Mental and social health in disasters: the Sphere standards and post‐tsunami psychosocial interventions in Asia

The primary objective of this paper is to examine and inform the mental health and psychosocial support standards of the 2011 edition of the Sphere Project's Humanitarian Charter and Minimum Standards in Humanitarian Response. This is done through a qualitative analysis of internal evaluation documents, reflecting four long‐term humanitarian psychosocial programmes in different countries in post‐tsunami Asia. The analysis yielded three overall conclusions. First, the Sphere standards on mental health and psychosocial support generally are highly relevant to long‐term psychosocial interventions after disasters such as the Indian Ocean tsunami of 26 December 2004, and their application in such settings may improve the quality of the response. Second, some of the standards in the current Sphere handbook may lack sufficient guidance to ensure the quality of humanitarian response required. Third, the long‐term intervention approach poses specific challenges to programming, a problem that could be addressed by including additional guidance in the publication.     

Linking rights and standards: the process of developing "rights-based" minimum standards on food security, nutrition and food aid

This article examines the recent revision of the Sphere Minimum Standards in disaster response relating to food security, nutrition and food aid. It describes how the revision attempted to incorporate the principles of the Humanitarian Charter, as well as relevant human rights principles and values into the Sphere Minimum Standards. The initial aim of the revision was to ensure that the Sphere Minimum Standards better reflected the principles embodied in the Humanitarian Charter. This was later broadened to ensure that key legal standards and principles from human rights and humanitarian law were considered and also incorporated, in part to fill the "protection gap" within the existing standards. In relation to the food security, nutrition and food aid standards, it was agreed by participants in the process that the human right to adequate food and freedom from hunger should be incorporated. In relation to more general principles underlying the Humanitarian Charter, itself drawn largely from human rights and humanitarian law, it was agreed that there was a need to strengthen "protection" elements within the standards and a need to incorporate the basic principles of the right to life with dignity, non-discrimination, impartiality and participation, as well as to explore the relevance of the concept of the progressive realisation of the right to food. The questions raised in linking rights to operational standards required thought, on the one hand, about whether the technical standards reflected a deep understanding of the values expressed within the legal instruments, and whether the existing standards were adequate in relation to those legal rights. On the other hand, it also required reflection on how operational standards like Sphere could give concrete content to human rights, such as the right to food and the right to be free from hunger. However, there remain challenges in examining what a rights-based approach will mean in terms of the role of humanitarian agencies as duty-bearers of rights, given that the primary responsibility rests with state governments. It will also require reflection on the modes and mechanisms of accountability that are brought to bear in ensuring the implementation of the Minimum Standards.     

Rights,Standards and Quality in a Complex Humanitarian Space: Is Sphere the Right Tool?

The Sphere Project (consisting of both the Humanitarian Charter and Minimum Standards for Disaster Response) has made prominent contributions to the debates, thinking and work on the quality of assistance and accountability of aid agencies. However, since its inception in 1997, several agencies expressed concerns regarding Sphere's approach, many of which were confirmed by the Sphere evaluation (2002/3). The present article restates these concerns, and addresses more fundamental issues regarding Sphere's cornerstone. It questions the validity of Sphere's rights-based approach, which consists of a tenuous link between the rights of affected populations and standards for technical interventions. Sphere is founded on "the right to assistance", although this right does not exist in international law. Its elaboration would entail solving several complex legal and political issues, which Sphere fails to address. This article also questions the validity and usefulness of universal standards for technical performance in helping relief agencies provide adapted assistance to disaster-affected populations, in line with their mandates and principles. It suggests that Sphere's approach and content largely reflect the concerns, priorities and values of technical professionals in Northern agencies, leaving limited space to genuine "participation" by affected populations and partners from the South.     

Children and the Sphere standard on mental and social aspects of health

Most of the world's children live in resource-poor countries where people are at a relatively high risk of exposure to catastrophic situations arising from conflict and natural disasters.(6) Given the potential social, psychological and psychiatric consequences of exposure to disaster, mental health and psychosocial support programmes are increasingly part of humanitarian aid. A minimum standard on mental and social aspects of health is included in the recently revised Humanitarian Charter and Minimum Standards in Disaster Response (Sphere Handbook) (Sphere Project, 2004). Most recommendations for mental health and psychosocial interventions in guidance documents are based on expert opinion rather than research. Consequently, interventions are being implemented without full understanding of their potential benefit or harm. This paper offers a child-focused review of the evidence for each of the interventions described as indicators for the Sphere standard on mental and social aspects of health. It suggests some, but limited, support for each of them. However, the evidence base needs substantial strengthening.     

