Historical perspective

Historically, there is evidence of both Eastern and Western humanitarian gestures, that is, the will and action to alleviate the suffering of others in response to natural and human-made disasters. Conceptually humanitarian work roughly parallels human history itself as it seems reasonable to postulate that family members, friends, relatives, and tribal brothers of the victims must have mounted some kind of relief effort based on the situation. Tribal customs and religious traditions probably dictated the response of the community to the survivors and to the disposal of the dead bodies in the aftermath of natural tragedies and war. When the first groups organized themselves to deal with such events, the involvement of NGOs in disaster management was born. Asian history points to the Han Dynasty as having one of the earliest recorded humanitarian systems with specific disaster and famine relief functions dating back to the Southern Song Dynasty (1127-1279 ad ).

In western history, Christians established hospitals in Jerusalem to serve traveling pilgrims centuries ago. Peter, the Patriarch of Jerusalem, requested funds from Emperor Justinian to establish a hospital in the holy city in the sixth century, and Pope Gregory I founded a hospice near the Church of the Holy Sepulcher in 603 ce . Other records show that specific humanitarian systems were later designed to deal with the effects of natural disasters and wars in Europe. In 1767, a Society for the Recovery of the Drowned was established in Amsterdam, and by the early 1800s, humane societies specializing in the rescue and resuscitation of victims of drowning and shipwrecks had been founded on every continent. The goal of these “Humane Societies” was the dissemination of new resuscitation techniques, whereas the Royal Jennerian Society (another humane society founded in 1803) had as its objective the speedy extermination of smallpox through the newly discovered methods of vaccination.

Organized international humanitarian aid shows itself in the late nineteenth century in response to the Northern Chinese Famine of 1876-1879 and simultaneously the Great Famine of 1876-1878 in India, both brought about by a severe drought that claimed the lives of as many as 10 million people in China alone. The Shandong Famine Relief Committee was established with the participation of diplomats, businessmen, and Protestant and Roman Catholic missionaries in response to a plea from British missionary Timothy Richard, and led to collected donations of between $7 million and $10 million for the relief work in China.

The terms nongovernmental organization (NGO) and civil society organization (CSO) were created in the UN charter to describe certain nonstate entities to be awarded observer status at UN assemblies and other meetings. The UN further established the Committee on Non-Governmental Organizations as a standing committee of the Economic and Social Council (ECOSOC) by Council resolution 3(II) on June 21, 1946, with original terms of reference in 1950 and subsequent revisions in 1968 by resolution 1296 (XLIV) and 1996 by resolution 1996/31. NGOs have been actively engaged with the UN since its inception. “They work with the United Nations Secretariat, programs, funds and agencies in various ways, including in consultation with Member States. NGOs contribute to a number of activities including information dissemination, awareness raising, development education, policy advocacy, joint operational projects, participation in intergovernmental processes and in the contribution of services and technical expertise” ( Box 19-1 ).

In general terms, an NGO is civilian-based, independent of government, and staffed by volunteers who share a common background or motivations; has a primary mission that is not commercial; and depends on funding and materials from external sources. Ball and Dunn outlined some of the common traits of NGOs as follows: (1) formed voluntarily; (2) they are independent of government; (3) they do not exist for private profit or gain; and (4) their principal objective is to improve the circumstances and prospects of disadvantaged people. NGOs also tend to be highly practice-oriented, prize neutrality (i.e., giving nonpartisan assistance), and are decentralized and somewhat resistant to centralization as they value their independence and have strong commitments to “their” cause.

Classifying NGOs is difficult. One useful system was described in 1989 by Brown and Korten, who divide all NGOs into one of four types: (1) voluntary organizations (VOs); (2) people’s organizations (POs); (3) hybrid governmental and nongovernmental organizations (co-opted NGOs, or CONGOs); and (4) public service contractors (PSCs). Yet there is a virtual alphabet soup of differing combinations and flavors of ideologies, activities, and main and subsidiary foci that defies simple characterization of NGOs ( Box 19-2 ).

Common NGO ideologies include the golden rule, that all possible steps should be taken to alleviate human suffering arising out of calamity and conflict, an emphasis on human rights and dignity, health care as a right not a privilege, that people affected by disaster have a right to life with dignity and therefore a right to assistance, democracy for all, those who can must help those who can’t help themselves, no life is less valuable than any other, technical knowledge is a means to escape poverty, and geography is no fault of anyone.

Their diversity of focus spans a wide spectrum of issues: social, cultural, environmental, educational, developmental, technological, peace-building, human rights and dignity, health (public health, health services, and access), humanitarian assistance, shelter, children and youth, law and justice, disaster relief and management, and resiliency. Regarding the NGOs that have disaster relief and management as their primary focus, their scope may be local, regional, national, or international, and their competencies may be specifically well developed in one or more areas: for example, procurement and distribution of clothes, blankets, and appropriate supplies; disaster awareness and preparation; building community resiliency; assisting in search and rescue exercises; providing first aid and medical assistance to the wounded; providing shelter to disaster victims; providing psychosocial and psychospiritual care to victims, survivors, bystanders, and response personnel; assisting with or providing disaster response and recovery logistics; facilitating or providing transportation (to victims and/or response and recovery workers) for relocation or evacuation; providing or facilitating food and water procurement and distribution; assisting in and garnering help for postdisaster sanitation and mortuary services; caring for lost children; attending to animals and pets; vector control; and linking donors with disaster relief activities.

