Politicisation of Humanitarian Aid and Its Consequences for Afghans

This paper outlines the implications of international approaches to humanitarian assistance in Afghanistan, focusing in particular on the period since the Taliban assumed power. It argues that international efforts to use conditionality on humanitarian assistance have proved ineffective in influencing the Taliban's policies, and have been implemented despite the negative impact on the welfare of the whole population. Efforts to adopt a principled approach to aid programming in this environment have also raised many ethical dilemmas which are likely to remain major challenges in that country and elsewhere.     

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.     

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.     

Humanitarian Crises: What Determines the Level of Emergency Assistance? Media Coverage,Donor Interests and the Aid Business

This paper proposes a basic hypothesis that the volume of emergency assistance any humanitarian crisis attracts is determined by three main factors working either in conjunction or individually. First, it depends on the intensity of media coverage. Second, it depends on the degree of political interest, particularly related to security, that donor governments have in a particular region. Third, the volume of emergency aid depends on strength of humanitarian NGOs and international organisations present in a specific country experiencing a humanitarian emergency. The empirical analysis of a number of emergency situations is carried out based on material that has never been published before. The paper concludes that only occasionally do the media play a decisive role in influencing donors. Rather, the security interests of Western donors are important together with the presence and strength of humanitarian stakeholders, such as NGOs and international organisations lobbying donor governments.     

Cash and voucher assistance along humanitarian supply chains: a literature review and directions for future research

This study reviews research on cash and voucher assistance (CVA) by applying a humanitarian supply chain management perspective. A systematic literature review was conducted to identify, analyse, and synthesise past academic research. The content, context, and process framework was used to structure the content analysis. The findings reveal that the outcomes of CVA programmes are dependent on critical context-specific variables that influence feasibility and operability. Humanitarian actors must consider factors that are external (the nature of disaster, politics, economy, and infrastructure) and internal (local market availability and accessibility, supplier/donor interest, supplier/vendor selection and contracting, and beneficiary preference) to the supply chain. The delivery process is influenced by them, impacting on programme responsiveness and cost-efficiency. The results provide insights that humanitarian practitioners can utilise to reconsider their supply chain strategies when deciding on the selection and implementation of CVA programmes. Potential literature gaps are identified, and recommendations for further research are provided.     

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.     

The United Nations' humanitarian pillar: refocusing the UN's disaster and emergency roles and responsibilities

Changes in the nature of humanitarian crises and in the ways that the international community responds to such crises demand a radically overhauled role for the United Nations system. At a time when the UN and its member states are pursuing reform of some of that institution's most fundamental peace and security functions, this paper suggests that reform, too, is required to meet humanitarian crises of the future. This paper proposes a new type of operational role for the UN, while at the same time arguing that the UN has to place itself in the vanguard of humanitarian assistance as "the standard-bearer". The article draws many of its conclusions and recommendations from a recently completed study, requested by the Inter-Agency Standing Committee, concerning the effect for the UN system of changes in humanitarian financing.     

International NGOs and the role of network centrality in humanitarian aid operations: a case study of coordination during the 2000 Mozambique floods

In February 2000, Mozambique suffered its worst flooding in almost 50 years: 699 people died and hundreds of thousands were displaced. Over 49 countries and 30 international non-governmental organisations provided humanitarian assistance. Coordination of disaster assistance is critical for effective humanitarian aid operations, but limited attention has been directed toward evaluating the system-wide structure of inter-organisational coordination during humanitarian operations. Network analysis methods were used to examine the structure of inter-organisational relations among 65 non-governmental organisations (NGOs) involved in the flood operations in Mozambique. Centrality scores were used to estimate NGO-specific potential for aid coordination and tested against NGO beneficiary numbers. The average number of relief- and recovery-period beneficiaries was significantly greater for NGOs with high relative to low centrality scores (p < 0.05). This report addresses the significance of these findings in the context of the Mozambican 2000 floods and the type of data required to evaluate system-wide coordination.     

Hope Suspended: Morality, Politics and War in Central Africa

The Great Lakes tragedy from 1994—8 has demonstrated the impact of a new consensus in favour of conditional relief for the protection and assistance of disaster victims. This paper attempts to catalogue the failures of the international humanitarian community, African leaders and donor governments to act effectively in defence of humanitarian principles throughout the crisis. The paper places special emphasis on the events in eastern Zaire during 1996—7 that have, so far, received limited treatment, and, it contends, led to the loss of hundreds of thousands of lives.
The paper argues that the new orthodoxy of developmental relief, as adopted by UN and NGO humanitarian agencies in the Great Lakes, has acted more in support of the geopolitical and economic agendas of Northern governments and African leaders than in defence of disaster victims. The paper points out that the evidence of the Great Lakes tragedy suggests that the adoption of these approaches has sanctioned the abandonment of ideas about universal rights of protection for non-combatants at the moment when they are most at risk, with catastrophic results for those most vulnerable to abuse.     

Effects of social interaction between Afghan refugees and Iranians on reproductive health attitudes

Afghan refugees in Iran, like many Muslims around the world, think that using contraceptives is against their religious beliefs. The majority of Iranians also thought so until a decade ago. Since then an all-encompassing social movement has emerged in Iran in which women and young people have played decisive roles. This movement has led to an attitude shift towards acceptance of family planning across Iranian society. High-ranking clerics, responding to the social movement, issued progressive edicts indicating that poor families could practise family planning. This paper reports the findings of focus group studies carried out among Afghan refugee men in two communities in Iran. The findings indicate that exposure to Iranian life, especially the rulings of Iranian clerics, have influenced Afghans' views on family planning. The findings also indicate that a system of justification is needed to help people avoid both social sanctions and individual stresses resulting from a controversial practice regarded as a sin for centuries.     

