Following two days of open hostilities between the Lebanese Armed Forces and opposition forces early in the civil war which raged in Lebanon between 1975 and 1990, a convoy of Lebanese Red Cross ambulances took advantage of a short ceasefire to evacuate the wounded to hospital. Two Lebanese Red Cross ambulances transporting wounded and dead Lebanese Armed Forces soldiers were stopped at a military checkpoint manned by members of an opposing group. The Red Cross volunteers managed to persuade the group not to detain the wounded soldiers, but were less successful in stopping them from interrogating them. As the ceasefire came to a close and the fighting re-ignited, the Red Cross workers urged those at the checkpoint to let them through, highlighting the neutral medical mission of the Lebanese Red Cross. The volunteers also argued that should their interrogators find themselves in a similar position, they would not want the Red Cross to hand them over to their opponents. Negotiations continued until a call from a senior commander settled the matter at the request of a well-connected senior Lebanese Red Cross official in Beirut, and the ambulances were able to pass through and deliver the soldiers to hospital for treatment.
This article highlights some of the many strategies employed by the Lebanese Red Cross to provide humanitarian services and gain and maintain acceptance, safety and access over the past thirty years. Having suffered a series of security incidents during the civil war, the Lebanese Red Cross deliberately sought to increase its trust and acceptance amongst different groups by applying the International Red Cross and Red Crescent Fundamental Principles (hereinafter the Fundamental Principles). Although not without numerous challenges – to which the example above attests – the decision has paid off. Later in the civil war, the emergency medical services of the Lebanese Red Cross were able to work across as many as fifty different checkpoints. During the Israeli occupation of southern Lebanon, the Lebanese Red Cross provided services across the different territories. The Lebanese Red Cross also provided services for both sides during the 2006 armed conflict between Israel and Hezbollah. At the time of writing, the Lebanese Red Cross is providing emergency medical transport and humanitarian assistance for wounded Syrian nationals who are fleeing across the Lebanon border, adjusting and intensifying their acceptance strategies and security measures, to enable safe passage through various sensitive confessional areas within Lebanon.
Drawing on the experience of the Lebanese Red Cross, this paper argues that the Fundamental Principles are more than just normative aspirations. It shows that when applied systematically, they can be tools to support the management of operations. It examines the numerous accounts of external attacks on, and limitations of, humanitarian action in accordance with the principles and suggests that there is a relative absence of attention to the responsibilities of humanitarian organisations in applying them. The article highlights how the Lebanese Red Cross and its volunteers have systematically applied the Fundamental Principles in their daily work – a key factor in ensuring that the Principles are genuinely meaningful and useful, and not simply an empty rhetorical commitment. The article shows that considerable and consistent effort is required to build organisational commitment in order to ensure the rigorous application of the Fundamental Principles, but that this, along with specific acceptance and security management measures, has been effective in improving acceptance and access for the National Society. The action of the Lebanese Red Cross highlights the interdependence of all the Fundamental Principles in helping to get aid safely to those who need it most.
The article is structured in four parts. The first part begins with a brief overview of the Lebanese context and the methodology of the original case study from which this article draws. The second part examines some of the debates regarding humanitarian principles, including the degree to which they are understood as operationally relevant. The third highlights the interplay between the application of the Fundamental Principles and other actions and measures contained in the Safer Access Framework. It describes the impact of the strategies and approaches employed by the Lebanese Red Cross to apply the Fundamental Principles and the Safer Access actions and measures to increase its acceptance, security and access. The fourth part analyses the importance and implications of perceptions, access and security for the National Society. The paper concludes by highlighting some lessons that can be drawn and some questions raised by the Lebanon case study.
Lebanon and the emergency medical services of the Lebanese Red Cross
Lebanon gained independence in 1943 as a parliamentary democracy based on religious denominational or confessional lines, with government traditionally composed of a Maronite Christian president, a Sunni Muslim prime minister and a Shia Muslim speaker of the Chamber of Deputies or National Assembly.Footnote 1 Confessional divisions underpinned a civil war that spanned from 1975 to 1990 – a conflict which continues to act as a backdrop to the ongoing tensions and the fragility of relations between Lebanon's different communities today. Lebanon's political stability is also closely intertwined with that of the region: Syria occupied parts of the country for almost thirty years, which in turn played a role in the later occupation of southern Lebanon by Israel for almost two decades. Today, the interconnections between Syrian and Lebanese societies and politics leave Lebanon vulnerable to spillover from the current conflict in Syria. At the time of writing, the number of confrontations between pro- and anti-Syrian factions within Lebanon is rising, particularly since the influx of Syrian refugees into northern Lebanon and Tripoli.Footnote 2
Established in 1945, the confessional system of government in Lebanon affects the Lebanese Red Cross in a number of ways, including a governance structure which largely mirrors that of the Lebanese government. The work of the Lebanese Red Cross is largely health-related and includes the provision of emergency services, medical-social assistance, blood services, educational services and youth support. The Lebanese Red Cross's emergency medical services department, which was the focus of this study, carries out 200,000 medical missions every year, providing emergency support and ambulance care for medical emergencies as well as first aid at major public and sporting events. The Lebanese Red Cross currently operates the only national emergency hotline. With forty-five ambulance stations across the country, supported by an estimated 2,700 first-aid volunteers and 270 ambulances, the service aims to respond to 80% of emergency calls within nine minutes. The Lebanese Red Cross faces significant challenges – not least in providing a national twenty-four-hour emergency service run almost entirely by volunteers and on a low budget – but the professionalism of the highly motivated volunteers results in the provision of reliable and relevant humanitarian emergency services for communities across Lebanon.
