part of the Ukrainian nation. This argument, that ethnic Russian and Russian-speakers cannot be part of the Ukrainian national group, is absurd. President Zelensky-a patriot Ukrainian nationalist leader if there ever was one-speaks Russian as a first language and clearly sees himself as a member of the Ukrainian national group. Tens of millions of ethnic Russians and Russian speakers are fighting and struggling to preserve a Ukrainian nation they view themselves as belonging to.

Moreover, political elites in Moscow also view Russians in Ukraine, who clearly prefer to identify as Ukrainians, as not belonging to "their" Russian national group. In fact, there is good evidence that elites across the Russian state are intending to wage this conflict in these exact genocidal terms. Dmitry Medvedev, the former president and prime minister of Russia and the current Deputy Chairman of the Russian Security Council, called for the extermination of all Ukrainian radicals who deny that Ukraine and Russia is one nation. This claim inherently delegitimizes and marks for death anyone who holds a belief that being Ukrainian is different than being Russian. Included in this group of "radicals" marked for death would be anyone who speaks and sees themselves as Ukrainian and therefore not Russian, or any ethnic Russian or speaker of Russian who wants to be a Ukrainian. So, if this case is not legal genocide against national groups, then it is genocide against ethnic groups.

It is not just Putin and a handful of loyalists making these statements of genocidal intent. Over the last two months, Russian state media has been awash in elite speculation about what should be done to Ukraine after the Russian victory. The narratives, broadly synthesized from statements by Putin and other Russian leaders, have coalesced around a plan to destroy Ukraine as a nation-state and begin a campaign of de-Nazification, which should be understood as a euphemism for de-Ukrainianization because elite narratives in Russia draw a direct line between being Ukrainian and being a Nazi.

One prominent article published in the state run media outlet RIA Novosti cited highly placed sources who stated the state post-victory policy would be to erase the word Ukraine from map and "liquidate" the nationalist elite and a "substantial part of the populace" who are "beyond reeducation" out of their Ukrainian nationalism, while the rest of the population who are guilty of being Ukrainians but could still be saved through reeducation that would require a "generation-long program of ideological repression." As the noted scholar Eugene Finkel wrote recently, "It is hard to imagine a more actionable template to destroy a national group. The text's publication on a major state media platform would have been impossible without explicit approval from above."

Just because Medvedev, like many others, has articulated what are clearly genocidal ambitions for the Russian Security Council, does not mean that he can be automatically prosecuted for genocide. Granted, international lawyers do not need a prior order by the head of state or ruling elite to destroy in whole or in part a national, racial, ethnic, or religious group - a so-called "smoking gun" - to secure a conviction of genocide. This means Putin and Russian elites can be prosecuted for genocide even if they did not give the specific order to officers or individual soldiers to commit massacres in Bucha, or bomb hospitals and children's shelters across the country. To do so, however, genocide prosecutions must be able to connect the high level discourses and narratives of elites to the individual acts committed by those who carry out orders.

In war crimes tribunals, judges normally hold that simply showing a defendant was in a position of authority over those who committed the criminal act is all that is required for establishing a direct causal link between the accused and the criminal act. Even if a head of state claims they did not order a criminal act, Article III(e) of the UN Genocide Convention allows for complicity in genocide to be punished as genocide. Thus a head of state, or a commanding officer, can be found guilty of genocide for not preventing those under their orders from committing it. In these instances, all that is required to demonstrate the mental element of criminal liability is to show that the defendant must have known that the crime was going to occur as a result of his or her actions or inaction as a superior in the chain of command.

When it comes to those further down in the chain of command, all that is legally necessary to prosecute soldiers, officers, and mid-ranking officials for genocide is to demonstrate they obeyed orders they knew were given within the context of a plan of group destruction. To date, there is evidence of repeated cases of rape used as a weapon of war, committed by Russian soldiers against Ukrainian civilians, and there is much evidence of torture and summary executions of Ukrainians by Russian soldiers who repeated elite conspiracy theories and told their victims they were being killed in order to cleanse Ukrainian soil of Nazis. There are strong indications that evidence of many more executions will be forthcoming, with recent reports that German intelligence has intercepted communications of Russian soldiers discussing and planning the execution of Ukrainian civilians.

Legally, in certain contexts, the genocidal intent for such acts of violence can be shown when soldiers use the same forms of hate speech and dehumanizing language by the elites and state leaders in Moscow who are organizing and ordering the genocide. Calling Ukrainians "Nazis," and other forms of hate speech that Russian elites are using, can therefore expose individual soldiers to genocide prosecution when that speech accompanies an attack or assault. As Shannon Fyfe has argued, in certain contexts hate speech itself can even be prosecuted as incitement to genocide, which is important because Article III(c) of the Genocide Convention stipulates that "direct and public incitement to commit genocide" is punishable as genocide.
Justice Towards Peace
It is possible that the threat of prosecuting Russian war crimes will create a disincentive for Putin to stop fighting, and may even bolster his popularity at home. Both outcomes would unnecessarily drag the war on and increase human suffering. As Laurie Nathan and Tim Murithi recently debated, including a genocidal villain in a peace settlement that will ultimately save lives requires ceding painful concessions to that villain's power, especially when the concession is justice. And, yet, we know that true peace is never really achieved without justice.

It is possible that meaningful justice is not found in the actual legal judgements of tribunals, anyway, but the many social processes and political institutions that courts create a space for in the aftermaths of atrocities. And, for that matter, any sense of justice that victims and survivors gain from tribunals usually does not have much to do with the utopian ideas of human rights and democracy that international supporters of these tribunals like to talk about, but the way courts are able to document the suffering of victims and preserve memory.

Even if no verdict is ever reached, and the justice process stalls out at the stage of investigating and documenting atrocities, a tribunal that takes seriously the international law around genocide will still be important. Genocide tribunals are powerful political tools, which do play a significant role in preventing a return to violence by providing a forum where post-atrocity conflicts can be hashed out with words, testimony, and competing narratives instead of guns. This turns a courtroom into a " theater of ideas" where the drama of how a genocidal conflict should be remembered can build new forms of social solidarity around ideas of reconciliation. An international or national tribunal that includes the crime of genocide, even if it is never able to prosecute a single case, can support national truth commissions and public education efforts, and thus offer an important form of recognition for those who often remain silent after suffering, surviving, and witnessing such horrific events.

International criminal tribunals, or national tribunals supported by Ukraine's allies, are the best way to investigate and document atrocities according to the highest possible evidentiary standards and scholarly conventions. And, documenting what happened will matter. It always does.

Genocide, at its very core, is a philosophical denial of the principle of diversity, and a fundamental denial of the equal humanity of the victims. As such, the denial of genocide by those who commit it is actually part of the logic of genocide, carrying the dehumanization of the victims forward into time, and grounding future claims that the victims were responsible for what happened to them and deserved it. Though maybe not the final stage of genocide, denial is certainly stitched into the very conflict systems from which genocides emerged in the first place.

Even if the reasons why the genocide happened are eternally contested in perpetual culture wars over history and memory, telling the truth about what happened will fight denial and uphold the dignity and humanity of the victims that the very act of genocide denies.

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Is Russia Committing Genocide in Ukraine?

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Douglas Irvin-Erickson is Assistant Professor at the Jimmy and Rosalynn Carter School for Peace and Conflict Resolution, George Mason University, where he directs the Raphaël Lemkin Genocide Prevention Program.] Dictator, assassin, war criminal. Russian President Vladimir Putin may soon add genocidaire to his resume.

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Is Russia Committing Genocide in Ukraine? (b)

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Is Russia Committing Genocide in Ukraine? (b)

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Is Russia Committing Genocide in Ukraine? (n.d.). United States Institute of Peace. Retrieved October 3, 2022, from https://www.usip.org/publications/2022/09/russia-committing-genocide-ukraine

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Is Russia Committing Genocide in Ukraine?

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Russian troops forced to beat a hasty retreat in Ukraine are leaving behind evidence of war crimes and crimes against humanity. As this body of evidence grows, officials and experts are becoming increasingly convinced that Russia is committing genocide against the Ukrainian people.

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What is Genocide? (n.d.-a). Retrieved October 3, 2022, from https://www.ushmm.org/genocide-prevention/learn-about-genocide-and-other-mass-atrocities/what-is-genocide

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Genocide is an internationally recognized crime where acts are committed with the intent to destroy, in whole or in part, a national, ethnic, racial, or religious group. These acts fall into five categories:

1. Killing members of the group

2. Causing serious bodily or mental harm to members of the group

3. Deliberately inflicting on the group conditions of life calculated to bring about its physical destruction in whole or in part

4. Imposing measures intended to prevent births within the group

5. Forcibly transferring children of the group to another group

There are a number of other serious, violent crimes that do not fall under the specific definition of genocide. They include crimes against humanity, war crimes, ethnic cleansing, and mass killing.

