Women, Health and Humanitarian Aid in Conflict

The burden of political conflict on civilian populations has increased significantly over the last few decades. Increasingly, the provision of resources and services to these populations is coming under scrutiny; we highlight here the limited attention to gender in their provision. Women and men have different exposures to situations that affect health and access to health-care and have differential power to influence decisions regarding the provision of health services. We argue that the role of women in planning is central to the provision of effective, efficient and sensitive health-care to conflict-affected populations.     

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.     

Aid in the midst of plenty: oil wealth, misery and advocacy in Angola

This paper examines advocacy initiatives by humanitarian and human rights organisations to address problems of governance in resource-rich and conflict-affected countries, focussing on the case of Angola. Humanitarian principles preclude the use of indiscriminate conditionality and point towards a cautious approach to advocacy aimed at assisting vulnerable populations. Furthermore, the relatively insignificant amount of aid supplied to resource-rich local authorities means that individual agencies have precious little leverage, especially when commercial interests rather than humanitarian or 'good governance' principles influence the priorities of bilateral donors. A context of resource wealth calls for: high levels of coordination and cooperation between human rights groups, aid agencies and donors; balanced use of conditionality, based on the drawing, by donors, of a clear distinction between emergency and development-oriented assistance; and a sustained effort to highlight the responsibilities of local authorities, foreign governments and businesses in meeting humanitarian and development objectives.     

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.     

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.     

Aid and Violence, with Special Reference to Sierra Leone

This paper looks at how departures from humanitarian principles can be accommodated, legitimised and obscured within the international humanitarian system. It looks particularly at the case of Sierra Leone between 1991 and 1995. It analyses how misinformation about the causes and dynamics of violence and regarding the aid system contribute to the erosion of humanitarian principles.     

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.     

Reproductive health in Afghanistan: results of a knowledge, attitudes and practices survey among Afghan women in Kabul

A reproductive-health knowledge, attitudes and practices (KAP) survey was carried out among 468 Afghan women of reproductive age. A convenience sample of women was selected from attendees in the outpatient departments of four health facilities in Kabul. Seventy-nine per cent of respondents had attended at least one antenatal consultation during their last pregnancy. Two-thirds (67 per cent) delivered their first child between 13 and 19 years. The Caesarean-section rate was low (1.6 per cent). Two-thirds (67 per cent) of deliveries occurred in the home. The contraceptive prevalence rate was 23 per cent (16 per cent modern and 7 per cent natural methods). Twenty-four per cent had knowledge of any STIs, although most of these women did not know correctly how to prevent them. Most of the women (93 per cent) needed authorization from their husband or a male relative before seeking professional health-care. In multivariate analysis, women's schooling was significantly associated with antenatal-care attendance (AOR 4.78), institutional delivery (AOR 2.29), skilled attendance at birth (AOR 2.07) and use of family planning (AOR 4.59). Reproductive-health indicators were noted to be poor even among these women living in Kabul, a group often considered to be the most privileged. To meet the reproductive-health needs of Afghan women, the socio-cultural aspects of their situation--especially their decision-making abilities -- will need to be addressed. A long-standing commitment from agencies and donors is required, in which the education of women should be placed as a cornerstone of the reconstruction process of Afghanistan.     

Economic evaluation of measles catch-up and follow-up campaigns in Afghanistan in 2002 and 2003

This paper assesses the cost-effectiveness of, and the return on the investment in, the 2002 catch-up and the 2003 follow-up measles campaigns in Afghanistan from the perspective of the donor. The catch-up campaign targeted nearly 12 million children aged between six months and 12 years, while the follow-up campaign targeted over five million children aged between 9 and 59 months. Both campaigns successfully vaccinated approximately 96 per cent of the respective target populations, and are expected to avert an estimated 301,000 measles deaths over the next 10 years. The average cost per dose of measles vaccine delivered was USD 0.40. The cost per death prevented is USD 23.6, assuming a case fatality rate of 10 per cent and a discount rate of three per cent. With more than 42,000 measles deaths avoided for every one million US dollars spent, the campaigns are an excellent public health investment for precluding childhood mortality in a country affected by a complex emergency.     

