Checklists up for a reality check: Decades of debate on humanitarian standards
Markus Forsberg 8 May 2013
Over the past years, enormous changes have transformed IT, the media, medicine, travel, and communications, to name just a few areas. In some sense, humanitarian aid is no exception—our field is booming, with almost 17 billion in funds and an estimated workforce of 274 000 aid workers growing at 4% annually. Humanitarian aid has gained increasing political prominence, with ever greater interest among donor and recipient states to use emergency aid to promote their own political or economic interests. At the same time, communication has become more global in nature, resulting in new exchanges and wider scrutiny of aid responses. Increasingly complex emergencies are arising alongside protracted crises that challenge the existing humanitarian toolbox. New donors and aid actors are emerging in the BRIC countries and beyond, while new geographic areas of response are opening in Syria and the larger Middle East and North Africa region. However, the actual provision of humanitarian aid itself has a lot of catching up to do in order to reach our stated aspirations in the face of both older and more recently emerging challenges.
Standards and professional practices
A quick look at our professional practices in the field today reveals little change for the better, despite the much-cited expansion of humanitarian aid and its ostensible professionalization. Some innovations have emerged at the field level, including telemedicine, use of cash and cash vouchers, and communication with beneficiaries via mobile technologies. Médecins Sans Frontières (MSF) and others have also harnessed wider changes in medicine and technology to improve their responses. Yet barring some revisions and additions, the key standards for our work all date from at least one to two decades ago. These range from humanitarian principles based on international humanitarian law and field practice to technical standards based on universal human needs (e.g. water provision) and codes of conduct and best practices drawn from years of field experience. Such standards are often aimed at ensuring the baseline conditions for the survival and human dignity of people in crises.1 These include the Red Cross Code of Conduct (1994), the “Oslo Guidelines” (1994), the Sphere standards (1997), work of the Humanitarian Accountability Partnership (HAP) (2003), and Good Humanitarian Donorship (2003), to name a few.2
Ten to twenty years after their inception, humanitarian debates still centre on how to realize these standards, aspirations, and proven best practices in the field. Recent research and initiatives of donors,3 practitioners,4 and analysts5 point to the failure in reaching these long-established standards and in advancing the debate to deal with whether humanitarian aid is really “fit for purpose.” Even as debates about the fundamentals rage on, new guidelines are being developed to navigate even further-reaching dilemmas and decision-making processes, such as the realization of principles in practice, interaction with armed actors, access strategies, and measuring the impact of protection activities.6
Balancing the approach to standards
While technical standards and best practices have their place, they need to remain adapted to specific contexts and resist becoming meaningless numbers in a one-size-fits-all approach.7 Quality, efficiency, and accountability, while fundamental to improving aid delivery, cannot be reduced to technical standards and templates. Other key objectives, such as upholding humanitarian principles in practice, are also vital even if they resist pre-established guidelines.8 The difficulties related to improving the respect for humanitarian principles cannot be allowed to lead to the abandonment of this project – if principles are not respected, humanitarians may no longer be able to operate and many standards may not be attainable in the first place.
An outsider observing our field-level practices will notice the continual struggle to establish a basic “who does what where,” the push to obtain and exchange accurate information, evaluations of present and past interventions, and the constant calls to improve coordination (e.g. the UN clusters) in the wider humanitarian system—often against the backdrop of volatile, politically charged, and often violent contexts rife with human suffering. The irony is that so much work and energy is expended on improving humanitarianism as a system, including the development of new standards, yet existing minimum standards fail to be met in terms of delivery at the field level—the true indicator in terms of accountability to people in need.
We’re still not reaching the minimum standards
In recent emergencies, such as the cholera outbreak in Haiti9 and refugee arrivals in South Sudan,10 aid responses failed to address even minimum needs such as adequate potable water and sanitation, exacerbating health consequences and putting lives at risk. In the Haitian capital Port-au-Prince, hundreds of thousands of displaced persons had sheltered in informal settlements and camps, where minimum standards would have prescribed the delivery of adequate water and sanitation. Yet cholera hit hard there because water and sanitation standards were not in place despite the huge humanitarian presence. From mid-October to end of December 2010, over 2500 Haitians died of cholera—despite the presence of over 12,000 NGOs after the January 2010 earthquake. Normally, cholera is a disease easily preventable with adequate potable water and sanitation—and easily treatable with low-cost measures familiar to experienced humanitarian personnel.