Origin of the Term Genocide

The word "genocide" did not exist prior to 1944. It is a very specific term coined by a Polish-Jewish lawyer named Raphael Lemkin (1900-1959) who sought to describe Nazi policies of systematic murder during the Holocaust, including the destruction of European Jews. He formed the word genocide by combining geno-, from the Greek word for race or tribe, with -cide, from the Latin word for killing.

Genocide as an International Crime

On December 9, 1948, the United Nations approved a written international agreement known as the Convention on the Prevention and Punishment of the Crime of Genocide. This convention established genocide as an international crime, which signatory nations "undertake to prevent and punish." Preventing genocide, the other major obligation of the convention, remains a challenge that nations, institutions, and individuals continue to face.

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What is Genocide? - United States Holocaust Memorial Museum

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Genocide as a term did not exist before 1944. Learn about its origins and legal definition.

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What is Genocide? (n.d.-b). Holocaust Encyclopedia. Retrieved October 3, 2022, from https://encyclopedia.ushmm.org/content/en/article/what-is-genocide

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The Term "Genocide"

The term " genocide" did not exist before 1944. It is a very specific term, referring to violent crimes committed against groups with the intent to destroy the existence of the group. Human rights, as laid out in the US Bill of Rights or the 1948 United Nations Universal Declaration of Human Rights, concern the rights of individuals.

In 1944, Polish Jewish lawyer Raphael Lemkin (1900-1959) coined the term "genocide" in a book documenting Nazi policies of systematically destroying national and ethnic groups, including the mass murder of European Jews. He formed the word by combining geno-, from the Greek word for race or tribe, with - cide, from the Latin word for killing. Noting that the term denoted "an old practice in its modern development," Lemkin defined genocide as "a coordinated plan of different actions aiming at the destruction of essential foundations of the life of national groups, with the aim of annihilating the groups themselves." The next year, the International Military Tribunal held at Nuremberg, Germany, charged top Nazis with "crimes against humanity." The word "genocide" was included in the indictment, but as a descriptive, not legal, term.

"[T]he allies decided in Nuremberg a case against a past Hitler, but refused to envisage future Hitlers, or like situations ... In brief, the Germans were punished only for crimes committed during or in connection with the war of aggression. Crimes against humanity were not an independent category of crimes in themselves. They were only considered crimes when their connection with other crimes could be established."
-Unpublished memoir of Raphael Lemkin

The Crime of Genocide

On December 9, 1948, in the shadow of the Holocaust and in no small part due to the tireless efforts of Lemkin himself, the United Nations approved the Convention on the Prevention and Punishment of the Crime of Genocide. This convention establishes "genocide" as an international crime, which signatory nations "undertake to prevent and punish." It defines genocide as:

[G]enocide means any of the following acts committed with intent to destroy, in whole or in part, a national, ethnical, racial or religious group, as such:

a. Killing members of the group;
b. Causing serious bodily or mental harm to members of the group;
c. Deliberately inflicting on the group conditions of life calculated to bring about its physical destruction in whole or in part;
d. Imposing measures intended to prevent births within the group;
e. Forcibly transferring children of the group to another group.

While many cases of group-targeted violence have occurred throughout history and even since the Convention came into effect, the legal and international development of the term is concentrated into two distinct historical periods: the time from the coining of the term until its acceptance as international law (1944-1948) and the time of its activation with the establishment of international criminal tribunals to prosecute the crime of genocide (1991-1998). Preventing genocide, the other major obligation of the convention, remains a challenge that nations and individuals continue to face.

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The term " genocide" did not exist before 1944. It is a very specific term, referring to violent crimes committed against groups with the intent to destroy the existence of the group. Human rights, as laid out in the US Bill of Rights or the 1948 United Nations Universal Declaration of Human Rights, concern the rights of individuals.

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Williams, T. (2016, October 6). Why Genocide Occurs. Heinrich-Böll-Stiftung. Retrieved October 3, 2022, from https://kh.boell.org/en/2016/10/06/why-genocide-occurs

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Abstract.
Why do genocides occur? This paper applies qualitative comparative analysis (QCA) to revisit this question, and analyses 139 cases of genocide and non-genocide. The paper demonstrates the importance of both priming, contextual conditions which provide a political opportunity structure conducive to genocide, as well as triggering, more proximate conditions which constitute immanent motivations. Most centrally, sufficiency is demonstrated for genocide occurrence when an autocratic regime and the salience of an elite's ethnicity are present, and are combined with either an exclusionary ideology or political upheaval. As such, the autocratic nature of the state provides an opportunity structure allowing genocide to occur, while the salience of elite ethnicity can serve as a motivation. Finally, the ideology and the political upheaval serve as an additional motivation or opportunity structure, respectively. While political upheaval can play a part in causing genocide, its role is much more understated than is suggested in previous literature.
Introduction
Why genocides occur has been one of the central debates within the study of genocide over previous decades and has been informed by studies from a range of disciplines. It is an important research endeavour as it is pivotal to identify the conditions under which genocide occurs if there is ever to be any possibility of preventing genocide from occurring. In an attempt to shed fresh light on the debate this paper conducts a Qualitative Comparative Analysis (QCA) of the 40 genocide cases and 100 non-genocidal incidents which occurred between 1955 and 1998. The data used here builds on data from the Political Instability Task Force's State Failure Problem Set as is common in much of the emerging quantitative genocide literature and in Barbara Harff's seminal statistical paper "No Lessons Learned from the Holocaust? Assessing Risks of Genocide and Political Mass Murder since 1955." ¹ While drawing on the same dataset as several papers before, this paper takes the dataset further and interrogates the cases from a new methodological perspective, QCA. With this alternative method which is based on set-theory it is possible to tease out deeper insights from the data and allow for a richer analysis of why genocides occur.

Specifically, QCA provides a method for capturing the general patterns of genocide occurrence while also allowing for complexity better than other methods used hitherto, constituting a significant step forward in the understanding of the causes of genocides. Although genocide is a complex phenomenon, this paper suggests ways of breaking down central conditions which coalesce across certain subsets of categories by applying an alternative methodology thus far not used to address this question. This paper demonstrates that QCA - which is neither traditionally qualitative nor quantitative - is a suitable and possibly preferential methodology for studying genocide occurrence as it uses Boolean algebra to identify multiple pathways to genocide with different combinations of conditions acting as causes of genocide in different cases. QCA systematically provides different profiles of condition combinations which provoke genocide outbreak, thereby identifying necessary and sufficient conditions. This paper demonstrates that sufficient and necessary causes can be found when examining genocides. The findings are less parsimonious than previous statistical results but offer a more realistic picture of the complex conditions that can be seen as sufficient or necessary for genocide to occur. This research, thus, has the potential of providing a framework for policy makers and civil society actors for anticipating when genocidal situations are more likely to arise, providing configurations of conditions of when genocide has occurred in the past.

This paper will first clarify some issues around the concept of genocide, before presenting a theoretical framework of different determinants emphasised in previous research and explaining the merits of the chosen QCA approach. Subsequently, the case and condition choice will be explained in detail, as well as their respective operationalisations. Finally, the results of the QCA will be presented and expanded in an empirical analysis, before bringing together these results to identify the central determinants of genocide and demonstrate how these results are a step forward for the study of genocide occurrence.
Why Do Genocides Occur?
This section will discuss various conditions identified previously as central to causing genocide occurrence. It is helpful to split them into two types of categories: priming, contextual conditions and motivating, triggering conditions. The first priming conditions provide a context which is opportune for genocide, and suggest conditions can help to overcome certain societal or international restrictions; these conditions should as such not suffice to cause genocide, but instead they necessitate a triggering conditions, something about why key actors want genocide to occur and thus instigate it. In the following discussion of various conditions, the presence of an autocratic regime and an economically autarkic economy can be seen as setting the context, while an exclusionary ideology has a more triggering character; other conditions could play into both categories to varying degrees. It is to be expected that any situation of genocide arises out of a context conducive to it, combined with triggering motivations. Thus, the QCA solutions are expected to combine several of the following conditions to create individually sufficient pathways to genocide. Genocide is taken here to mean "the promotion, execution, and/or implied consent of sustained policies by governing elites or their agents-or, in the case of civil war, either of the contending authorities-that are intended to destroy, in whole or part, a communal, political, or politicized ethnic group." ² This definition of genocides and politicides is the foundation of Harff's comprehensive list of genocides and politicides which underlies the dataset used in this paper.
Political Upheaval
The most commonly cited determinant of genocide occurrence, in both qualitative and quantitativestudies, is political upheaval and direct threats to governments which also finds a prominent position in Harff's study. ³ Harff defines political upheaval as "an abrupt change in the political community caused by the formation of a state or regime through violent conflict, redrawing of state boundaries, or defeat in international war." ⁴ In this context, Melson and Krain emphasise the importance of revolutions, ⁵ but it is also a category in which decolonisation or other radical system changes or collapses would equally be well placed. The logic behind all these is that political upheaval provides a context and a political opportunity structure which is conducive to starting genocide. With the constraints of a previous system removed, the legitimacy of the political community and its identity (including which groups constitute it) can be called into question. ⁶ Political upheaval provides the opportunity to re-define the demos, the circle of people included as constituents of the state, in a deinstitutionalised setting. ⁷ In the context of political upheaval, rules of conduct between the state and its population can become re-defined and enable a regime intent on genocide to implement a new eliminationist policy. The period of transition, and the often concurrent chaos, can also serve as a smokescreen for action against the targeted group, given that internal and external observers could be distracted by other macro-political transformation processes. Besides providing a contextual background, political upheaval can also be a motivational impulse and thus trigger genocide. In the throes of political upheaval, reigning elites may feel particularly threatened by certain groups they believe could try to exploit the upheaval to topple them, and thus desire to have these groups removed. The empirical founding of the impact of political upheaval since World War II is immense and Harff finds a significant impact on the risk of genocide occurrence, while Krain suggests that extra-constitutional changes (a similar concept) have a significant impact on this likelihood. ⁸

