A Review into the Acute Emergency Response of Operational Partnerships During the Rohingya Refugee Crisis in Cox’s Bazar

Background: The unprecedented influx of Rohingya refugees into Cox’s Bazar, Bangladesh, in 2017 led to a humanitarian emergency requiring large numbers of humanitarian workers to be deployed to the region. The World Health Organization (WHO) contributed to this effort through several well-established deployment mechanisms: the Global Outbreak Alert and Response Network (GOARN) and the Standby Partnerships (SBP). The aim of the study was to capture the views and experiences of those humanitarian workers deployed by WHO through operational partnerships between December 2017 and February 2019.Methods: A mixed methods design was used. A desktop review was conducted to describe the demographics of the humanitarian workers deployed to Cox’s Bazar and the work that was undertaken. Interviews were conducted with a subset of the respondents to elicit their views relating to their roles and contributions to the humanitarian response, challenges during their deployment and how the process could be improved. Thematic analysis was used to identify key themes.Results: We identified sixty-five deployments during the study period. Respondents’ previous experience ranged between 3 and 28 years (mean 9.7 years). The duration of deployment ranged from 8 to 278 days (mean 67 days) and there was a higher representation of workers from Western Pacific and European regions. Forty-one interviews were conducted with people who experienced all aspects of the deployment process. Key themes elicited from interviews related to staffing, the deployment process, the office environment and capacity building. Various issues raised have since been addressed, including the establishment of a sub-office structure, introduction of online training prior to deployment, and a staff wellbeing committee. Conclusions: This study identified successes and areas for improvement for deployments during emergencies. The themes and subthemes elicited can be used to inform policy and practice changes, as well as the development of performance indicators. Common findings between this study and previous literature indicate the pivotal role of staff deployments through partnership agreements during health emergency response operations and a need for continuous improvements of processes to ensure maximum effectiveness.

Ethiopia faces a major humanitarian disaster in Tigray

With no end in sight to Ethiopia’s ongoing northern conflict, a massive humanitarian emergency looks nearly inevitable

Localisation in the Context of UK Government Engagement With the Humanitarian Reform Agenda

Localisation is a key element of the humanitarian reform agenda. However, there are continuing debates regarding its form and emphasis, linked to understandings of the local, the role of the state and the implications for interpretation of humanitarian principles of “de-internationalised” humanitarian response. This paper considers UK engagement with the localisation agenda, particularly through examination of the policies and programmes of the Department for International Development (DFID). The UK was a major contributor to dialogue on localisation at the World Humanitarian Summit of 2016 and has subsequently shown strong support for Grand Bargain commitments and implementation of a larger proportion of programmes involving cash transfers. Overall, however, advance on this agenda has been limited. The paper notes three major areas of constraint. First, logistical concerns have frequently been noted, particularly with respect to tasks such as procurement and financial monitoring. This has limited the engagement of many local actors lacking organisational capacity in these areas. Second, conceptual ambiguity has also played a significant role. Localisation is poorly theorised, and the roles, functions and capacities—beyond procurement of supplies and emergency technical assistance—that local actors may be able to fulfil far more effectively than international ones are not frequently addressed. Narrowly framed understandings of principles such as independence and impartiality, for instance, appear to severely limit confidence in engaging with local religious actors. Third, political considerations appear to have increasingly limited the space for more radical interpretations of the implications of localisation. Successive UK Secretaries of State for International Development have defended the commitment to a fixed proportion of Gross National Income (GNI) for development assistance based on strong public support for UK aid expenditure to reflect national interests and values. In this context, there are few clear political incentives to cede power over decision-making regarding UK Overseas Development Assistance (ODA) to national and local actors in a manner required for fundamental localisation of humanitarian response. Even where there is a clear potential UK interest—for example, bolstering capacity of local actors in contexts vulnerable to humanitarian emergency to avert more costly emergency response—the public perception of capacity strengthening (compared to life-saving humanitarian actions) mitigates against such moves in a climate of contested public spending. The establishment of a merged Foreign Commonwealth and Development Office in 2020 signals the likelihood of a reframing of localisation. While some advancement in terms of some logistical and conceptual barriers may be anticipated, issues of both national interest and public perceptions of national interest seem likely to continue to constrain a more radical implementation of localisation, particularly with current suspension of the commitment to spend 0.7% of GNI on ODA.