Preventing corruption in humanitarian assistance: perceptions, gaps and challenges

Corruption is a threat to the purpose of humanitarian assistance. Until fairly recently, humanitarian assistance has not been considered an important arena in broader efforts aimed at curbing corruption, and corruption has not always been considered a particularly important concern for humanitarian assistance despite the obviously challenging nature of the context of humanitarian emergencies. Corruption, though, is a threat to humanitarian action because it can prevent assistance from getting to the people who most need it, and because it can potentially undermine public support for such assistance. This paper examines perceptions of corruption and its affects, documents best practices, and outlines gaps in understanding. It suggests recommendations for improving the capacity of humanitarian agencies to prevent and manage the risk of corruption. Agencies have taken steps to combat corruption and improve accountability--downwards and upwards--but scope remains for improvement and for greater sharing of learning and good practice.     

The impact of workplace exclusion on the humanitarian response to the refugee crisis in Lebanon

A contemporary issue of major concern is the millions of people fleeing homelands owing to political and socioeconomic challenges and seeking assistance elsewhere throughout the world. An effective response to this crisis includes support models that meet the various needs of refugee populations. In the complex system of humanitarian action, aid workers, among a multiplicity of actors, are the most important assets. This study utilised an inclusion–exclusion theoretical lens to examine the impact of their workplace experiences on activities in the context of the refugee crisis in Lebanon. In-depth interviews were held with 36 humanitarian practitioners, representing five international organisations that are involved in refugee aid programmes in the country. The study led to a new understanding of the link between inclusion and exclusion and the effectiveness of the humanitarian response to emergencies. In addition, it yielded new insights into apprehension about the national–international divide and its consequences for humanitarian assistance.     

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.     

A tale of two cities: restoring water services in Kabul and Monrovia

Kabul and Monrovia, the respective capitals of Afghanistan and Liberia, have recently emerged from long-lasting armed conflicts. In both cities, a large number of organisations took part in emergency water supply provision and later in the rehabilitation of water systems. Based on field research, this paper establishes a parallel between the operations carried out in the two settings, highlighting similarities and analysing the two most common strategies. The first strategy involves international financial institutions, which fund large-scale projects focusing on infrastructural rehabilitation and on the institutional development of the water utility, sometimes envisaging private-sector participation. The second strategy involves humanitarian agencies, which run community-based projects, in most cases independently of the water utilities, and targeting low-income areas. Neither of these approaches manages to combine sustainability and universal service. The paper assesses their respective strengths and weaknesses and suggests ways of improving the quality of assistance provided.     

Global factors shaping the future of food aid: the implications for WFP

Food aid is a key component of a humanitarian response but its use in other programming contexts is subject to numerous criticisms. Even in humanitarian emergencies food aid is often late, unreliable and out of proportion to other elements of the response. Three major factors will shape the future of food aid. First, mechanisms of food aid governance are being reviewed and may undergo major changes—particularly the Food Aid Convention now that hopes have diminished for an Agreement on Agriculture at the World Trade Organisation. The second significant factor is donor agency trends. Overall levels of food aid have dropped fairly steadily in recent decades and there are several discernible trends in resource allocation, procurement and the use of food aid. The third factor is an emerging body of best practice that will define acceptable standards of food aid programming in the future.     

Being Good at Doing Good? Quality and Accountability of Humanitarian NGOs

Quality enhancement of humanitarian assistance is far from a technical task. It is interwoven with debates on politics of principles and people are intensely committed to the various outcomes these debates might have. It is a field of strongly competing truths, each with their own rationale and appeal. The last few years have seen a rapid increase in discussions, policy paper and organisational initiatives regarding the quality of humanitarian assistance. This paper takes stock of the present initiatives and of the questions raised with regard to the quality of humanitarian assistance.     

Between war and peace: humanitarian assistance in violent urban settings

Cities are fast becoming new territories of violence. 1 The humanitarian consequences of many criminally violent urban settings are comparable to those of more traditional wars, yet despite the intensity of the needs, humanitarian aid to such settings is limited. The way in which humanitarian needs are typically defined, fails to address the problems of these contexts, the suffering they produce and the populations affected. Distinctions between formal armed conflicts, regulated by international humanitarian law, and other violent settings, as well as those between emergency and developmental assistance, can lead to the neglect of populations in distress. It can take a lot of time and effort to access vulnerable communities and implement programmes in urban settings, but experience shows that it is possible to provide humanitarian assistance with a significant focus on the direct and indirect health consequences of violence outside a traditional conflict setting. This paper considers the situation of Port‐au‐Prince (Haiti), Rio de Janeiro (Brazil) and Guatemala City (Guatemala).     

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.     

Dead letter or living document? Ten years of the Code of Conduct for disaster relief

This paper examines the present value of the Code of Conduct for the International Red Cross and Red Crescent Movement and Non-Governmental Organizations (NGOs) in Disaster Relief, in view of discussions on neutrality and the Western bias of the humanitarian aid system, and assesses how it can retain its relevance in future. The Code of Conduct was launched just after the Rwanda genocide of April 1994. A decade later, the crises in Afghanistan and Iraq have sparked renewed interest in humanitarian principles and in whether the code can serve as an instrument to define humanitarianism and guide humanitarian decision-making and coordination. More than 300 organisations have now subscribed to it. This paper is based on the findings of a survey of code signatories and the outcomes of a conference on the value and future of the code, held in The Hague, Netherlands, in September 2004 to mark its tenth anniversary.