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.     

Military Intervention and Humanitarian Action: Trends and Issues

An important trend in military doctrine for so-called 'peace support operations' has been to place them on a spectrum that includes coercion and enforcement. This paper focuses on British writers of doctrine as those responsible for driving the debate forward and forging a consensus among leading military powers. Their discourse is combat oriented, a fact reinforced by a trend towards strategic subcontracting to coalitions of the militarily willing and able. At the same time, there has been a move to institutionalise the involvement of military forces in relief, peace building and development activities. The overall emphasis is on stability and security to facilitate the delivery of humanitarian relief and to establish the conditions for peace-building processes. In the case of Bosnia, this involves conditionality and economic leverage. Although there is a long-established record of peace-keeping forces engaging in goodwill activities (with mixed results), the current trends contain contradictions that seem likely to contribute to the widely perceived erosion of classical humanitarian principles.     

Humanitarian aid and local responses: the aftermath of the rebuilding effort on Tongoa island,Vanuatu

Cyclone Pam swept through the archipelago of Vanuatu on 13–14 March 2015, with wind speeds exceeding those recorded anywhere in the South Pacific since the 1980s. Southern and central parts of the country were particularly affected. Material damage on Tongoa, one of the most afflicted islands, was extensive, but no deaths were reported. During the storm, villagers found shelter in their kitchen, in what is considered locally as a ‘lifeboat’. The aftermath was managed and mitigated by international aid organisations. On Tongoa, this included a ‘Shelter Cluster’ programme, under which villagers were given house rebuilding kits. Elaborating upon extensive ethnographic investigations on site between 2011 and 2018, this paper explores and reveals the ways in which this aid generated confusion among the local population. In a larger context of regular disasters triggered by natural hazards, locals have found endogenous ways of dealing with such extreme climatic events, for the most part without any external assistance.     

Success in Kashmir: a positive trend in civil–military integration during humanitarian assistance operations

The modern cast of disaster relief actors includes host nations, non-governmental organisations, private volunteer organisations, military organisations and others. Each group, civilian or military, has valuable skills and experiences critical to disaster relief work. The goal of this paper is to supplement the study of civil–military relief efforts with contemporary anecdotal experience. The paper examines the interaction between US military forces and other disaster relief actors during the 2005 Kashmir earthquake relief effort. The author uses direct observations made while working in Pakistan to contrast the relationships and activities from that effort with other accounts in prevailing scholarly disaster literature and military doctrine. Finally, this paper suggests that the Kashmir model of integration, coordination and transparency of intent creates a framework in which future humanitarian assistance operations could be successfully executed. Recommendations to improve civil–military interaction in future relief efforts will also be addressed.     

The internal brain drain: foreign aid,hiring practices,and international migration

Building on empirical material gathered in Haiti, this paper advances a new and innovative understanding of the internal brain drain phenomenon—the poaching of local skilled workers by international organisations (IOs) or international non-governmental organisations (INGOs)— by conceptualising it as an equilibrium. This equilibrium is composed of two sets of tensions: (i) those between the salary conditions in the public sector and those on offer to local personnel working for IOs and INGOs; and (ii) those inherent in the dual salary scale used by IOs and INGOs for local and international staff. These two sets of tensions contribute in their specific ways to international migration, and, as such, the internal brain drain has a bearing on external brain drain dynamics. In addition, the paper addresses the difficult policy choices facing development and humanitarian organisations, since every set of policies that impacts on one side of the equilibrium is bound to affect its other side.     

Humanitarians' ethics: the role of face-to-face experiences in humanitarian aid workers' motivation

This paper analyses the significance of specific ethical experiences for humanitarian aid workers' motivation. Following Emmanuel Levinas's understanding of ethics as arising from intersubjective face-to-face encounters, the study illuminates the experiential origins of the humanitarian commitment by analysing James Orbinski's memoir entitled An Imperfect Offering: Dispatches from the Medical Frontline. Orbinski, a former International Council President at Médecins Sans Frontières, was directly involved in humanitarian responses to several major crises during the 1990s, including those in Somalia, Afghanistan, Rwanda, and what was then Zaire. This paper explores three formative experiences from Orbinski's childhood and teenage years to analyse the personal ethics of humanitarian aid workers and to illuminate the intersection of the personal and professional level of humanitarian aid work. Illustrating that Orbinski's humanitarian commitment is a surrendering to the other's call, the paper argues for stronger inclusion of aid workers' lives and experiences to achieve a comprehensive understanding of humanitarian work.     

