Normalising the Crisis in Africa

Developmental relief has become the central doctrine of 'good practice' in humanitarian responses to complex political emergencies. This is despite the fact that a proliferation of such emergencies reflects a failure of development for people in those countries in crisis. Drawing on case study material from Sudan, Somalia, Rwanda and Uganda, this paper challenges assumptions made about the efficacy of developmental relief models in complex emergencies. The trend towards developmental relief practices coincides with an increasing acceptance of higher levels of humanitarian distress in Africa. Myths of aid dependency and the pursuit of sustainable programming in the midst of war are linked to a global reduction in aid. The mantra of 'local solutions to local problems' locates the causes of crises firmly within those societies in crisis. It provides a premise for international disengagement, and the denial of international responsibility for the genesis and prolongation of humanitarian crises in Africa. Assigning solutions to the poor, the marginalised and victimised through enhanced 'participation' and local financing of services sustains a myth that development is occurring, when in fact levels of distress are rising.     

Changing tracks as situations change: humanitarian and health response along the Liberia–Côte d'Ivoire border

In recent years, protracted crises and fragile post‐conflict settings have challenged the co‐existence, and even the linear continuum, of relief and development aid. Forced migration has tested humanitarian and development paradigms where sudden‐onset emergencies, violence and displacement arise alongside ongoing development work. Drawing on Médecins Sans Frontières interventions in the region from December 2010 to May 2011, this paper examines aid and healthcare responses to displacement in Côte d'Ivoire and Liberia; it focuses on challenges to the maintenance of preparedness for such foreseeable emergencies and to adaptation in response to changing situations of displacement and insecurity. This ‘backsliding’ from development to emergency remains a substantial challenge to aid; yet, in exactly such cases, it also presents the opportunity to ensure access to medical care that is much more urgently needed in times of crisis, including the suspension of user fees for medical care.     

Matching response to context in complex political emergencies: 'relief', 'development', 'peace-building' or something in-between?

There is an ongoing debate over the value and pitfalls of the policy and practice of 'linking relief and development' or 'developmental relief' in aid responses to complex political emergencies (CPEs). Driven by concerns about relief creating dependence, sometimes doing harm and failing to address root causes of emergencies despite its high cost, pursuit of both relief and development has become a dominant paradigm among international aid agencies in CPEs as in 'natural' disasters. In CPEs a third objective of 'peace-building' has emerged, along with the logic that development can itself help prevent or resolve conflict and sustain peace. However, this broadening of relief objectives in ongoing CPEs has recently been criticised on a number of counts, central concerns being that it leads to a dilution of commitment to core humanitarian principles and is overly optimistic. This paper addresses these issues in the light of two of the CPEs studied by the COPE project: Eritrea and Somalia/Somaliland. It is argued that the debate has so far suffered from lack of clarity about what we mean by 'relief', 'development' and, for that matter, 'rehabilitation' and 'peace-building'. The wide spectrum of possible aid outcomes does not divide neatly into these categories. The relief-development divide is not always as clear-cut, technically or politically, as the critics claim. Moreover such distinctions, constructed from the point of view of aid programmers, are often of little relevance to the concerns of intended beneficiaries. Second, there has been insufficient attention to context: rather than attempting to generalise within and across CPE cases, a more productive approach would be to examine more closely the conditions under which forms of aid other than basic life support can fruitfully be pursued. This leads to consideration of collective agency capacity to respond effectively to diverse needs in different and changing circumstances.     

Apples, Pears and Porridge: The Origins and Impact of the Search for ''Coherence'' between Humanitarian and Political Responses to Chronic Political Emergencies

During the 1990s a consensus emerged within the international humanitarian system that there was a need to enhance the 'coherence' between humanitarian and political responses to complex political emergencies. Closer integration between aid and political responses was seen to be necessary in order to address the root causes of conflict-induced crises, and to ensure that aid did not exacerbate political tensions. This paper explores the theory and practice of coherence over the past decade. It argues that, by sleight of hand, the coherence agenda has been reinterpreted such that humanitarian action has become the primary form of political action, rather than merely a substitute for it. The coherence agenda has been driven by geopolitical events, domestic policy considerations in donor countries and the more parochial concerns of aid policy, and is reflected in a number of substantive changes in the humanitarian architecture. Many of the tenets of this 'new humanitarianism' have been embraced by the majority of relief agencies, and thus legitimised it. The paper concludes that political humanitarianism, as opposed to active engagement by political and military actors, is flawed ethically and technically. It will provide neither an effective palliative for the ill effects of war, nor address its causes.     