A further condition often associated with genocide occurrence is war, ⁹ and for Krain a country's involvement in civil war is the single most significant determinant of genocide occurrence in his statistical study. ¹⁰ War is here defined as "a contested incompatibility that concerns government and/or territory where the use of armed force between two parties, of which at least one is the government of a state, results in at least 25 battle-related deaths." ¹¹ War can be seen as a contextual condition which - as suggested above for political upheaval - provides a conducive opportunity structure for genocides to emerge: war allows the destruction of a population to happen as other policy options are closed off or the state becomes increasingly autonomous from other internal social forces, such as public opinion. ¹² Moreover, war provides the opportunity to scapegoat certain unwanted groups and portray them as internal enemies of the state who are coalescing with the external enemies one is fighting militarily in the war, triggering a genocide against them. Also, in particular in the context of guerrilla wars, wars can motivate governments to include genocide in military strategy as rebels are particularly dependent on their local populations for support and security. ¹³

Both political upheaval and war thus encompass a political opportunity structure founded on an exceptional situation which removes the standard constraints of government from the political elites. However, there are two key differences between war and political upheaval in the mechanics of how they affect genocide occurrence. First, political upheaval can be nonviolent, while war inherently brings with it the internal mobilisation of arms, minimally through the secondment of military troops, oftentimes also in the armament of civilian defence groups, paramilitaries or similar groups. This expansion of available weapons and their distribution to wider circles of the population make it possible to then implement a genocidal policy quickly and effectively, particularly if these civilian or paramilitary groups are encompassed in a strong military or other hierarchy of authority; furthermore, such armament and genocidal operations can go largely unnoticed in the more general context of military war action. Second, war - both civil and international - tends to strengthen the political elites' hold on power (in the areas under their control) as security fears in the population can increase popular support and facilitate rallying around the leadership in order to avert a military defeat; further, war is normally fought between two or more clearly demarcated parties, while political upheaval can include struggles for power between unclear and diffuse constellations of actors. Both these aspects differ fundamentally from political upheaval in which the political elites wanting to pursue genocide capitalise on political uncertainty and destabilisation.
Elite Ethnicity and Ethnic Cleavages
Defined as "states with re-existing internal cleavages and real opposition," ¹⁴ pluralistic states have often come into existence during the process of colonisation and decolonisation when multiethnic states emerged as borders were determined arbitrarily by colonial masters. ¹⁵ While ethnic fractionalization measures the actual degree of these internal cleavages, much more significant is the actual impact this has and the perception of these cleavages within the societies themselves. Thus, Harff suggests the incorporation of the ethnic character of the ruling elite, i.e. whether the ethnicity of the ruling elites is salient. The concept used here does not differentiate between whether the political leadership comes from a minority or a majority ethnic group but solely asks whether its ethnicity is important.

The causal logic underlining this condition is that if elites are disproportionately from one section of society and this power differential based on ethnicity is perceived as such and regarded as salient in the population, underrepresented groups may challenge this. These challenges to the elites' political power could prompt them to frame security and ideology in communal terms, e.g. advocating racial denigration or exclusion of the other groups. These ethnic factors, as argued here, could participate in causing genocide in conjunction with other conditions, such as political upheaval (as this creates a situation of uncertainty in which elites have incentives to mobilise along ethnic lines). Given the broad definition of genocide beyond just ethnic groups, it cannot be expected that the salience of elite ethnicity will be a determining feature for all genocides, but when present it will be able to help explain mechanisms for victim group identification and, to a certain degree, elite motivation.

A further condition that is sometimes mentioned is political and economic discrimination of a minority. However, such discrimination can lead to this group's political mobilisation and, in turn, to repression by the state. This repression can escalate into genocide. However, this is only an intervening condition and the discrimination will stem from other sources, such as disproportionate elite representation or an exclusionary ideology. Since political and economic discrimination of a group could only be an indicative warning sign of genocide, rather than the actual reason for genocide happening, it will not be included as a condition here. The decision to include only the salience of elite ethnicity is a pragmatic choice for the application of QCA, ¹⁶ but it is also theoretically more interesting to include this than discrimination as a condition in the analysis.
Autocratic Regime
Rummel adapted Lord Acton's iconic phrase on corruption to read "Power kills; absolute power kills absolutely." ¹⁷ In countries with limited and accountable power, democides (as he terms mass murder by governments of their own citizens) are less likely to happen because of cross pressures and the associated political culture. This argument can be focused on a more narrow definition of democracies, in which no one group can become the driving force and there is a democratic culture which "involves debate, demonstration, and protests as well as negotiation, compromise, and tolerance." ¹⁸ Inversely, autocratic regimes have a free hand at dealing with disagreeable groups with no other actors constraining their actions or contesting one-sided genocidal action, clearly demarcating this as an opportunity condition. This is reinforced by Colaresi and Carey's findings in their statistical analysis that genocide occurrence is conditional on "institutional executive constraints". ¹⁹ While Harff finds autocracies to be three-and-a-half times more likely to commit genocide than democracies, Krain finds no statistical relation. ²⁰ However, one can expect that it will play a role particularly in cases in which an exclusionary ideology is perpetuated by the elites, who then have free hand to act on their ideology, or in cases of political upheaval, as the autocratic elites must fear losing power and thus attempt to consolidate their position by drastically changing the playing field, as was evidenced by Hutu radicals in the 1994 Rwanda genocide.
Exclusionary ideology
Chalk and Jonassohn posit that modern genocide is implemented as an ideology, selecting victims according to who they are, not what they have or where they are, as in premodern genocides. ²¹ Harff also emphasises the importance of exclusionary ideologies and finds that they significantly impact the probability of genocide occurrence. She defines an exclusionary ideology as "a belief system that identiﬁes some overriding purpose or principle that justiﬁes efforts to restrict, persecute, or eliminate certain categories of people." ²² Freeman posited that while neither a strong state nor a pluralistic society were strictly necessary for genocide occurrence a genocidal ideology is. ²³ It does not seem apparent that such an ideology should be necessary for genocide occurrence, as there are several examples of cases in which genocide is a rational, political decision, rather than an ideological impulse. However, an elite that subscribes to an exclusionary ideology, and has the capacity to follow through, needs no other conditions for genocide to occur, making this a motivational condition. For instance, Mann demonstrates that the most important genocidal ideology in modernity has been that of the unified nation-state, from which the victim group is excluded. ²⁴ Exclusion becomes possible because in the process of building a new nation, a new identity can be created which redefines the demos (citizens of the state) to include only one ethnos (ethnic sub-group in the country), thus expelling the victim group from the security of citizenship and opening up the possibility of their destruction. This condition should not be conflated with the salience of elite ethnicity, as an exclusionary ideology can but does not need to be congruent with ethnic categorisations. For instance, in the context of a politicide, the exclusionary ideology can be directed also at groups which are politically, economically or socially defined, such as the urban population or intellectuals under the Khmer Rouge regime.
Economic and Political Autarky
A further contextual, opportunity condition not commonly mentioned in the genocide literature, which nonetheless played an important part in Harff's analysis, is a country's degree of international involvement and interdependence, particularly regarding how strong political and economic ties and dependencies are. ²⁵ Similarly to a democratic setting, this interdependence constrains elites' actions. The more interdependent a country is, the less likely it is to choose genocide as a course of action due to the possibility of facing hard repercussions from international reactions. On the other hand, there are two consequences for politically or economically relatively isolated (autarkic) states. Leaders of such states can, firstly, work on the assumption that they can act without having to fear too strong economic repercussions as their economies or political systems are for the most part dependent only on internal dynamics. For instance, countries with relatively independent economies will have less to fear from economic boycotts. Secondly, these state leaders can also assume that the occurrences within their borders will be less interesting and important for more powerful states, as they have few interests to protect here, and thus will be less likely to intervene in any genocidal action. In Harff's analysis, political interdependence has no significant impact, while economic interdependence does; following Harff's findings this analysis will include only economic interdependence.
Case Selection and Conditions Operationalisation
The QCA model for this paper takes as its unit of analysis events of political instability identified in the Political Instability Task Force's (PITF) State Failure Problem Set between 1955 and 1998, as is common in most recent contributions to quantitative genocide studies. ²⁶ The analysis focusses on occurrence of genocide as the dependent outcome (coded one for occurrence and zero for non-occurrence) and six key independent conditions. All values of independent conditions and dependent outcome must be coded dichotomously for all cases-is this condition present or absent in each case? Unless otherwise specified the values of these conditions are selected from the first year of the genocide or non-genocidal conflict (or as close as possible when data points are missing), in order to avoid reverse causality by which the genocide or non-genocide itself would impact these conditions which are supposed to be determining its outbreak. Table 1 shows the number of cases (genocidal and non-genocidal) per condition.