História psicossocial das emergências humanitárias: Uma sistematização da resposta brasileira ao impacto da COVID-19 na saúde da população

O objetivo do artigo é apresentar os índices de orientação ideológica do governo brasileiro para o enfrentamento da pandemia de COVID-19, obtidos como resultado do desenvolvimento da pesquisa do Laboratório de Psicopatologia Fundamental em Estudos de Subjetividade e Emergência Humanitária. Nela, foi elaborada a denominação de história psicossocial e clínica das emergências humanitárias para designar o registro sistematizado das pesquisas, informações, ações de governo, estudos de caso, testemunhos, que possibilitem traçar uma história sobre o impacto do contexto de emergências humanitárias – e, mais especificamente, da COVID-19 – na saúde mental das populações. Foram privilegiados os dados obtidos a partir da sistematização: 1.Teórica de referências do pensamento de Sigmund Freud sobre o impacto da emergência humanitária da I Guerra no funcionamento subjetivo; 2.De informações e ações dos países e do governo brasileiro em relação a pandemia de COVID-19, com base na busca de artigos científicos nacionais e internacionais, documentos oficiais da FIOCRUZ, OMS, ONU, IHR e manifestações públicas de autoridades federais em jornais, redes sociais e plataformas de vídeo. Os dados foram coletados, entre 27 de fevereiro de 2020 e 27 de maio de 2021, com base nos seguintes descritores: COVID-19; Emergência humanitária; Políticas de saúde e segurança sanitária; Saúde Mental; Subjetividade; Humanitarian Emergency; Health and health safety policies; Mental health; Subjectivity. Os resultados obtidos foram organizados em quatro eixos: a irrupção da COVID-19; a denominação de emergência humanitária e o impacto da COVID-19 na saúde mental; o aporte financeiro para ciência, tecnologia e inovação no tocante a COVID-19; Ciência e políticas públicas de saúde e segurança sanitária. Eles indicam a elevada orientação ideológica, interferindo na formulação de políticas públicas de saúde para o enfrentamento da pandemia. Os resultados consistiram na formulação de dez índices de orientação ideológica do governo brasileiro para o enfrentamento da pandemia. Eles indicam elevada orientação ideológica, interferindo diretamente na formulação de políticas públicas de saúde e segurança sanitária para sua prevenção e combate.

Providing Food and Nutrition Services during the COVID-19 Surge at the Javits New York Medical Station

Military field hospitals typically provide essential medical care in combat zones. In recent years, the United States (US) Army has deployed these facilities to assist domestic humanitarian emergency and natural disaster response efforts. As part of the nation’s whole-of-government approach to the coronavirus disease (COVID-19) pandemic, directed by the Federal Emergency Management Agency and the Department of Health and Human Services, during New York City’s (NYC) initial surge of COVID-19, from 26 March to 1 May 2020, the US Army erected the Javits New York Medical Station (JNYMS) field hospital to support the city’s overwhelmed healthcare system. The JNYMS tasked a nutrition operations team (NuOp) to provide patient meals and clinical nutrition evaluations to convalescent COVID-19 patients. However, few guidelines were available for conducting emergency nutrition and dietary response efforts prior to the field hospital’s opening. In this case study, we summarize the experiences of the NuOp at the JNYMS field hospital, to disseminate the best practices for future field hospital deployments. We then explain the challenges in service performance, due to information, personnel, supply, and equipment shortages. We conclude by describing the nutrition service protocols that have been implemented to overcome these challenges, including creating a standardized recordkeeping system for patient nutrition information, developing a meal tracking system to forecast meal requirements with food service contractors, and establishing a training and staffing model for military-to-civilian command transition. We highlight the need for a standardized humanitarian emergency nutrition service response framework and propose a Nutrition Response Toolkit for Humanitarian Crises, which offers low-cost, easily adaptable operational protocols for implementation in future field hospital deployments.

