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Freedom of Belief

War & peace

20 September 2023

7 min read

Updated: the war that we’re not seeing

Nagorno-Karabakh remains the epicentre of a complex and ongoing conflict, Belle Tindall probes at the way religious identity is being continually targeted.

Belle Tindall

Belle is the staff writer at Seen & Unseen.

An aerial view looking down the damaged spire of a cathederal to a holes in the roof caused by shelling.

Ghazanchetsots Cathederal, Sushi, damaged in the 2020 Nagorno-Karkabah war.

ԶԻՆՈՒԺ MEDIA, via Wikimedia Commons.

Update from September 2023:

It's been six months since I wrote this piece about a war that has been raging under our noses, hidden in plain sight. Six months since I spoke to people trapped in their cities, people cut off from their families, people scared for their lives.

Since then, the situation has only worsened. On the 19th of September, after ten months of blockading Nagorno-Karabakh (cutting off any access to Armenia), Azerbaijan launched an aggressive attack on the enclave. Calling it an 'anti-terror' operation, 60,000 Azerbaijani soldiers have forcefully taken control of main roads, villages, and major cities. This is a major offensive against a region with a population of only 120,000. 27 people, including civilians, are reported to have been killed in the past twelve hours alone. And with Azerbaijan declaring that it will not retreat without complete surrender from the Armenians living in Nagorno-Karabakh, the violence is unlikely to cease in the near future.

This is a humanitarian crisis; one which deserves our full attention. The piece below was originally written in March 2023, it provides the long and complex context for what is currently happening in Nagorno-Karabakh - the war which can no longer remain invisible.

The war that we're not seeing

In the landlocked region of Nagorno-Karabakh (Artsakh in Armenian), peace has not yet had the final say.

Since the 12th of December 2022, the Lachin Corridor (referred to by Armenian inhabitants of Nagorno-Karabakh as the ‘Road to Life’) has been blocked, and the 120,000 people who call the 4,000 square km enclave home have been effectively trapped. This corridor is the only physical link that Nagorno-Karabakh, which is internationally recognised as territory of Azerbaijan, has to Armenia. Subsequently, the trauma of this essential road being obstructed is twofold:

Firstly, the very nature of this blockade means that there is a dangerous shortage of food, medication and other every-day essentials being brought into the region. Speaking to a Priest who is among those currently trapped in Nagorno-Karabakh, he described what he is experiencing as a humanitarian disaster, he explained ‘I am witnessing the stripping away of my community’s human rights’.

Secondly, the people of Nagorno-Karabakh are experiencing the trauma of being disconnected from friends, from family, and from their sense of self, as almost the entire population identify as Armenian. To fully appreciate the situation that the small region currently finds itself in, it is necessary to zoom out of the detail of the current blockade and briefly take a wider view of historic relations between Armenia and Azerbaijan.

The context of conflict

The blockade of the Lachin Corridor is the latest incident in what has been a complex and enduring conflict between the neighbouring countries. Since the disintegration of the Soviet Union and the re-mapping of territorial boundaries throughout the twentieth century, the countries have fought over the legal governance of Nagorno-Karabakh. The 21st century has therefore been characterised by both recurring attempts at reconciliation and episodic clashes. This culminated in a short but devastating war in 2020, resulting in Armenia being forced to relinquish any military control over the region.

The Armenian people of Nagorno-Karabakh have not moved, and yet the entirety of their ethnic identity has been frequently altered. Their home has been absorbed by a neighbouring region, and conflict has been a constant reality.

While both Azerbaijan and Russia are determined that the people of Nagorno-Karabakh are being kept safe and well, it seems that such an insistence isn’t quite translating into action. As one interviewee put it,

‘Azerbaijan won the war, now they need to win the peace’.

The immediate vulnerability of the people of Nagorno-Karabakh cannot be overstated; as is being exemplified by the severe destabilisation that the blockade of the Lachin Corridor is causing.

A faith that is targeted

This is, undoubtedly, an ethnic and political conflict. It is the residue of the re-drawing of territorial lines and the legacy of a fragile form of peace. Local leaders stress that it is not primarily driven by religion. They are critical of foreign commentators who position it as such.

What is not being understood, even still, is the way that religion is being targeted, weaponised even, within this ethnic and political conflict. Religious aspects being either sensationalised or ignored by the global media. It serves one well to be wary of one-dimensional interpretations of this conflict, this includes narratives that reduce it to a quarrel between two world religions. However, it is equally unhelpful to ignore the way in which the people of Nagorno-Karabakh's sense of self is being tactically targeted. This includes their profoundly Christian heritage.

On October 8th, 2020, the Ghazanchetsots Cathedral in the city of Shushi was shelled by Azerbaijani forces. It was struck not once, but twice, within the space of only a couple of hours. Despite Azerbaijan’s insistence that the Cathedral was not their intended target, the Armenian Ministry of Défense remain resolute that the destruction of their cathedral was intentional. Having had Nagorno-Karabakh on his radar for many years, it was the footage of the Ghazanchetsots Cathedral in ruins that caught the attention of Rt. Revd Dr Christopher Cocksworth, Bishop of Coventry. Filming a message from the ruins of Coventry cathedral, which was largely destroyed by German bombs as part of the Coventry blitz during WWII, Bishop Christopher wanted to let Armenian Christians know that they weren’t unseen, nor were they alone.

