Global Disaster Response

We cannot predict when or where disasters will happen, but we know they will, and they are on the rise. In 2012 there were 357 reported natural disasters affecting 120 different countries. According to the United Nations Office for the Coordination of Humanitarian Affairs (UN OCHA), in that same year, 1.4 million people were affected by disasters or displaced by conflict, with billions (in U.S. dollars) spent on disaster response and recovery. This upward trend in numbers affected and economic burden will continue to affect populations increasingly in the future. Increased urbanization, globalization, climate change, and migration of populations because of the scarcity of and resulting competition for resources all contribute to these large-scale disasters. , Disasters can range from sudden or gradual onset “natural” occurrences, such as tsunamis, earthquakes, or droughts to “human-made” or complex emergencies that involve political upheaval and violence or technological disasters, such as chemical spills and radiation exposure. The “humanitarian space” describes the increasingly complex milieu between those needing assistance and those wishing to deliver it. This chapter focuses on the response phase of the disaster management cycle. It is important to understand the unique functions of the various response sectors, the actors, and the necessary skills, attitudes, and behaviors, or competencies, of the workforce in order to function effectively in this space. This workforce has grown at a rate of 6% per annum, and thus we are even more compelled to ensure that those responders are trained as professionals, no matter what their background or specialty.

The key sectors of global disaster response are also known as clusters, essential components necessary to prioritize in order to mitigate disaster effects. In acute settings, humanitarian responders strive to provide for the immediate needs of those affected in terms of shelter, food, medical care, clean water, and sanitation. Additional sectors of logistics, protection, coordination, education, telecommunications, and food security, are just as important. Table 18-1 provides definitions of these sectors. Finally, early transition to recovery is a crucial component of early response that must also be considered. During this transition, those delivering aid need to focus on sustainable interventions, mitigation, and disaster risk reduction to prepare for the future.

Table 18-1

United Nations Office for the Coordination of Humanitarian Affairs: Cluster Coordination Sectors and Their UN-Lead Organizations and Sector Definitions *

(From the UN Office for the Coordination of Humanitarian Affairs, New York, NY, © [2014] United Nations. Reprinted with the permission of the United Nations.)

Cluster Mission Un-Lead Organization
Protection Provide protection to internally displaced persons and other populations affected by nonrefugee emergencies Office of the United Nations High Commissioner for Refugees (UNHCR)
Food security Ensure physical and economic access to sufficient safe and nutritious food that meets the dietary needs of those affected by humanitarian disasters Food and Agriculture Organization (FAO) and World Food Program (WFP)
Emergency telecommunications Provide vital IT and telecommunications services to help humanitarian workers carry out operations efficiently and effectively WFP
Early recovery The restoration of basic services, livelihoods, shelter, governance, security, the rule of law, and environment and social dimensions, including the reintegration of displaced populations United Nations Development Program (UNDP)
Education A formal forum for coordination and collaboration on education in humanitarian crisis United Nations Children’s Fund (UNICEF) and the International Non-governmental Organization (INGO) Save the Children
Sanitation, water, and hygiene (WASH) Improve the predictability, timeliness, and effectiveness of a comprehensive WASH response to humanitarian crisis UNICEF
Logistics To ensure lifesaving relief cargo reaches affected populations in time WFP
Nutrition Safeguard and improve the nutritional status of emergency affected populations by ensuring a coordinated, appropriate response that is predictable, timely, effective, and at scale UNICEF
Emergency shelter Supports country-level shelter clusters and other nonrefugee coordination mechanisms by providing predictable, effective, and timely shelter coordination services to improve humanitarian response UNHCR and the International Federation of the Red Cross (IFCR)
Camp management and coordination Ensure equitable access to services and protection for displaced persons living in communal settings, to improve their quality of life and dignity during displacement, and advocate for solutions while preparing them for life after displacement UNHCR and International Organization for Migration (IOM)
Health Strengthen system-wide humanitarian preparedness by ensuring sufficient capacity in information management; surge; normative guidance and tools; development of the capacities of national stakeholders; as well as advocacy and resource mobilization World Health Organization (WHO)
Information management Collecting, analyzing, and sharing information that is important for the cluster stakeholders to make informed strategic decisions Humanitarian and Emergency Relief Coordinator

* .