Birthing Sphere

This paper tells the story of the initiation and first year of Sphere. It traces the history of how the project was started and its relationship to other major events of that time, principally the multi-donor Rwanda evaluation. The paper describes how the basic structure of the Sphere standards was agreed upon and discusses why some sectors were eventually left out of the standards. Tensions and public disagreements between the agencies that created Sphere are discussed, along with the manner in which the chosen working processes contributed to the successful publication of the Sphere standards. We show how the process of policy formulation, which led up to the publication of the first edition of the Sphere standards, was as dependent upon the ability of the project team to work opportunistically as it was upon the application of agency principles. Finally the paper reflects upon the success of Sphere and lessons that can be learned from this early Sphere process.     

Revisiting Sphere: new standards of service delivery for new trends in protracted displacement

The proportion of people living in protracted displacement, as well as the duration of this displacement, is increasing. International humanitarian standards for services provided in protracted displacement are based on the Sphere Standards, which were formulated using evidence and experience from acute phase emergencies. However, the majority of protracted emergencies are in the post‐emergency phase. This paper discusses trends in displacement, outlines reasons why using the Sphere Standards as minimum standards of service provision in protracted displacement does not adequately meet the needs of these populations, and analyses areas where greater standards of service provision are necessary. An expansion of the evidence base regarding determinants of morbidity and mortality in protracted emergencies is needed. This, followed by a joint approach to designing new, effective standards focused on proactive policies, will allow the humanitarian community more appropriately to serve and enable the millions of people currently living in protracted displacement.     

Questionable accountability: MSF and Sphere in 2003

This article examines the relationship between Médecins Sans Frontières (MSF) and the Sphere Project. Prior to revisiting the concerns MSF had with the project, it looks at factors that give rise to differences between NGOs and cites some reasons for why an organisation such as MSF would not embrace such a project and clarifies some key elements of MSF-style humanitarianism. The author revisits the original concerns and arguments presented by MSF when it decided not to participate beyond assisting with the establishment of technical standards and key indicators for the handbook. This is followed by a critical discussion examining these concerns and counter-criticism with reference to experiences a few years after the inception of Sphere. It concludes with MSF's perceptions and stance regarding Sphere and accountability in 2003.     

The Sphere Project: The Implications of Making Humanitarian Principles and Codes Work

In 1996, in recognition of concerns about humanitarian response efforts, non- governmental organisations (NGOs) launched the Sphere Project, the first collaborative initiative to produce globally applicable minimum standards for humanitarian response. The aims of the Sphere Project are to improve the effectiveness of humanitarian efforts and to enhance the accountability of the humanitarian system, primarily to those people who have a right to protection and assistance in disasters, as well as to agency members and donors.
This paper discusses the purpose of the Sphere Project, the unique process that brought it about and the major concerns that have been raised about its practical application. Finally, the paper considers the implications of this for improving the impact of humanitarian response and for future initiatives given the process that Sphere has begun. It argues that improved accountability does not start and stop with NGOs. They are just one element of a wider humanitarian response effort and more needs to be done to improve the system as a whole.     

The Sphere Project: the implications of making humanitarian principles and codes work

In 1996, in recognition of concerns about humanitarian response efforts, non-governmental organisations (NGOs) launched the Sphere Project, the first collaborative initiative to produce globally applicable minimum standards for humanitarian response. The aims of the Sphere Project are to improve the effectiveness of humanitarian efforts and to enhance the accountability of the humanitarian system, primarily to those people who have a right to protection and assistance in disasters, as well as to agency members and donors. This paper discusses the purpose of the Sphere Project, the unique process that brought it about and the major concerns that have been raised about its practical application. Finally, the paper considers the implications of this for improving the impact of humanitarian response and for future initiatives given the process that Sphere has begun. It argues that improved accountability does not start and stop with NGOs. They are just one element of a wider humanitarian response effort and more needs to be done to improve the system as a whole.     

