Lt. General James B. Peake (Former US Secretary of Veterans Affairs; Former Surgeon General of the US Army)

Q1: What are the major challenges of using health initiatives as a form of cultural diplomacy?

The first major challenge is building trust with people to assure them you are there for the right reasons. Secondly, we must ensure that the program has longevity and continuity, with measurable progress points, so it doesn’t amount to a hit and run.

Q2: Providing health care aid to countries where it is needed may foster gratitude among locals towards the donor country. However, does this not create a one-way street in terms of cultural diplomacy, seeing as mutual understanding requires the exchange of ideas rather than simply the imposition of them?

A big component of health initiatives is the exchange of ideas and education. I used the example of military labs in my discussion, which have done huge amounts of capacity building. Many of the people working in these labs are locals who have been trained to understand the mission, and have subsequently been back working into their own health system. It is almost part of the tradition in medicine to have ongoing education as part of the healing.

Q3: Given that you served as United States Secretary of Veterans Affairs, can you tell us what are the main difficulties, pathologies, and problems the American soldiers are facing when they come back from Afghanistan and Iraq—especially in comparison with the veterans who have served in the past in other war zones?

There are many similarities with what we have experienced in previous war zones. In every era of warfare we develop better ways of identifying issues; for example, issues such as Post Traumatic Stress disorder and traumatic brain injuries were well described and well written about during World War One. We now have a lot of other tools to utilize, which will allow us to make the next leap in medical knowledge. Sadly, these advances were developed during war, but honestly, many surgical advances have come through war. We are now seeing some severely physically injured people survive in situations where they would have never made it off the battlefield previously. This is due to advances we have made in battlefield care and rapid transport across long distances. In my role as Secretary of Veteran Affairs, I talk to my counterparts among our allies, and they experience the same kinds of issues. We have collaborated by sharing information on how to best serve our soldiers, and often this will take the form of a cultural exchange as well.

Q4:  Regarding the crisis in Libya, the USA didn't take the leading role of the coalition, preferring to pursue a multilateral approach, stating that they are not available to provide American troops on the ground. What is your opinion about this approach, so different from the one America showed in the recent past?

I’m not sure it’s different from what America has shown in the past.  We are part of a team; it doesn’t mean that in every case you must lead this team. Obviously I’m not in a position to see the things that Secretary Gates and President Obama see now. Secretary Gates is a tremendous Secretary of Defense; he has great judgment, and knows the strengths and capabilities of our allies. I can’t comment further than that.

Thank you for your time.