Methodology and the relevance of the Fundamental Principles to the study's findings
This article draws on findings from an internal learning review of the operations of the Lebanese Red Cross by representatives of the British Red Cross and the International Committee of the Red Cross (ICRC) in February 2012. The review sought to examine the process and actions undertaken by the Lebanese Red Cross's emergency medical services to manage the acceptance, access and security of its operations and personnel, and the relevance of the Fundamental Principles to this process. The Lebanese Red Cross was chosen in order to draw learning from a National Society known within the International Red Cross and Red Crescent Movement (hereinafter the Movement) for its successful application of the Fundamental Principles.
Conducted over a month, the case study draws on a review of documents and a joint ICRC/British Red Cross eight-day research mission to Lebanon (Beirut, Tyre, Rmaich, Tripoli and Qobeyat). Semi-structured interviews and focus group sessions were held with a range of stakeholders from within and outside the National Society, including several Movement partners, external government and media representatives and family members of the first-aid responders. Guided by a set of questions, the approach was open and iterative in order to understand the rationale, nature and outcomes of the process and the implications for the identity, actions and behaviours of the Lebanese Red Cross and its volunteers, as well as how external actors perceived these. The findings were then analysed to identify the relevance of both the Fundamental Principles and the Safer Access FrameworkFootnote 3 to the Lebanese Red Cross's emergency services operations. Analysis was undertaken in relation to all seven Principles to establish whether and in what ways they were relevant to the emergency medical services of the Lebanese Red Cross.
The research team used the framework below to analyse their findings. This framework, which draws from both National Society and ICRC practice and is an important concept underpinning the Safer Access Framework, depicts how neutral, impartial, independent humanitarian action can enhance acceptance, access and security. This approach recognises that to provide assistance and protection, humanitarian agencies and their personnel and activities must be accepted by both state and non-state armed groups and by communities – specific actions must be taken to reduce risks and increase acceptance and security so as to improve access and thereby support increased assistance and protection for those in need. Effective, relevant and community-based humanitarian services, provided in accordance with the Fundamental Principles and other relevant Movement policies, form its basis. The perception of an organisation – including its public identity and reputation, and how its actions are understood – is critical. In order to provide an effective response, it is important that at all times stakeholders perceive an organisation to be a neutral, independent, impartial provider of relevant humanitarian services. Trust and respect that have previously been established through interactions by carefully trained volunteers and staff with communities and armed actors need to be increasingly fostered and will contribute to greater acceptance of the organisation. This, together with a context-specific operational security risk management approach, should result in enhanced security for staff and volunteers, which, combined with additional measures, will enable them to gain increased access to those in need.
Figure 1. A principled approach to Safer Access.Footnote 4
The success of the Lebanese Red Cross in improving its acceptance, security and access raises an important question of causation. To what degree can this be attributed to the application of the Fundamental Principles alone, or to other organisational strategies and processes, such as the various actions and measures contained in the Safer Access Framework? Is the work of the emergency medical services accepted amongst different communities because of the reliability, quality and effectiveness of the service or because it is delivered in accordance with the Principles, or both? In what way is this influenced by the National Society's investment in the training of volunteers – not only in medical standards, but also in the application of the Fundamental Principles?
While it would be helpful to be able to isolate neatly the effect of the application of the Fundamental Principles, they are standards that guide strategic and operational decisions and influence organisational processes, communications and actions, and are often combined with other acceptance measures. In Lebanon, it was clear to the interviewers that the Principles helped embed shared values, behaviour and identity within the National Society. This was evident from interviews with volunteers and staff as they spoke about themselves, their decision-making, their work and its humanitarian impact in terms of the Principles, ranging from their influence on communication and response strategies to how they recruit volunteers and manage security protocols.
The Fundamental Principles and the work of the International Red Cross and Red Crescent Movement
Today, although the International Red Cross and Red Crescent Movement often treats the Fundamental Principles as revealed wisdom, they are, in reality, the distillation of practical operational experience over a very long period of time and not a priori or normative in origin.Footnote 5
The work of the Movement is underpinned by seven Fundamental Principles – humanity, impartiality, neutrality, independence, voluntary service, unity and universality – which inspire and influence its conduct and activities. Based on, but not codified in, international humanitarian law (IHL), they were agreed in 1965 as a framework for the action and organisation of the Movement.