Humanitarian governance and the consequences of the state‐fragility discourse in the Democratic Republic of Congo's health sector

This paper examines how the discourse on state fragility affects the preferences of key actors in humanitarian governance for different types of health‐sector interventions in the Democratic Republic of Congo. It argues that, instead of focusing on the actual meaning of state fragility, attention should be paid to interactive processes around the discourse among stakeholders in the health sector. The lack of consensus on state fragility influences humanitarian governance, especially the perceptions of and interactions between the host government, donors, and international non‐governmental organisations. The latter have legitimised the persistence of vertical, emergency‐based interventions by emphasising state fragility, whereas state officials have preferred to assert political statehood and a higher degree of control. Nevertheless, they agree that donors’ financial contributions ensure the survival of the public health sector. Looking ahead, a policy coalition based on harmonised views about addressing fragility is necessary for effective engagement and the sustainability of interventions, but this is unlikely to happen any time soon.     

Humanitarian emergencies and military help: some conceptual observations

In 1988 the International Peace Academy, New York, sponsored a study exploring the interface between security and the delivery of humanitarian aid. The aim was to evaluate the possible use of military help to support humanitarian relief workers during armed conflicts. As part of this pioneering work, the authors of this paper discuss the conceptual questions that must be raised before dealing with the associated practical difficulties. It examines those circumstances in which foreign military organizations might offer help in humanitarian emergencies; the nature of contemporary examples of humanitarian need that result in international responses; and the importance of factors which affect how these are perceived. The paper then analyses the pertinent functions that military units might undertake and finally examines the constraints that would apply if such forces were to become involved.     

Humanitarian governance and resilience building: Ethiopia in comparative perspective

Humanitarian governance is usually understood according to the classic, Dunantist paradigm that accords central importance to international humanitarian agencies. However, this is increasingly paralleled by ‘resilience humanitarianism’ that focuses, among other things, on including national actors in humanitarian governance. This article views humanitarian governance as emerging through interactions between authorities, implementing agencies and communities. It is based on interactive ethnography in five countries by Partners for Resilience (PfR). Using the Theory of Change (ToC) tool, it analyses the various interpretations and priorities of actors involved in humanitarian problems, solutions and programme governance. For example, PfR had a ‘software’ focus, aiming to unlock communities’ potential for resilience, whereas communities and authorities preferred to receive tangible ‘hardware’ support. The findings highlight the crucial role of local authorities in shaping humanitarian aid. This is especially pertinent in view of the international agenda to localise aid, which requires the understanding and support of national actors in order to responsibly protect the vulnerable.     

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.     

Cash-based interventions: lessons from southern Somalia

Commodity distributions, the predominant relief response, are subject to growing criticism, while donors and humanitarian actors are increasingly viewing cash-based interventions as a viable alternative. This paper aims to contribute to the current debate on cash-based interventions by drawing on the experience of Action Contre la Faim in southern Somalia, where it has implemented cash for work programmes since 2004. The authors conclude that cash-based interventions are a feasible option in complex emergencies as well as in highly insecure environments as long as appropriate modalities are employed and objectives are clearly set in accordance with the needs and the context. Cash as a relief response offers wide-reaching possibilities for the future from both the perspective of the donor/agency and the standpoint of the beneficiary. It enables the beneficiaries to take control of the relief themselves and to adapt it to their individual requirements in a timely manner.     

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.     

Privatisation and outsourcing in wartime: the humanitarian challenges

The tendency today to privatise many activities hitherto considered the exclusive preserve of the state has given rise to sharp debate. The specific nature of humanitarian emergencies elucidates in particularly stark contrast some of the main challenges connected to the privatisation and outsourcing of essential public services, such as the provision of drinking water and health care. Privatising the realms of defence and security, which are at the very core of state prerogative, raises several legal and humanitarian concerns. This article focuses on the roles and responsibilities of the various parties involved in armed conflicts, especially those of private companies engaged in security, intelligence and interrogation work, and in the provision of water supply and health services. It highlights the need for humanitarian and development actors to grasp better the potential risks and opportunities related to privatisation and outsourcing with a view to supplying effective protection and assistance to communities affected by war.     

