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.     

Reproductive health services for refugees by refugees: an example from Guinea

The need to involve refugees in their own reproductive health (RH) services has long been recognised, but there is a lack of published examples describing how this can be achieved collaboratively between refugee initiatives, UNHCR, bilateral development organisations and international relief agencies. This paper outlines the work, outputs and lessons learnt of the Reproductive Health Group (RHG), an organisation of Liberian and Sierra Leonean refugee midwives and laywomen providing RH services to fellow refugees in Guinea's Forest Region between 1996 and 2000. Working as part of the Guinean health system, RHG midwives and community facilitators helped make the RH services in their region the most effective in Guinea at the time. Looking at RHG's achievements, the challenges it faced and partly overcame, it is argued that refugee organisations can plan and implement RH services for refugees where UNHCR and its international partners ensure that they receive funding and technical assistance.     

The politics of protection: aid, human rights discourse, and power relations in Kyaka II settlement, Uganda

This paper explores the conceptualisation and application of 'protection' by the United Nations High Commissioner (UNHCR), Ugandan government, and Congolese refugees in Kyaka II refugee settlement, Uganda. Analysing the origins and consequences of a demonstration against school fees, and drawing on other ethnographic data, it explores how different interpretations of this incident reflect different conceptions of, and approaches to, protection. Ugandan government officials viewed the demonstration as a security incident; Congolese and Ugandan adults responded with increased monitoring and 'sheltering' of children and young people; students justified the demonstration as a legitimate manifestation of their rights; while UNHCR promoted assistance and resettlement. The paper argues that prevailing protection responses, including 'sensitisation', sheltering, and resettlement, are de-contextualised from daily realities and fail to address the underlying power relations that undermine protection. It concludes with recommendations on how international refugee agencies can reorient assistance to address protection concerns in refugee contexts.     

Rural refugees in Africa: Past experience, future pointers

Rapid change In rural Africa raises new policy problems In dealing with mass influxes of rural refugees. Self-settlement in agriculture has become less feasible and is less acceptable now that Its disadvantages are better understood. Organized smallholder settlement can be a better solution where it is economically viable, refugees have freedom of movement, and staff are suitable. But growing land shortage means that Increasing proportions of refugees are being placed in camps. To offset this trend, more attention is suggested to programmes for groups of refugees, categorized by time of arrival, by ability to self-settle or to farm, and by skills and experience. Practically-oriented social science research can contribute to these and other approaches which will require imagination and ingenuity. Solutions to future rural refugee problems should be linked with programmes of social and economic development which will make easier the achievement of humanitarian objectives.     

A general assessment of the environmental impact of refugees in Somalia with attention to the refugee agricultural programme

This paper attempts to examine the broad features of Somalia's harsh physical environment into which several hundreds of thousands of refugees, with mainly a nomadic or semi-nomadic life style and culture, dramatically descended six years ago. The thirty-six rural camps in which at least half of them live are described as is the refugee agricultural programme which is training several thousand families so that they may be "self-supporting." The four regions where the camps are located are each briefly summarized in terms of their soils, their climates, their natural vegetation, and the type of agriculture which the refugee farmers practice. A more detailed analysis is then given on the following critical environmental concerns: Vegetation and erosion on refugee farms, the growing problem of refugee livestock, the destruction of trees, and irrigation practices and salinity on refugee farms. The paper concludes with an argument to preserve Somalia's environment from careless and destructive exploitation, which is leading towards desertification, and calls for an in-depth study of the situation.     

Refugee Density and Dependence: Practical Implications of Camp Size

Different refugee camps may have widely differing morbidity and mortality rates. Some of these differences are ascribed to environmental factors. This paper reviews the key issues relating to one environmental factor: the size of the refugee camp, and provides a tentative theoretical framework for examining the effect of camp size on refugees. This effect may not be considered because aid workers chronically underestimate the value of the refugees' contribution to their own survival. Large camps settle great numbers of refugees to the hinterland of the camp and limit their access to resources available there. This may increase refugee dependency and vulnerability. There is some slight evidence from the analysis of data provided by Mercer (1992) that child mortality rates (aged 0–4 years) are positively correlated with camp size (as inferred from child populations). If other factors allow, it might be wise for camp planners to try to limit camps to a size which allows refugees reasonable access to local resources.     

The dual imperative in refugee research: some methodological and ethical considerations in social science research on forced migration

Social scientists doing fieldwork in humanitarian situations often face a dual imperative: research should be both academically sound and policy relevant. We argue that much of the current research on forced migration is based on unsound methodology, and that the data and subsequent policy conclusions are often flawed or ethically suspect. This paper identifies some key methodological and ethical problems confronting social scientists studying forced migrants or their hosts. These problems include non-representativeness and bias, issues arising from working in unfamiliar contexts including translation and the use of local researchers, and ethical dilemmas including security and confidentiality issues and whether researchers are doing enough to 'do no harm'. The second part of the paper reviews the authors' own efforts to conduct research on urban refugees in Johannesburg. It concludes that while there is no single 'best practice' for refugee research, refugee studies would advance its academic and policy relevance by more seriously considering methodological and ethical concerns.     