Fundamental Principles of the International Red Cross and Red Crescent MovementFootnote 6
Humanity: The International Red Cross and Red Crescent Movement, born of a desire to bring assistance without discrimination to the wounded on the battlefield, endeavours, in its international and national capacity, to prevent and alleviate human suffering wherever it may be found. Its purpose is to protect life and health and to ensure respect for the human being. It promotes mutual understanding, friendship, cooperation and lasting peace amongst all peoples.
Impartiality: It makes no discrimination as to nationality, race, religious beliefs, class or political opinions. It endeavours to relieve the suffering of individuals, being guided solely by their needs, and to give priority to the most urgent cases of distress.
Neutrality: In order to continue to enjoy the confidence of all, the Movement may not take sides in hostilities or engage at any time in controversies of a political, racial, religious or ideological nature.
Independence: The Movement is independent. The National Societies, while auxiliaries in the humanitarian services of their governments and subject to the laws of their respective countries, must always maintain their autonomy so that they may be able at all times to act in accordance with the principles of the Movement.
Voluntary service: It is a voluntary relief movement not prompted in any manner by desire for gain.
Unity: There can be only one Red Cross or one Red Crescent Society in any one country. It must be open to all. It must carry on its humanitarian work throughout its territory.
Universality: The International Red Cross and Red Crescent Movement, in which all Societies have equal status and share equal responsibilities and duties in helping each other, is worldwide.
According to Jean Pictet, the celebrated ICRC lawyer and commentator on the Fundamental Principles, there is a clear hierarchy of Principles. Humanity and impartiality ‘stand above all contingencies’ as ‘substantive’ Principles; moral goods in and of themselves. Neutrality and independence are ‘substantive’ Principles of utility, which help to achieve humanity and impartiality. These two tiers of Principles thus reflect both their moral intent and practical orientation. Voluntary action, unity and universality are seen as less far-reaching than other Principles and describe the ideals of a Red Cross/Red Crescent institutional organisation.Footnote 7 Although the work of the Movement is underpinned by all seven of the Fundamental Principles, those of humanity, impartiality, neutrality and independence are particularly significant in the context of collective violence.
Attention to the operational relevance of the Fundamental Principles
Many organisations have since adopted elements of the Principles of the Movement. Humanity, impartiality and independence are referred to in the Code of Conduct for the International Red Cross Red Crescent Movement and NGOs in Disaster Relief, which has been adopted by 522 organisations at the time of writing.Footnote 8 Within and outside the Movement, the Principles are often perceived first and foremost as an expression of values and ideals. Their relevance as an operational, decision-making and guide-to-conduct tool is often underestimated or under-analysed. Surprisingly, the Movement has provided limited public accounts of the benefits of adherence to its Fundamental Principles and how they are achieved in practice, except for the newly produced Safer Access guide for National Societies.Footnote 9 Where accounts do exist, they tend to be by NGOs or humanitarian specialists; a recent description of the neutral action by the ICRC in Afghanistan is an important exception.Footnote 10
The limited attention within the humanitarian community to the operational importance and relevance of applying the Principles can, to a degree, be explained by a lack of in-depth knowledge and training on how they can be used. Many claim that the Principles are often applied very loosely in accordance with various organisational interests, or are disputed or misunderstood.Footnote 11 A recent ‘State of the System’ report, for example, highlighted the limited understanding amongst humanitarian staff of humanitarian principles and IHL, whilst reviews of humanitarian action in response to the so-called ‘IDP crisis’ in Pakistan in 2009 highlighted the challenges faced by the United Nations (UN) and NGOs in ensuring principled humanitarian action in a highly politicised context where doing so would risk access due to efforts by the Pakistan government to downplay the crisis and Western governments' interest in using the crisis as an opportunity for more comprehensive stabilisation agendas.Footnote 12 Such shortcomings are not, however, the preserve of non-Movement actors. Fiona Terry has noted the inconsistent application of the Fundamental Principles by different components of the Movement, for instance,Footnote 13 whilst Pictet himself has recognised that the Principles are ideals to aspire to and argued that no Red Cross or Red Crescent Society has put this ‘doctrine into effect at all times and in its totality’.Footnote 14
This lack of appreciation of the practical relevance of the Principles is further compounded by what Collinson and Elhawary describe as ‘a preoccupation with the role that external actors play in challenging humanitarian action’.Footnote 15 For example, national and donor governments can manipulate aid for their own political or military purposes;Footnote 16 stabilisation operations blur the lines between military and humanitarian actors;Footnote 17 counter-terrorism legislation criminalises humanitarian support to areas controlled by proscribed groups, thus undermining impartial humanitarian action;Footnote 18 the list goes on. Whilst not underplaying the important impact of these issues on humanitarian action, this sweeping externalisation of challenges means that there is also limited reflection on the responsibilities of humanitarian actors themselves to ensure that they are indeed focused and delivering on humanitarian objectives and applying humanitarian principles systematically. It also means that limited attention is applied to examining when and whether increased adherence to humanitarian principles can influence access and operational space in specific contexts. A parallel and related challenge to humanitarian principles emanates most often from within the aid sector. Faced with the limitations of humanitarian action in contexts such as Rwanda and Bosnia, where relief was critiqued as doing more harm than good by fuelling and failing to address the underlying causes of conflict, many question the ethical basis of neutrality in particular and call for a more politicised form of humanitarian action, as Oxfam for example did in relation to Somalia and Kosovo.Footnote 19
