Violence and complex humanitarian emergencies: implications for livelihoods models

This paper explores the nature of the violence that characterises complex humanitarian emergencies and the related implications for modelling livelihoods systems. While noting the importance of livelihoods approaches in complex humanitarian emergencies, it deliberates the limitations of sustainable livelihoods frameworks when applied in environments marked by protracted instability. Adaptations to the model are discussed, with a particular focus on the relationships among violence, assets and liabilities within livelihoods systems. Political economy of violence theories intimate that the assets on which livelihoods systems are constructed in peaceful times may instead become life-and livelihood-threatening liabilities in periods of conflict. Adaptations to livelihood systems in violent settings require that analysts consider violence from policy, institutional and process perspectives. It is suggested that vulnerability should be re-conceptualised as endogenous to livelihoods systems in violent settings. Building on the work of others, a livelihoods model adapted for complex humanitarian emergencies is presented.     

The rationality of resistance: alternatives for engagement in complex emergencies

The different conceptualisations of conflict in the complex emergency literature have profound implications on the perception of the agency of different groups and the prospects for conflict management. While much recent analysis has focused on the rational political and economic functions of violence, relatively little analysis has focused on why the majority of people chose not to resort to violence. Using Foucault's analysis of power relations, a new framework for conflict analysis is proposed which includes non-violent resistance as well as violence as a means of domination. Non-violent resistance is explored as a rational, highly adaptable response to acts of domination. A comprehensive understanding of conflict must recognise local forms of resistance and identify the barriers and opportunities for the engagement of the international humanitarian community with these groups. This engagement can be used to foster capacities for the creation of legitimate, inclusive, non-violent political and economic processes in the attempt to provide alternatives for everyone in the conflict. If the purpose of the study of complex emergencies is to understand the nature of various conflicts and, based on that understanding, make recommendations for possible routes to conflict management, the analysis of local resistance and efforts to foster it must become a major aspect of the research agenda.     

Establishing moral bearings: ethics and expatriate health care professionals in humanitarian work

Expatriate health care professionals frequently participate in international responses to natural disasters and humanitarian emergencies. This field of practice presents important clinical, logistical and ethical challenges for clinicians. This paper considers the ethics of health care practice in humanitarian contexts. It examines features that contribute to forming the moral landscape of humanitarian work, and discusses normative guidelines and approaches that are relevant for this work. These tools and frameworks provide important ethics resources for humanitarian settings. Finally, it elaborates a set of questions that can aid health care professionals as they analyse ethical issues that they experience in the field. The proposed process can assist clinicians as they seek to establish their moral bearings in situations of ethical complexity and uncertainty. Identifying and developing ethics resources and vocabulary for clinical practice in humanitarian work will help health care professionals provide ethically sound care to patients and communities.     

大中城市震害预测与辅助决策的空间分析

利用GIS的空间分析功能，对大中城市防震减灾示范研究成果进行了空间区划分析，给出了城市高危害街区的计算方法和结果，同时给出了各种结构类型房屋破坏面积、人员伤亡和无家可归人口数在各个街区的空间分布结果，以及基于此空间分布结果的医疗救护、人员疏散和物资供应等辅助决策分析。该分析的主要意义在于能充分了解大中城市潜在震害的空间分布，为震前采取相应预防措施和震后开展应急救灾工作提供了方便。     

The rise of politics and the decline of vulnerability as criteria in disaster decisions of the United States, 1953–2009

This paper examines the shift from vulnerability to political responsiveness in presidential and gubernatorial disaster decisions in the United States from 1953–2009 (President Dwight D. Eisenhower to President Barack Obama) using annual request, declaration, and approval data from multiple sources. It makes three key conclusions: first, the 1988 Stafford Act expanded federal coverage to all categories of disasters, added a significant range of individual types of assistance, and provided extensive funding for recovery planning. Second, the election effects on disaster decisions increased over time whereas the impact of social and economic vulnerability (measured by scope of disaster) declined. Third, the changes affected governors more than presidents, and the choices of governors drove those of presidents. The analysis underscores the increasingly political nature of the disaster decision‐making process, as well as the difficulty in emphasising mitigation and preparedness as intensively as response and recovery. Proactive intervention yields fewer political rewards than responsiveness.     

