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PubMed2005

Civil society development versus the peace dividend: international aid in the Wanni.

Donors that provide aid to the Wanni region of Sri Lanka, which is controlled by the Liberation Tigers of Tamil Eelam (LTTE), are promoting initiatives that seek to advance the national peace process. Under the rubric of post-conflict reconstruction, the actions of political forces and structural factors have led to the prioritisation of two different approaches to peace-building: community capacity-building projects; and support for the 'peace dividend'. Both of these approaches face challenges. Cooperation with civil society actors is extremely difficult due to intimidation by the LTTE political authority and the authoritarian nature of its control. Peace-building successes with respect to the peace dividend are difficult to measure, and must be balanced against the negative effects of misdirected funds. Aid organisations must be careful not to consider the tasks of peacebuilding, humanitarian relief and community empowerment as either interchangeable or as mutually reinforcing endeavours.

Humans↗
PubMed2005

Planning environmental sanitation programmes in emergencies.

Environmental sanitation programmes are vital for tackling environmental-related disease and ensuring human dignity in emergency situations. If they are to have maximum impact they must be planned in a rapid but systematic manner. An appropriate planning process comprises five key stages: rapid assessment and priority setting; outline programme design; immediate action; detailed programme design; and implementation. The assessment should be based on carefully selected data, which are analysed via comparison with suitable minimum objectives. How the intervention should be prioritised is determined through objective ranking of different environmental sanitation sector needs. Next, a programme design outline is produced to identify immediate and longer-term intervention activities and to guarantee that apposite resources are made available. Immediate action is taken to meet acute emergency needs while the detailed programme design takes shape. This entails in-depth consultation with the affected community and comprehensive planning of activities and resource requirements. Implementation can then begin, which should involve pertinent management and monitoring strategies.

Disasters↗
PubMed2005

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.

Adolescent↗
PubMed2005

Food security in complex emergencies: enhancing food system resilience.

This paper explores linkages between food security and crisis in different contexts, outlining the policy and institutional conditions needed to manage food security during a crisis and to rebuild the resilience of food systems in periods of relative peace. The paper reviews experiences over the past decade of countries in protracted crisis and draws lessons for national and international policy. It assesses the different alternatives on offer in fragile countries to address, for example, the disruption of institutional mechanisms and the decreasing level of support offered by international donors with respect to longer-term expectations. It proposes a Twin Track Approach to enhance food security resilience through specific policies for protracted crises that link immediate hunger relief interventions with a long-term strategy for sustainable growth. Finally, the article analyses policy options and the implications for both short- and longer-term responses vis-a-vis the three dimensions of food security: availability; access; and stability.

Altruism↗
PubMed2005

Food security in protracted crises: building more effective policy frameworks.

This paper considers the principal elements that underpin policy frameworks for supporting food security in protracted crisis contexts. It argues that maintaining the food entitlements of crisis-affected populations must extend beyond interventions to ensure immediate human survival. A 'policy gap' exists in that capacities for formulating policy responses to tackle the different dimensions of food insecurity in complex, fluid crisis situations tend to be weak. As a result, standardised, short-term intervention designs are created that fall short of meeting the priority needs of affected populations in the short and long term and only partially exploit the range of policy options available. The paper discusses key attributes of agency frameworks that could support more effective policy processes to address longer term as well as immediate food security needs. Additionally, it points to some main challenges likely to be encountered in developing such frameworks and, with the participation of beneficiaries, translating them into effective action.

Emergencies↗
PubMed2005

A 'principled' approach to complex emergencies: testing a new aid delivery model in the Nuba mountains.

This paper provides an analysis of the Nuba Mountains Programme Advancing Conflict Trans-formation (NMPACT) as an example of an operational response in a complex emergency that innovatively addressed an incipient food security crisis. NMPACT is notable for having brought together an array of actors around a common principled agenda and for being the only operational programme in the Sudan to which both warring parties subscribed during the conflict. The key features of the programme are presented and the main innovative elements are reviewed, including the role of the principles of engagement and the 'political humanitarianism' of NMPACT. The paper looks at how NMPACT broke from traditional externally driven responses to food insecurity, and, drawing on lessons from Operation Lifeline Sudan, adopted an approach that focuses on capacity building, sustainable agriculture and market revitalisation, alongside conflict transformation and peace-building. The limitations of the model are also assessed, and preliminary lessons regarding its replication in other complex emergency contexts are presented.

Altruism↗
PubMed2005

Making humanitarian relief networks more effective: operational coordination, trust and sense making.