One of the implications is that these viewpoints create the perception that humanitarian principles are from a more politically straightforward ‘golden age’ of humanitarianism and are no longer relevant to the complexities and problems faced today. However, as SmillieFootnote 20 describes, this underplays a more complex and politicised history of humanitarianism replete, for example, with precedents of political inaction in the face of mass suffering (the 1915 Armenian genocide, the 1935 Italian invasion of Abyssinia, the short-lived secession of Biafra in 1967) and of military action on the grounds of humanitarianism (the 1824 Russian, British and French Anti-Ottoman intervention in the Greek war of independence, the 1860–1861 French expedition in Syria, the 1877 Russian anti-Ottoman intervention in Bulgaria). This limited engagement, understanding and application of humanitarian principles also narrows the purpose of humanitarian action to material relief rather than the broader purpose of ‘protect[ing] life and health’ and ‘ensur[ing] respect for the human being’ found in the Fundamental Principle of humanity, for example, thus again reducing its relevance.Footnote 21
Importantly, these narratives also ignore the contingent aspect of humanitarian action and the significance of respect for the application of humanitarian principles in humanitarian negotiations precisely because of the enduring challenges of providing humanitarian assistance in complex environments. Although this is often forgotten, there is no automatic right of access for humanitarian agencies under IHL; rather, this access is a process of negotiation between parties to the conflict and humanitarian agencies. It could almost be described as a negative right – that humanitarian agencies cannot be obstructed if certain conditions are met. Under the Geneva Conventions, warring parties have the primary responsibility to ensure the humane treatment of those not participating in hostilities,Footnote 22 but impartial humanitarian agencies can offer their services.Footnote 23 Customary humanitarian law establishes that parties to both international and non-international conflicts must allow and facilitate the rapid and unimpeded passage of humanitarian relief which is impartial in character and conducted without any adverse distinction, subject to their right of control.Footnote 24 This assumes a responsibility on the part of humanitarian agencies to demonstrate that they are indeed impartial and neutral in character so that they can come to the negotiating table to offer their services, and that access cannot be denied where the needs of those not participating in conflict are not met. However, by emphasising the limitations posed by external threats to principled action and focusing less on the accountabilities of humanitarian agencies themselves, there is arguably less incentive for humanitarian agencies to move beyond what are often rhetorical assertions of being principled and to explore in context-specific and nuanced ways how their actions and principles can be used to negotiate and navigate complex operating environments.
National Societies and the Fundamental Principles
Despite the importance of the Fundamental Principles to Red Cross and Red Crescent National Societies, their experience in applying the Fundamental Principles is largely absent from the humanitarian literature, which is partially explicable by the lack of research on the challenges and dilemmas faced by national organisations involved in humanitarian service delivery during conflict. This is despite the fact that with the onset of conflict, a National Society may have to shift quickly from its usual disaster response mechanisms to those required for operating securely in conflict, such as negotiating access with various local and national actors and adapting its methods of providing assistance and protection.
The ICRC, together with National Societies, has developed a guide, centred on the Safer Access Framework, to support National Societies in increasing their acceptance, security and access. When applying the guide, National Societies first reflect on their operational experiences within their context (past, present and anticipated) and isolate the root causes of the barriers, gaps and challenges to their acceptance, security and access to people and communities in need in sensitive and insecure contexts including armed conflict, internal disturbances and tensions.Footnote 25 They then define and take specific interlinked actions and measures – many of them associated with the application of the Fundamental Principles – which have been proven to address these challenges. The Framework is underpinned by the Safer Access cycle outlined above (perceptions, acceptance, security and access) and infused by the application of the Fundamental Principles.
Elements of the Safer Access FrameworkFootnote 26
The following elements are essential considerations for all National Societies in their efforts to gain and maintain safer access to people and communities affected by sensitive and insecure contexts including armed conflict, internal disturbances and tensions in order to provide protection and assistance.
Context and risk assessment and analysis: National Societies should have a clear understanding of the environments in which they operate and of the associated risks so that they can prevent and manage those risks in order to operate safely and effectively.
National Societies' legal and policy basis for action: Sound statutory and legal instruments and an equally sound policy base are very important in terms of facilitating access to restricted areas during armed conflict, internal disturbances and tensions.
Acceptance of the organisation: Providing relevant humanitarian services for the most vulnerable in accordance with the Fundamental Principles and other Movement policies helps National Societies to gain acceptance, which in turn contributes to security and hence helps to improve access to those in need.
Acceptance of the individual: To facilitate acceptance, National Society volunteers and staff should be representative of the community that they serve and should be recruited and deployed on the basis of their ability to represent their National Society and to adhere to the Fundamental Principles of the Movement.
