Within bilateral and multilateral funding circles, there has been a strong and growing emphasis on the importance of understanding and responding to gender inequalities in humanitarian settings. However, given the often-short funding cycles, among other operational challenges, there is limited scope to incorporate interventions that address the root causes and social norms underpinning gender inequalities, or other gender transformative interventions. In the context of the decade-long crisis in the Lake Chad Basin, fuelled by incursions from non-state armed groups (NSAGs), including Boko Haram, and the resultant protracted and chronic humanitarian crisis, this article examines Save the Children’s child nutrition programmes in northeast Nigeria. Taking an ethnographic approach focused on volunteer-driven peer support groups (mother-to-mother and father-to-father) that aim to increase knowledge on best practices for infant and child nutrition, we investigate whether these activities are transforming societal gender norms. While evidence shows an improved understanding and awareness of gender-positive roles by both men and women, restrictive gender norms remain prevalent, including among lead volunteers. We suggest the possibility of longer term shifts in power dynamics in the home and society at large as well as suggest how humanitarian response can better integrate gender transformative programming.
In the absence of a normative framework, the concept of humanitarian corridors lacks a consistent definition and is highly vulnerable to political interpretation. The notion underwent multiple semantic shifts, from referring to a right of passage in situations of armed conflict, to an appeal to facilitated access in the face of bordure closures or bureaucratic constraints. The diverse range of situations in reference to which the terms ‘humanitarian corridor’, ‘relief corridor’ or ‘access corridor’ are used, often interchangeably, is matched only by the diverse range of actors that use them. Calls for their opening have become so common that corridors seem increasingly considered a relevant modality of humanitarian action despite much ambiguity around what they are expected to achieve, how much protection they offer, and how they are likely to affect the overall dynamic of conflicts. Meant to allow the unobstructed deployment of humanitarian aid and/or the evacuation of civilians, humanitarian corridors are by definition temporary and limited in geographical scope. As such, they are a timid assertion of the principle of free access to victims, prone to manipulation by belligerents or third parties to serve war strategies or to project an image of civility. Looking at the wide array of its application in history, the author puts the use of the concept into perspective, drawing on a variety of examples to illustrate how both the idea and its implementation have been problematic. A few operational recommendations are then derived from this analysis for humanitarian practitioners to consider and adapt in light of their particular context.
Writing about Personal Experiences of Humanitarianism
This interview hopes to build on and contribute to research on humanitarian memoirs by talking to two humanitarians who have written memoirs: Professor Tony Redmond OBE and Gareth Owen OBE. Tony Redmond’s book Frontline: Saving Lives in War, Disaster and Disease was published in 2021 by HarperNorth and Gareth Owen’s book When the Music’s Over: Intervention, Aid and Somalia will be published in June 2022 by Repeater Books. The interview was conducted by Róisín Read.
Local Understandings of Resilience after Typhoon Haiyan in Tacloban City, Philippines
Ara Joy Pacoma
In the context of disasters, the term ‘resilience’ is viewed by some humanitarians as overused, underdefined and difficult to operationalise. Moreover, much of this process has been expert- and humanitarian-led, leaving out the understanding of resilience at the local level, among disaster-affected people and in local languages. And when local input from disaster-affected households is included, their understanding of resilience is often filtered through expert and professional opinions. Looking at the case study of resilience-oriented interventions in Tacloban City, Philippines, after Typhoon Haiyan, this study examines local conceptions of resilience by disaster-affected households. Designed and led by local researchers who were also Haiyan survivors, we conducted in-depth interviews with 31 Haiyan survivors in a typhoon-affected community. Results reveal that disaster-affected people have drastically different conceptions of resilience than those promoted by institutions, such as family’s well-being, intactness of the family members after the disaster, durability and having faith in God. Food, financial capacity and psychosocial status significantly influence people’s contextualised meanings of resilience. Access to social and material resources from a household’s social capital networks was also found to be an important factor to understanding resilience.
Substantial evidence across disciplines indicates that children’s early years are critical for building the foundation for optimal development. In contexts of crisis, conflict, disaster and displacement, children are at particular risk. Primary caregivers often have fewer resources and less time to provide children with attention and necessary socio-emotional and cognitive stimulation. Risk factors for children are often multiplied in crises and conflict settings, and access to services becomes more challenging where family and social networks have been weakened and social service delivery interrupted.
