During political strife or military fighting, innocent populations often are unwillingly involved. The challenges only increase when a disaster occurs or large groups are displaced and need assistance. The delivery of aid can be compromised, and relief workers may be put in harm’s way.
Such events are termed Complex Humanitarian Emergencies (CHEs).The United Nations defines a CHE as “a humanitarian crisis in a country, region, or society where there is total or considerable breakdown of authority resulting from internal or external conflict and which requires an international response that goes beyond the mandate or capacity of any single and/or ongoing UN country program.” In short, CHEs involve an acute emergency layered over ongoing instability. Consider the 2010 devastating earthquake in Haiti, striking an area already beset with poverty and poor sanitation, or the Indian Ocean Tsunami of 2004, wreaking havoc in a region under martial law. In that case, international aid groups had been forced out.
CHEs may be worsened by famine, and heightened by the outbreak of disease or poor sanitary conditions as people flee their homes due to the fighting. Such has been the case in Syria, in the middle of a civil war and now in Mali, where fighting has displaced nearly 250,000 people as of January 17, 2013. There, the drought and famine in the Sahel have combined with political instability, internal conflict, and a rise of armed militants.
As these emergencies involve so many competing issues, the UN has established an order of priority:
- Rapid needs assessment
- Water, sanitation, and hygiene (WASH)
- Food and nutrition
- Shelter and site planning
- Health care
- Control of communicable diseases
- Public health surveillance
- Human resources and training
- Coordination between aid groups
An acute CHE includes the presence of war, poverty, hunger, and displacement. A serious CHE includes any three of the four components. Other CHEs are termed “violent,” in which military action causes a displacement of people groups.
In recent years, most CHEs have been caused by intra-country fighting, not as a result of wars between nations.This can bring its own complications. Unraveling a complex humanitarian emergency and providing relief typically requires an understanding of the motivation of the actors involved. In addition, intervention can take on political overtones.
- Groups that are fighting sometimes will not allow humanitarian assistance. Combatants often target civilians, putting them at risk for human rights abuse, food shortages, breakdown of publicly supported health systems, and unhealthy living conditions in refugee camps. When conflicts are intra-state, participants do not wear military uniforms, making it difficult to differentiate between combatants and civilians.
- CHEs often bring about Complex Security Environments, situations which cause difficulty for aid workers. Between 2001 and 2011, the number of aid worker deaths tripled to 100 per year. The kidnapping of aid workers also has risen dramatically.
- CHEs can cause tremendous loss of life. The United Nations estimates that in the 20th century, more than 169 million people were killed during these events, including 17 CHEs that killed more than 1 million each.
- In the early stages of a CHE, most deaths occur due to diarrheal diseases, respiratory infections, measles, or malaria. As the event lingers and people continue to be displaced, the issue often becomes malnutrition.
How to Help
- Provide mental health aid for those affected. Those who have been displaced have undergone a significant change in way of life, perhaps including loss of livelihood, extreme poverty, and damaged social support structure. Because of the ongoing conflict, they also may suffer from post-traumatic stress disorder.
- Provide assistance for women and children. These groups often constitute more than three-fourths of the victims, and mortality rates rise 10- to 30-fold above normal levels, according to a study published in the journal Medicine and Global Survival. In addition, in refugee camps, extra care is needed to ensure female-headed households receive rations.
- Fund research into lessons learned in previous CHEs. Each situation has unique elements, but some lessons may be applied more broadly. In addition, this area of aid has lacked accountability and evaluation, according to the Organization for Economic Co-Operation and Development. Funding for post-event evaluations would enhance accountability while providing resources that could be adapted for future events.
- Provide assistance for public health needs. With a disaster or ongoing conflict, gains made in public health—immunization, water, sanitation and the like—can be quickly wiped out. Shoring up public health assistance in developing nations and those that focus on complex humanitarian emergencies is an area of need. Developing epidemic preparedness protocols could aid public health in a variety of situations as well.
What Donors Are Doing
- The Vodaphone Foundation Technology Partnership has teamed with the United Nations Foundation to provide expertise and telecommunications resources to NGOs during an emergency. The program allows relief workers to quickly establish a mobile phone network for reliable communications. It also has been used to take photos of refugees with a goal of reuniting families.
- The MacArthur Foundation has funded numerous initiatives related to CHEs in recent years, including providing a $225,000 grant to create an international criminal court for crimes committed in Uganda; and $1.5 million for programs aimed at children affected by civil war in Uganda.
- The W.K. Kellogg Foundation has long been active in Haiti, but since the earthquake has devoted significant resources to immediate health needs, such as $65,000 to the Soul Foundation for medical care for special needs orphans, and $540,000 to St. Boniface Haiti Foundation for prenatal, maternal, and child health care. Long-term efforts have included $600,000 to World Vision for programs to help farmers in poor regions increase food supply, and $300,000 to the Nature Conservancy to develop eco-tourism development and environmental protection in coastal areas.