Identification: National Societies should take initiatives to strengthen their image and that of the Movement, for example linking the public's image of the Red Cross or Red Crescent to the emblem, supporting their governments in fulfilling their responsibility to prevent and address misuse of the emblem, and developing and enforcing internal guidelines on the use of the emblem.
External communications: A well-developed communications strategy, systems, procedures and implementation plan, coordinated with other components of the Movement and supported with the necessary tools and resources, reinforces the positive image and position of the National Societies and the Movement at the same time as fulfilling operational communication needs. This, in turn, can have a positive impact on access.
Internal communications: The effectiveness of a response and the safety of National Society staff and volunteers are highly dependent on the unobstructed flow and analysis of information between the field and headquarters as well as between the National Society, the ICRC and other Movement components. Appropriate systems, procedures and equipment are therefore required.
Security and risk management: A security/risk management system can increase the safety of National Society staff and volunteers and their access to affected people and communities. To that end, the system should include well-defined security guidelines and protective measures that are based on ongoing context and risk assessment, coordinated with other Movement components and fully incorporated into response procedures, training and response operations.
Application of the Principles by the Lebanese Red Cross
Lebanon's history of armed conflict, internal disturbances and tensions, along with the overall sensitive operational context due to the need to navigate various confessional interests, has compelled the Lebanese Red Cross to develop and sustain approaches that help to build trust in and acceptance of the emergency medical services and the staff and volunteers who run it. In the late 1980s the organisation suffered a series of security incidents, which impacted its staff, volunteers and assets. For example, one incident resulted in a fleet of newly donated vehicles, clearly marked with the red cross emblem, being commandeered by armed actors.
Working closely with the ICRC, the Lebanese Red Cross undertook concerted action to improve its operational approach, including efforts to build its acceptance, access and security. The Fundamental Principles were central to this work. The Fundamental Principles are not codified and there is no specific guidance on their application, but in a National Society drawn from a deeply divided nation, the Principles' secular standards provided an objective language, a guide to conduct and a decision-making framework that underpinned this strategy. Today, the Fundamental Principles influence a range of Lebanese Red Cross organisational priorities, such as the importance attributed to the ability of the emergency medical services to respond to needs throughout Lebanon; the selection, profile and make-up of its volunteers; and the increased level of coordination and association with the authorities and other key stakeholders. They also connect and anchor the leadership and volunteers' operational approach and their ability to explain and justify their actions internally and to external actors.
The Lebanese Red Cross recognises that deliberate and systematic action is required to apply the Fundamental Principles. The Fundamental Principles are used to guide the communications and operational decision-making of emergency medical services staff and volunteers. It is clear from staff and volunteers that the Fundamental Principles are living instruments. Lebanese Red Cross staff and volunteers at every level – from first-aid volunteers to the director of operations – were able to supply specific practical examples of how they had used the Fundamental Principles personally or of how they had observed them being applied within the emergency medical services department.
The interplay between the Fundamental Principles
In a context of sectarian divisions, neutral, impartial and independent humanitarian action is paramount to engendering trust and acceptance amongst different Lebanese communities. Strict neutrality is demanded from and imposed on all staff and volunteers by the Lebanese Red Cross leadership. During the recruitment process, prospective volunteers must sign a neutrality oath, and formal and informal checks with communities are often undertaken by the Lebanese Red Cross to make sure that the applicants are not actively affiliated to any political group. The neutral composition of the workforce of the Lebanese Red Cross is reinforced by a history of volunteering with the Red Cross as an alternative to being conscripted by militia forces during the civil war. This view of the Lebanese Red Cross as a kind of sanctuary is still evident today in the face of confessional divisions within society and some continuing conscription; parents of volunteers drew particular attention to this aspect of volunteering, which they perceive as positive. The Lebanese Red Cross's neutrality is a considerable draw for some young people who are uncomfortable with the system of confessionalism and limited meritocracy that persists in Lebanon today.
The Lebanese Red Cross's neutrality is complemented by its impartial and universal approach of working with those in need irrespective of their political, religious or other affiliations. Knowing that the emergency medical service is available to all confessional groups throughout Lebanon, without discrimination, reinforces the confidence of the population that their service is delivered impartially. There are a number of other ambulance service providers in Lebanon, including the Ministry of Health, military actors, charitable organisations, confessional groups and the Lebanese Armed Forces, but the Lebanese Red Cross is the only one which can operate universally throughout Lebanon and which enjoys a high degree of confidence and acceptance among Lebanon's eighteen confessional groupings. In interviews, volunteers provided numerous examples of how they act impartially. One such example occurred during violent clashes in 2007 between the Lebanese Armed Forces and an armed Palestinian group in the Nahr el-Bared refugee camp.Footnote 27 Volunteers spoke proudly of providing both sides with medical services, according to need. This was true even of volunteers who had siblings, spouses and friends actively engaged in the fighting as members of the Armed Forces. One stated, ‘The person is a person; we don't care who it is.’
