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PubMed2001

'Scaling-up' in emergencies: British NGOs after Hurricane Mitch.

This article examines research on NGO 'scaling-up' in a disaster context and links it to a broader discussion on whether scaling-up is a useful concept for understanding NGO processes in an emergency. Using concepts of scaling-up from development literature, research findings from a study of the responses of British NGOs to Hurricane Mitch in Central America are presented. The article assesses the extent and type of scaling-up that occurred, constraints faced by the agencies and the impact of scaling-up on support to partners. Broader issues relating to scaling-up post-Mitch are also explored. The conclusion suggests that while the concept of scaling-up is useful, the tendency for its use to refer to organisational growth has limited a wider understanding and evaluation of the role of Northern NGOs in humanitarian crises.

Altruism↗
PubMed2001

East Timor emerging from conflict: the role of local NGOs and international assistance.

International assistance efforts have represented a conundrum for East Timorese seeking to assert their new independence and autonomy. While urgent needs have been met, local participation, involvement and capacity building have not been given adequate attention. This outcome is aptly demonstrated in the case of local non-government organisations (LNGOs). This paper specifically examines the role of LNGOs in the recovery of East Timor within the international assistance programme. It examines the challenges of rehabilitation efforts in East Timor with a particular focus on capacity building of East Timorese NGOs as part of a broader effort to strengthen civil society. The initial crisis response in East Timor highlighted tension between meeting immediate needs while simultaneously incorporating civil society actors such as NGOs and communities. It has been argued that local NGOs and the community at large were not sufficiently incorporated into the process. While it is acknowledged that many local NGOs had limited capacity to respond, a greater emphasis on collaboration, inclusion and capacity building was desirable, with a view to supporting medium and longer term objectives that promote a vibrant civil society, sustainability and self-management.

Altruism↗
PubMed2001

Needs assessment of the displaced population following the August 1999 earthquake in Turkey.

In August 1999 a major earthquake struck north-western Turkey. An assessment followed to identify the immediate needs of the displaced population. A random cluster sample of displaced families living in temporary shelter outside of organised relief camps was designed. Representatives of 230 households from the four communities worse affected by the earthquake were interviewed. Most families lived in makeshift shelters (84 per cent), used bottled water (91 per cent), obtained food from relief organisations (61 per cent), had access to latrines (90 per cent), had a member on routine medication (53 per cent) and obtained information by word of mouth (81 per cent). Many respondents reported having family members who were over the age of 65 (32 per cent) or under age three (20 per cent), who were pregnant (6 per cent), or who had been ill since the earthquake (64 per cent). The greatest immediate need reported by most families was shelter requirements (37 per cent), followed by food (23 per cent) and hygiene requirements (19 per cent). Ten days after the earthquake, basic environmental health needs of food, shelter and hygiene still predominated in this displaced population. Significant portions may have special needs due to age or illness.

Adult↗
PubMed2001

Misanthropy without borders: the international children's rights regime.

The issue of children's rights has become key to human rights-based international security strategies. The UN Convention on the Rights of the Child (1989) is being operationalised in complex political emergencies. Children's rights now inform humanitarian principles. Universal concern for children is viewed as transcending political and social divides and able to mobilise societies to confront social problems and prevent war. The operationalisation of child rights is accompanied by the development of psycho-social programmes to rehabilitate the child victim. Critically analysing the implications of the children's rights regime for the right to self-determination, the paper unpacks the assumptions underlying children's rights and psycho-social intervention. The paper begins by examining the conceptualisation of the rights-holding subject universalised under the UN Convention and then goes on to consider Article 39 on the right to psycho-social intervention. Equally important as the novel conceptualisation of childhood and children's rights under the international children's rights regime is the (unspoken) mistrust of adulthood and political rights that informs the imperative to institutionalise children's rights as higher law. Moreover while the rights-based approach consciously sought to move away from the earlier moralising child-salvation model, psycho-social rehabilitation reveals a similar preoccupation with deviancy, but conducted through the paradigm of psychological functionalism. Rather than representing a trend towards more humane international relations, the paper suggests that the elevation of children's rights is premised on a profound disenchantment with humanity. The logical implication of the international children's rights regime is to challenge both the moral and political capacity of individuals and their right to self-determination and to institutionalise a more unequal international system.