Effective coordination of humanitarian assistance activities remains elusive. This paper briefly addresses some of the reasons for what is widely perceived as a coordination dilemma in humanitarian affairs and argues for a new conceptualisation of the issue. Rather than continue to request that more authority be vested in a single organisation to secure coordination through top-down control, it contends that it may be timely to consider whether relief agencies involved in an emergency should be reconceived as social networks and efforts made to achieve changes in their organizational cultures that encourage operational coordination across institutional lines. Since such labours imply the need to trust, this article explores what forms of trust might be employed to promote improved coordination among relief institutions and how those relationships could themselves be conceptualised. Finally, while acknowledging that coordination is not costless, it suggests that its effective pursuit may be advantageous even in scenarios where aid organisations balk at cooperating to secure it.

Altruism↗
PubMed2005

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.

Altruism↗
PubMed2005

Evidence against disaster-induced migration: the 2004 tornado in north-central Bangladesh.

Migration is generally considered to be one of the primary responses to a natural disaster. The existing literature widely acknowledges the fact that disaster victims migrate from affected areas. This paper, though, provides empirical evidence of the non-occurrence of out-migration in the aftermath of the 14 April 2004 tornado in Bangladesh. Data collected from 291 respondents from eight tornado-affected villages suggest that no one from these locations migrated to other areas. The constant flow of disaster aid and its proper distribution by the government and non-governmental organisations (NGOs) were the main reasons why victims did not leave. This study contributes to the disaster literature by providing three important findings: disasters do not always create out-migration; emergency aid can compensate in monetary terms for damage caused by disasters; and some of the arguments made in the literature against the provision of emergency relief for disaster victims are not always valid for all countries.

Adult↗
PubMed2006

Tsunami mortality and displacement in Aceh province, Indonesia.

A survey of 388 Indonesian households displaced by the December 2004 tsunami was conducted in Aceh province in February 2005. Of tsunami-displaced households in Aceh Barat and Nagan Raya districts, 61.8 per cent reported one or more family members as dead or missing due to the tsunami, with an overall mortality rate of 13.9 per cent (95% confidence interval (CI): 12.4-15.4). Risk of death was greatest in the youngest and oldest age groups, and among females. Overall, 36 per cent of tsunami-displaced households indicated an intention to return to their original community within three months, and displaced households residing in host communities were 2.2 (95% CI: 1.2-2.8) times more likely to state an intention to return to their original villages or another community as those residing in camps. The tsunami recovery effort should focus on strategies that facilitate either prompt return or permanent, voluntary relocation for those displaced.

Adolescent↗
PubMed2006

Organisational learning and self-adaptation in dynamic disaster environments.

This paper examines the problems associated with inter-organisational learning and adaptation in the dynamic environments that characterise disasters. The research uses both qualitative and quantitative methods to investigate whether organisational learning took place during and in the time in between five disaster response operations in Turkey. The availability of information and its exchange and distribution within and among organisational actors determine whether self-adaptation happens in the course of a disaster response operation. Organisational flexibility supported by an appropriate information infrastructure creates conditions conducive to essential interaction and permits the flow of information. The study found that no significant organisational learning occurred within Turkish disaster management following the earthquakes in Erzincan (1992), Dinar (1995) and Ceyhan (1998). By contrast, the 'symmetry-breaking' Marmara earthquake of 1999 initiated a 'double loop' learning process that led to change in the organisational, technical and cultural aspects of Turkish disaster management, as revealed by the Duzce earthquake response operations.

Acclimatization↗
PubMed2004

Features of the development of a welfare system for visually disabled people in Denmark.

PURPOSE: To describe the development of a formal system of welfare for blind and partially sighted people in Denmark. METHODS: The principal laws in Denmark relating to a formal system of welfare for blind and partially sighted people are noted and commented on. No such collection of laws has been found in the literature. The history of aid to visually disabled people in Denmark is described, as are the Danish classifications of visual impairment. DEVELOPMENT: Formalized welfare for blind and partially sighted people was started in Denmark in 1811, as a private initiative by the Kjaede Order. Later, the Danish state took over responsibility, and in 1858 the Royal Danish Institute for the Blind was established. Since then a series of laws concerning welfare for blind and partially sighted people have been issued in accordance with economic and social development in Denmark. In 1858 the Braille writing system for blind people was introduced. The Danish Association of the Blind was founded in 1911 and has profoundly influenced subsequent legislation. During the last 10 years, several visual centres have been established. Since 1968 prevention of blindness has also played a prominent role in Denmark. CONCLUSION: Great steps have been taken towards improving the welfare of blind and partially sighted people. However, being blind is still very difficult. Modern technologies and hectic lifestyles have created new problems for blind people. The obligations of the Danish state towards visually disabled people have, therefore, increased in recent years.

Blindness↗