As genocide definitions vary, the lists of included cases in different studies diverge also. Most of the recent quantitative literature builds on the Political Instability Task Force's (PITF) State Failure Problem Set, which in its updated form includes genocides and non-genocides from 1955 until 2006 ²⁷ and this is also the basis for Harff's list and analysis. ²⁸ In order to ensure full comparability to the non-genocides regarding time frame, this paper focuses on genocides which began between 1955 and 1998, thus excluding only one of Harff's cases (Sudan since 2003), and resulting in altogether 40 cases of genocide in this study. Non-genocides are taken as any other case in the PITF consolidated list, encompassing 99 events coded as adverse regime changes, ethnic wars or revolutions, but which are not coded as genocide; the logic underlying this choice of nongenocides is that political instability or upheaval is posited widely to be a precursor for genocide. Therefore, as in Harff's study, the non-genocides included in this paper are interesting as they are cases of political upheaval which have not developed into genocide. This is possibly not the optimal operationalisation of the concept of non-genocides as potential genocides which did not happen, but in order to ensure the comparability of this study to Harff's seminal work and with the theoretical foundation of instability breeding genocide, it would seem a plausible strategy. Nonetheless, it will still be an important part of this paper to analyse the importance of political upheaval in determining genocide occurrence. However, rather than looking into the mere presence of political upheaval, it will look at the magnitude of political upheaval present in a country, thus avoiding any interaction between the condition of political upheaval and the outcome genocide or non-genocide.

Table 1: Overview of condition distribution.
Autocratic regime (A)
This indicator of whether a regime is autocratic (1) or non-autocratic (0) is taken from the Polity IV dataset variable POLITY ²⁹ and reassessed using Freedom House's Freedom in the World index. ³⁰ Altogether, there are 107 autocracies included in the study, along with 32 democracies; 95% of genocidal events occur in autocratic countries and 69% cases of nongenocides are also autocratic.
Political upheaval (P)
Given the focus on political upheaval in the definition of the outcome, the condition of interest here is not the presence or absence of political upheaval itself, but- following Harff-a differentiation between high levels and low levels of political upheaval. A case is classified as being in political upheaval (P) if either the difference of the highest and lowest democracy / autocracy values over the whole conflict is 10 or higher (indicating a system change from either autocracy to democracy or vice versa), or if the maximum value of the political upheaval variable in Harff's dataset during the conflict is 30 or higher. ³¹ Harff operationalises political upheaval using the "the sum of the maximum magnitude of events in the prior 15 years, including revolutionary wars, ethnic wars, and regime crises" from the State Failure Problem Set. ³² Thus, the value 0 indicates that there were no such politically upheaving events in the 15 years prior to the genocide or non-genocide, while the value 60 indicates that each of the previous years had the highest upheaval magnitude of 4. Any cases with a value of lower than 15 were classified as not having political upheaval while all intermediate cases (between 15 and 30) were classified after a qualitative assessment of the individual cases by the author; this qualitative assessment of intermediate cases ensures that the thresholds are not arbitrary. Altogether, there are 56 cases in which high political upheaval is present, which constitutes 40% of the dataset. As with autocracy, a significant difference is notable between genocides and non-genocides, with 62.5% of genocides having some degree of prior political upheaval, while this is only the case in 31% of non-genocides.

Data on whether a country is at war was taken from the UCDP-Peace Research Institute, Oslo (PRIO) armed conflict dataset, ³³ classifying any case as at war (1) if it was labelled as such in the armed conflict dataset during any year of the case (80 cases (58%), whereby 65% of genocidal events occur in the context of war, compared with 54% of non-genocidal events).
Exclusionary ideology (I)
Harff codes exclusionary ideology herself as "belief systems that are articulated by governing elite, and that identify some kind of overriding purpose or principle that is used to restrict, persecute, or eliminate categories of people who are defined as antithetical to that purpose or principle." ³⁴ In cases in which there is no coding available from Harff, cases were coded by the author according to in-depth accounts of the cases. Hereby, 1 signals the presence of such exclusionary ideologies among the elites (47 cases). 62.5% of genocides have an exclusionary ideology present, in contrast to only 22% of non-genocides.
Salience of elite ethnicity (S)
Regarding the salience of elite ethnicity the dataset differentiates between elite ethnicity not being salient (0) (62 cases) and ethnicity being salient whereby the political leadership is representative of a majority or minority communal group or coalition (1) (77 cases). In Harff's analysis, she divides the latter category into two; however, this differentiation is not needed here as there is no theoretically plausible reason for there to be a difference between majority and minority communal groups.
Economic autarky (E)
Data on the condition regarding economic interdependence and autarky was sourced from World Bank import and export data. These data were added together (as percentages of the country's gross domestic product in the relevant year) to indicate the trade openness of a country. Case were coded as economically autarkic (1) if their trade percentage was below the world average according to the World Bank data over the relevant time frame from 1960 until 1998, which was 33% (41 cases), and otherwise as economically interdependent (0) (98 cases).
QCA - an Intermediate Method for Multi-Causal Phenomena
Qualitative Comparative Analysis (QCA) is first used here to study the subject of genocide occurrence. Popularised in the social sciences by Charles Ragin, ³⁵ this method categorises cases by combinations of conditions leading to the occurrence or non-occurrence of the outcome, and reduces these combinations to the lowest common denominator using Boolean algebra. By executing this reduction one can show which conditions are necessary and which are sufficient for causing the outcome. The dependent outcome can be caused not by the same condition in all cases, but by different combinations of multiple conditions, each coming to a fore in different cases.

QCA is thus an intermediate method between quantitative and qualitative methodologies, as it traditionally relies on a strong qualitative judgement by the researcher when categorising the cases, but uses a mathematical technique to categorise and reduce complexity. Its key advantage is its ability to cope with multiple pathways to an outcome, each consisting of different combinations of conditions. QCA allows several conditions to act together in unison, following a conjunctural logic, and also allows for conditions to act differently in different cases depending on their interaction with other conditions. Another key strength, the importance of the qualitative input of the research when coding the conditions, is also its main weakness. As a set-theoretical method, it can only cope with dichotomous conditions, thus losing much information about the countries being studied and not sufficiently allowing for ambiguous cases to be coded appropriately, as they must fit the box. However, there are methodological developments towards fuzzy set QCA (fsQCA) which allows for a more continuous categorisation. However, fsQCA cannot work with a dichotomous outcome such as genocide occurrence, so this paper will remain with classic so-called crisp set QCA (csQCA), pointing out contentious categorisations. Thus, with this method, this paper hopes to go beyond Harff's original statistical analysis, ³⁶ pinpointing several key combinations that can lead to the occurrence of genocide. While QCA is classically used for medium-n datasets, its application to larger numbers of cases is not unprecedented and allows for a different perspective on the data than a statistical analysis would allow, better allowing for equifinality and complex, configurative causation. ³⁷
Why do Genocides Occur? Empirical Results from the QCA
To approach this data with QCA, each condition must first be specified for each of the cases. Purely by looking at this unsorted table, as well as Table 2 below, it is plain to see that autocratic regimes (A) are present in nearly all genocide cases (38 out of 40, that is 95% of cases), approximating a perfect score as a necessary cause for the outcome of genocide occurrence. This goes against the argument that liberal democracies also perpetrate genocide, but for post-1945, physical genocides this result of most occurring in autocratic settings remains interesting. ³⁸ However, some cases of non-genocide also occur in autocracies - thus an autocracy is a necessary condition for genocide occurrence, but not sufficient. The truth table also provides further central conditions which are sufficient for genocide occurrence, i.e. that the presence of this combination will always lead to the outcome, although not all instances of the outcome will be caused by this combination.

