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.     

Ethnicity, politics and inequality: post-tsunami humanitarian aid delivery in Ampara District, Sri Lanka

The provision of humanitarian aid at times of disaster in multi-ethnic community settings may lead to conflict, tension and even the widening of the distance between various ethnic groups. That aid agencies distribute humanitarian aid directly to affected communities, to speed up recovery, may often lead to chaos and the intensification of ethnic sentiments. The new distribution mechanisms introduced for the delivery of tsunami aid in Ampara District, Sri Lanka, did not recognise local networks and the culture of the ethnically mixed community setting. This paper analyses post-tsunami aid distribution in Ampara and shows how such an extemporised effort in an ethnically cognisant context increased ethnic division, inequality and disorder, while marginalising the poor segments of the affected population. It recommends the inclusion of local networks in aid dissemination as a measure for improving ethnic neutrality and social harmony in disaster-hit multi-ethnic communities.     

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.     

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.     

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.     

Food aid and development in southern Sudan: implications of the Comprehensive Peace Agreement for response planning

In the post-Comprehensive Peace Agreement (CPA) era a greater impact on the unacceptably high prevalence of child malnutrition is more likely to come from additional investment and attention to education, health, hygiene, sanitation and childcare practices than from expanded food aid interventions. The negligible impact of food aid on malnutrition, although most commonly challenged on the quality of needs assessments, is equally attributable to the timing of deliveries, and a dysfunctional distribution system. Comparatively few resources have been allocated to strengthen skills for assessing, analysing and understanding community priorities, local economies, and social safety nets. A more thoughtful allocation of scarce funds could have more impact if a range of alternative responses was considered. Participation in and commitment to a more independent livelihoods analytical forum would improve communication with the new government, local leaders and other partners, as well as providing a platform for reaching consensus on both humanitarian and development planning over the next five years.     

The development of aid agency policy on the use of imported biscuits in emergency relief

During 1985 more than 5,000 tonnes of biscuits consisting of twenty-eight different brands were sent to Ethiopia and Sudan for emergency relief feeding. They were freely available to recognized agencies operating feeding programmes. Biscuits were popular with programme supervisors as few resources (fuel, staff and personnel) were required for their preparation and distribution. They were also popular with beneficiaries.
Different aspects of biscuits were examined and characteristics considered important included: nutritional composition, acceptability to beneficiaries, packaging, the biscuit dimensions, shelf-life and accompanying information (nutritional composition, ingredients and guidelines for use).
The results of a field study indicated that biscuits have a limited, but useful, role to play in the early stages of emergency relief. Based on the study, guidelines for both donors and users, on the use of food aid biscuits were developed, which emphasize their joint responsibility in minimizing the misuse of biscuits.     

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.     

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.