Mortality beyond emergency threshold in a silent crisis– results from a population-based mortality survey in Ouaka prefecture, Central African Republic, 2020

Background The Central African Republic (CAR) suffers a protracted conflict and has the second lowest human development index in the world. Available mortality estimates vary and differ in methodology. We undertook a retrospective mortality study in the Ouaka prefecture to obtain reliable mortality data. Methods We conducted a population-based two-stage cluster survey from 9 March to 9 April, 2020 in Ouaka prefecture. We aimed to include 64 clusters of 12 households for a required sample size of 3636 persons. We assigned clusters to communes proportional to population size and then used systematic random sampling to identify cluster starting points from a dataset of buildings in each commune. In addition to the mortality survey questions, we included an open question on challenges faced by the household. Results We completed 50 clusters with 591 participating households including 4000 household members on the interview day. The median household size was 7 (interquartile range (IQR): 4—9). The median age was 12 (IQR: 5—27). The birth rate was 59.0/1000 population (95% confidence interval (95%-CI): 51.7—67.4). The crude and under-five mortality rates (CMR & U5MR) were 1.33 (95%-CI: 1.09—1.61) and 1.87 (95%-CI: 1.37–2.54) deaths/10,000 persons/day, respectively. The most common specified causes of death were malaria/fever (16.0%; 95%-CI: 11.0–22.7), violence (13.2%; 95%-CI: 6.3–25.5), diarrhoea/vomiting (10.6%; 95%-CI: 6.2–17.5), and respiratory infections (8.4%; 95%-CI: 4.6–14.8). The maternal mortality ratio (MMR) was 2525/100,000 live births (95%-CI: 825—5794). Challenges reported by households included health problems and access to healthcare, high number of deaths, lack of potable water, insufficient means of subsistence, food insecurity and violence. Conclusions The CMR, U5MR and MMR exceed previous estimates, and the CMR exceeds the humanitarian emergency threshold. Violence is a major threat to life, and to physical and mental wellbeing. Other causes of death speak to poor living conditions and poor access to healthcare and preventive measures, corroborated by the challenges reported by households. Many areas of CAR face similar challenges to Ouaka. If these results were generalisable across CAR, the country would suffer one of the highest mortality rates in the world, a reminder that the longstanding “silent crisis” continues.

Role of Digital Financial Services in Confronting Covid-19 Crisis in Bangladesh

This study examines the impact of Digital Financial Services (DFSs) in confronting COVID-19 crisis in Bangladesh. It attempts to explore the magnitude of using DFSs along with the efficacy and difficulties of DFSs in coping with humanitarian emergency during COVID-19 pandemic. For analyzing the role of DFSs, the study collects primary data by carrying out a computerized questionnaire survey among 100 respondents. According to the field survey outcomes, DFSs are found useful as transactions can be done efficiently while maintaining social distance. Therefore, an increasing number of people are using DFSs for financial transactions during the pandemic. However, the survey outcomes also report that preferring DFSs over physical cash have many challenges such as data privacy concern, digital fraud, transaction limit problem, difficulty in cashing out and others. If these challenges are addressed properly, DFSs can play an important role in strengthening the resilience of populations during the crisis. JEL classification numbers: G01. Keywords: Digital Financial Services, COVID-19 Crisis, Humanitarian Emergency, Bangladesh.