Although the Lebanese Red Cross operates as an auxiliary to the government, its independence is valued and guarded fiercely both by the leadership of the National Society and by the public authorities themselves, which have at times faced challenges in providing humanitarian assistance in some communities. The Lebanese Red Cross's role in running the national ambulance service means that daily liaison with the authorities is often required, for instance to ensure coordinated planning for receiving and transporting sensitive cases from across the border or for public events. Representatives of the Lebanese Armed Forces, the Civil Defence and the Ministry of Health all reported the importance of having an independent, neutral humanitarian actor that could provide services for people residing in all areas and communities. Given this high level of coordination with the authorities, it is important for the Lebanese Red Cross to also retain autonomy over operational decision-making and to maintain an organisational distance from all stakeholders, in both reality and perception. Examples of independent action include challenging a government request to open a station in a particular location; safeguarding perceptions of neutrality by refusing to be on stand-by for the Civil Defence during demonstrations, preferring rather to be on call for everyone through the national hotline; and transferring patients to treatment locations where it was believed that they would feel safe instead of following advice from the authorities to deliver them to an alternative location. Of course, to manage these sensitive situations, an open and trustful relationship and dialogue must accompany these actions.
It is clear that it is not just humanity, neutrality, impartiality and independence that are important for acceptance of the Lebanese Red Cross, but also the other three Principles of voluntary service, unity and universality (covering the needs of the entire country, thus reinforcing the Principle of impartiality). These are also of great significance, highlighting the mutually reinforcing interplay between all of the Fundamental Principles.
Most notable is the Lebanese Red Cross's application of the Principle of voluntary service. The commitment of the volunteers providing emergency medical services to the work and approach of the Lebanese Red Cross is particularly noteworthy and inspiring. Each volunteer provides twelve hours of service one day a week and thirty-six hours one weekend a month, ensuring that the entirely voluntary national ambulance service operates effectively. A strong team spirit contributes to a sense of collective enterprise, and this is developed not only through commitment to the work itself but also through the humanitarian ethos developed through the understanding and application of the Fundamental Principles. Team spirit and unity of action is developed further by the need for each station to improvise in order to maintain services due to budget shortfalls. In interviews, volunteers recounted recycling non-essential items, using substitutes where possible (for example, old ties as slings) and even paying out of their own pockets to ensure that the service continues. Many of the thirty-five paid members of staff started their work with the Lebanese Red Cross as volunteers. All of them, including the then director of the emergency medical services, continue to volunteer at the ambulance stations in their spare time.
Training, mentoring and leadership in ensuring adherence to the Fundamental Principles
The experience of the Lebanese Red Cross demonstrates the importance of building an understanding and application of the Principles on the ground and of the role of the leadership in engendering a culture where the Fundamental Principles are respected and used to guide strategic and operational decision-making as well as everyday conduct. Lebanese Red Cross volunteers' adherence to the Fundamental Principles is reinforced by consistent mentoring and training, although informal approaches and codes of behaviour are more important in a National Society where funding is limited. No political or religious discussions are allowed at ambulance stations (at some, the news is turned off to discourage reactions), and joint celebrations of religious festivals are organised between stations to promote a sense of unity, understanding and tolerance. The importance of understanding and of applying the Fundamental Principles is reinforced through example and mentoring by the experienced leadership and peers. They remind volunteers of the danger of one ‘rotten apple’ or one action or word ruining the National Society's reputation and set an example for more junior volunteers through their commitment to the systematic application of the Fundamental Principles. There is a strong hierarchical structure at the stations, where orders are expected to be followed fully. Contraventions are punished by shame and sanctions, with behaviour warnings publicly displayed at ambulance stations.
The perception of the neutrality of staff and volunteers and a sense of unity and camaraderie are reinforced at times by the use of nicknames The acceptance by external stakeholders of the Lebanese Red Cross's cadre of 2,700 volunteers is enhanced through the use of ‘neutral’ names and enhances their ability to be deployed everywhere in Lebanon, regardless of their personal affiliation or background. Historically, the personal acceptance of individuals has been challenged by different actors, usually on the basis of religion or due to the profile of an individual volunteer. An important aspect of gaining acceptance has been ensuring representation from the eighteen different confessional groups among staff and volunteers, while another focus has been on ensuring that both women and men are represented in teams that operate in socially conservative areas, whose residents may not be comfortable with male health workers providing humanitarian assistance to female victims.
Perceptions, acceptance and security
In today's volatile operating environments, acceptance of humanitarian action by local authorities and communities needs to be approached as a process rather than as an event, requiring presence, time, and sustained engagement with all relevant parties, including non-state actors as well as influential political, military, or religious leaders.Footnote 28
The Lebanese Red Cross's approach to acceptance centres on the provision of relevant and effective humanitarian services in accordance with the Fundamental Principles. This is accompanied by a concerted strategy to take the necessary actions and measures required to establish understanding, trust, respect and acceptance for the work and approach of the National Society amongst different groups.