This analysis of sufficient conditions is the cornerstone of QCA and requires the re-categorisation of this information into a so-called truth table in which each logical combination of independent conditions constitutes one row. This study has six conditions (A, P, W, I, S, E) ³⁹ leading to the outcome genocide, meaning that there will be 64 (26) rows of possible combinations in the truth table. A row could read A*P*W*I*S*E (as in the case of Rwanda 1994), and A*P*W*~I*S*E (as in the case of Bosnia 1992-95). ⁴⁰ The truth table then assigns to these combinations the presence or absence of the outcome; in these two cases, it is present. By combining the two terms, one can say that I is irrelevant for the outcome genocide in the presence of all other five conditions, as I is present in one

Table 2: Autocracy as quasi-necessary for genocide.

case and absent in another. By continually combining truth table rows in this manner, it is possible to reduce the whole table to a selection of solution sets. ⁴¹

As the amount of combinations rises exponentially by the number of conditions included, the six conditions included here produce a relatively intricate solution. When the data is reduced according to the principles of Boolean algebra, there are several possible ways for the condition combinations to be reduced, complex, intermediate and parsimonious solutions. ⁴² Here an intermediate solution has been chosen, but the complex and parsimonious solutions are reported in the appendix. It is normally standard practice to select an intermediate solution, so that as many genocides as possible are covered by the solution, without including too many non-genocides as well; also, in this case the complex and parsimonious solutions lose out strongly regarding coverage and consistency values, ⁴³ respectively, vis-à-vis the intermediate solution; further, with five configurations the intermediate reduction allows for a more meaningful interpretation of the solution. Using this intermediate solution one receives the following formula:

These five terms altogether can explain a significant amount of variance between genocide and non-genocide. First, technical features of this solution will be discussed and then what it means substantively for the research question of why genocides occur.

Table 3 lists coverage and consistency scores for this solution. The coverage score of 0.750 indicates that altogether this solution can explain 75% of genocide cases, that is 30 out of 40 genocide occurrences, leaving only one quarter of the cases of genocide unexplained. Nonetheless, the consistency is not perfect and with these combinatory solutions, some non-genocides are also predicted to be genocides: 76.9% of the cases with these condition combinations are actually genocides, whereas only 23.1% are non-genocide, so-called false positives. Altogether 39 cases were predicted as genocide, of which 30 were actually genocides, and 9 were non-genocides, a good result regarding consistency. Following from this, it means that 90 non-genocides were successfully predicted as such as they were not included in the configurations.

While this result does not provide absolute sufficiency, given the complexity of this topic, this is an extremely high score for consistency and is better than in many comparable studies. It also performs considerably better than Harff's model. ⁴⁴ While the amount of genocides correctly classified is comparable with Harff's value of 74%, Harff's model incorrectly predicts 27% of nongenocides as false positives, while this model only predicts 9% of the non-genocides to be genocide. Altogether, this means that this QCA-produced model can discriminate better between genocides and non-genocides than Harff's model based on logistical regression.

The configurations in this solution have certain elements in common, so that one can re-write them in the following way, which substantively is the same, but tells us more about how the terms are connected:

Substantively this means that genocide will occur, firstly, in autocracies (A) ⁴⁵ in which the ethnicity of the government members is salient (S) when an exclusionary ideology is present (I) or the country is in a state of major political upheaval (P). The second set of configurations suggests that autocracies (A) with exclusionary ideologies (I) experience genocide when their economies are autarkic (E) and the county is either in a state of political upheaval (P) but not at war (~W), or reversely at war (W) but not in a state of political upheaval (~P). Lastly, a remainder of genocides can be predicted in countries in which the ethnicity of the elites is salient (S), but in which there is no exclusionary ideology (~I) when the country's economy is autarkic (E), the state is in political upheaval (P) and at war (W).
Discussion of the underlying mechanisms
The two primary configurations which are most interesting due to their large coverage are A*S*I and A*S*P. This can be interpreted that the autocratic nature of the state provides a context which is primed for genocide, that is an opportunity structure allowing genocide to occur, while the salience of elite ethnicity can serve as a more proximate trigger, providing a motivation for elites, or at least as a categorisation along which lines of demarcation between the victim group and the rest of the population can be drawn. Finally, the ideology and the political upheaval serve as an additional motivation or opportunity structure, respectively. While Aand S are not sufficient alone, the addition of either this additional motivation I (within a slightly more constrained opportunity framework-just A, not A*P) or with less motivation (I not included) but within a stronger opportunity framework (A*P) allows genocide to occur. In the presence of an exclusionary ideology, the elites can want to enforce this through rigorous exclusionary policies, which can culminate in genocidal practices of elimination. On the other hand, in a context of high political upheaval, elites can feel threatened by challenging groups and then decide to target for elimination the group which is challenging them. They are able to do this as the political upheaval provides a framework in which a scapegoat can be identified and then use its elimination to consolidate their power and support in the population in the face of an imaginary threat. This is particularly interesting as it undermines the central importance of political upheaval as it has been posited not only in Harff's study, but also in much of the (comparative) case study literature. Political upheaval is one way to expand the political opportunity structure for elites in order that they can commit genocide if they have a sufficient motivation; however, it is not the only factor and it pales in significance with autocracy, for example, which is necessary in nearly all combinations leading to genocide occurrence. With enough motivation present in the form of an exclusionary ideology, the opportunity structure provided by political upheaval becomes irrelevant.

Table 3: Solution case coverage and consistency by combinations.

Solution coverage: 0.750.
Solution consistency: 0.769.

The underlying mechanisms of these configurations can be best understood by highlighting the dynamics in individual cases. ⁴⁶ The mechanisms of the configuration A*S*I are well exemplified in the case of the genocide in Cambodia in the late 1970s: Pol Pot's clique of French-educated Khmer Rouge brothers took over power after a protracted armed struggle in 1975 and subsequently ruled through one of the most totalitarian regimes of the 20th century (A). This all-encompassing power of Ângkar, the Organisation, provided fertile turf for the regime to implement their extreme Communist ideology, which also fed on radical anti-Vietnamese rhetoric, underlining the importance of the leadership's Khmer identity (S); the vision that the Khmer Rouge had for Cambodia encompassed an extreme ideology which was geared at returning the country to an agrarian economy and glorifying the role of the peasant. In this context, the ideology was exclusionary (I) towards the urban population and intellectuals particularly, forcing all to evacuate the cities and become second-class citizens who had no rights at all; also they enforced racist (and thus exclusionary and eliminationist) policies towards the country's Vietnamese and Muslim Cham minority populations, as well as towards foreign nationals in the country.

Another example of this configuration, a case which is explained uniquely by A*S*I, is provided by the Serbian genocide of ethnic Albanians in Kosovo between February 1998 and June 1999, which ended through NATO bombing and a ceasefire allowing NATO administration of Kosovo. Again, this occurred in the context of a more autocratic than democratic government under Slobodan Milosevic (A), whose Serbian identity was extremely important in politics (S), having cemented itself during the previous wars in the early 1990s with Slovenia, Croatia and in Bosnia, including the genocide which occurred there. This Serbian ethnic identity, as propagated by Milosevic and his nationalists, also incorporated a strong exclusionary ideology, as it is was purported that Serbia was for Serbians only and that the other nationalities within its borders should leave or be eliminated (I). Furthermore, Milosevic attempted to use this conflict, as he had the previous genocide in Bosnia, to frame security concerns along ethnic lines, and thus cement his hold on power and rally the population behind him.

Turning to the next configuration, Rwanda presents itself as an excellent example of A*S*P. The country under Juvénal Habyarimana did have multi-party parliament, but the system was nonetheless highly autocratic and dominated in all aspects of political life by Habyarimana's Mouvement républicain national pour la démocratie et le développement (MRND) party (A), which instigated and led the Hutu Power movement, proclaiming Hutu leadership as the only legitimate leadership for Rwanda (S) and branding the Tutsi minority as aliens in the country with increasingly few rights; the situation worsened after Habyarimana's airplane was shot down and he died, as hardliners took power and systematically assassinated all moderate political leaders (P), thus paving the way for the genocide against the Tutsi minority.

A case explained uniquely by the combination A*S*P is that of the genocide against Muslim Bosniaks by ethnic Serbs in Bosnia between 1992 and 1995. In the context of the break-up of the Yugoslav Federation in the early 1990s (P), war broke out between several of the republics, first
between the central state which was dominated by Serbia and Slovenia, followed soon by Croatia, a conflict into which eventually Bosnia was also caught up. Both Croatia and Serbia had increasingly nationalistic leaderships (S) who mobilised along these ethnic lines of Serbian and Croatian in order to mobilise support and consolidate their grip on power (A). The political upheaval experienced in these countries gave the political leaders the opportunity to consolidate their power vis-à-vis their political opponents and to attempt to retain their positions in the course of these violent transitions. Particularly the ethnic Serbian military and paramilitary groups in Bosnia aimed at ethnically cleansing their territory and in this context engaged in genocidal action against the Bosniaks, expelling them from their homes and often killing the population.