From Coventry to Nagorno-Karabakh

Subsequently, Bishop Christopher has become a long-standing advocate and ally for the people of Nagorno-Karabakh, having visited the region on numerous occasions, including with a parliamentary group in 2022. When asked about the instrumentalization of religion within the ongoing conflict, Bishop Christopher observed that:

‘if you want to get at people’s identity, you get at their religion. If you want to destroy their identity, you destroy their religious symbols’.

And this is arguably what is being seen in Nagorno-Karabakh, a Christian enclave that, according to tradition, traces its Christian roots back to the first century AD.

To intentionally target sites of religious and/or cultural importance has long been considered an international war crime. This is largely because of the profound and lasting effect it has upon those who accredit a sense of belonging to such places – such an obliteration strikes at the heart of their sense of self. And yet, according to reports, the 2020 destruction of the Ghazanchetsots Cathedral (intentional or otherwise) is by no means anomalous.

The seemingly systemic disappearance of religious and cultural sites of significance in Nagorno-Karabakh has led researchers and reporters to interpret what is happening in the region as a 'pattern of total cultural erasure' and communicate their fears of the eventual disappearance of Nagorno-Karabakh as a self-identified Christian enclave.

A faith that is responding

Ironically, the people’s Christian faith, and the hope that it offers, is one of the only things that has not, and cannot, be stripped away.

Despite the immense pressures being placed upon the residents of Nagorno-Karabakh, Bishop Hovakim Manukyan, Primate of the Armenian Churches of the United Kingdom, is assured that ‘the people’s faith is stronger than ever’ and that it ‘has not, and will not, ever be abandoned’.

Speaking once again from within the currently entrapped region, a local priest tells of how church attendance and a sense of spiritual unity is particularly strong. Is seems that this is partly because the residents of Nagorno-Karabakh don’t believe they are receiving the help they require from their global neighbours, making God their most tangible solution. This is also, in part, a rebellious dedication to their faith. It is people holding onto a Christian identity in defiance of any attempted erasure of it.

This is not unusual. Interestingly, it is in places where the possession of Christian faith can bring forth difficulty, discrimination, and even danger, that it sees its most rapid growth. As is exemplified in various countries, both historically and in the present day, a dangerous faith simply does not equate to a disappearing one.

A faith that can reconcile?

Is reconciliation between Armenia and Azerbaijan, and ultimate peace Nagorno-Karabakh, possible? This was my final question posed to both the Bishop of Armenian churches in the UK and the Bishop of Coventry, a city which has affectionately been entitled the City of Peace and Reconciliation (due to its response to the afore mentioned Coventry-blitz).

Bishop Christopher of Coventry was profoundly hopeful that reconciliation is possible. After all, this is by no means an ancient conflict. However, the process of reconciliation will undoubtedly be long and complex and must begin with an immediate cease in the ‘nurturing of hate’.

Bishop Hovakim also shared his hopes for reconciliation, that although reconciling the deep divisions will undoubtedly be ‘challenging and painful’, it is by no means impossible. He places emphasis, not on the moments of intense conflict, but on the times where Armenia and Azerbaijan have been neighbours ‘living side-by-side' and ‘sharing so much’.

Surely, just and lasting peace can only be possible when the people of Nagorno-Karabakh are re-afforded their safety, their security, and their fundamental human rights. Considering that possession of one’s own identity has long been considered one such human right, the reinstatement and reparation of the Christian heritage and identity of the people of Nagorno-Karabakh must surely be an essential ingredient in any reconciliation.

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26 July 2024

6 min read

Are we forgetting how to care?

The profound act at the heart of nursing.

Helen Cowan

Helen is a registered nurse and freelance writer, writing for audiences ranging from the general public to practitioners and scientists.

A nurse bends beside a bed and talks to a patient

Marie Curie.

Recently, at a nursing leadership programme in Oxford, attendees focused on the fundamentals of care. Have we forgotten how to care? What can we re-learn from those who pioneered an ordinary yet profound act that affects millions?"

Anam Cara is an old Gaelic term for ‘soul friend’, a person with whom you can share your innermost self, your mind and your heart. It is a term that Tom Hill, former chief executive at Helen House Hospice in Oxford, used to describe the relationship between his staff and the thousands of children and their families who passed through their ‘big red door’ in its first twenty-five years. The hospice (or ‘loving respice’ as it became known) had been founded by Sister Frances Dominica in 1982.

Other care in this country can also trace its religious roots. Between 1048 and 1070 in Jerusalem, the Order of St. John was founded for the purpose of helping pilgrims (“our Lords, The Sick”) who had become lost, weary, or beset by other difficulties while on their way to the Holy Land. Today, in the United Kingdom, the British Association of the Order has extended care to older people first in almshouses and later in care homes. A trustee for ten years was John Monckton, a man of ‘considerable talent, enormous integrity and deep religious conviction’; his tragic murder in 2004 led to the creation of the John Monckton Memorial Prize, which recognised and rightly celebrated commitment to care by care workers.