Similarly, in Maban County, South Sudan, persistent deficits in provision of water and sanitation led to high rates of diarrhoea among Sudanese refugees, with the later emergence of hepatitis E in June 2012—again, a preventable disease. Following this outbreak, 3991 cases of hepatitis E were treated between June 2012 and January 2013, with 88 deaths, including 15 pregnant women.11
Why this failure to achieve even minimum standards for the people we assist?
Competing priorities
The debate about professionalism in humanitarian aid delivery is surely one that needs to happen—but it is not a silver bullet either. Many other factors come into play. Contextual understanding and responsiveness to urgent needs will be essential to give any meaning to established standards and practices. But this kind of independent baseline analysis is rarely carried out to a sufficient degree in an era where “bunkerization” is recognized as an ever greater risk in insecure settings and the level of situational monitoring and surveillance identified as a “major weakness” in humanitarian aid delivery.12
In some aid responses, large gaps exist between the presence of humanitarian actors, their stated responsibility for particular sectors, and actual delivery. It is time for a debate about what “coverage,” “accountability,” and “lead agency” actually mean in terms of provision of life-saving assistance to populations in need. What happens when individual agencies, or the humanitarian “community” as a whole, overpromise yet under-deliver? A collective push toward more accountability risks instead meaning no accountability—and no relevant response—unless we can also be honest about instances where standards are not met. In addition, where agencies are committed to the idea of building a state or a system, how will the humanitarian “community” ensure that the needs of the most vulnerable—or responses to unforeseen or politically unwelcome emergencies—are covered?
In multi-mandate organizations and in coherent donor approaches, humanitarianism ends up competing with all manner of other priorities on the agenda of the actors involved –everything from longer-term development to state-building and gaining hearts and minds for security or foreign policy objectives. Today’s financial crisis only risks aggravating this tendency with a simultaneous push toward both greater accountability and more joined-up approaches, such as initiatives to improve resilience that aim at achieving multiple objectives with the same resources as before.
Like the debate on standards, the problem of blurring politics and humanitarianism, as well as the recurring tensions between development and emergency relief, has been documented and debated for decades and is now acknowledged as a key concern. Perhaps it is time to take that critical step: to finally use these lessons learned across humanitarian aid and to see what an entirely independent and impartial aid community could look like in practice.
Refocusing on delivery
Many questions persist. Is the failure to meet standards a question of a lack of resources or of political will? Or are the standards simply too demanding to achieve for humanitarians confronting operational obstacles, low risk tolerance, and remote control strategies? Are standards simply a victim of an ever more crowded yet fragmented humanitarian landscape dogged by the limits of coordination, inter-agency competition, and an increasing divide between principled actors and those who approach the provision of relief assistance as one of several objectives?13 The challenge is to know if reaching minimum standards—basically a proxy for human survival and dignity—is still the primary goal of the humanitarian community. Today, the risk is that other strategies like resilience, state-building, or support to systems become the new objective, pre-empting long-established standards and the imperative of saving lives.
If debates around standards and accountability are not to gain the upper hand over actual delivery, we would do better to serve our beneficiaries and humanitarianism as a whole by being more honest about these open questions-- including our difficulties, shortcomings, and limits in an imperfect and often violent world. As a first step to refocus our efforts on meeting needs, this alone would be a change worth welcoming.
About the author
Katharine Derderian works with the Humanitarian Innovation Team at Médecins Sans Frontières (MSF) in Brussels, Belgium. With MSF since 2001, Katharine has worked in Liberia, Angola, Kenya, DRC, Haiti, Ivory Coast and South Sudan. Since joining headquarters in 2005, she has focused on analysis, operational support and advocacy around contexts of conflict, and on humanitarian aid response in emergencies. Katharine has a PhD in classical philology from Princeton University.
Notes
1 “The minimum standards describe conditions that must be achieved in any humanitarian response in order for disaster-affected populations to survive and recover in stable conditions and with dignity.” Sphere Handbook (2011).
2 See IFRC, Red Cross Societies and ICRC (31 December 1994), “The Code of Conduct for the International Red Cross and Red Crescent Movement and Non-Governmental Organisations (NGOs) in Disaster Relief”; “Guidelines on The Use of Foreign Military and Civil Defence Assets in Disaster Relief – ‘Oslo Guidelines’,” Revision 1.1 (November 2007); “The Sphere Project: Humanitarian Charter and Minimum Standards in Humanitarian Response,” (1997, revised 2009-2010); Humanitarian Accountability Partnership (HAP), “Standards”; Good Humanitarian Donorship (2003), “23 Principles and Good Practice of Humanitarian Donorship.”