There are a multitude of actors working in the diverse but interconnected sectors involved in humanitarian assistance. Most familiar is the United Nations (UN), created in 1945, and its member states. Article 71 of Chapter 10 of the UN charter designates a consultative role for organizations that are neither governments nor member states, referred to as nongovernmental organizations (NGOs). When the UN was formed there were just 45 of these consultative organizations. Now there are well over 33,000, and many more form during crises. NGOs involved in disaster response have an ill-defined classification system. For example, the World Bank divides NGOs into operation and advocacy (or campaigning) groups. In general, NGOs deliver services and play coordination and funding roles in their area of expertise. Other actors in the response process include the military, police, donors, the diaspora, academic institutions, hospitals, and community-based organizations. With so many varied participants it is imperative that they speak a common language, share at least minimum standards, and have a common framework.

This has led to professionalization and standardization in the field of emergency response. , The ability of governments and response organizations to prepare for, mitigate, and respond to humanitarian disasters has increased, while concurrent international standards, frameworks, and guidelines have been developed and implemented. Even though there are still many obstacles to overcome, there has been much progress made, especially during the past decade. The following are but a few of the examples of the transformation now occurring in disaster management:

  • The formation of the Sphere standards in humanitarian response

  • The humanitarian accountability partnership (HAP), a multiagency initiative working to improve accountability in humanitarian actions to people affected by disasters and other crises

  • The progress of the transformation agenda described by the Inter-agency Standing Committee (IASC), a branch of the UN that is a unique interagency forum for coordination, policy development, and decision making involving the key UN and non-UN humanitarian partners

  • The classification and implementation of guidelines for foreign medical teams as defined by the Global Health Cluster

This chapter will explore global disaster response involving humanitarian assistance as it moves toward a more professional framework. Reviewing the history of global disaster response will provide context for the current practices. The actors, sectors, and major organizations will be discussed, as will the current practice and existing standards (through frameworks) for operations. Finally, a review of the challenges in future responses will provide a way forward for our next generation of providers.

Historical perspective

Global disaster response has undergone a transformation since Henry Dunant, a Swiss businessman and social activist, first formulated the concept in 1863. In reaction to the horror of war he witnessed at the 1859 Battle of Solferino, Italy, Dunant became instrumental in the creation of the International Committee of the Red Cross (ICRC), incorporated by the Geneva Society for Public Welfare in 1876. The mission of the ICRC was to be the first politically neutral organization to provide humanitarian relief. In the ensuing years, continued war and conflict, natural disasters and epidemics, and the advent of modern military combat resulted in more populations being affected, and thus to an expansion of the humanitarian aid community. This in turn brought further development and innovation to the field of disaster-response medicine, legal frameworks, and institutional organizations.

The ICRC was formed based upon the humanitarian ideals of neutrality, independence, and impartiality. It was the basis for the adoption of the first Geneva Convention in 1864, a treaty requiring care for wounded soldiers and establishing the use of the Red Cross emblem to protect and provide aid to those removed from combat. Natural disasters and epidemics also played an important role in the growth of aid organizations, and, consequently, regulations for assistance began to emerge. This period in history saw the first international conferences and committees on issues related to disaster and epidemic response, such as the first International Sanitary Conference (1850s) and the International Health, Maritime, and Quarantine Board (1881).

World War I and the Influenza Pandemic of 1918 played a considerable role in the further development of global disaster response. A new disaster taxonomy materialized as food insecurity, pandemic spread, mass displacement, and statelessness, emerged as newer, more complex catastrophes. World War II, however, was the major turning point for the humanitarian sector. More than twice as many civilians as combatants were killed during that conflict. With so many affected civilians and millions of internally displaced populations and refugees, several new humanitarian NGOs were formed, such as the International Rescue Committee (1933), Oxfam (1942), and Catholic Relief Services (1943).