Providing health services during a civil war: the experience of a garrison town in South Sudan

The impact of conflict, particularly conflict arising during civil wars, on the provision of healthcare is a subject that has not been widely considered in conflict‐related research. Combatants often target health services to weaken or to defeat the enemy, while attempts to maintain or improve health systems also can comprise part of counter‐insurgency ‘hearts‐and‐minds’ strategies. This paper describes the dynamics associated with the provision of health services in Malakal, an important garrison town in South Sudan, during the second Sudanese civil war (1983–2005). Drawing on the concepts of opportunity hoarding and exploitation, it explores the social and political dynamics of service provision in and around the town during the war. These concepts provide a useful lens with which to understand better how health services are affected by conflict, while the empirical case study presented in the paper illustrates dynamics that may be repeated in other contexts. The concepts and case study set out in this paper should prove useful to healthcare providers working in conflict zones, including humanitarian aid agencies and their employees, increasing their understanding of the social and political dynamics that they are likely to face during future conflict‐related complex emergencies.     

Index to Volume 23, 1999

In the 'chronically vulnerable areas ' (CVAs) of East Africa a smooth linear transition away from emergency programming towards rehabilitation and long-term development is difficult, if not impossible. This makes uncritical application of the 'relief-to-development ' continuum to programming unhelpful at best, and perhaps counter-productive. This paper is the result of CARE's efforts to review its own programmes – and those of some of its sister agencies – in chronically vulnerable areas in the East Africa region, to derive important lessons learned and to identify areas where improvements are needed. The paper focuses on strategic considerations and decision-making in relation to entry, programme design and strategies for transition and exit.     

Repatriation of 150,000 sudanese refugees from ethiopia: the manipulation of civilians in a situation of civil conflict

This paper outlines the dramatic return to Sudan of 150,000 men, women and children from Itang Refugee Camp in Ethiopia in June 1991. These people were pawns in Sudan's civil war, manipulated by governments, military forces and the media – a state of affairs that the international community failed to deal with effectively. At the time of the return to Sudan, ICRC and the United Nations were working to assist the returnees in two different areas and each had a different access agreement and thus a different impact on the survival of the returnees. The paper focuses on the role of political awareness and negotiation in the protection of refugees and in the organisation of relief in the context of a civil war.     

Programmes in chronically vulnerable areas: challenges and lessons learned

In the 'chronically vulnerable areas' (CVAs) of East Africa a smooth linear transition away from emergency programming towards rehabilitation and long-term development is difficult, if not impossible. This makes uncritical application of the 'relief-to-development' continuum to programming unhelpful at best, and perhaps counter-productive. This paper is the result of CARE's efforts to review its own programmes--and those of some of its sister agencies--in chronically vulnerable areas in the East Africa region, to derive important lessons learned and to identify areas where improvements are needed. The paper focuses on strategic considerations and decision-making in relation to entry, programme design and strategies for transition and exit.     

Transitional coordination in Sudan (2006–08): lessons from the United Nations Resident Coordinator's Office

With the increase in internal conflicts following the end of the Cold War, the scale and scope of the United Nations' work in conflict and post‐conflict environments grew markedly. As a result, the coordination of programming and policy in the transition from relief to recovery has been a central preoccupation of academics and practitioners alike. Intergovernmental bodies such as the United Nations Economic and Social Council (ECOSOC) have made these topics a subject of regular discussion, while some countries have altered their bureaucratic structures to respond more effectively in post‐crisis settings, particularly in cases involving the deployment of national troops. The United Nations Resident Coordinator's Office in Sudan provides a model for other transitional countries and is a useful case study of the broader challenges of post‐crisis programming. Effective coordination structures and planning/programming processes are identified as interdependent prerequisites for ensuring a successful transition from relief to recovery.     

Children's Experience of Conflict Related Emergencies: Some Implications for Relief Policy and Practice

This paper challenges the limited models of childhood, conflict and relief which determine most humanitarian interventions targeting children in conflict related emergencies. In particular, it notes the tendency of relief programmes to focus on "spectacular" groups of children (orphans, child combatants and refugees) at the expense of larger child populations indirectly affected by conflict. This relief bias is attributed to an inappropriate 'apocalypse model' of conflict which sees relief interventions only as repair. The bias also lies in a mistakenly universalist model of childhood and a medical paradigm which pathologizes children's experience in conflict and characterizes children as passive victims rather than active survivors. The paper argues for greater recognition of the wider social experience of children in conflict, and for relief practice which takes account of childhood resilience and children's different roles and capacities in coping with conflict. Appropriate interventions must engage with the wide variety of indigenous coping mechanisms involving children and not simply replicate a standard package of relief interventions in every emergency, based on simplistic and universalist interpretations of children's experience of conflict.     