3 European Commission (10 December 2012), “The Union’s humanitarian aid: Fit for purpose? Stakeholder consultation document.”
4 www.jointstandards.org/about, daraint.org/humanitarian-response-index/humanitarian-response-index-2011
5 ALNAP (2012), “The State of the Humanitarian System,” points to gaps in innovation in actual response as well as gaps in coverage—attributed to rising need against insufficient resources. At the same time others point to the need for greater professionalism: “There is a sense that the humanitarian endeavour is in the early, but very definite, stage of moving toward a more professional structure, making it timely and opportune to examine all aspects of such an evolution.” (Peter Walker and Catherine Russ (December 2011), “Fit for purpose: the role of modern professionalism in evolving the humanitarian endeavour,” International Review of the Red Cross 93.884, pp. 1193-1210). The challenge of meeting standards is also discussed by Collinson et al. (Collinson, S., Elhawary, S., Hammond, L., Donini, A., Duffield, M., Haver, K., Hagan, J. O., et al. (2012), "Humanitarian space: a review of trends and issues", Overseas Development Institute: London), who state that codes of conduct often “failed to ensure consistency across the system...because these networks and standards do not constitute a distinct or coherent normative framework for the sector as a whole. They also typically lack any monitoring or enforcement mechanisms, and compliance is almost always weak and uneven in practice.”
6 For guidelines on decision-making: HISS-CAM dates from 2008 and aims to “to help staff think through difficult operational and policy decisions they may face when interacting with military and other armed actors.” Similarly, D-NAV dates from 2007-2009 and intended to “bring objectivity and rigour to the challenge of balancing humanitarian principles with practical choices in increasingly complex operating environments. A series of questions examine the decision through four lenses – intent, impartiality, independence and impact. If they raise any doubts or serious concerns the decision is then subjected to further interrogation. The final step is implementation, comprising the final decision and action plan to address the issues identified through the process.” Cf. similar recent reflection processes on wider issues, Global Public Policy Institute (GPPI) (29 June 2012), “Evaluation and review of humanitarian access strategies in DG ECHO funded interventions” and Urban Reichhold and Andrea Binder (March 2013), “Scoping study: what works in protection and how do we know?” GPPI.
7 For MSF’s concerns on the Sphere project that led to disengagement from the Sphere process of developing technical standards and key indicators at the time, see Jacqui Tong (2004), “Questionable Accountability: MSF and Sphere in 2003,” Disasters, pp. 176-189.
8 Norwegian Refugee Council (2012), “Tools for the Job: Supporting Principled Humanitarian Action.”
9 Unni Karunakara (28 December 2010), “Haiti: where aid failed,” The Guardian. Other writing on the Haiti interventions during the earthquake and cholera outbreak echo the MSF analysis, e.g. F. Grunewald et al (2010), “Interagency Real Time Evaluation in Haiti: 3 months after the earthquake.”
10 Sandrine Tiller and Sean Healy , “Have we lost the ability to respond to refugee crises? The Maban crisis response,” forthcoming in Humanitarian Practice Network no. 56.
11 Epicentre (1 February 2013), “Outbreak investigation of hepatitis E in Batil camp refugee camp in the Maban district, Upper Nile - South Sudan”; MSF (1 February 2013), “MSF responds to hepatitis E outbreak in South Sudan refugee camps." Upcoming operational research by MSF shows how initial sub-standard choices in camp location for places like Yusuf Batil in Maban County, South Sudan, led to the inability to reach many other standards, including water and sanitation, in this refugee camp setting.
12 On bunkerisation and the search for alternatives, see OCHA (2011), “To Stay and Deliver: Good practice for humanitarians in complex security environments.” One study (James Darcy et al. (2013), “The Use of Evidence in Humanitarian Decision Making,” Feinstein International Centre, Tufts University) highlights the high level of personal and political bias in decision-making on humanitarian response, while pointing out that “situational monitoring and surveillance remain a major weakness in most contexts”; this being said, standards and lessons learned could hardly be applied without an up-to-date contextual perspective.
13 Yves Daccord (4 February 2013), “Humanitarian action in a changing landscape: fit for purpose?.”
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