Relevant and effective humanitarian action
Be clear of what your capacity is and do not promise more … keep some capacity in reserve … put stones in your pocket or you will fly.Footnote 29
The Lebanese Red Cross's wide access is dependent on the quality, reliability and effectiveness of its much-needed emergency services work. However, its 24/7 ambulance services also provide the necessary infrastructure, capacity and responsiveness to mobilise other humanitarian services quickly in an emergency. In interveiws, the leadership indicated the importance of the Lebanese Red Cross following through on its stated commitments so that confidence and trust in its work is earned and maintained. The leaders stated that the history of armed conflict, internal disturbances and tensions in Lebanon is such that the Lebanese Red Cross has proved itself to everyone over time, indicating, for example, how the 2006 armed conflict with Israel was important in developing further the Lebanese Red Cross's acceptance by Hezbollah to ensure access to those in need.
Repeated attention was drawn to the need for consistency in messages and adherence to strict communication lines, together with having the skills, strength and experience to take a principled stand in challenging circumstances, and at times to have the courage to say ‘no’. As a senior manager stated: ‘each decision is crucial; it can have serious implications. There is so much pressure on leaders. Many conversations are tough. In a stressful situation, you must know that you are strong.’
Building networks and relationships of trust
The security incidents in the 1980s triggered efforts by the Lebanese Red Cross leadership to widen its network of contacts, deepen its relations with stakeholders and communicate information about its work. Contacts developed at that time have been maintained and fostered, with the result that the leadership has established trustful relationships with many of the key people in government, with the Lebanese Armed Forces and within the various confessional groups today, highlighting the importance of investing in relationships and developing trust over time.
A significant amount of time is devoted to communicating the work and approach of the Lebanese Red Cross and cultivating and maintaining relationships. Senior representatives are appointed on the basis of their ability to undertake these roles. The Lebanese Red Cross's relationships are very strong at the central level and are replicated in all districts across Lebanon and Lebanese Red Cross ambulance stations, where the station heads emphasise how much of their time and attention is devoted to maintaining a strong network of local contacts. Relationships are built with political, military and community leaders during peacetime or before new operations and then drawn upon during armed conflicts, internal disturbances and tensions to secure safe passage. As one station head mentioned: ‘Even if you do not have any business, you need to regularly make contact … [You must] ensure they understand the mission of the Red Cross, convince them on the value of how we work and then later, during an operation, it is easier to make contact to secure safe passage.’ The depth and breadth of positive relationships are such that other Red Cross partners in Lebanon spoke of the credibility that they attained from being associated with the Lebanese Red Cross.
The Lebanese Red Cross's effective and principled humanitarian action, combined with relevant, reliable and quality service delivery and its investment in building relationships of trust and respect, has resulted in a very positive reputation across Lebanon. A 2007 poll found extraordinarily high levels of awareness of the Lebanese Red Cross (almost 100% recognition) and its work, with correspondingly high positive perceptions. While the National Society conducts sessions on the Movement, IHL and the Fundamental Principles with civil society groups, universities and different community groups, its positive reputation is largely generated by its sustained work on the ground, which is spread through word of mouth and profiled in the media. As one government official explained: ‘They are protected by their activities … From 1975 until now, they have gained their reputation through demonstration.’
These positive perceptions mean that today, the Lebanese Red Cross is the only public service and Lebanese humanitarian actor that enjoys national reach in Lebanon. According to the leadership, this is due to its conscious and systematic efforts to use the Fundamental Principles as a foundation for gaining access to all affected populations.
Challenges to acceptance and security
Acceptance is the cornerstone of the organisation's security strategy, although some protective and deterrence measures, such as the use of ballistic vests and driving in convoys and/or relays, are also employed.Footnote 30 This elaborate and well-honed system has been built up over many years and there is heavy reliance on the knowledge, experience and authority of the veteran leadership and its network of contacts to ensure the safety of the work and volunteers. There are limited formal security management structures, and systems and procedures are not fully integrated into the volunteers' work. Although the volunteers receive some security training, there is a high degree of risk tolerance and the leadership readily admits that one of the challenges is to hold back over-enthusiastic volunteers from entering high-risk environments. Operational reviews are mandatory after each response and although there is significant peer support and kinship between the volunteers, more formal psychological support is not available, despite the significant trauma that volunteers can witness and even experience first-hand. This lack of formal integration of security management adds to the high degree of stress on the leaders as responsibility for security rests solely on their shoulders.