Nutritional response to the 1998 Bangladesh flood disaster: Sphere minimum standards in disaster response

In this study we use a cross-sectional survey to evaluate the nutritional response to the 1998 Bangladesh Flood Disaster by 15 relief agencies using standards developed by the Sphere Project. The Sphere Project is a recent attempt by agencies around the world to establish universal minimum standards for the purpose of ensuring quality and accountability in disaster response. The main outcomes measured were resources allocated to disaster relief types of relief activities and percentage of agencies meeting selected Sphere food aid and nutrition indicators. Although the process of nutritional response was measured, specific nutritional and health outcomes were not assessed. This review found that self-reported disaster and nutritional resources varied widely between implementing agencies, ranging from US $58,947 to $15,908,712. The percentage of resources these agencies allocated to food aid and nutritional response also varied, ranging from approximately 6 to 99 per cent of total resources. Agencies met between 8 and 83 per cent of the specific Sphere indicators which were assessed Areas in which performance was poor included preliminary nutritional analysis; beneficiary participation and feedback; disaster preparedness during non-emergency times; monitoring of local markets and impact assessment. Agencies were generally successful in areas of core humanitarian response, such as targeting the vulnerable (83 per cent) and monitoring and evaluating the process of disaster response (75 per cent). The results here identify both strengths and gaps in the quality of humanitarian response in developing nations such as Bangladesh. However, they also raise the question of implementing a rights-based approach to disaster response in nations without a commitment to meeting positive human rights in non-disaster times.     

Humanitarian Daily Rations: the need for evaluation and guidelines

Over 13 million Humanitarian Daily Rations (HDRs) have been distributed by NGOs, international organisations and the US military since 1993. In that time, not a single technical end-user study of HDRs has been published. Nor have practical guidelines been established for HDR distribution or use. This paper seeks to establish a baseline of knowledge concerning HDRs, surveying their history, composition and distribution. Criticisms of the ration are reviewed. A comprehensive evaluation is required to understand and improve HDR distribution, end-use, perceptions, design and nutritional contents. HDRs must also be added to technical guidelines on planning nutritionally adequate rations.     

Risk Removed? Steps Towards Building Trust in Humanitarian Mine Action

This article examines the role of building trust in Humanitarian Mine Action (HMA). The role of trust following a mine-clearance operation is largely an unexplored region. Drawing on case studies from Angola, Mozambique and Afghanistan, the article explores how trust can be understood in the context of humanitarian initiatives such as landmine clearance, and outlines the challenges associated with building trust among populations with experience of armed conflict. Because trust is difficult to re-establish following a war, the argument presented here suggests that one way in which this can be done is through building relationships at the organisational and interpersonal levels. The analysis reviews specific measures that mine-action agencies have used to build trust, looking at the strengths and weaknesses of different approaches. The analysis concludes by suggesting general guidelines for how mine-action practitioners can facilitate trust, and by outlining some promising avenues for future research.     

Integration of different data bodies for humanitarian decision support: an example from mine action

Geographic information systems (GIS) are increasingly used for integrating data from different sources and substantive areas, including in humanitarian action. The challenges of integration are particularly well illustrated by humanitarian mine action. The informational requirements of mine action are expensive, with socio-economic impact surveys costing over US$1.5 million per country, and are feeding a continuous debate on the merits of considering more factors or 'keeping it simple'. National census offices could, in theory, contribute relevant data, but in practice surveys have rarely overcome institutional obstacles to external data acquisition. A positive exception occurred in Lebanon, where the landmine impact survey had access to agricultural census data. The challenges, costs and benefits of this data integration exercise are analysed in a detailed case study. The benefits are considerable, but so are the costs, particularly the hidden ones. The Lebanon experience prompts some wider reflections. In the humanitarian community, data integration has been fostered not only by the diffusion of GIS technology, but also by institutional changes such as the creation of UN-led Humanitarian Information Centres. There is a question whether the analytic capacity is in step with aggressive data acquisition. Humanitarian action may yet have to build the kind of strong analytic tradition that public health and poverty alleviation have accomplished.     

The vulnerable do‐gooders: security strategies of German aid agencies

Humanitarian and development agencies have confronted growing insecurity in some of the regions in which they work over the course of the past decade. Consequently, aid agencies are changing their approach to security issues. Compared to aid agencies from other countries, especially the United Kingdom and the United States, German aid agencies have been relatively slow to adopt security measures. In addition, the security measures they have selected differ from one agency to another, even in comparable security contexts. The literature on organisational learning helps to explain these differences. The findings show that external and internal organisational factors influence an aid agency's choice of a particular security measure. The different responses of German aid agencies to the changing security environment demonstrate that security measures are not only influenced by an organisation's identity but also can be a way for them to demonstrate their identity and thereby distinguish themselves from other actors that deliver aid.     