Today, across the world, seen and unseen, nurses, carers and families continue to provide compassionate care. “Assisting individuals, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge” is the very essence of nursing, captured by ‘architect of nursing’, researcher and author Virginia Henderson in 1966. Meeting more than basic needs such as breathing, eating, drinking and eliminating bodily waste (which are of essential importance), Henderson recognised the role of the nurse in enabling humans to communicate with others, worship according to their faith, satisfy curiosity and sense accomplishment.

In the desire for modernisation and professionalisation, have we lost sight of the core values and activities central to patient care?

An uncomfortable truth brought out in healthcare reports such as the Final Report of the Special Commission of Inquiry (The Garling Report) 2008, and the Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry (The Francis Report) 2013 is though that this type of nursing is too often done badly or even missed, leading to pressure injury, medication errors, hospital-acquired infection, falls, unplanned readmission, critical incidents and mortality. According to nurse scientist and scholar Professor Debra Jackson, “missed care occurs much more frequently than we might think”. She cites a systematic review in which ‘care left undone’ on the last shift ranged from 75 per cent in England, to 93 per cent in Germany, with an overall estimate of 88 per cent across 12 European countries’.

In one offensively-titled paper, “Shitty nursing - the new normal?” (in which the authors apologise for the title but not the questions raised), real-life pen portraits are drawn of patients lying for hours on hospital trolleys, immobile through infection or injury, ignored by staff. Whilst acknowledging contextual factors for poor care, such as a shortage of nurses and resources, the authors argue that circumstances cannot be the sole cause of missed nursing care.

A report published by the University of Adelaide, School of Nursing, has called for nurses to ‘reclaim and redefine’ the fundamentals of care. It asks whether the cause of the problem (of missed nursing care) lies “deep in the psyche of the nursing profession itself?” “Has something happened to the way modern nursing views and values caring?” it continues. “Indeed, is nursing in danger of losing its claim to care? In the desire for modernisation and professionalisation, have we lost sight of the core values and activities central to patient care? Or is this a broader social pattern where individuals are less inclined to show kindness, compassion, and care for others even if it is a necessary requirement of the job?”

Compassion, he emphasises, is more than empathy - and way "less fluffy" but much more measurable than kindness.

Writing in the British Medical Journal, Professor of critical care medicine Peter Brindley and Consultant in intensive care Matt Morgan wonder whether doctors also “too often default to high-tech and low-touch” when patients are dying – a time “when community and connection matter most”. They powerfully begin with a mother’s comment: “Humans are gardens to tend – not machines to fix.”

Professor Sir Al Aynsley-Green, the first National Clinical Director for Children in Government and former Children’s Commissioner for England, and past president of the British Medical Association, suggests that we as a society need a “momentum for compassion”. Struck by the extremes of compassion witnessed during his wife’s treatment in the last years of her life, Sir Al wants to see a cultural transformation in healthcare: for compassion to be a key operating principle in NHS and care settings, led by the Chief Nurse’s Office; for every organisation to promote the importance of compassion at the professional level; for the views of patients and families to be sought regularly; for much earlier and better focus on compassion in undergraduate and postgraduate teaching programmes for all staff; for compassion to be inspected against by the Care Quality Commission; and for a willingness to encourage staff at all levels to expose poor practice as well as celebrating excellent care.

Compassion, he emphasises, is more than empathy - and way "less fluffy" but much more measurable than kindness. “It’s putting yourself into somebody else’s shoes – and doing something about it.” Recently appointed the UK’s first Visiting Professor in Compassionate Care at Northampton University, at the age of 80, Sir Al certainly is doing something about it. He has made it his new purpose in life to “embed compassion into every aspect of care”.

Like Sir Al, Queen Elizabeth II, the UK’s longest serving monarch, espoused compassion, in word and deed. Living a life of compassionate service, the Queen made clear that her Christian faith was her guiding principle. She speaks of Jesus Christ as ‘an inspiration,’ a ‘role model’ and ‘an anchor’. “Many will have been inspired by Jesus’ simple but powerful teaching,” she said in her Christmas Broadcast, 2000. “Love God and love thy neighbour as thyself – in other words, treat others as you would like them to treat you. His great emphasis was to give spirituality a practical purpose.”

When nurses do unto others as they would have done unto themselves, and act as role model to colleagues, not only do patient experiences of care and their outcomes improve – but so does job satisfaction for nurses: a critical factor in nurse recruitment and retention – the biggest workforce challenge faced by healthcare organisations. Across the UK, there are currently more than 40,000 nursing vacancies, and thousands of burnt-out nurses are leaving the profession early. Whether nurses decide to stay or go is driven in part by their daily experience at work. The late Kate Granger, Consultant in medicine for older people, inspired Compassionate Care Awards in her name, envisioning that such a legacy would drive up standards in care - and surely also help retain nurses, through restoring a sense of pride, achievement and fulfilment to the nursing workforce.