It was during this time that the UN charter was formed (1945), which subsequently led to four Geneva Conventions, adopted in 1949. The Geneva Conventions and Additional Protocols are the backbone of international humanitarian law. These set forth protections for civilians and aid workers, as well as the wounded, ill, and prisoners of war. Another direct result of World War II was the formation of the United Nations High Commissioner for Refugees (UNCHR) in 1950. This organization was initially formed to help those displaced by the war, and it now works with over 33.9 million individuals worldwide who are internally displaced, refugees, returnees, stateless people, or asylum seekers.

After World War II, the United States also addressed the need for global disaster response. Recognizing that the country needed a single agency to coordinate development and international assistance, the Foreign Assistance Act of 1961 was passed, authorizing the development of the U.S. Agency for International Development (USAID) as the single U.S. agency responsible for foreign economic development, including humanitarian assistance. The USAID Office of Foreign Disaster Assistance (OFDA) is tasked to lead the U.S. government’s global disaster response.

In 1971, UN Resolution 2816 established the Office of the UN Disaster Relief Coordinator. The same year, Médecins San Frontières (MSF), translated as Doctors Without Borders, was formed. MSF was a new kind of humanitarian organization, one devoted to the principles of providing medical aid, but also committed to speaking out against the actions of the offending governments and related actors, including the humanitarian sector as a whole. MSF was founded by a group of physicians and has grown to be a lead organization in the medical sector of humanitarian response, creating guidelines for refugee health, books on rapid health assessments, and clinical guidelines for working in remote settings and field hospitals. Unlike the ICRC and the UN, MSF does not wait for diplomatic efforts with state governments to occur before accessing the populations in need.

During the 1980s, conflict and natural disasters continued to influence the further development of the global response field. There were ongoing challenges that included coordination, duplication of efforts, funding, communications, and civil-military interactions. As a direct result, in 1991, the UN General Assembly passed Resolution 46/182, establishing the position of Emergency Relief Coordinator (ERC) and the IASC, the Central Emergency Revolving Fund (CERF), which is now the Central Emergency Response Fund), and the Consolidated Appeal Process (CAP). Resolution 46/182 “… was designed to strengthen the UN response to complex emergencies and natural disasters, while improving the overall effectiveness of humanitarian operations in the field.” One way to accomplish this objective was to make funds immediately available to those who were responding in the field through the CERF and the CAP.

The United Nations Office for the Coordination of Humanitarian Affairs (UN OCHA) was created in 1998. The UN OCHA is responsible for communications, coordination, needs assessments, coordinated funding appeals, and creating humanitarian policies. During this time, the NGO community was working to create common principles and frameworks for providing disaster response. The Sphere Project was launched in 1997 to develop a set of minimum standards in core areas of humanitarian assistance. In 1998 the first edition of the Humanitarian Charter and Minimum Standards in Humanitarian Response (also known as the Sphere standards) was published. This is a handbook for humanitarian organizations created by a consensus of global response agencies striving to improve their work and have more accountability. The handbook sets forth minimum standards, guidelines, and indicators for each of the large sectors, including water, sanitation, and hygiene (WASH), and health. The most recent edition, available for free on the Internet, was revised in 2011. Most workers in the field are familiar with these guidelines, which have become an essential tool for all providers.

In 2005 the UN IASC undertook major humanitarian reforms in which they introduced the coordinated cluster, or sector, approach to humanitarian response. Using the cluster system, groups of UN and non-UN humanitarian actors in the same sector could work together more easily with a designated UN office to oversee the sectoral response at the country level, rather than in the field. At the field level, one NGO usually takes this responsibility.

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Aug 25, 2019 | Posted by in EMERGENCY MEDICINE | Comments Off on Global Disaster Response
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