Supporting breastfeeding in emergencies: protecting women's reproductive rights and maternal and infant health

Women have the right to support that enables them to breastfeed. Supporting breastfeeding in emergencies is important because artificial feeding places mothers and children at risk. In emergencies, artificial feeding is dangerous to the infant, difficult and requires substantial resources. In contrast, breastfeeding guards infant health. It is also protective against postpartum haemorrhage, maternal depletion, maternal anaemia and closely spaced births and should therefore concern not only nutritionists, but also those involved in reproductive health. However, it is common for women's ability to breastfeed to be undermined in emergencies by the indiscriminate distribution of breast-milk substitutes and the absence of breastfeeding support. Controlling the distribution of breast-milk substitutes, providing supportive environments, and appropriate medical and practical assistance to breastfeeding women safeguards the health and well-being of mothers and babies. Greater collaboration between the nutrition and reproductive health sectors is required to promote best practice in protecting breastfeeding women and their children in emergencies.     

Civilians under fire: evacuation behaviour in north Israel during the Second Lebanon War

This paper seeks to understand evacuation behaviour in a case of spontaneous evacuation. During the Second Lebanon War of 2006, more than one‐third of residents in north Israel spontaneously evacuated—the remainder stayed in situ. Using a telephone survey of 665 respondents residing in north Israel, we were able to characterise the behaviour of evacuees and non‐evacuees. The main reasons cited for evacuating were fear of injury to self or family, the effect on children, inability to remain in a protective space, and family pressure. The main reasons cited for remaining at home were no suitable alternative, did not perceive a high level of danger, had to go to work, and there is no place like home. There were no significant differences with regard to most socio‐demographic characteristics of the population. These findings should aid emergency managers in preparing the population for a future emergency and in engaging in effective dialogue with the population during an emergency on the evacuation option.     

Temporary site selection and decision‐making methods: a case study of Tehran,Iran

Decisions on selecting an appropriate site for temporary shelter used to be taken in a limited amount of time after a disaster. The need for a systematic method in this area inspired the MADM (multi‐attribute decision making) for complex disaster management decisions. This research proposes a model for appropriate and systematic site selection for temporary shelters, before an earthquake, using a geographical information system and MADM based on an earthquake damage assessment. After the effective criteria for site selection of temporary shelters are determined, the geographical layers of these criteria are prepared for Municipal District No.1 of Greater Tehran, the capital of Iran. Given these attributes and the required shelter area (415–610 hectares), 14 zones are proposed initially. Various MADM methods are used for the final selection. The mean of the aggregated ranking results are determined, and 10 of the 14 initial zones are ranked.     

GIS and local knowledge in disaster management: a case study of flood risk mapping in Viet Nam

Linking community knowledge with modern techniques to record and analyse risk related data is one way of engaging and mobilising community capacity. This paper discusses the use of the Geographic Information System (GIS) at the local level and the need for integrating modern technology and indigenous knowledge into disaster management. It suggests a way to mobilise available human and technical resources in order to strengthen a good partnership between local communities and local and national institutions. The paper also analyses the current vulnerability of two communes by correlating hazard risk and loss/damage caused by disasters and the contribution that domestic risk maps in the community can make to reduce this risk. The disadvantages, advantages and lessons learned from the GIS flood risk mapping project are presented through the case study of the Quang Tho Commune in Thua Thien Hue province, central Viet Nam.     