Ethics and Democracy in Access to Food. The Venezuelan Case

The humanitarian emergency that Venezuela is experiencing, one of whose edges is the food insecurity of more than 80% of the population, coincides with the serious institutional deterioration of the country and with the rupture of the constitutional order under the so-called “socialism of the 21st century” (2005 to the present), as reflected in various reports, including that of the United Nations High Commissioner for Human Rights. Access to food as a fundamental human right is better valued and guaranteed in democracies, where free media and independent public powers function as counterweights to the central executive power and act as effective instruments for correcting the wrong policies in food and nutritional matters, and officials responsible for direct and indirect damages to the general population or to vulnerable groups, are sanctioned. This topic has been studied by Nobel laureate Amartya Sen. In functional democracies, the ethical dimension of the right to food is also better guaranteed, since this right is realized not only by ensuring sufficient, balanced and healthy food, to meet the nutritional needs of the population, but that food is supplied in a culturally acceptable manner and seeking ways, mechanisms and procedures that are not contrary to the dignity of human beings. As a human right, the State has the greatest responsibility in guaranteeing the right to food, but not to fulfill a mere welfare duty or as a benefactor, but to guarantee that no one suffers from hunger or severe malnutrition, providing safe, nutritious and sufficient food, to those who cannot do it themselves, prevent all forms of discrimination in access to food or resources that are used to produce them, such as land, and take measures to ensure that families and their members can feed themselves in a dignified manner. As the Venezuelan regime closed the door to freedoms, malnutrition, hunger and non-fulfillment of the right to food also grew, according to FAO reports and Sen's assumptions under these scenarios seem to hold in the country.

Self-Determination and the Southern Cameroons’ Quest for Sovereign Statehood

In this article, I provide a historical narrative and legal analysis of the Southern Cameroons’ quest for sovereign statehood on the basis of the right to self-determination under international law, which grants entitlement to political independence and to socio-economic and cultural development. This account is motivated by the manner in which the question of self-determination for the Southern Cameroons has been dealt with since the times of decolonisation, resulting in yet another bloody conflict on the African continent. Contrary to the global commitment to secure universal peace and security and the adherence by member states of the African Union to human rights and a peaceful and secure Africa, the escalating conflict in the Southern Cameroons not only challenges these aspirations but has also generated a humanitarian emergency of enormous proportions. Because self-determination is guaranteed to apply unconditionally within the context of decolonisation, I post two important questions. First, why was the Southern Cameroons deprived of the right to sovereign statehood when other trust territories gained independence? Second, is the Southern Cameroons still entitled to assert sovereignty on the basis of the inalienable right to self-determination? In responding to these questions, I explain how self-determination for the Southern Cameroons was compromised and further provide justification for the legitimate quest to sovereign statehood.

Conducting research on building psychosocial support for Syrian refugee families in a humanitarian emergency

BackgroundThis case study describes research, which is located in Turkey, where more than 750,000 Syrian refugees reside autonomously in Istanbul. The research developed and pilot tested a novel model for helping urban refugee families with limited to no access to evidence-based mental health services, by delivering a transdiagnostic family intervention for common mental disorders in health and non-health sector settings using a task-sharing approach. This case study addresses the following question: What challenges were encountered in developing and piloting a low intensity trans-diagnostic family support intervention in a humanitarian emergency setting?DiscussionThe rapidly growing scale of humanitarian crises requires new response capabilities geared towards addressing populations with prolonged high vulnerability to mental health consequences and limited to no access to mental health, health, and social resources.The research team faced multiple challenges in conducting this research in a humanitarian emergency setting including: 1) Non-existent or weak partnerships geared towards mental health research in a humanitarian emergency; 2) Lack of familiarity with task-sharing; 3).Insufficient language and cultural competency; 3) Fit with families’ values and demands; 4) Hardships of urban refugees. Through the research process, the research team learned lessons concerning: 1) building a coalition of academic and humanitarian organization partners; 2) investing in the research capacity building of local researchers and partners; 3) working in a community-collaborative and multi-disciplinary approach.ConclusionConducting research in humanitarian emergency settings calls for innovative collaborative and multidisciplinary approaches to understanding and addressing many sociocultural, contextual, practical and scientific challenge.