A funny thing happened to me on the way to South Sudan this past summer. Initially, I had been called out by International Medical Corps to develop a training program for local doctors and nurses at some of the smaller, rural hospitals around the country. En route to Africa, though, I received word from International Medical Corps that I would be needed in another capacity. They had just been notified that 15,000 South Sudanese were being forcibly repatriated from Khartoum (in Sudan) to Juba (in South Sudan) over the next two weeks, and a camp was going to be set up at a nearby teacher training college to house them temporarily. International Medical Corps had agreed to manage health and nutrition programs for the returnees, and I was needed to rapidly set up a medical clinic for the camp.
While this particular crisis was an acute one, with nearly a dozen organizations including my own scrambling to ensure enough shelter, food, water, sanitation, and medical care for the returnees in the span of just a few days, it was not a new one. Hundreds of thousands of refugees have been pouring back and forth across the border between Sudan and South Sudan since long before the border even officially existed. In many parts of the world, refugee crisis have become protracted events, smoldering on for decades without a clear end in sight. Even natural disasters can stretch on for years after the initial event, with the 2010 Haitian earthquake being a prime example -- three years on, and thousands of people in Port-au-Prince still remain without permanent housing or adequate sanitation. And not only are humanitarian emergencies lasting longer, but research conducted by the Center for Research on the Epidemiology of Disasters (CRED) has also shown that both the frequency of disasters and the number of people impacted by them have increased sharply in recent decades, a trend which is only likely to continue given the long-term effects of climate change and global patterns of migration. All of which is to say that we need to stop treating humanitarian emergencies as one-off events, praying after each one that it never happens again, and instead start preparing for a future in which humanitarian emergencies are commonplace, but where we do everything we can to mitigate their effects on populations, improve the quality of response, and shorten the recovery period.
This notion of improving the delivery of humanitarian assistance was at the heart of a recent symposium held at Brown University in Providence, Rhode Island this past weekend titled "Humanitarian Assistance at the Crossroads." The symposium brought together humanitarian professionals and academics from several universities to discuss the adequacy of the worldwide response to recent large-scale disasters and refugee crises; the need for improvement in both the training of humanitarian aid workers and the quality of aid provided by humanitarian organizations; and the ways in which academia can partner with both the governments that fund humanitarian relief and the organizations that provide it in order to improve the delivery of humanitarian assistance in the 21st century.
One of the major themes to emerge from the symposium was the increasingly interdisciplinary nature of humanitarian assistance. Speakers and panelists came from a variety of academic departments, including public health, medicine, international relations, political science, population studies, economics, technology, communication, gender studies, and human rights. In the past, it would be rare to find individuals from these various academic silos at the same conference, let alone in the same room. Yet the content of the discussion at the symposium highlighted the importance of bringing together individuals with very different perspectives and sets of expertise. Yong Lee, an economist from Williams College, shared some of the results of his research showing that the quality, and economic impact, of housing and boat aid delivered by various international humanitarian organizations after the Indian Ocean tsunami varied considerably depending on the specific channels they utilized to provide that aid. In a similar vein, Melani Cammett, a political science professor at Brown University, discussed some of her research from Lebanon, which found that most aid was being delivered by organizations with specific sectarian and religious biases, with profound effects on both the distribution of aid and electoral politics in the region[1]. Captain Shimkus, former commander of the USNS COMFORT and currently a professor of national security affairs at the Naval War College, also discussed the biases inherent in the provision of humanitarian aid by the U.S. military, in many ways a by product of the U.S. government's increased focus on the use of "soft power" to maintain American interests around the world.
Not surprisingly, technology and human rights were also prominent topics at the symposium. Jennifer Chan, co-author of the recent United Nations report "Disaster Relief 2.0," discussed the future of information sharing in humanitarian emergencies and the ways in which new technologies from texting to Twitter can empower disaster victims and help direct humanitarian response, or, if used incorrectly, can lead to information overload and even put some communities at increased risk during violent conflict. Jennifer Leaning, Director of the Center for Health and Human Rights at Harvard University, spoke of the human rights implications of various types of humanitarian assistance, highlighting the areas in which aid workers needed to take special care to avoid exacerbating the plights of the very people they were attempting to serve. The specific examples brought up by the various speakers make clear that aid delivery in the 21st century is about far more than just food, water, and medicine; humanitarian providers of the future need to develop a far broader perspective on the complex array of issues involved in order to ensure that their good work actually does some good -- or at the very least does no harm.
The final, and perhaps most important, theme of the symposium was the need for better training and professionalization of the humanitarian workforce. Both Selim Suner, Director of the Rhode Island Disaster Medical Assistance Team (DMAT), and Hilarie Cranmer, Director of Disaster Response at Massachusetts General Hospital, spoke about the importance of intensive and specialized training to prepare doctors, nurses and other healthcare professionals to practice in the austere and often dangerous environments of many disasters and humanitarian emergencies. A recent report by the Global Health Cluster of the United Nations Interagency Standing Committee raised "serious questions... about the clinical competencies and practices of some of the foreign medical teams deployed in recent years," and recommended "greater accountability, more stringent oversight and better coordination of their work." Partly in response to these recent criticisms, the symposium highlighted the work that Brown University, alongside dozens of other academic institutions from around the world, has begun to do to professionalize this rapidly growing field. Collaborating together under the umbrella of the Enhancing Learning & Research for Humanitarian Assistance (ELRHA) project, these universities are working to create common competencies, develop core curricula, and establish a system of accreditation for training humanitarian professionals in order to reduce the variability and improve the overall quality of humanitarian response. While much remains to be done, symposia such as this one represent important starting points for creating a far more robust and dependable system of response to future disasters and humanitarian emergencies.
REFERENCES
[1] Cammett MC. Partisan Activism and Access to Welfare in Lebanon. St Comp Int Dev (2011) 46:70-97. DOI 10.1007/s12116-010-9081-9.