The Symphony of the Damned: Racial Discourse, Complex Political Emergencies and Humanitarian Aid

This paper concerns the manner in which the West is responding to protracted political crises beyond its borders. It examines the conceptual world-view that aid agencies bring to complex emergencies and which shapes action. The paper provides an analysis of developmentalism. That is, the currently dominant idea of development which is an adapted form of multiculturalism. It is based on the empowerment of cultural differences and the relativisation of progress. As a variant of multiculturalism, developmentalism is part of Western racial discourse. In terms of understanding conflict, it establishes a mirror-image relationship with new rascist ideas premised on cultural pluralism inevitably leading to social breakdown, violence and anarchy. To the contrary, with its functional view of social harmony, libertine developmentalism claims that even unresolved political crisis constitutes a development opportunity.
Developmentalism, like culturalism generally, is incapable of analysing power. It therefore cannot understand the effects and significance of its own organisational forms. Moreover, since the absence of power translates into operational neutrality in a war zone, it is also unable to analyse the nature of new political formations emerging in the global periphery. That is, the so-called weak or failed states, warlords and so on. This functional ignorance has allowed a widespread incorporation of humanitarian aid into the fabric of political violence. Developmentalism is an essential underpinning for the growing organisational accommodation to ongoing conflict and eroding standards of justice and accountability.     

From Relief to Development: The Long-term Effects of 'Temporary' Accommodation on Refugees and Displaced Persons in the Republic of Croatia

The increasing scale of international intervention in conflict is generating new pressures on the humanitarian community. Increased expenditure on emergency relief, static levels of overseas development aid and subsequent lack of funds for development are dictating that agencies design relief projects that positively effect developmental reconstruction.
This paper examines the provision of shelter for refugees and displaced persons in the Republic of Croatia and identifies ways in which it has encouraged and discouraged sustainable reconstruction. It argues that to promote lasting reconstruction, programmes must focus on saving livelihoods as well as lives, thus minimising the long-term psychological and physical impacts of aid on refugees, displaced persons and host communities.     

What happens to the state in conflict?: political analysis as a tool for planning humanitarian assistance

It is now part of received wisdom that humanitarian assistance in conflict and post-conflict situations may be ineffective or even counterproductive in the absence of an informed understanding of the broader political context in which so-called 'complex political emergencies' (CPEs) occur. Though recognising that specific cases have to be understood in their own terms, this article offers a framework for incorporating political analysis in policy design. It is based on a programme of research on a number of countries in Africa and Asia over the last four years. It argues that the starting-point should be an analysis of crises of authority within contemporary nation-states which convert conflict (a feature of all political systems) into violent conflict; of how such conflict may in turn generate more problems for, or even destroy, the state; of the deep-rooted political, institutional and developmental legacies of political violence; and of the difficulties that complicate the restoration of legitimate and effective systems of governance after the 'termination' of conflict. It then lists a series of questions which such an analysis would need to ask--less in order to provide a comprehensive check-list than to uncover underlying political processes and links. It is hoped these may be used not only to understand the political dynamics of emergencies, but also to identify what kinds of policy action should and should not be given priority by practitioners.     

Conflict, camps and coercion: the ongoing livelihoods crisis in Darfur

This paper presents the findings of a study commissioned by World Food Programme (WFP) in early 2006 to enhance understanding of how the conflict in Darfur has affected livelihoods and markets, and of the effects of food aid. The livelihoods of many in Darfur were devastated early on in the conflict, principally through the widespread looting or destruction of assets and highly restricted population movements, which struck at the heart of pre-conflict livelihoods. Livelihood strategies for most people are now restricted, poorly remunerated and often associated with high risk of attack. Patterns of coercion and exploitation have also become entrenched; and markets and trade, the lifeblood of Da fur's economy pre-conflict, severely disrupted. Against this backdrop the impact of food aid on livelihoods in Darfur has been overwhelmingly positive. The paper proposes a number of preconditions for investment in recovery in Darfur, and recommends ways in which livelihoods can be supported in the current context of ongoing conflict.     

