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To Do No Harm: Humanitarian Aid in Conflict Demands Political Engagement

Published online by Cambridge University Press:  19 January 2018

Ronak B. Patel*
Affiliation:
Harvard Humanitarian Initiative, Cambridge, Massachusetts, Department of Emergency Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts Freeman Spogli Institute for International Studies, Stanford, California
Hannah B. Wild
Affiliation:
Stanford University School of Medicine, Stanford, California
*
Correspondence and reprint requests to Ronak B. Patel, Harvard Humanitarian Initiative, 14 Story St., Second Floor, Cambridge, MA 02138 (e-mail: rbpatel11@bwh.harvard.edu)
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Abstract

Humanitarian aid in settings of conflict has always been fraught with challenges. In the absence of political engagement, however, manipulation by state authorities, however, have the potential to pervert aid intervention to inflict harm. South Sudan exemplifies how states may abuse the humanitarian response to retreat from public responsibility, divert funds to further violence and conflict and dictate the distribution of aid. Recent trends toward nationalist policies in the West that favor disengagement and limited military strikes have the very effect of allowing this abuse to transform humanitarian aid into a tool for harm. (Disaster Med Public Health Preparedness. 2018;12:567–568)

Type
Policy Analysis
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2018 

Given the growing complexity of addressing humanitarian crisis in conflict settings, our response to persistent crises such as the current situation in South Sudan must be evaluated more broadly than one driven by reactive measures. In lieu of true engagement, this approach only perpetuates the suffering of civilians affected by conflict. The current administration’s proposed budget cuts from the State Department and accompanying cuts to the United States Agency for International Development as well as threats to defund the United Nations show a retreat from engagement. This plays into the hands of the perpetrators of violence and allows humanitarian aid to be used as a tool for harm.

Humanitarian aid in settings of conflict is fraught with complexity. As students of humanitarian studies will point out, the birth of modern humanitarianism and the Geneva Conventions can be traced back to the work of Henry Dunant caring for the wounded during the 1859 battle for Solferino. He followed this work by calling for aid organizations to intervene in conflicts as neutral parties, backed by international treaties, to relieve suffering. Humanitarian practice, facing complex challenges, has expanded to encompass the wide array of needs that crisis-affected populations may have from medical care to shelter to livelihoods.

The value and necessity of these humanitarian efforts is not in question. However, as South Sudan illustrates, the complexity of conflicts and the ability of states, as parties to these conflicts, to manipulate humanitarian efforts challenges the best of intentions.

Discussion

Difficulties with humanitarian operations are nothing new. There are multiple examples of humanitarian aid being commandeered by militias for their own use or profit. Hutu militias responsible for the 1994 Rwanda genocide displayed this with frightening skill.Reference Lischer 1 There are further examples of humanitarian access limited by active conflict. Most troubling, and at an increasing rate, humanitarians themselves are targeted and killed with complete disregard for their neutral status. 2 The recent ambush and murder of six aid workers in South Sudan earlier this year is a stark reminder of the great personal risk taken by humanitarians to help those in need. These problems represent, to some extent unavoidable, risks that define humanitarianism. When committed by non-governmental armed actors, these crimes lie beyond immediate legal and diplomatic solutions but continue to spur better practice. Stolen aid, reduced access, and even aid worker deaths diminish the effectiveness of humanitarian efforts but are not arguments against intervention.

In setting of conflict, abuse by governments, however, may have the very effect of manipulating the aid apparatus to harm populations in need through several pathways. South Sudan has shown with striking example, how humanitarian engagement may actually allow governments to ignore their responsibility to their own citizens, divert resources toward conflict and manipulate access to exacerbate harm to specific populations.

The ecosystem of aid organizations in South Sudan effectively acts to provide many goods and services for which the government would normally be responsible. This has saved countless numbers of lives and relieved suffering as intended. However, it has also allowed the government of President Salva Kiir to use this aid as a replacement for its own duties. A 2015 report by the International Growth Center found that South Sudan had over 450 police personnel per 100,000 persons, but only 1.5 doctors and two nurses.Reference Nunberg 3 Liberia, also facing security challenges, by contrast had 108 policemen but 7.1 doctors and 30 nurses per 100,000 people. The government spends 6% of gross domestic product on education and a shockingly paltry 3% on health.Reference Nunberg 3 The amount of humanitarian aid has only expanded in response to the growing need while the government has continued to retreat from its responsibility. Humanitarian aid should supplement government efforts, not subsidize the ongoing conflict.

This retreat has also enabled the government of President Salva Kiir to divert more funds toward the conflict, inflicting further violence and suffering. A confidential report by UN sanctions monitors documented that even as the humanitarian situation deteriorates, the government continued to make arms deals, spending over half of its budget on weapons. Alarmingly, the government’s 2014/2015 budget allocated 62% of its funding to security spending.Reference Nichols 4 There is little doubt that development aid dollars are being directly misused to further the war effort. Plans to use aid as a source of revenue generation have grown even more audacious as the government recently attempted to raise the license fee required by aid workers to operate in the country from $100 per person to $1000. By transforming small scale looting into a national and state-sponsored scale, states can use aid to further violence. By both allowing the state to divert resources away from public services and toward a war effort, aid can facilitate harm.

Despite international humanitarian laws, ensuring humanitarian access has always remained a negotiation in the field but state authorities have taken denying access to a new level. The government and other armed actors can block access to specific populations that are not parties to the conflict but part of a rival ethnic group or seen as loyal to the opposition. As a party to the conflict, the government creates need in specific areas through violence. By denying aid to these same areas, it compounds the suffering. Using this strategy, the government of South Sudan has been able to steer resources toward locations it wishes and away from others. The government can effectively dictate which populations are served and which continue to suffer both by its armed forces and by the denial of humanitarian corridors in the name of security.Reference Shimanyula and Meier 5 This form of control over aid by controlling access while contributing to the violence and suffering allows the state to exacerbate harm in a targeted manner.

Conclusion

The situation in South Sudan is complex and exposes many limitations about the current approach to complex humanitarian crises. Clearly, with a declared famine, simply withdrawing and leaving such desperate populations on the brink of widespread starvation is not an option. The immediate effect would be disastrous as large swaths of the population depend on the humanitarian system for survival. However, the question of how much harm is caused and furthered by allowing the government to manipulate an aid response divorced from a political solution is valid. The example of South Sudan tips the scales heavily toward harm.

The government of South Sudan is an amoral actor fueling conflict and suffering in the guise of a state and using that status to manipulate the humanitarian system. A more engaged approach is required. Many have been offered, from using peacekeepers to force humanitarian access all the way to dissolving the current government and making South Sudan a trustee state of the African Union or UN. Funding for intensive community-based conflict resolution among warring groups may hold even more promise. Humanitarian intervention cannot be prescribed as he sole remedy in conflicts zones. It must be an adjunct to active efforts by the international community to end the conflict. It remains unclear when and if any lasting solution will move forward as there seems to be no end in sight to the downward spiral. Meanwhile, the international community must ask itself how much harm is being caused by continued humanitarian engagement without a strong push for conflict resolution and what can be done about it.

Acknowledgment

None.

Funding

None.

References

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3. Nunberg, B. South Sudan’s civil service challenges: an outside perspective. International Growth Center Working Paper, 2015. http://www.theigc.org/wp-content/uploads/2015/09/Nunberg-2015-Working-paper.pdf. Accessed April 12, 2017.Google Scholar
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