Challenges to the Lebanese Red Cross's acceptance in international armed conflict include a number of serious security incidents during the 2006 armed conflict, which underscore the limitations of over-reliance on acceptance strategies alone for security and the need for a greater investment in more formal and diverse security measures. These limitations were brought home all too clearly to the Lebanese Red Cross in an incident near Qana in south Lebanon during the 2006 armed conflict with Israel. Civilians were being transferred by two clearly marked, well-lit and security-cleared Red Cross ambulances with Red Cross flags on the sides and flashing blue strobe lights on the roofs. Despite these markings, a missile struck the first ambulance and a further attack struck the second ambulance a few minutes later. Nine Red Cross volunteers and patients were injured. The incident severely damaged the affected volunteers' trust in the power and protection of the Fundamental Principles, the protective emblem and the ability of the Movement to secure safe access. For many, it highlighted how the Lebanese Red Cross can, over time, attain high levels of access and security in non-international armed conflicts, internal disturbances and tensions through extensive and deep contacts with all stakeholders which build high levels of trust. However, in an international armed conflict, where direct contact by the Lebanese Red Cross with the authorities of the opposing side is most often not possible, relationships of trust are more difficult or even impossible to establish.
This example highlights that despite employing various operational strategies and applying the Fundamental Principles fully, unpredictable operational factors can affect safety and access drastically. It shows that while the Principles can serve as a framework for action and decision-making, they must be accompanied by other operational measures (not least rigorous security measures) – and even then, they have their limitations in certain contexts. It also shows that although they can serve as tools for access and security, their value is contingent not only on the manner in which they are applied, but also on the decisions and actions of armed actors.
Conclusion
The experience of the Lebanese Red Cross highlights that the Fundamental Principles are more than an abstract code or ideological commitment. Applied systematically, they can have important operational benefits and can help improve the effective delivery of humanitarian services.
The Fundamental Principles provide operational tools to guide communication, decision-making and the conduct of activities and serve as a basis for acceptance by different interlocutors for the National Society. When combined with strategies, actions and measures focused on building trustful relationships and acceptance and on increasing the security of its personnel, and through the delivery of reliable high-quality services over time, their impact is compounded. Limitations exist in contexts where the National Society does not have direct contact with the authorities of one or more groups or parties to the conflict and it must be understood that the dynamics of the context can thwart the protective aspect offered by systematic application of the Fundamental Principles.
Having built up its experience over the past twenty-five years, there are a number of lessons to be drawn from the Lebanese Red Cross for other National Societies and humanitarian agencies in other contexts. These include:
• A deliberate, structured strategy for gaining and maintaining access safely and for applying the Fundamental Principles is required. Time and experience are essential; acceptance cannot be achieved overnight and is stronger when systematic actions and measures are taken during peacetime.
• For National Societies, the human resource base should be representative of the people whom it serves. Its members must adhere to the Fundamental Principles at all times, inside and outside work, and must be perceived to think and to act neutrally and impartially.
• Applying all Fundamental Principles, not just humanity, neutrality, impartiality and independence, is important for the acceptance of a National Society. The ‘other’ three Principles – voluntary service, unity and universality – are distinctive to the Movement and their application also contributes toward the acceptance and operational access of a National Society.
• Organisations are judged by what they do and how they perform their actions on the ground rather than by words, making it important for promises to be kept and effective delivery to be ensured. Trust and credibility can be established by the consistent provision of effective, relevant community-based services during peacetime, as well as during armed conflict, internal disturbances and tensions. Impartiality must be demonstrated through actions.
• Challenges should be resolved by early and swift action and should be seen as an opportunity to reinforce the organisation's principles and its acceptance. Strong, experienced leadership, consistency and good internal communication are all required.
• A large number of contacts at all levels and strong relationships of trust and respect with key stakeholders are essential. Systematic demonstration and communication of the organisation's work, objectives and principles must take place.
The experience in Lebanon confirms the findings of studies that have highlighted the limitations of over-reliance on acceptance-based strategies alone, highlighting for example the security challenges posed in highly political or criminal environments or in contexts where targeting of aid organisations or their staff is deliberate.Footnote 31
Despite the significance of the Fundamental Principles to the Movement and their enduring effectiveness as operational tools, there has been little recent articulation of their operational value and limitations in the crises of today. This is particularly surprising given the present level of external debate regarding humanitarian principles and their relevance.
Current debates tend to focus on their relevance to international humanitarian organisations in armed conflict, but the Lebanon case study has highlighted the importance of humanitarian principles for national actors and of applying them at all times – even in peaceful environments, as well as during times of armed conflict, internal disturbances or tensions. The work of National Societies in peacetime or in periods of armed conflict, internal disturbances and tensions suggests that their experience might be of interest both to other national actors and to multi-mandate organisations. These are issues that have yet to be explored fully.
Questions are sometimes raised as to whether a National Society can ever implement fully the Fundamental Principles, due to suggestions that National Societies' auxiliary role to their governments may at times be incompatible with their independence. The autonomy of action exhibited by the Lebanese Red Cross and the value that the authorities place on it suggest otherwise. The Lebanon case study was chosen due to the potential for capturing good practice that might be relevant elsewhere, but in order to understand the value of the Principles it will be important to reflect on less positive examples – including where the authorities are less willing to allow independent action. These questions – as well as the positive lessons learned from Lebanon – suggest that there is much to be gained from the Movement, in particular National Societies, by increasing its engagement in debates regarding humanitarian principles, and using its experience – both positive and negative – to understand better the role of humanitarian principles in helping to meet the needs of those in crisis.
