Context and Legal Considerations

Several actors are usually involved in consular crisis management operations. The country in which the disaster event has occurred is responsible for assisting affected people in general, and is therefore an essential stakeholder. The MFA in all countries has the overall responsibility for consular crisis operations abroad and an interest in both the nationals of their country and in diplomatic relations. Interstate organizations, such as the European Union (EU), have several interests in consular crisis management: to protect and offer consular assistance, to coordinate consular assistance, and to analyze and take action on interests occurring outside the EU.^{Reference Lindström4} Travel agencies and travel insurance companies are important actors, even if “force major” clauses may hamper their ability to provide services at the usual level for affected individuals.^{Reference Morakabati, Page and Fletcher5} Non-governmental organizations, including faith-based organizations, may also be involved in the consular crisis management operation, as well as military resources. Finally, humanitarian organizations may be part of the general disaster response and are therefore partly involved in consular matters, even if it is not part of their primary focus.

Disaster management in general is characterized by complex situations in which the common challenges include, for example, collaboration, logistics, priorities, and complex problem solving under stress.^{Reference Steigenberger6,Reference Fredholm and Göransson7} All of these aspects are also present in consular crisis management operations. A well-defined and robust response organization with a functional command and control system forms the basis of an effective response. While most consular crisis management operations are active during a short timeframe, from days to weeks, there are exceptions. The Swedish consular crisis management operation in Thailand following the 2004 tsunami lasted for over one year.^{Reference Reports8}

One important difference between humanitarian response and consular crisis response is that consular crisis management operations are not founded primarily on expressions of empathy, but on legal frameworks and agreements focused not on the general population, but on the responding country’s own residents. This may lead to ethical issues, especially among medical professionals. However, removing affected foreigners from a disaster area does frequently ease the burden for the affected country, and can therefore be seen as a valuable contribution to the overall response. Major disasters often activate interstate relief, which may have political and diplomatic implications that can be referred to as disaster diplomacy.^{Reference Streich and Bell Mislan9} Diplomatic relations are also an important part of consular crisis management operations. Understanding “the diplomatic language” and respecting diplomatic concerns are therefore important skills for all professionals involved in consular crisis management operations. The legal basis for consular crisis management operations relies on the Vienna Convention on Consular Relations of 1963.¹⁰ Several specific legal aspects need to be considered in consular crisis management operations, such as determination of nationality, dual nationals, and identifying who is covered under country-specific consular crisis laws or bilateral or interstate agreements of consular crisis operations. Such questions may be regulated differently in different countries.^{1,Reference Haynal, Welsh, Century and Tyler11} It is the nature of consular crisis management operations that they are conducted in other territories. When operating in another country, that country owns the crisis, and their jurisdiction must also be followed in consular matters.^{Reference Tindall12} This may require specific approvals to conduct, for example, medical interventions by foreign medical professionals, even if caring for their own nationals.

A consular crisis most often occurs in the context of a general or humanitarian crisis situation. This relationship between the consular crisis management operation and other relief operations can be organized in different ways. An isolated consular crisis operation may be conducted if the affected population consists mainly of foreign citizens, as in the aftermath of the Bali bombings. If the consular component is integrated with a humanitarian relief operation—for example, when consular personnel are embedded within a team of humanitarian responders—it can be described as an integrated operation. A third strategy involves conducting consular and humanitarian operations as parallel operations. Integrated and parallel teams may profit from joint logistical and practical arrangements.

General and Specific Assistance

Providing drinking water, food, and a safe place to stay are essential in any crisis situation, and are therefore also fundamental in consular crisis management operations. Even if such services have been arranged by local authorities, foreigners tend to depend on representatives from their home countries for assistance. A critical need for people affected by crises abroad is information. Not having access to websites, radio channels, or mobile phone apps; not understanding the language; or having difficulties judging the trustworthiness of information may put foreigners in a situation where they are dependent on information provided by their MFA. Another practical challenge in disasters that involves several nationalities is the spelling of names and difficulties in determining nationality. Constructing lists of survivors or injured may cause confusion among both local authorities and consular entities. Evacuations from a dangerous place to a safer place usually present a logistical challenge in any major consular emergency. Evacuations will affect both airports in the country where the disaster event has occurred and in the home country.^{Reference Deebaj, Castrén and Gunnar13} Organizing an evacuation requires careful planning that must address security and logistics; even so, the process may have psychological health effects for those involved. A recent study indicated that an early evacuation from the disaster area was associated with a higher risk of posttraumatic stress disorder (PTSD) among tourists affected by the 2004 tsunami disaster in Thailand.^{Reference Gudmundsdottir, Hultman and Valdimarsdottir14}

Medical Care, Evacuation, and Psychosocial Support

Providing medical assistance in a foreign country often involves legal issues, such as permission to act as a health professional in another country, but also practical matters such as access to drugs and medical supplies. Therefore, the medical component of consular crisis operations often positions health professionals in a consultancy role acting as mediators between the local hospital and injured foreign citizens. Medical evacuation of severely injured people is another activity of consular crisis management operations. To conduct a controlled medical evacuation of a significant number of severely injured patients requires time and specific skills, and long distances may further complicate the medical evacuation.^{Reference Peytremann, Baduraux, O´Donovan and Loutan15} From a psychosocial perspective, temporary visitors such as tourists are especially vulnerable as they have been disconnected from their normal social networks and likely have only a limited understanding of the local rescue and medical services system. Significant stress reactions and long-lasting psychological problems, including PTSD, have been reported among tourists exposed to disaster experiences abroad.^{Reference Kraemer, Wittmann, Jenewein and Schnyder16-Reference Stevens, Dunsmore and Agho21}

Disaster Victim Identification (DVI)

Funerals, as well as identification and potential repatriation for foreign citizens, are other common activities in consular crisis management operations. The 2001 Bali bombings and the 2004 tsunami disaster in Thailand raised the issue of massive disaster victim identification (DVI) operations necessitating international collaborative efforts.^{Reference Byard, Cooke and Leditsche22} Formally, DVI operations are managed by Interpol and led by local police in close cooperation with international DVI teams. Medical professionals and consular personnel are often involved in the DVI process, both during and after the identification phase.^{Reference Sabah, Alsharqawi and Haddad23,Reference Bolling, Ehrlin and Forsberg24} As DVI operations can take a considerable amount of time, they may be part of both the emergency phase—as part of a specific consular crisis management operation—and the ordinary consular work that follows the disaster.