The future of humanitarian action: mapping the implications of Iraq and other recent crises

In late 2003 the Feinstein International Famine Center, in partnership with institutions in London, Geneva and Washington, organised a series of consultations on the future of humanitarian action post-Iraq. This article is based on those discussions. A number of recurring concerns are elaborated, ranging from the perception of humanitarianism as a Northern-driven and Northern-controlled enterprise, through the politicisation of security and the devaluation of the protective power of emblems, to the very nature of how the crisis in Iraq is perceived. The article explores the implications of such issues for humanitarian workers and their institutions. It concludes by framing an agenda for action by the humanitarian sector.     

Gender and drought: experiences of Australian women in the drought of the 1990s

A unique collaborative, sociological study undertaken during 1995-7, explored the social construction of drought as a disaster, looking at farm families in two Australian states: Queensland (beef producers) and New South Wales (sheep/wheat producers). A decision was made to interview the women and men separately to test our hypothesis that there would be gender issues in any analysis of a disaster, but particularly one which has had so much long-term impact on individuals, families and communities, such as drought. Interviews were conducted with over 100 individuals male and female. We conclude that drought as a disaster is a gendered experience. The paper draws on the narratives of some women involved in the study to identify 'themes of difference' which confirm the necessity to maintain gender as a variable in all studies of the social impacts of disaster.     

Faith-based aid, globalisation and the humanitarian frontline: an analysis of Western-based Muslim aid organisations

This paper focuses on the emergence and modus operandi of Muslim faith-based aid organisations from the West, particularly those from the United Kingdom. Through case studies of Islamic Relief Worldwide and Muslim Hands, it examines the actual and potential added value generated by these humanitarian players in Muslim-majority contexts at times when aid actors from or associated with the West are being perceived by some as instrumental to the political agendas of Western powers, or are being confronted with the consequences thereof. The study analyses Muslim faith-based aid organisations' transnational networks, their implementing partnerships with local faith-based non-governmental organisations (NGOs), and their security position within and their access to insecure contexts, drawing on field examples and opinion from Central Asia, Iraq and Pakistan. It thereby argues that there is ground for an expansion of the role of Muslim aid actors, because of the existence of social and political realities in the field that cannot be always effectively tackled by the dominant international development approaches.     

Female adolescents and their sexuality: notions of honour, shame, purity and pollution during the floods

This paper explores the experiences of female adolescents during the 1998 floods in Bangladesh, focusing on the implications of socio-cultural norms related to notions of honour, shame, purity and pollution. These cultural notions are reinforced with greater emphasis as girls enter their adolescence, regulating their sexuality and gender relationships. In Bangladeshi society, adolescent girls are expected to maintain their virginity until marriage. Contact is limited to one's family and extended relations. Particularly among poorer families, adolescent girls tend to have limited mobility to safeguard their 'purity'. This is to ensure that the girl's reputation does not suffer, thus making it difficult for the girl to get married. For female adolescents in Bangladesh, a disaster situation is a uniquely vulnerable time. Exposure to the unfamiliar environment of flood shelters and relief camps, and unable to maintain their 'space' and privacy from male strangers, a number of the girls were vulnerable to sexual and mental harassment. With the floods, it became difficult for most of the girls to be appropriately 'secluded'. Many were unable to sleep, bathe or get access to latrines in privacy because so many houses and latrines were under the water. Some of the girls who had begun menstruation were distressed at not being able to keep themselves clean. Strong social taboos associated with menstruation and the dirty water that surrounded them made it difficult for the girls to wash their menstrual cloths or change them frequently enough. Many of them became separated from their social network of relations, which caused them a great deal of anxiety and stress. Their difficulty in trying to follow social norms have had far-reaching implications on their health, identity, family and community relations.     

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.     