Bioethics↗
PubMed2001

Review of policies and guidelines on infant feeding in emergencies: common ground and gaps.

Recent crises in regions where exclusive breastfeeding is not the norm have highlighted the importance of effective policies and guidelines on infant feeding in emergencies. In 1993, UNICEF compiled a collection of policy and guideline documents relating to the feeding of infants in emergency situations. In June 2000 Save the Children, UK, UNICEF and the Institute of Child Health undertook a review of those documents, updating the list and identifying the common ground that exists among the different policies. The review also analysed the consistency of the policy framework, and highlighted important areas where guidelines are missing or unclear. This article is an attempt to share more widely the main issues arising from this review. The key conclusions were that, in general, there is consensus on what constitutes best practice in infant feeding, however, the lack of clarity in the respective responsibilities of key UN agencies (in particular UNICEF, UNHCR and WFP) over issues relating to co-ordination of activities which affect infant-feeding interventions constrains the implementation of systems to support best practice. Furthermore, the weak evidence base on effective and appropriate intervention strategies for supporting optimal infant feeding in emergencies means that there is poor understanding of the practical tasks needed to support mothers and minimise infant morbidity and mortality. We, therefore, have two key recommendations: first that the operational UN agencies, primarily UNICEF, examine the options for improving co-ordination on a range of activities to uphold best practice of infant feeding in emergencies; second, that urgent attention be given to developing and supporting operational research on the promotion of optimal infant-feeding interventions.

Guidelines as Topic↗
PubMed2001

From policy to practice: challenges in infant feeding in emergencies during the Balkan crisis.

The preparation and dissemination of policy statements are necessary but insufficient to prevent the inappropriate use of infant-feeding products in emergencies. The widespread failure of humanitarian agencies operating in the Balkan crisis to act in accordance with international policies and recommendations provides a recent example of the failure to translate infant-feeding policies into practice. This article explores the underlying reasons behind the failures which include: (1) the weak institutionalisation of policies; (2) the massive quantities of unsolicited donations of infant-feeding products: (3) the absence of monitoring systems; (4) inadequate co-ordination mechanisms; (5) the high costs of correcting mistakes; and (6) the cumulative effects of poor practice. Efforts to uphold best practice during the crisis are also documented. Finally, the article identifies actions that could be undertaken in advance of and during future emergencies to enhance the application of infant feeding policies in emergencies.

Albania↗
PubMed2001

Rapid assessment of population size by area sampling in disaster situations.

In the initial phase of a complex emergency, an immediate population size assessment method, based on area sampling, is vital to provide relief workers with a rapid population estimate in refugee camps. In the past decade, the method has been progressively improved; six examples are presented in this paper and questions raised about its statistical validity as well as important issues for further research. There are two stages. The first is to map the camp by registering all of its co-ordinates. In the second stage, the total camp population is estimated by counting the population living in a limited number of square blocks of known surface area, and by extrapolating average population calculated per block to the total camp surface. In six camps selected in Asia and Africa, between 1992 and 1994, population figures were estimated within one to two days. After measuring all external limits, surfaces were calculated and ranged between 121,300 and 2,770,000 square metres. In five camps, the mean average population per square was obtained using blocks 25 by 25 meters (625 m2), and for another camp with blocks 100 by 100 m2. In three camps, different population density zones were defined. Total camp populations obtained were 16,800 to 113,600. Although this method is a valuable public health tool in emergency situations, it has several limitations. Issues related to population density and number and size of blocks to be selected require further research for the method to be better validated.

Africa↗
PubMed2001

The accuracy of mortality reporting in displaced persons camps during the post-emergency phase.

