Elizabeth Pantaleon

While many would say that a picture is worth a thousand words, I would argue that one data point can be just as powerful. For that matter, so can the absence of data. An elusive yet illustrative finding that would pack such a punch is the exact cancer incidence rate among Amazigh patients from the Rif region compared to other areas in Morocco. Such a figure would tell the story of a country and a people grappling with issues of social exclusion, unequal development, and inequitable colonial legacies featuring rebellion and chemical weapons. If the Moroccan government were to commission and act on a study that reveals this figure and other human development disparities, then this data could illuminate a pathway to equitable development and social inclusion.

Historical Inequities with Modern-day Health and Development Consequences

The exact number of the Amazigh population is unclear from census data, but Tamazight-speakers are Morocco’s largest ethno-linguistic group, comprising 40% to 60% of the population. Riffians––those residing in Morocco’s mountainous northeastern regions––are just one of the multiple Amazigh identities that manifest through tribal, dialectical, geographical, gender and class affiliations. 

In 2015, Moroccan jurist Mimoun Charqi reported that 70% of adults and 50% of children who received cancer treatment in a Rabat oncology hospital hailed from the same northeastern Rif region. In the mid-1920s, civilians in this area suffered a string of airborne  chemical weapons attacks by the Spanish Army of Africa during the Rif War––a bloody five-year conflict between Spanish colonial forces and Amazigh resistors. Studies that directly focus on cancer incidence among the war survivors’ descendants are rare; the latest figures date back to 1995 and 1999. There have been medical publications exploring cancer incidence and geographic variability in Eastern Morocco. But despite these reports and Charqi’s revelation, there remains a lack of reliable studies that explore the causal link between cancer and the effects of chemical weapons used by Spanish forces against Amazigh communities during the Rif War. 

Riffian activists of civil society organizations, such as the Rif Memory Association, understand the illustrative power such a study would carry. In 2017, they demanded the intergovernmental Organization for the Prohibition of Chemical Weapons to recognize, investigate, and provide reparations as a form of justice for Riffians that have suffered the consequences of the first-ever aerial bombardment of mustard gas. As of this writing, no such effort has come to pass. Current day inaction by the Moroccan government, Spain, France, and the international community in redressing this injustice echoes the silence of the League of Nations when Spain deployed the weapons despite signing the 1925 Geneva Protocol, which prohibited the use of chemical weapons.

Stronger data on cancer incidence and other disaggregated health indicators in the Rif could shed new light on an Amazigh population that has been historically excluded from access to basic public services, markets, and spaces. During the Rif War against the Spanish, Riffians fought for liberation and an autonomous Amazigh region. Arabization and pan-Islamism served as tools for consolidating the post-colonial Moroccan state, which sidelined Amazigh identities.  King Hassen II, who ruled from 1961 to 1999, remained deeply suspicious of the Riffians’ autonomous ambitions and, as punishment, neglected to invest in the region, depriving the area of infrastructure for public services as well as education and health facilities. The ramifications of this marginalization are felt today in the form of large migration outflows from the region and grave disparities in economic, health and social inclusion indicators. The Riffian Hirak movement cited these trends as key grievances during the 2017 popular protests, which mobilized tens of thousands of civilians demonstrating against police brutality and insufficient state services. The protests resulted in a repressive government crackdown. 

Moroccan Development for All?

Morocco has made strides in maintaining economic growth and reducing absolute poverty, and maternal/infant mortality rates. Despite this aggregate success, large disparities exist between urban centers and the country’s rural and largely Amazigh-majority areas.

The Ministry of Interior reports 111 maternal deaths per year in rural areas, compared to 45 in urban areas. A 2016 study in the International Journal of Equity in Health highlighted the interconnected nature of urban–rural differences and noting that wealth and educational attainment can significantly affect health care access and outcomes. In Al Hoceima region— where Riffian Amazigh communities are located— there is only one physician per 4,046 inhabitants compared to Rabat and Casablanca where there is one physician per 662 and 767 inhabitants respectively.

Redressing Inequities for a Stronger Morocco

Addressing decades of exclusion and inequalities is an urgent priority. Morocco teeters on the spectrum of fragility with an “elevated warning,” according to the Fund for Peace Fragile States Index. An 8.5 out of 10 ranking in group grievances and 7.5 in human flight and brain drain are the highest in non-conflict MENA countries and signal concerns for social cohesion and economic development. While efforts such as the National Initiative for Human Development and reforms in the 2011 Constitution started laying the foundation to address disparities, there is an urgent need for greater intentionality in addressing the specific health and socio-economic needs of Amazigh communities. 

To do so, Moroccan health and development authorities, as well as international organizations such as the World Health Organization and World Bank, should commission studies to collect recent disaggregated data to understand the ethnic, linguistic, geographic and gender dimensions of health and socio-economic disparities. Moreover, these authorities must collaborate with Amazigh community members most affected by these disparities to address their needs. Lastly, if the government is to reconcile its history of excluding Amazigh communities, it should adopt and honor frameworks such as the UN Declaration on the Rights of Indigenous Peoples (UNDRIP) and ILO 1989 Convention on Indigenous and Tribal Peoples. Such frameworks open avenues for Amazigh communities, such as Riffian activists seeking justice, to advocate before their government and the international community for the inclusive and responsive government they deserve.

Image: Openness to Amazigh (الانفتاح على الامازيغية). Symbolizes the inclusion of ethno-linguistic Amazigh groups in Morocco by representing a Tifinagh symbol about to walk through an open door. Tifinagh is the written script of the Tamazight language

Elizabeth Pantaleon is a Master of Science in Foreign Service candidate with interests in the intersection of gender in international development, diplomacy and peace building in the Middle East and Latin America. She serves as the president of the graduate student organization Diversity and Inclusion at Georgetown University. Elizabeth is a State Department Pickering Foreign Affairs Fellow and an incoming U.S. Foreign Service Officer.