Human immuno-deficiency virus and infant feeding in complex humanitarian emergencies: priorities and policy considerations

Issues surrounding mother-to-child transmission of HIV/AIDS pose considerable challenges in complex humanitarian emergencies. The risk of vertical transmission through breastfeeding is well recognised, but safe alternatives are limited by the social, economic and environmental conditions of emergency situations. In 2000, the World Health Organisation published a technical report on behalf of the UNFPA/UNICEF/WHO/UNAIDS Inter-agency Task Team on Mother-to-child Transmission of HIV which outlined revised recommendations for infant feeding by HIV-positive women. This paper outlines reasons why these recommendations may be insufficient during the initial stages of complex humanitarian emergencies and proposes recommendations for establishing infant-feeding policy. Methods of mother-to-child transmission of HIV are reviewed and recent research findings are discussed. Rationale for modifying the 2000 UNFPA/UNICEF/WHO/UNAIDS infant-feeding recommendations in complex emergency situations is explored from the perspective of the infant, the mother and humanitarian field staff. Ethical limitations and future priorities are considered. The paper concludes with recommendations and a policy decision-making framework for consideration during the initial stages of humanitarian crises.     

Landslides, risk and decision-making in Kinnaur District: bridging the gap between science and public opinion

In November 1989 a major landslide destroyed the link road to the village of Sapni in Kinnaur District of Himachal Pradesh in the Indian Himalaya. Although aware of the risk of further landslide activity, the community has campaigned successfully for reconstruction of the road. Decisions of this kind take place at the local level, through village institutions and open debate, with good feedback between villages and district government authorities. In this way a balance is established between meeting more immediate needs (such as domestic water supply, irrigation, road access) and taking acceptable risks. Using the Sapni landslide as a case study, this paper explores the issue of 'acceptable risk', and looks at the existing strategy for risk and disaster reduction in the district.     

HIV risk and prevention in emergency-affected populations: a review

While basic guidelines on HIV prevention in emergencies have been available for several years, international agencies involved in the provision of health services have not placed sufficient priority on the prevention of the human immune deficiency virus (HIV) and other sexually transmitted infections (STIs) in complex emergencies. This paper reviews the factors that may increase the risk of HIV transmission in populations affected by complex emergencies and outlines recommendations for research and programmes. Research into the most appropriate methods of carrying out HIV surveillance and interventions in these settings is needed. In the post-emergency phase programmes need to be far more extensive than those offered under the Minimal Initial Services Package (MISP). While the potential for stigmatization represents an important constraint, there is a need to prioritize HIV/STI interventions in order to prevent HIV transmission in emergency-affected populations themselves, as well as to contribute to regional control of the epidemic.     

Flood proneness and coping strategies: the experiences of two villages in Bangladesh

This paper explores peoples' indigenous survival strategies and assesses variations in people's ability to cope with floods in two flood‐prone villages in Bangladesh. It reveals that people continuously battle against flood vulnerability in accordance with their level of exposure and abilities, with varied strategies employed at different geophysical locations. The paper reports that people in an area with low flooding and with better socioeconomic circumstances are more likely to cope with impacts compared to people in areas with high and sudden flooding. Similarly, households' ability to cope varies depending on people's socioeconomic conditions, such as education, income and occupation. Although floods in Bangladesh generate socioeconomic misery and cause damage to the environment, health and infrastructure, people's indigenous coping strategies have helped them to reduce significantly their vulnerability. Such flood‐mitigating strategies should be well recognised and emphasised further via proper dissemination of information through an early‐warning system and subsequently external assistance.     

The Management of Severe Malnutrition in Burundi: An NGO's Perspective of the Practical Constraints to Effective Emergency and Medium-term Programmes

The NGO, Action contre la Faim (ACF), has been operating in Burundi since 1994, where the situation has dramatically hampered humanitarian programmes. These include poor security resulting in an inability to maintain 24-hour care for the severely malnourished and poor access to the beneficiaries, all within a politically and economically unstable context. However, ACF has been able to capitalise on lessons learnt and reflect on ways to move forward, which have included the improvement of their capacities in the treatment of severe malnutrition and the integration within broader disciplines and national structures.
The protocols for the treatment of severe malnutrition currently used in Burundi have been developed as a result of the research of ACF over the past five years. Other aspects of the nutrition programme remain to be further developed. These include, for example, an improved capacity to care for severely malnourished adolescents and adults; and also a better knowledge of the beneficiaries to allow for stronger links between the provision of treatment and support for their longer-term food security.