For humanitarian organisations, accurate data are essential to identify emerging health problems and determine programme needs. We visited 45 post-emergency phase displaced persons camps and collected three months' mortality data which we compared with organisations' routine mortality reports. Organisations reported 612 deaths and we identified 741 deaths, for a mortality-reporting ratio, defined as the number of organisation-reported deaths divided by the number of investigator-identified deaths, of 83 per cent. For the majority of camps which under-reported deaths, mortality reporting ratios were significantly higher for women than men, and for camps with central mortality registers rather than those without. In the few camps which over-reported deaths, these occurred primarily among children younger than five years of age, probably due to the inclusion of abortions and stillbirths. Despite the overall under-reporting of deaths by humanitarian organisations, the existing health information systems appear to estimate mortality rates adequately in these post-emergency camps. However, organisations should improve the precision and completeness with which they report the characteristics of deaths in order to provide valuable data to target their programmes at the most vulnerable people.

Adult↗
PubMed2001

Re-framing risk: the changing context of disaster mitigation and preparedness.

This issue of Disasters explores the roles of NGOs and other actors in disaster mitigation and preparedness and also reviews broad international trends in risk management and disaster prevention. The need to address risk, and with that the motivation to improve disaster mitigation and preparedness, has tended to fall between the cracks of grander frameworks of development co-operation and humanitarian assistance. Despite the seemingly glaring need to reduce the horrific impact of floods, droughts and wars, disaster mitigation and preparedness have neither the allure of directly 'saving lives', nor of providing an 'escape from poverty'. There are, however, signs that risk management is becoming a mainstream concern. Factors such as the need to address factors that do not fit into traditional slots on the relief-development continuum, the rising economic costs of disasters and a growing acknowledgement that aid will never cover more than a small fraction of the costs of disasters are all leading to new approaches, priorities and institutional configurations. A realisation that dealing with risk and insecurity is a central part of how poor people develop their livelihood strategies has begun to position disaster mitigation and preparedness within many poverty alleviation agendas. A number of long-standing challenges remain; most of all, the complexities of maintaining the political will that is needed to ensure that risk management becomes more than a passing fad.

Disaster Planning↗
PubMed2001

The changing emphasis of disasters in Bangladesh NGOs.

Bangladesh is one of the most disaster-prone countries in the world, affected by cyclones and floods, as well as chronic hazards such as arsenic poisoning. NGOs have played a major role in bringing concerns related to risk management on to the national agenda and promoting a shift of focus from mere relief response to disaster mitigation and preparedness. The government has, after earlier scepticism, now accepted NGOs as major partners in these tasks. Innovative approaches, such as the use of microfinance, have been applied; many of which are related to preserving the gains of development efforts as part of rehabilitation. NGOs have pressured for better coordination with government. Improved structures are now approved, but it is still too early to judge their impact. Despite progress, neither NGOs nor governmental agencies have clearly defined roles in the effort to link disaster management priorities. This will ensure that longer-term development efforts build on local capacities and reduce vulnerabilities.

Bangladesh↗
PubMed2001

Disaster mitigation and preparedness on the Nicaraguan post-Mitch agenda.

Nicaragua provides an example of how a major disaster, in this case Hurricane Mitch, can transform the national agenda for disaster mitigation and preparedness. Hurricane Mitch was a reminder of how extremely disaster prone Nicaragua is, and also how neoliberal reforms have weakened governmental response capacity. In the face of critiques of how governmental policies had affected preparedness and response, discussions of this transformation became a highly politicised process where the debate over alternative development models tended to overshadow the original calls to strengthen risk management. Progress can be seen in some areas, such as disaster mitigation through environmental management. This study of NGO roles, and their relations with other key actors, draws attention to the need to anchor improved risk management in local-level NGO-government collaboration. Structures are being put into place to achieve this aim, but dependence on donor financing raises questions regarding the longer-term sustainability of these efforts.

Community Participation↗
PubMed2001

Risk and the neoliberal state: why post-Mitch lessons didn't reduce El Salvador's earthquake losses.

