Last week I took a class on humanitarian emergencies around the world. It ran from 9 to 5 each week day. With speakers from
- U.S. Agency for International Development (USAID),
- Bureau of Humanitarian Affairs (BHA),
- Center for Disease Control (CDC), and
- Doctors without Borders / Medicens Sans Frontieres (MSF),
we really got a massive introduction to how American-based agencies and non-governmental organizations respond to disasters and conflict across the world. Response is complex, from the rapid assessments, logistics, measurement and evaluation for response, to the research and development prior, during, and after the onset of humanitarian emergencies. Nobody can do it all, and nobody can do it alone.
The American Red Cross has been part of my college going experience, both in my undergraduate years at Tulane in New Orleans, and here in my doctoral program at the University of Washington in Seattle. I advise a group of really cool and caring undergraduates, and what I want most for them is to develop the disposition to be brave and responsible. The skills and knowledge will come from more formal training, but I think the primary lesson from these experiences is "You are doing something most other people aren't doing. We need more of that."
The mural outside the New York Red Cross from a trip in 2011. |
Challenges for Humanitarian Response
Worldwide, according to the United Nations High Commissioner for Refugees (UNHCR) about 108.4 million people have been displaced from their homes, with about 30 million refugees and 53 million internally displaced people (IDPs). The primary difference between refugee status and IDP status is whether a national border has been crossed. Resettlement, integration, or repatriation are longer term goals for assisting these populations, but more immediately,
Situations become humanitarian emergency when local and national governments cannot cope to alleviate these conditions following a natural disaster or armed conflict. People are often displaced due to immediate safety, but they may also move because their means of making a living have been disrupted. Displacement becomes a serious disruption to a population's living conditions, and communities may have difficulties sustaining their services once the shock of a disaster occurs.
The big four communicable disease and the one preventable comorbidity that we see in humanitarian emergencies:
- Measles - highly contagious among vulnerable, unvaccinated children
- Malaria - vector-borne diseases caused by different plasmodia carried by mosquitos
- Cholera / Acute Watery Diarrhea (AWD) - the consequence of insecure water, sanitation, and hygiene infrastructure, or WASH
- Acute Respiratory Illness - overcrowding and poor air circulation in shelters make parts of the population more vulnerable
- Malnutrition - marasmus and kwashiokor, especially in children under 5; different grades of malnutrition are all avoidable, yet treatable
Some questions that arise when addressing a response:
- How many people are affected? Who are they?
- What services are already there?
- Who else is helping? When will their operations be running? What are our timetables?
- Where are the people? Where can people camp? Are there other kinds of shelter?
- What are the priorities to provide the most effective assistance?
- Which externalities do we need to mitigate? How do we reduce risk?
- What data are we basing decisions on?
- Do we have the community's trust?
- How can we survey for needs?
- What surveillance do we have on communicable diseases?
- How can we prevent the situation from getting worse?
- How long are we here? What if it becomes unsafe for us?
The hand-off between humanitarian response, which focuses on life-sustaining and immediate stabilization, to recovery and international development, isn't something we focus on. Who has the most immediate responsibility for housing and economic opportunities? Usually, that's the host government, but the disaster obviously worsens how they function.
Minimum Standards
We talked about the Sphere Handbook for minimum standards in humanitarian response.
These Sphere standards include:
- 7.5 L of water per person per day for all uses after the onset of the response with 15 L per person per day as a goal
- 500 m to the closest potable water source
- 3.5 m2 of space per person, just above the size of a queen-sized bed
- 1 latrine per 20 people with a goal for 1 latrine per family
It's far from ideal, but some disasters can displace tens of thousands of people. With a moving population, and unfortunately, the expectation of casualties, the "right" logistical decisions flux. Space and supplies are limited, and distribution, use of resources, and open supply chains require constant monitoring in environments where real-time data collection, or even post-hoc data collection, is delayed with high potential for under-reporting.
The Network and the Work
I'm thinking about what might come after my doctoral work.
- ReliefWeb.int - for humanitarian news, brought to the world by the United Nations Office for the Coordination of Humanitarian Affairs
- USA Jobs - the U.S. federal government jobs site
- CDC Fellowships - a broad range of training opportunities for college students and K-12 educators
- Oak Ridge Institute for Science Education (ORISE) - a U.S. Department of Energy institute for STEM Education and STEM workforce development
Discussion
I have personally never been part of a humanitarian emergency. I haven't traveled abroad (besides Canada when I was a kid. When I interned for the Red Cross in Southeast Louisiana, hurricane season was mild.
I do donate, just knowing how a little can go a long way. Some of the translational work in communicating the scale and scope of humanitarian response might be converting dollar amounts to hypothetical resources such as "this provides a tent for a family" or "this provides water for this amount of people."
The dollar amounts for worldwide humanitarian response is usually in the hundreds of billions range, but I always think about how the GDP of Earth is something like $85 trillion. GDP is obviously not the best number for this situation, but to me, I think it puts our priorities into perspective. Some disaster responses might cost about the same as one of the more middling Marvel movies or the collective amount we spend on holiday decorations. It's more complicated than that, but at the root, much of human suffering is the result of the uneven distribution of humanity's collective resources across our planet.
Some countries are not as vulnerable to prolonged humanitarian crises, and the countries that are most vulnerable cannot fix their infrastructure themselves.