As indicated in Table 3 the configurations A*S*I + A*S*P cover by far the most cases within the dataset, explaining most of the cases of genocide and non-genocide, and were thus the focus of the further discussion here. However, the other three configurations all have perfect consistency, explaining an additional four unique cases not explained by the main two configurations, while not adding any extra non-genocides as false positives.

The configuration S*~I*E*P*W uniquely explains only the genocide in Pakistan from 1973 until 1977. In Pakistan there was a war against Balushi separatists (W) which was prompted by a rebellion backed by the National Awami Party against the economically autarkic (E) Pakistani central state - a form of political upheaval (P) - which was motivated by the ethnic composition of the government (S), but not by any exclusionary ideologies propagated by them (~I). Primarily the specificity of this case is due to it being one of only two cases which occurred in countries which were not classed as autocracies.

The other two configurations which are less interesting by coverage, but have perfect consistency, thus being truly sufficient for genocide occurrence are A*I*E*P*~W and A*I*E*~P*W, which can be summarised as A*I*E* (P*~W + ~P*W). Given that they both lack the condition ethnic salience of the elite, it is plausible that these could be better at explaining politicides than the other discussed configurations, while at the same time still providing a distinct pathway into this form of mass violence; this cannot be conclusively resolved here as Harff's dataset does not differentiate between the two, but could be an interesting avenue for further research.

Both configurations include the necessary condition autocracy combined with an exclusionary ideology and the context of economic autarky. Here ideology presumably plays the part of the motivation for genocide as a strategy for dealing with a minority, while the autarkic economic system provides a facilitative condition under which this can occur, as the state does not have to fear that sanctions will damage its economy; one could frame this as the opportunity. However, the economic autarky is not sufficient in providing the opportunity for genocide (even in the absence of democratic controls in an autocratic country, but must be supplemented by either political upheaval in the context of peace (or at least the absence of war), or in the context of war without political upheaval. This suggests that political upheaval and war are not complimentary but interchangeable in the absence of the other. This can best be highlighted by two of the uniquely explained cases for the configurations A*I*E*~P*W and A*I*E*P*~W, China in 1959 and China from 1966 to 1975 respectively. ⁴⁷ Both settings are relatively similar, given that it is the same country, with an autocratic regime, with an exclusionary ideology and in a context of economic autarky; here already the exclusionary ideology suffices as a motivation to commit genocide, and the autocratic regime and the autarkic nature of the economy provide an opportunity, but are not sufficient in and of themselves for genocide to occur, necessitating the inclusion of either political upheaval or war as a further facilitating opportunity factor. In the genocide of 1959, in which people who were deemed as counterrevolutionary were targeted for elimination, including Tibetan Buddhists, landowners, and supporters of the former Chiang Kaishek regime; this occurred in the context of war against Tibet, providing an opportunity structure for the Communist leadership to define people they wanted to eliminate as state enemies. On the other hand, from 1966 to 1975, the genocide was truly a politicide targeting many groups within society for arrest, torture and execution, in order to further the aims of the Cultural Revolution. This, however, did not occur in the context of war, but instead was directly connected to the political upheaval of the Cultural Revolution, which provided not only the opportunity structure for committing such atrocities, but also the motivation to cleanse society in order to establish the new order envisaged by Mao Tse-tung.
False Negatives and False Positives
While the results of the QCA analysis identify several convincing pathways to genocide occurrence, these cannot explain all cases of genocide included in this study and the pathways sometimes falsely predict genocide, where actually a non-genocide occurs. False negatives are cases which experienced genocide, but their specific combination of conditions was not included in any of the solution configurations and thus genocide was not expected. For the false positives, the configurations predicted that genocide would occur, but the case is actually among the countries that did not experience genocide. Compared with Harff's statistical analysis, ⁴⁸ the model classified a similar proportion of genocides correctly with around one quarter of cases being false negatives, but this model reduces the proportion of false positives, that is non-genocides predicted to be genocide, radically to 9% compared with Harff's 27%.

False negatives misclassify genocides, with the solution configurations not expecting them to be genocides and thus reducing the coverage of the overall solution. ⁴⁹ Half of these were also genocides which Harff could not explain in her study, and Harff identifies weaknesses in the dataset as the key reason for this, something which is likely to also impact this study as it builds on the same data. ⁵⁰ The main problem is the political upheaval condition which takes the maximum value of political upheaval during the event; however, due to the cumulative nature of the condition, this is biased against short episodes. Argentina (1976-80) was coded as not in political upheaval due to the very low scores in the political instability data, however, given the dynamics of Peronist vs. military power struggles during this time, a qualitative assessment of the case would probably have coded this as political upheaval. The overthrow of the Allende administration by General Pinochet in Chile (1973-76), separatist aspirations of the Katanga province in Democratic Republic of Congo (1977-79), the violent separation of Bangladesh from Pakistan (1971), the turmoil surrounding Idi Amin's ascent to power in the Ugandan case (1971-79) could be equivalently argued. Similarly, Burundi (1988) was also coded as not in political upheaval, unlike the genocide in 1993; however, the power struggles between the Tutsi-dominated military and democratic reformers predated the 1993 genocide and could have allowed a qualitative assessment of Burundi being in political upheaval at this time. Furthermore, the Philippines (1972-76) was coded 0 on the category of salience of elite ethnicity, which captures the diversity of clans and ethnicity coalescing for power in Manila, but does not do justice to the fact that all of these were Christians, whereas the genocide victims were Muslim Moros from Mindanao, thus making the classification the probable reason for this misprediction as non-genocide. By using Harff's dataset an immediate comparability to her results is possible, but this also comes at the cost of some misclassifications in the data which she had already been forced to contend with.

Besides these genocides not covered by the solution, the two main configurations are also not strictly sufficient, as there also exist non-genocides in which these conditions are present, so-called false positives. ⁵¹ One possible explanation for some of these cases is the fact that they are very similar to other cases which were actually genocide, as they are temporally proximate and occur in the same country, thus sharing some of the same structural conditions. This is the case for nearly half of the false positives: Algeria (1991-xx), Cambodia (1997), DR Congo (1992-xx) and Pakistan (1983-xx). In future research, a more differentiated focus would be possible if one can overcome the dichotomy of conditions, meaning that more structural conditions would be able to vary more subtly over time. Furthermore, some cases' false prediction of being a genocide could also, as with the false negatives, be due to coding problems: Both Turkey (1971) and Romania (1989) were coded as having an exclusionary ideology in Harff's dataset, a categorisation which could be contested.
Conclusion and Outlook
The aim of this paper was to look into the research question of why genocides occur and what combinations of conditions play together to determine its occurrence, and further this research agenda by applying a different methodology to previous studies: the set-theoretic QCA. The key advantage provided by QCA is that it allows for complexity and explicitly models into its analysis the complexity of the world, while also showing up generalisable patterns. The analysis of genocide using QCA provides multiple combinations of conditions which are sufficient for causing genocide to occur, thus allowing for several pathways to be described and each of these to present a relatively complex picture; thus, it does not present results as parsimonious as statistical analyses, but radically reduces the complexity of why genocide occurs in each individual instance to observable patterns. Using the conjunctural and combinatorial logic of QCA, this paper examined 139 cases of genocide and non-genocide from the Political Instability Task Force's (PITF) State Failure Problem Set in direct comparison to Barbara Harff's seminal statistical study on genocide occurrence. This paper presented more systematic results than past research regarding sufficient and necessary conditions. The analysis revealed that the presence of an authoritarian regime is necessary for genocide to occur. Furthermore, autocratic regimes with governments whose elites' ethnicity is salient will experience genocide in the presence of either an exclusionary ideology or high political upheaval; also, the same outcome will occur if an economically autarkic autocracy propagates an exclusionary ideology in the context of either high political upheaval, not in war, or in war without high political upheaval.

Furthermore, this analysis brings more depth into the discussion of the different conditions which coalesce to make genocide occur, demonstrating not just the impact of individual conditions as most statistical work does, but instead showing how the conditions combine to certain configurations which are sufficient for genocide. By pursuing this methodology, it is possible to take previous findings of what are important determinants of genocide and structure them into meaningful combinations.