Climate,urbanisation and vulnerability to vector-borne disease in subtropical coastal Australia: Sustainable policy for a changing environment

This paper examines the current health policy response to the management of vector-borne disease (VBD), specifically Ross River (RR) virus, in subtropical coastal Australia. It demonstrates the multi-dimensional nature of the VBD problem and considers the value of more sustainable policy responses. The paper provides an integrated exploration of the incidence of RR virus in the context of socio-biophysical interactions and change, climate variability, and possible enhanced threat due to climate change. The study focuses on two subtropical coastal case study regions in Australia. Collectively, the existing and emerging socio-biophysical interactions in these regionsraise questions as to the future risks and management of RR virus, while climate change adds a significant further dimension. The paper demonstrates the need for the incorporation of environmental planning elements, particularly attention to strategic assessment and planning, into the traditional suite of health policy responses given the multi-dimensional nature of the problem and evident socio-biophysical environmental change.     

Refugee perceptions of the quality of healthcare: findings from a participatory assessment in Ngara, Tanzania

This article describes the findings of a participatory assessment of Burundian and Rwandan refugees' perceptions of the quality of health services in camps in Ngara, Tanzania. Taking a beneficiary-centred approach, it examines a collaborative effort by several agencies to develop a generic field guide to analyse refugees' views of healthcare services. The objective was to gather information that would contribute to significant improvements in the care offered in the camps. Although the primary focus was on healthcare, several broader questions considered other general apprehensions that might influence the way refugees perceive their healthcare. Findings indicated that while refugees in Ngara were generally satisfied with the quality of healthcare provided and healthcare promotion activities, recognition of some key refugee concerns would assist healthcare providers in enhancing services. With increasing need for refugee community participation in evaluating humanitarian assistance, this assessment has relevance both in the context of Ngara and beyond.     

In Defence of Humanitarianism

The humanitarian crisis which followed in the wake of the genocidal regime in Rwanda in 1994 generated massive media attention and an unprecedented outpouring of international public and private assistance. In late 1997, the Rwanda refugee population in Zaire was subjected to a disaster of similarly epic proportions as a result of military action. Yet this crisis went relatively under-reported and failed to attract substantial aid funds, particularly from official donors. This paper seeks to document and account for the demise of the humanitarian imperative. It confronts a number of the criticisms of humanitarian action, concluding that, rather than being flawed, traditional humanitarian values remain valid and should be defended wherever there are situations of conflict.     

On the amount of counterpart assistance to be provided after natural disasters: from the perspective of indirect economic loss assessment

China’s counterpart assistance policy is of vital importance in providing guidance for emergency management and post-disaster reconstruction. However, the amount of assistance that partner provinces should provide as well as the criteria that partners should abide by in offering counterpart assistance remain a main challenge. The goal of this research is to fill this gap by proposing a new framework consisting of an interregional input–output (IRIO) model and a resilience index. Subsequently, the indirect economic loss is obtained by utilizing the index system of provincial economic resilience assessments, with measures of indirect economic loss developed from the IRIO. Furthermore, to examine the internal validity and systematic error, the reliability of the adopted models, the calculation methods, and the index systems are investigated. To assess the external validity of the proposed measures and resilience index of the framework, data from the 2008 Wenchuan Earthquake are applied for estimating parameter values of the framework, and a follow-up investigation was conducted for examining the fairness and enhanced effectiveness of the new counterpart assistance criteria. In summary, this paper attempts to present some new ideas about the analysis of economic motivations of mutual aid and the improvement of the counterpart assistance policy.     

Evaluative research in a refugee cAMP: the effectiveness of community health workers in khao I dang holding center, Thailand

An evaluation of Khmer refugee public health services found a strong cultural preference for older females as Community Health Workers (CHWs), in contrast to the young males employed. Class conflicts were identified between educated, upper-class CHWs and the uneducated camp majority. Poor community acceptance of the CHWs impaired their effectiveness, and was attributed to age, sex and socioeconomic barriers. Based on these evaluation findings, the refugee health program was restructured to include a preponderance of female workers. A repeat survey demonstrated enhanced program effectiveness following this change.
Selection of refugee health workers should be based on intrinsic community roles, taking age, sex, socioeconomic and other group distinctions into account. Additional research is needed on the adaptation of community health principles to the refugee context.     

The impact of refugees on the health status and health services of host communities: Compounding bad with worse?