Hunger, poverty and food aid in Sub-Saharan Africa: Retrospect and potential

Frustrations and failures will continue to mount if we do not immediately summon the courage to revise the ways we think and take action-as well as maintaining essential services to support life and health … Saving hundreds of thousands … who are at risk of dying from malnutrition or infection is an immediate imperative. But it must be only one stage in the progress toward other activities, and one element in the truly comprehensive approach… The main intent of this paper is to explore aspects of the nature and evolution of poverty in Sub-Saharan Africa with special reference to food and hunger and their interaction with macro-economic policy. An attempt is made to outline the overall context within which food aid needs to be used in order to have a greater developmental impact. Following an Introductory Section I, Section II provides a sketch map of how recession and lagging food production - with cyclical weather crises superimposed - affect the human condition of poor people. Section III reviews die interaction between "standard" IMF stabilization and World Bank structural adjustment strategies and poverty/hunger. Improvements in the design of stabilization and adjustment programmes, and of the inter-relationship with them of emergency programmes, can be identified. A number turn on the broadened and more innovative or catalytic use of food aid. Section IV reviews aspects of facing a continuing series of emergencies and of designing life support programmes to facilitate rehabilitation of the households directly affected as well as of the national economies. From this base it explores a series of elements in achieving renewed development. The concluding Section seeks to explore the strengths, limitations and potentials of food aid in the context set by the previous sections. The standard criticisms of food aid appear to be overstated and/or to relate to particular modalities or approaches rather than to anything intrinsic. A number of criteria for improving the effectiveness of food aid - especially in respect to rehabilitation, recovery and renewed development - are set out.     

Dividing disasters in Aceh, Indonesia: separatist conflict and tsunami, human rights and humanitarianism

This paper examines the interface between human rights and humanitarian action in the context of the conflict and tsunami in Aceh, Indonesia, between 1998 and 2007. It looks at the challenges international humanitarian non-governmental organisations (NGOs) faced as they engaged in human rights work in the conflict period and in conflict-related activities in the post-tsunami period. The paper argues that many large NGOs may have compromised what some would hold to be essential principles for humanitarian action because of domestic political concerns, donor restrictions and resistance among certain NGO chiefs. In contrast with the pre-tsunami period, in which NGOs worked for years amid military operations, in the post-tsunami period NGOs were decidedly apolitical, neglecting the conflict in their tsunami response--despite significant developments that permitted greater political engagement in Aceh's post-conflict transformation. The evidence suggests that NGOs are challenged in contextualising humanitarian responses and that there is a need to underscore donor flexibility and independence in humanitarian action.     

Refugee income generating projects and occupational health

The shift from purely emergency relief for refugees in developing countries to aid within the context of development strategies is slowly gathering momentum (UN, 1983; UNHCR, 1984; Simmonds, 1984). Such a move implies that if self-reliance is to be a realistic goal then employment for refugees is essential; a number of income-generating schemes are therefore being both proposed and developed (ILO, 1983 and 1984).
Many of these schemes have implications for the health of the refugees, so this paper summarises some occupational health hazards and offers suggestions for future action.     

Targeting the Vulnerable: A Review of the Necessity and Feasibility of Targeting Vulnerable Households

This article examines whether it is possible to target vulnerable households within a geographically defined area. It looks first at the justification for targeting and then reviews recent practical experience in actually trying to reach vulnerable groups. As complex emergencies increasingly last longer, strategies to target vulnerable households are common in the protracted phase of the emergency. While this is often necessary because of a decline in resources, it is not always justified by an improvement in nutritional status or food security of the beneficiary population.
Common target groups are the poor and the malnourished, but in complex emergencies these are not always the most vulnerable. Moreover, recent practical experience has shown considerable difficulties in targeting the poor. Methods to target the poor rely on community-based relief committees, whose priorities are not necessarily the same as those of external agencies. This paper gives examples of such targeted assistance programmes in Kenya, south Sudan and Tanzania. The paper concludes that situations where targeting vulnerable households is justified and feasible are extremely limited. It is suggested that if targeting has to be done because of scarce resources, this should be done on a geographical basis and on the basis of nutritional status. Case-study material shows that it is essential to understand the political determinants of vulnerability and to design methods that will reach the most vulnerable.     

Targeting the vulnerable: a review of the necessity and feasibility of targeting vulnerable households

This article examines whether it is possible to target vulnerable households within a geographically defined area. It looks first at the justification for targeting and then reviews recent practical experience in actually trying to reach vulnerable groups. As complex emergencies increasingly last longer, strategies to target vulnerable households are common in the protracted phase of the emergency. While this is often necessary because of a decline in resources, it is not always justified by an improvement in nutritional status or food security of the beneficiary population. Common target groups are the poor and the malnourished, but in complex emergencies these are not always the most vulnerable. Moreover, recent practical experience has shown considerable difficulties in targeting the poor. Methods to target the poor rely on community-based relief committees, whose priorities are not necessarily the same as those of external agencies. This paper gives examples of such targeted assistance programmes in Kenya, south Sudan and Tanzania. The paper concludes that situations where targeting vulnerable households is justified and feasible are extremely limited. It is suggested that if targeting has to be done because of scarce resources, this should be done on a geographical basis and on the basis of nutritional status. Case-study material shows that it is essential to understand the political determinants of vulnerability and to design methods that will reach the most vulnerable.