Current practice

Despite sovereign governments having the ultimate disaster management responsibility, NGOs often fill response gaps when conventional local or national emergency response personnel are negatively impacted by the disaster itself. The link between disaster medicine and NGOs is special as most expatriate medical and other health care personnel who respond to a disaster do so through or in conjunction with an NGO, be it an international NGO, a church group, or an academic or community medical facility. However, use of NGOs to provide a quick fix for short-term relief is a thing of the past. Instead, through coordination and collaboration with all stakeholders, NGOs are often involved with facilitating sustainable recovery and development which, in turn, empowers local communities to manage their own environments.

Whether national or international, NGOs improve relief efforts and capacity to address a wide range of victims’ needs, especially in dealing with complex emergencies. NGOs may be deployed to provide direct assistance (e.g., distribution of goods and services directly to the people), indirect assistance (e.g., services one step removed from the people, like transporting relief supplies and personnel), and even infrastructure and logistical support that may be entirely invisible to the people. Sometimes one large NGO has a diverse skill set and a great capacity, but often multiple smaller NGOs, each focused primarily on their individual mission, complement each other, are more flexible, and collaborate better with an integrated approach. In 2002, a Regional Workshop on Networking and Collaboration among NGOs of Asian Countries in Disaster Reduction and Response was held, in which the participants agreed on a number of steps aimed at promoting and strengthening networking and collaboration among NGOs in Asia for disaster reduction and response “in recognition of the important role played by NGOs especially in Asia (the most natural disaster prone region on the planet).”

As of 2008, worldwide humanitarian work was being accomplished by an estimated 210,800 humanitarian aid workers as calculated by the Active Learning Network for Accountability and Performance (ALNAP), a research and analysis agency serving organizations working in the humanitarian system. This total workforce comprises roughly 50% workers from NGOs, 25% Red Cross/Red Crescent personnel, and 25% workers from the UN system. In 2014 there were more than 4 million NGOs worldwide and about 1.5 million in the United States alone. Their cumulative size, scope, and diversity make their impact almost inestimable. From the small two- or three-person local organization acceptable by U.S. law, to the gigantic international and multinational behemoths such as BRAC International, which has 120,000 staff touching the lives of more than 135 million people, and the International Co-operative Alliance with approximately one billion individuals in its member organizations ; NGOs encompass a wide array of endeavors and represent an enormous amount of resources.

The International Federation of Red Cross/Red Crescent Societies (IFRC), perhaps the most recognizable disaster-related NGO worldwide (with 189 recognized national societies, one in almost every country in the world and supported by 17 million volunteers, 80 million members, and 430,000 staff globally), and other large disaster-related NGOs typically establish alliances and develop an international presence almost on par with the UN itself. The IFRC even has special status in transgovernmental international relief and disaster management circles. Large NGOs like the IFRC develop strong, long-lasting local institutional collaboration and networks that increase their influence and capacity to provide or procure immediate and highly effective response services. Smaller NGOs tend to address single needs or sets of related needs around which they have focused and refined their abilities and/or niche. This allows major humanitarian aid organizations to fund response and recovery by financially supporting “niche NGOs” that respond to the given disaster, rather than trying to do the same work using their own staff and resources. Over time, the work of the NGOs has improved the efficiency and efficacy of emergency management operations at the local, national, and, most significantly, international levels.

After and in Between Disasters

Because of the cyclic nature of disasters, vulnerable communities are always predisaster or postdisaster when not involved in an active event. Nonetheless, research shows that there is a low level of priority placed on disaster mitigation and preparedness. Recently, Houghton stated, “… disaster preparedness/mitigation is cited as the most important issue to emerge from recent (humanitarian assistance) evaluations.” Interestingly, NGOs have not been as visible in the phases of preparation and mitigation or prevention as they are in response and recovery. Reasons for this were described in a Tearfund study in 2003 on donor practice and policy in natural hazard reduction. The study echoes other literature which suggests that donors still see these phases as low priority, which is reflected in relief and development planning and processes as well. The study offers three possible explanations: (1) poor understanding of what risk reduction really is; (2) lack of obvious ownership of preparedness and risk reduction; and (3) competition for mind share within the phases (response, health care, and education are much more visible and pressing). Progress in this arena has been made with the formation of NGOs specifically addressing preparedness and mitigation, for example, the Los Angeles Emergency Preparedness Foundation ( www.laemergencypreparednessfoundation.org ), which accomplishes its mission by fostering collaborative preparedness efforts with business, government, academic institutions, other NGOs, and the communities it serves.

In the United States, all responding organizations including NGOs are expected to apply the concepts of hazard vulnerability analysis (HVA) to identify risk, estimate risk probability, and establish key components of an operative response plan. Combined efforts and pooled resources are then employed as measures to reduce potential loss of life and property. NGOs fill gaps in the local planning and in the resource pooling. The organized activities of VOLAGs, including NGOs, permit more robust planning and preparation for disaster ( Table 19-1 ). VOLAGs participate in all aspects of the disaster cycle: some create disaster plans and train responders; others make disaster areas habitable again; still others help displaced families regain some semblance of normalcy post-event. Interweaving NGOs’ activities with governmental responses as complementary or supplementary actions helps to stretch limited federal or state resources.

Table 19-1

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