Although there have been a number of recent developments in our understanding of refugee health problems that have influenced policies and action, the effects of refugees on the health status and services of host communities remain relatively neglected. This article sets out to explain why this is an important issue with implications for policy, planning surveillance and evaluation, training and research.
The first sections outline some of the problems facing host governments and communities in Africa and discuss the changing rhetoric between the first and second International Conferences for Assistance to Refugees in Africa. A number of possible ways in which refugees could affect the individual, agent and environmental causes of disease are considered, as are the characteristics of the refugees, the host communities and the response which may all modify this impact.
Policy implications of the impact of the refugees, both negative and positive, are discussed, and detailed consideration is given to the pros and cons of integrated and parallel approaches to health care provision. The need to monitor carefully the health status and services of host communities is emphasized and recommendations are made for this and other essential developments relating to training and research.     

Vulnerable groups*

As a rule, refugees arrive in their host country with a bare minimum of possessions; in this respect every refugee can be classified as vulnerable. However, a certain category is especially at risk, namely those persons who would be considered vulnerable in a "normal society." These people are doubly in need of assistance, firstly, inasmuch as they are refugees and secondly, insofar as they are vulnerable. If these refugees can be helped to overcome (or at least reduce) their handicaps, they can begin to become self-reliant and form an active, productive parts of their community, rather than remaining an extra burden to an already vulnerable part of the society in their country of asylum. Whilst their able-bodied companions work in the fields or the towns, part of this category can be trained and usefully employed in sectors of work that do not require great mobility or physical fitness (such as handicrafts, trade, teaching and services)..     

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.     

Cholera in Sudan: An account of an epidemic in a refugee camp in eastern Sudan, May-June 1985

In 1985 cholera has been a serious problem in the horn of Africa, particularly affecting the many famine victims and refugees in that region. In this paper the history of cholera in Africa is briefly summarized, as is the background to the current refugee situation in eastern Sudan. A cholera epidemic involving 1,175 cases in two adjacent refugee camps in eastern Sudan is described. In this epidemic there were thirteen inpatient deaths and thirty-eight known home deaths from cholera. The management of the epidemic is described in detail. Overall an average of 8 1. of intravenous fluid was used per case, a higher figure than was anticipated, probably because of the unexpected degree of vomiting and the shortage of trained nursing staff.
The relationship between cholera and malnutrition is explored and hypochlorhydria is suggested as the main reason for the increased susceptibility to cholera among malnourished populations. It was observed that severely malnourished adults and children appeared to nave less severe diarrhoea with their cholera, presumably because of reduced mucosal surface area and poor enterocyte function. Finally possible means of aborting cholera epidemics are discussed.     

The Efficacy of the Neo-Liberal Individual Choice Model for Encouraging Post-Disaster Change: Developments in the East Cape Region of New Zealand following Cyclone Bola (March 1988)

The government of New Zealand instituted a new policy of disaster response in an attempt to bring about change and development in the relatively remote agricultural region which was struck by a severe cyclone in March 1988. The new policy involved a change from payment for restoration to compensation for loss. This new policy was based on the neo-liberal position that individual choice should prevail in decision making and that significant change will result from this adherence to an individual decision making approach. The new policy did not accomplish any significant degree of change in the intended areas of land ownership and land use. Most of the farmers used the compensation funds to carry out on-farm restoration work which facilitated the resumption of pre-cyclone farming activities. It is argued that the efficacy of a neo-liberal individual choice model for accomplishing post-disaster change and development is limited and that a more institutionally and organisationally based approach would be much more effective and efficient.     

防灾公园的减灾功能

地震灾害避难疏散的经验与教训表明 ,城市公园是重要的避难场所 ;防灾公园是减灾功能特别强的城市公园 ;城市公园改造成防灾公园或规划建设新的防灾公园可以提高城市公园的综合防灾减灾功能。发生城市突发事件时 ,防灾公园可以用作紧急避难所、灾害对策据点。防灾公园具有供居民避难以及确保避难人员基本生活条件的功能、防灾减灾功能、情报收集与传递功能、医疗与救护功能、运输基地功能等。强化防灾公园减灾功能的主要措施是广泛采用高新科学技术 ,并对防灾公园系统实施综合性的科学管理     

Between international donors and local faith communities: Intermediaries in humanitarian assistance to Syrian refugees in Jordan and Lebanon

This paper explores the crucial part that faith‐based organisations (FBOs) play in acting as intermediaries between international donors and local faith communities (LFCs) implementing humanitarian relief projects for Syrian refugees. Humanitarian responses to the mounting Syrian refugee crisis have coincided with greater collaboration between international donors and LFCs. This cooperation often is facilitated by a complex web of non‐state intermediaries at the international, national, and local level. This study probes the breadth of roles of these intermediaries, drawing on primary data from case studies of two Christian intermediaries supporting Christian LFCs as they deliver aid primarily to Muslim Syrian refugees in Jordan and Lebanon. The results of the study are connected to the wider literature on LFCs in humanitarian response, revealing how intermediaries address issues of accountability, capacity‐building, impartiality, neutrality, and professionalism. The paper concludes by offering suggestions for further research on intermediaries as key actors in the localisation of humanitarian assistance.