BOOK REVIEWS

Book reviewed in this article:
Rwanda: Which Way Now? , by David Waller
Humanitarian Aid to Somalia , by the Operations Review Unit, Netherlands Development Corporation, The Hague
The State of the World's Refugees 1995. In Search of Solutions , by the United Nations High Commissioner for Refugees
Mercy Under Fire: War and the Global Humanitarian Community , by Larry Minear and Thomas G. Weiss
The Politics of Humanitarian Intervention , edited by John Harriss
'The Conscience of the World', The Influence of Non-Governmental Organisations in the UN System , edited by P. Willetts
Nutrition Matters: People, Food and Famine , by Helen Young and Susanne Jaspars
Nutrition Guidelines , by Médecins Sans Frontieres
Who Will Feed China: Wake-up Call for a Small Planet , by Lester Brown
Urban Disaster Mitigation: The Role of Engineering and Technology , edited by F.Y. Cheng and M.-S. Sheu
Learning from Failure – The System Approach , by Joyce Fortune and Geoff Peters, John Wiley and Sons, Chichester
Landslides Hazard Mitigation with Particular Reference to Developing Countries: Proceedings of a Conference Held at the Royal Society, November 1993 , The Royal Academy of Engineering
Crisis and Opportunity. Environment and Development in Africa , by François Falloux and Lee M. Talbot
Megacities: Reducing Vulnerability to Natural Disasters , by the Institution of Civil Engineers     

Understanding the security management practices of humanitarian organizations

Humanitarian organisations operate in increasingly hostile environments. Although authoritative statistics are scarce, anecdotal evidence suggests that aid workers face life-threatening risks that are exacerbated by the growing number of humanitarian organisations operating in the field, the diversity of their mandates, the lack of common professional security standards, and limited success in inter-agency security coordination. Despite broad acceptance of the need for better security management and coordination, many humanitarian organisations remain ambivalent about devoting increased resources to security management and security coordination. A critical lack of basic empirical knowledge of the field security environment hampers efforts to enhance security management practices. The absence of a systematic means of sharing incident data undermines the capacity of the humanitarian community to address proactively security threats. In discussions about humanitarian staff safety and security, the least common denominator remains cumulative anecdotal evidence provided by the many security personnel working for humanitarian organisations in the feld.     

"How near were we to Ruine": the effects in England of the earthquake of 8th September 1692

This paper attempts to Illustrate some of the advantages and disadvantages of using contemporary evidence in the study of historical seismicity. The event considered here is doubly significant—it was a large event by British standards, as well as arguably the best documented earthquake to have occurred before the mid-eighteenth century. At a time when an interdisciplinary approach to historical seismicity is still in its infancy this paper identifies those areas where the available sources can assist in the evaluation of early macroseismic data.     

Protecting people in cities: the disturbing case of Haiti

Humanitarian actors have sought increasingly not only to assist people affected by natural disasters but also to protect them. This paper examines the efforts of international humanitarian actors to protect Haitians affected by the devastating earthquake of 12 January 2010. It begins with an analysis of the particular difficulties of conceptualising and operationalising protection in an urban environment and traces the efforts of international actors on the ground to develop appropriate protection strategies. The particular difficulties of working with camps and spontaneous settlements in urban areas are explored as are the challenges that stemmed from working with different levels of governmental authorities and a multitude of humanitarian actors. The paper concludes by highlighting some of the lessons learned from the successes and failures of international protection efforts in Haiti. It is hoped that these may assist future efforts to protect people living in urban environments.     

The analytical framework of water and armed conflict: a focus on the 2006 Summer War between Israel and Lebanon

This paper develops an analytical framework to investigate the relationship between water and armed conflict, and applies it to the ‘Summer War’ of 2006 between Israel and Lebanon (Hezbollah). The framework broadens and deepens existing classifications by assessing the impact of acts of war as indiscriminate or targeted, and evaluating them in terms of international norms and law, in particular International Humanitarian Law (IHL). In the case at hand, the relationship is characterised by extensive damage in Lebanon to drinking water infrastructure and resources. This is seen as a clear violation of the letter and the spirit of IHL, while the partial destruction of more than 50 public water towers compromises water rights and national development goals. The absence of pre‐war environmental baselines makes it difficult to gauge the impact on water resources, suggesting a role for those with first‐hand knowledge of the hostilities to develop a more effective response before, during, and after armed conflict.