‘The Ethiopian famine’ revisited: Band Aid and the antipolitics of celebrity humanitarian action

In many ways the Ethiopian famine of 1983–85 has served as a watershed with respect to humanitarian action. One of its lasting legacies has been the emergence of Band Aid and the subsequent increase in celebrity humanitarianism. A revisiting of the events of 1983–85 occurred in 2010 during a dispute in which it was alleged that a portion of the donations of Band Aid were spent on arms purchases. This paper takes this controversy as its starting point. It goes on to use the theoretical reflections of Giorgio Agamben to consider the dynamics that unfolded during the Ethiopian famine of 1983–85 and to analyse the underlying conceptualisation behind the emergence of Band Aid‐type celebrity humanitarianism. The paper concludes with some wider thoughts on how the in essence antipolitical agenda of celebrity humanitarian action is transported into the everyday understanding of ‘African disaster’, resulting ultimately in the perpetuation of hegemonic control by the global North.     

The influence of caste,class and gender in surviving multiple disasters: A case study from Orissa,India

Sociological and anthropological studies in India reveal that caste, class and gender in everyday life are both rigid and dynamic, but little is known about how they influence the survival mechanisms of women during ‘multiple disasters’, nor about how women negotiate with these structural mores to meet their cultural and biological needs. This is explored through the experiences of 12 women-headed households from different social castes in Orissa, India. Multiple disasters or disasters that occur in ‘one specific place’ (such as floods, cyclone and drought) are regular events in coastal parts of the state of Orissa. The super-cyclone of 1999, two floods of 2001 and 2003 and drought of 2000 and 2002 form the case study. Participant observation, in-depth interviews and documentary evidence complement the fieldwork. The findings suggest a complex interplay of caste, class and gender in surviving the multiple disasters including structural mutability under the purview of social organization. In doing so, women demonstrated their individual and collective agencies in order to meet their cultural and biological needs under severe crisis. This research stresses that gender and disaster studies must include a consideration of caste and class for effective disaster management and social vulnerability reduction.     

为地震应急救援注入专业的力量——济南市全市地震系统应急救护培训侧记

“嗨!这儿有人受伤了。我是急救员。有会急救的可以过来帮忙。小伙子，请你拨打1201”济南市地震局杜贻合局长大声呼喊着，句句有力，字字铿锵。     

The social context of childcare practices and child malnutrition in Niger's recent food crisis

In 2004–05, Niger suffered a food crisis during which global attention focused on high levels of acute malnutrition among children. In response, decentralised emergency nutrition programmes were introduced into much of southern Niger. Child malnutrition, however, is a chronic problem and its links with food production and household food security are complex. This qualitative, anthropological study investigates pathways by which children are rendered vulnerable in the context of a nutritional 'emergency'. It focuses on household-level decisions that determine resource allocation and childcare practices in order to explain why practices apparently detrimental to children's health persist. Risk aversion, the need to maintain self-identity and status, and constrained decision making result in a failure to invest extra necessary resources ingrowth-faltering children. Understanding and responding to the social context of child malnutrition will help humanitarian workers to integrate their efforts more effectively with longer-term development programmes aimed at improving livelihood security.     

有限运力条件下的地震救灾物资调度模型及方法

救灾物资的调度是地震救灾工作中的一个重要环节。如何将地震救灾物资以时间最短、安全性最高及经济性最好的方式运送到物资需求点是救灾物资调度的关键。本文从时效性、安全性及经济性方面考虑了地震救灾物资的调度问题。建立了运力不足的条件下,时间最短、出救点数目最少、安全性最高的地震救灾物资调度数学优化模型;将问题转化为不受运力约束的情况,求解出可行方案的集合,再利用模糊规划对每个可行方案求最优解;通过比较最优解,求出时间最短,出救点数目最少,安全性最高的方案。最后,通过一个仿真算例阐述了本文方法的使用。     

7级强震备震过程的科普宣传及其减灾意义

随着中国经济的持续发展,公众对高质量生活充满渴望,对防震减灾和社会安全产生了强烈需求.联系到国家科技战略层次高度重视科普宣传的最新动态,提出了7级强震备震科普宣传工作的概念,从备震科普宣传的一般问题、7级强震备震科普宣传的重点问题及意义等方面展开了初步研究讨论.