The fact that the presence of autocratic regimes is necessary for genocide to occur is perhaps not surprising due to the dichotomous nature of this condition, but is certainly an interesting finding of this paper. Furthermore, it is interesting to note that while political upheaval can play a part in causing genocide, its role is much more understated than is suggested in previous literature, including in Harff's analysis. Political upheaval is necessary in the provision of an augmented opportunity structure in the context of autocratic regimes with ethnically salient governments, with the former providing a baseline of opportunity and the latter a fundamental genocidal motivation;
however, political upheaval became irrelevant when an exclusionary ideology was present, as this provided an overarching motivation which can be realised even within the context of a minimal autocratic opportunity structure. Also, in other configurations political upheaval is not as central as previously asserted, as the solution demonstrated that it is functionally equivalent to the occurrence of war, both providing an opportunity structure in addition to the autocratic regime.

This paper presents a new perspective on why genocides occur and opens up new avenues for future research: First, this paper has had to work with crisp set QCA using only dichotomous conditions. If it were possible to find an ordinal scale for genocide or a way of identifying cases as partly genocidal, then one could run more rigorous fuzzy set QCA tests, allowing for continuous coding of all conditions without reducing the complexity of the available data to a simple 0/1 dichotomy. Second, the country-level is probably not the most appropriate for the study of genocide, as some genocides occur within specific regions of a country, while others are perpetrated by one government but across borders into other countries. It would be a worthwhile endeavour to conduct a study which took these different spatial issues into account. Finally, as suggested in the discussion section, it could be interesting in a future study to differentiate between different types of genocide to gauge different pathways-the differentiation between politicide and genocide could be one avenue, but further work on typologising genocide could also bring to light helpful nuances. This could possibly strengthen the results and allow for a clearer set of conditions to crystallise for each distinct phenomenon.

Given that genocides vary greatly in their implementation and thus reality is extremely complex, the reduction of the dynamics across 139 cases to these combinations is certainly a success, demonstrating some more generalisable dynamics across cases. While this paper was not able to provide such clear-cut and parsimonious results as previous statistical analyses, it is able to provide new insights into genocide occurrence due to QCA's unique combinatorial and conjunctural approach. With these results and with further developments of the dataset and its analysis, policy makers and civil society actors should be better armed to take the identified configurations and flag situations which are particularly at risk of genocide occurring. The complex nature of the several pathways and each of their configurations allows these actors to better understand which dynamics occur under which circumstances and how the same condition can have varying effects in different contexts. Altogether, this complex-orientated approach will allow more tailored responses to at-risk situations to be developed and possibly play a contribution to ridding the world of the scourge of genocide.

¹ Harff, Barbara. 2003. "No Lessons Learned from the Holocaust? Assessing Risks of Genocide and Political Mass Murder Since 1955." American Political Science Review Vol. 97, No. 1, 57-73. Other quantitative genocide literature based on PITF data includes Colaresi, Michael and Sabine C. Carey. 2008. "To Kill or to Protect: Security Forces, Domestic Institutions, and Genocide." Journal of Conflict Resolution Vol. 52, No. 1, 39-67. Esteban, Joan, Massimo Morelli, and Dominic Rohner. Forthcoming. "Strategic Mass Killings." Journal of Political Economy. Goldsmith, Benjamin E., Charles R. Butcher, Dimitri Semenovich, and Arcot Sowmya. 2014. "Forecasting the Onset of Genocide and Politicide. Annual out-of-sample forecasts on a global dataset, 1988-2003." Journal of Peace Research Vol. 50, No. 4, 437-452. Krain, Matthew. 1997. "State-Sponsored Mass Murder: The Onset and Severity of Genocides and Politicides." The Journal of Conflict Resolution Vol. 41, No. 3, 331- 360. Montalvo, Jose G. and Marta Reynal-Querol. 2008. "Discrete Polarisation with an Application to the Determinants of Genocides." The Economic Journal Vol. 118, No. 9, 1835-1865. Rost, Nicolas. 2013. "Will It Happen Again? On the possibility of forecasting the risk of genocide." Journal of Genocide Research Vol. 15, No. 1, 41-67. Ulfelder, Jay and Benjamin Valentino. 2008. "Assessing Risks of State-Sponsored Mass Killing." Working Paper.

2 Harff, "No Lessons Learned", 58.

³ Chalk, Frank and Kurt Jonassohn. 1990. The History and Sociology of Genocide: Analyses and Case Studies. New Haven: Yale University Press. Harff, "No Lessons Learned". Krain, "State-Sponsored Mass Murder". Goldsmith et al. "Forecasting the Onset of Genocide and Politicide". Melson, Robert. 1992. Revolution and Genocide. On the Origins of the Armenian Genocide and the Holocaust. Chicago: University of Chicago Press. Rost, 'Will It Happen Again?'. Rummel, Rudolph. 1994. Death By Government. New Brunswick: Transaction Publishers. Weitz, Eric D. 2003. "The Modernity of Genocides; War, Race, and Revolution in the Twentieth Century." in The Specter of Genocide: Mass Murder in Historical Perspective. Edited by Robert Gellately and Ben Kiernan, 53-74. Cambridge: Cambridge University Press.

⁴ Harff, "No Lessons Learned ", 62.

⁵ Melson, Revolution and Genocide. Krain, "State-sponsored mass murder".

⁶ Melson, Revolution and Genocide, 21.

⁷ Mann, Michael. 2005. The Dark Side of Democracy: Explaining Ethnic Cleansing. Cambridge: Cambridge University Press.

⁸ Harff, "No Lessons Learned". Krain, "State-Sponsored Mass Murder".

⁹ Melson, Revolution and Genocide. Rummel, Death By Government. Weitz, "Modernity".

¹⁰ Krain, "State-Sponsored Mass Murder ".

¹¹ Gleditsch, Nils Petter, Peter Wallensteen, Mikael Eriksson, Margareta Sollenberg, and Håvard Strand. 2002. "Armed Conflict 1946-2001: A New Dataset." Journal of Peace Research Vol. 39, No. 5, 615-637.

¹² Melson, Revolution and Genocide, 19.

¹³ Valentino, Benjamin, Paul Huth, and Dylan Balch-Lindsay. 2004. "'Draining the Sea': Mass Killing and Guerrilla Warfare." International Organization Vol. 58, No. 2, 375-407.

¹⁴ Fein, Helen. 1990. "Genocide: A Sociological Perspective." Current Sociology Vol. 38, No. 1,39.

¹⁵ Kuper, Leo. 1981. Genocide. Its Political Use in the Twentieth Century. New Haven: Yale University Press.

¹⁶ This is due to the fact that the number of truth table lines expands exponentially to the number of conditions included, so that it is unwise to include too many conditions in any one analysis. Thus, it would not be fruitful to include two conditions which are so similar.

¹⁷ Rummel, Death By Government.

¹⁸ Rummel, Death By Government, 23.

¹⁹ Colaresi and Carey, "To Kill or to Protect".

²⁰ Harff, "No Lessons Learned". Krain, "State-Sponsored Mass Murder".

²¹ Chalk and Jonassohn, History and Sociology.

²² Harff, "No Lessons Learned ", 63.

²³ Freeman, Michael. 1991. "The Theory and Prevention of Genocide." Holocaust and Genocide Studies Vol. 6, No. 2, 185-199.

²⁴ Mann, Dark Side of Democracy.

²⁵ Harff, "No Lessons Learned ".

²⁶ Colaresi and Carey, "To Kill or to Protect". Esteban et al., "Strategic Mass Killings". Goldsmith et al. "Forecasting the onset of genocide and politicide". Harff, "No Lessons Learned". Krain, "State-Sponsored Mass Murder". Montalvo and Reynal-Querol, "Discrete Polarisation with an Application to the Determinants of Genocides". Rost, "Will it happen again?". Ulfelder and Valentino, "Assessing Risks of State-Sponsored Mass Killing".

²⁷ Operational guidelines applied by Harff, "No Lessons Learned", page 58 in compiling this list are: 1. Complicity of the state or contending authorities; 2. Evidence of intent; 3. Victims as members of an identifiable group; 4. Policies and practices that cause prolonged mass suffering; 5. Threat posed to survival of the group by these actions. These guidelines produce the following list of cases of genocide: Afghanistan 1978-92, Algeria 1962, Angola 1998-2002, Angola 1975-94, Argentina 1976-80, Bosnia 1992-95, Burundi 1993, Burundi 1988, Burundi 1965-73, Cambodia 1975-79, Chile 1973-76, China 1959, China 1966-75, DR Congo 1964-65, DR Congo 1977-79, El Salvador 1980-89, Equatorial Guinea 1969-79, Ethiopia 1976-79, Guatemala 1978-90, Indonesia 1965-66, Indonesia 1975-92, Iran 1981-92, Iraq 1988-91, Iraq 1963-75, Myanmar (Burma) 1978, Nigeria 1967-70, Pakistan 1973-77, Pakistan (now Bangladesh) 1971, Philippines 1972-76, Rwanda 1994, Rwanda 1963-64, Somalia 1988-91, Sri Lanka 1989-90, Sudan 2003-ongoing, Sudan 1983-2002, Sudan 1956-72, Syria 1981-82, Uganda 1971-79, Uganda 1980-86, Vietnam South 1965-75, Yugoslavia 1998-99.