Conflict-related mortality: an analysis of 37 datasets

Mortality rates are among the main indicators of the human impact of armed conflict and many surveys have assessed this impact both for targeting and evaluating humanitarian aid programmes. Almost no epidemiological analysis such as calculating relative risk was performed nor were reference values clearly described. Here the aim is to review published mortality rates for a better understanding of age-specific mortality in armed conflict. Published mortality rates from conflict situations were collected and pre-conflict reference rates composed. We calculated the relative risk of dying in conflict compared to pre-conflict for children under 5 and people older than five years old. Although limited by reporting inadequacies, the results confirm the high vulnerability of children < 5 but identify a higher relative risk of dying among the > or = 5 year olds. Although not entirely new, this observation is not fully understood. Further systematic epidemiological research is needed to estimate and understand the impact of armed conflict on mortality.     

The mental health of expatriate and Kosovar Albanian humanitarian aid workers

The mental health consequences of exposure to traumatic events and the risk factors for psychological morbidity among expatriate and Kosovar Albanian humanitarian aid workers have not been well studied. In June 2000, we used standardised screening tools to survey 285 (69.5%) of 410 expatriate aid workers and 325 (75.8%) of 429 Kosovar Albanian aid workers from 22 humanitarian organizations that were implementing health programmes in Kosovo. The mean number of trauma events experienced by expatriates was 2.8 (standard deviation: 2.7) and by Kosovar staff 3.2 (standard deviation: 2.8). Although only 1.1% of expatriate and 6.2% of Kosovar aid workers reported symptoms consistent with the diagnosis for post-traumatic stress disorder, 17.2% and 16.9%, respectively, reported symptoms satisfying the definition of depression. Regression analysis demonstrated that the number of trauma events experienced was significantly associated with depression for the two sets of workers. Organisational support services may be an important mediating factor and should be targeted at both groups.     

Humanitarian (in)security: risk management in complex settings

Attacks against humanitarian aid workers have received increasing attention in the media, particularly high-profile incidents such as those against the hospitals of Médecins Sans Frontières in Afghanistan, Syria, and Yemen. Concurrently, scholarly research has given rise to a number of articles, white papers, and books on humanitarian insecurity. Most of this work centres on external threats, neglecting the internal mechanisms that humanitarian organisations use to mitigate security situations. This paper builds on the existing literature by focusing on the decision-making processes of humanitarian organisations, drawing on data collected from 16 security managers or advisers. The findings reveal that several factors contribute to contextual uncertainty and complexity, including recipient perceptions, local government actions, the behaviour of other non-governmental organisations (NGOs) in the area, logistical issues, risk variance within a single location, and organisational mandate. Furthermore, the results indicate that NGOs utilise a combination of decision-making processes to determine how to manage security in high-risk environments.     

Putting affected people at the centre of humanitarian action: an argument for the principle of humanitarian subsidiarity

The humanitarian system has grown organically over the course of a generation to become a complex system bound by a common primary mandate. Its guiding principles provide it with a unique identity and separate humanitarian actors from other aid-related stakeholders. However, all of the evidence suggests that humanitarian actors will extend their reach and engage in new and unprecedented ways with an expanded mandate in years to come. Now, more than ever, they are challenged to retain the moral high ground and to put disaster-affected people at the centre of humanitarian action. Consequently, this paper proposes that the humanitarian system introduce a new principle: humanitarian subsidiarity. It moves the conception of subsidiarity beyond meanings ascribed by the Catholic Church and the European Union and links it instead to the attributes of agency, accountability, and trust to find accommodation with the core humanitarian principles of humanity, impartiality, neutrality, and independence.     

Two solitudes: post‐tsunami and post‐conflict Aceh

In August 2005, after the devastating tsunami in the Indian Ocean Basin, a Memorandum of Understanding (MoU) for the cessation of hostilities was signed by Aceh's longstanding adversaries—the Government of Indonesia and the Free Aceh Movement (GAM). The tsunami was a major catalyst for ‘disaster diplomacy’—international political pressure, which, this paper argues, was an important ingredient in creating conditions for the MoU, although the situation within Aceh also shaped the peace process. Based on interviews conducted in 2006 and 2007 with government officials, GAM representatives and fighters, and non‐governmental organization staff in Aceh, this paper finds that assistance for tsunami survivors far exceeds that available for conflict survivors and ex‐combatants. The formation of these two solitudes—the tsunami‐affected and the conflict‐affected—compounds challenges for sustaining peace in Aceh. This research points to an enduring lack of livelihoods for former fighters and conflict victims that may threaten a sustainable peace.     

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.