Although El Salvador suffered light losses from Hurricane Mitch in 1998, it benefited from the increased international aid and encouragement for advance planning, especially mitigation and prevention interventions. Thus, one would have supposed, El Salvador would have been in a very advantageous position, able more easily than its economically crippled neighbours, Honduras and Nicaragua, to implement the 'lessons of Mitch'. A review of the recovery plan tabled by the El Salvador government following the earthquakes of early 2001 shows that despite the rhetoric in favour of 'learning the lessons of Mitch', very little mitigation and prevention had actually been put in place between the hurricane (1998) and the earthquakes (2001). The recovery plan is analysed in terms of the degree to which it deals with root causes of disaster vulnerability, namely, the economic and political marginality of much of the population and environmental degradation. An explanation for the failure to implement mitigation and preventive actions is traced to the adherence by the government of El Salvador to an extreme form of neoliberal, free market ideology, and the deep fissures and mistrust in a country that follow a long and bloody civil war.

Disaster Planning↗
PubMed2001

New humanitarianism: does it provide a moral banner for the 21st century?

There is a 'new humanitarianism' for the new millennium. It is 'principled', 'human-rights based' and politically sensitive. Above all it is new. It marks a break from the past and a rejection of the traditional principles that guided humanitarianism through the last century. New humanitarians reject the political naivety of the past, assess the long-term political impact of relief and are prepared to see humanitarian aid used as a tool to achieve human rights and political goals. New Humanitarianism is compelling, in tune with our times and offers a new moral banner for humanitarians to cling to as we enter the new millennium. Or does it? After outlining the key elements of new humanitarianism, including the human rights approach and developmental relief, the paper spells out some of the dangers. The author claims that new humanitarianism results in an overt politicisation of aid in which agencies themselves use relief as a tool to achieve wider political goals. The paper shows how this approach has spawned a new conditionality which allowsfor aid to be withheld and has produced a moral hierarchy of victims in which some are more deserving than others. The paper concludes with a plea for a revival of the principle of universalism as the first step to a new set of principles.

Altruism↗
PubMed2001

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.

Afghanistan↗
PubMed2001

Governing the borderlands: decoding the power of aid.

This article examines aid practice, that is, the public-private contractual networks that link donor governments, UN agencies, military establishments, NGOs, private companies and others, as a relation of global liberal governance. In order to fulfil this function, such networks embody what could be called the 'securitisation' of international assistance. Based upon ideas of human security and ameliorating the effects of poverty and vulnerability reduction, aid is now seen as playing a direct security role. Rather than being concerned with relations between states, the primary aim of this security paradigm is to modulate and change the behaviour of populations within them. In doing so, it is able to exploit the opportunities afforded by privatisation. At the same time, however, aid as security is confronted by its own particular problem of 'governing at a distance'; how can calculations made by leading states be transformed into actions at the global edge when a multitude of private and non-government implementors now intervene? The article concludes by examining the contribution of risk analysis to solving this problem and, especially, the development of new contractual regimes based around technical standardisation, benchmarking and performance auditing. Through such technologies, metropolitan states are learning how to manage the public-private networks of aid practice and, as a result, to govern the borderlands in new ways.

Humans↗
PubMed2001

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.

Afghanistan↗
PubMed2001

The challenge of civil-military relations in international peace operations.

The relationship between military and civilian humanitarian organisations has developed in an increasingly integrative way. Military initiatives to institutionalise the relationship, since the interventions in Somalia and the Balkans, entail a dilution of humanitarian independence as was manifested in practice in Kosovo. Further, the state-centric foundations of military intervention run counter to the potential for humanitarian organisations to foster a cosmopolitan ethos that would not only preserve humanitarian principles but also contest statist assumptions about conflict, development and power.

Altruism↗
PubMed2001

Therapeutic governance: psycho-social intervention and trauma risk management,.

This paper critically analyses the significance of psycho-social intervention as a new form of international therapeutic governance based on social risk management. First, the paper examines the international psycho-social model and its origins in an Anglo-American therapeutic ethos. Second, the paper argues that psycho-social approaches jeopardise local coping strategies. Third, the paper highlights the potential political, social and psychological consequences of the pathologisation of war-affected societies. Finally the paper concludes that therapeutic governance represents the reduction of politics to administration.

Crisis Intervention↗