²⁸ Harff, Barbara. "Annual Data on cases of Genocides and Politicides 1955-2006.xls."Available from http://www.gpanet. org/content/genocides-and-politicides-events-1955-2002. (accessed 12 November 2012).

²⁹ Center for Systemic Peace, Polity IV Annual Time-Series 1800-2011, Polity IV Project, Political Regime Characteristics and Transitions, 1800-2011, 2011. Available from: http://www.systemicpeace.org/inscr/inscr.htm. (accessed 15 May 2013). For the precise coding procedure see Marshall, Monty G. Keith, Jaggers, and Ted Robert Gurr. 2011. "Dataset Users' Manual. Polity IV Project." Vienna, VA: Center for Systemic Peace. Available from: http://www.systemicpeace.org/inscr/p4manualv2010.pdf. (accessed 01 March 2013), 15ff.

³⁰ Freedom House. 2013. "Country ratings and status, FIW 1973-2013." Washington, DC: Freedom House. Available from: http://www.freedomhouse.org/report-types/freedom-world. (accessed 15 May 2013).

³¹ Harff, Barbara. "Genocide and Politicide Model Data (Phase III: 1955-1999)." Available from: http://www.gpanet.org/ webfm_send/51. (accessed 11 January 2013).

³² Harff, "No Lessons Learned".

³³ Uppsala Conflict Data Program-Peace Research Institute Oslo. 2012. "UCDP/PRIO Armed Conflict Dataset v.4-2012, 1946 - 2011." Oslo: Peace Research Institute Oslo. Available from: http://www.pcr.uu.se/research/ucdp/datasets/ucdp_ prio_armed_conflict_dataset. (accessed 15 May 2013).

³⁴ Harff, "Genocide and Politicide." Model Data. Harff, "No lessons learned", 63.

³⁵ Ragin, Charles. 2008. Redesigning Social Inquiry. Fuzzy Sets and Beyond. Chicago: University of Chicago Press. Ragin, Charles. 1987. The Comparative Method. Berkeley: University of California Press.

³⁶ Harff, "No Lessons Learned".

³⁷ Bara, Corinne. 2014. "Incentives and Opportunities: A Complexity-Oriented Explanation of Violent Ethnic Conflict." Journal of Peace Research Vol. 51, No. 6, 696-710.

³⁸ It should be noted that there is a broad literature which also discusses the occurrence of genocide in liberal democracies, particularly in a settler colonial context, however given the nature of the dataset as a post-1945 timeframe and its focus on physical violence, genocide appears to happen nearly exclusively in autocratic countries. See for a discussion of liberal democratic genocides Moses, A. Dirk. 2002. "Conceptual Blockages and Definitional Dilemmas in the 'Racial Century': Genocides of Indigenous Peoples and the Holocaust." Patterns of Prejudice Vol. 36, No. 4, 7-36. Powell, Christopher. 2007. "What Do Genocides Kill? A Relational Conception of Genocide." Journal of Genocide Research Vol. 9, No. 4, 527-547.

³⁹ Generally, capital letters signal the presence of a condition, while the symbol ~ before the letter denotes the condition's absence.

⁴⁰ The asterisk * is to be read as a 'logical and', meaning that all these conditions must happen together for the effect to occur.

⁴¹ In most rows it is clear whether to code the outcome as genocide or not when there are multiple cases, but in some rows there are cases with diverging outcomes meaning that the researcher must decide whether to include the rows as present, absent or ambiguous. Ambiguous cases (or 'Don't care' in QCA terms and represented by a dash (-) mean that this particular combination of conditions is permitted to be both genocide and non-genocide during the Boolean reduction. Here rows with no more than two contradictory cases were coded as either genocides or non-genocides, while rows with more contradictory cases and rows without any empirical data were coded as 'don't cares'.

⁴² Complex solutions focus on maximising consistency, and produce few but detailed combinations which are relatively specific to the presence of the outcome, but reduce the reach regarding coverage. Minimal solutions are the opposite extreme, producing many configurations in order to then have as many of the cases with the present outcome covered as possible, but in the process also covering many non-outcomes and thus reducing the consistency. Most commonly, an intermediate solution is thus used, which balances this and tries to find a solution which covers as many cases as possible, but still does not reduce the consistency too much.

⁴³ Consistency scores indicate how good a fit a particular combination is, that is how many non-occurrences of the outcome (here non-genocides) are also described by this term, thus falsely predicting an outcome where there is none. Coverage scores show how many of the outcome cases can be explained by this solution - raw scores detail how many cases are covered by this combination, while unique coverage means the cases which are explained only by this combination. To a certain degree, there is a trade-off between the consistency and coverage scores, as a solution with a higher consistency (thus explaining only the phenomenon itself and less 'other cases' too) will possibly not be able to explain the same amount of breadth as a very inclusive solution which explains all cases but also includes some nongenocides too. A consistency score of 1, for instance, would indicate that there are no cases in which the outcome does not occur with these combinations of conditions, thus making these combinations truly sufficient for causing the outcome.

⁴⁴ Harff, "No Lessons Learned".

⁴⁵ Given that this is a necessary condition, it is clear that it should appear in every sufficient configuration, only being left out in some remainder configurations which try to include the two cases in which genocides did not occur in an autocratic context.

⁴⁶ Cases of genocide covered by A*S*I are: Afghanistan 1978-92, Algeria 1962, Angola 1975-94, Cambodia 1975-79, Ethiopia 1976-79, Guatemala 1978-90, Indonesia 1965-66, Iraq 1963-75, Iraq 1988-91, Myanmar (Burma) 1978, Rwanda 1963-64, Rwanda 1994, Somalia 1988-91, Sudan 1983-xx; as well as uniquely covered by this configuration: Burundi 1965-73, Equatorial Guinea 1969-79, Indonesia 1975-92, Syria 81-82, Yugoslavia 1998-xx. Cases of genocide covered by A*S*P are: Afghanistan 1978-92, Algeria 1962, Angola 1975-94, Cambodia 1975-79, Ethiopia 1976-79, Guatemala 1978-90, Indonesia 1965-66, Iraq 1963-75, Iraq 1988-91, Myanmar (Burma) 1978, Rwanda 1963-64, Rwanda 1994, Sudan 1983-xx, as well as uniquely covered by this configuration Angola 1998-xx, Bosnia 1992-95, Burundi 1993, DR Congo 1964-65, Nigeria 1967- 70, Sudan 1956-72, Uganda 1980-86. [xx symbolises that the genocide ended after 1998 or is ongoing]

⁴⁷ The other unique case explained by A*I*E*~P*W is the Khomeini regime's actions in Iran from 1981 to 1992, in which the autocratic and autarkic regime waged war against the Kurds and in this context enforced its exclusionary ideology of Islamic hegemony propagated as part of the Islamic revolution, violently targeting not only dissidents and rebel Kurds, but also Bahá'ís.

⁴⁸ Harff, "No Lessons Learned".

⁴⁹ The genocides not accurately predicted by the model are: Argentina 1976-80, Burundi 1988, Chile 1973-76, DR Congo 1977-79, El Salvador 1980-89, Pakistan (now Bangladesh) 1971, Philippines 1972-76, Sri Lanka 1989-90, Uganda 1971-79, Vietnam (South) 1965-75.

⁵⁰ Chile 1973-76, El Salvador 1980-89, Philippines 1972-76, Sri Lanka 1989-90, Uganda 1971-79. See Harff, "No Lessons Learned ", 69.

⁵¹ The non-genocides which are also covered by these configurations are Cambodia 1997, Chad 1965-94, Congo-Kinshasa 1992-xx, Liberia 1985-xx, Sierra Leone 1991-xx, Turkey 1971, Romania 1989, Algeria 1991-xx, Pakistan 1983-xx.
Acknowledgements
I would like to thank Paul Steinheuer, Alice Williams, Judith von Heusinger, Sergio Gemperle, Dominic Pfeiffer, Lisa Gutenbrunner and Kerstin Hamman for comments on early drafts of this work.
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Why Genocide Occurs | Heinrich Böll Stiftung | Phnom Penh Office - Cambodia

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Abstract. Why do genocides occur? This paper applies qualitative comparative analysis (QCA) to revisit this question, and analyses 139 cases of genocide and non-genocide. The paper demonstrates the importance of both priming, contextual conditions which provide a political opportunity structure conducive to genocide, as well as triggering, more proximate conditions which constitute immanent motivations.