To address the needs of young children, we must strengthen humanitarian response. Practitioners often use humanitarian standards and guidance to systematise planning, implementation and evaluation of programming. These documents describe the broad principles and essential elements (i.e. specific benchmarks and actions) for high-quality response, reflecting best practices at a global level.
We analysed the degree to which existing humanitarian standards and guidance documents explicitly recognise young children and their caregivers in humanitarian response and looked at gaps in the five areas that experts agree are essential for children’s holistic development: good health, adequate nutrition, security and safety, responsive caregiving and opportunities for early learning. We then made recommendations for achieving more comprehensive and consolidated guidance to address early childhood development in emergencies.
Lessons Learned from an Intervention by Médecins Sans
Maria Ximena Di Lollo
Elena Estrada Cocina
Francisco De Bartolome Gisbert
Raquel González Juarez
Ana Garcia Mingo
When the COVID-19 pandemic struck in early 2020, it rapidly became apparent that
older individuals were at greater risk of serious illness and death. The risk
was even greater for residents in care homes, who live in close proximity and
may be suffering other comorbidities. Such facilities also saw a high turnover
of staff and visitors, meaning an increased risk of transmission. Data has
suggested that care home residents may account for up to a half of all
COVID-related deaths in Spain.
As morbidity and mortality for COVID-19 was increasing in March 2020, MSF offered
support to Spanish care homes during the first wave of infections. Our
intervention included different axes: advocacy, knowledge sharing, training and
implementation of measures for a reduction in transmission and for infection
prevention and control (IPC).
The situation for care home residents was dire, with many people dying alone,
away from loved ones and without access to palliative care. Staff were
overwhelmed and ill-equipped to deal with the scale and complexity of this
Although technical interventions to reduce transmission were crucial, it became
clear that other people-centred activities that supported residents, their
families and staff, were of equal importance, including facilitating contact
between families, providing emotional support and offering adequate pain
management and palliative care.
Residents in care homes have the same rights as everyone else. In the event of
future crises, the most vulnerable should not be neglected.
Despite a concerted international effort in recent decades that has yielded
significant progress in the fight against HIV/AIDS, the disease continues to
kill large numbers of people. Although there is still no definitive cure or
vaccine, UNAIDS has set an ambitious goal of ending the epidemic by 2030,
specifically via its 90-90-90 (‘treatment cascade’) strategy
– namely that 90 per cent of those with HIV will know their status, 90
per cent of those who know their status will be on antiretroviral therapy and 90
per cent of those on antiretroviral therapy will have an undetectable viral
load. These bold assumptions were put to the test in a five-year pilot project
launched in June 2014 by MSF and Kenya’s Ministry of Health in Ndhiwa
district, where an initial NHIPS 1 study by Epicentre (MSF’s epidemiology
centre) in 2012 revealed some of the world’s highest HIV incidence and
prevalence, and a poor treatment cascade. Six years later, a new Epicentre
study, NHIPS 2, showed that the 90-90-90 target had been more than met. What
explains this ‘success’? And given the still-high incidence, is it
truly a success? MSF Deputy Director of Operations Pierre Mendiharat and
physician Léon Salumu, Head of MSF France Kenya programmes, discuss the
political, scientific and operational challenges of the Ndhiwa project in an
interview conducted by Elba Rahmouni.
The COVID-19 pandemic has exposed multiple fault lines in the performances of
health services at every level – from community to national to global
– in ensuring universal, equitable access to preventive and curative
care. Tragically, this has been to the detriment of those who have suffered and
died not only from COVID-19, but also from the myriad other ailments affecting
people around the world. Of those, we wish to highlight here some key categories
of diseases that have caused a greater burden of illness and deaths as a
consequence of the policies and political decisions made in relation to the
COVID-19 pandemic. In our view, these should be considered epidemics or, more
accurately, syndemics – the clustering and interactions of two or more
diseases or health conditions and socio-environmental factors – of
This article explores the actions of Médecins Sans Frontières
during the 2018–20 Ebola outbreak in Nord Kivu, in the Democratic
Republic of Congo. Based on the experiences of practitioners involved in the
response, including the author, and on the public positioning of MSF during the
first year of the epidemic, it argues that although the actions of response
actors were usually well intentioned, they could rarely be described as
lifesaving, may have exacerbated disease transmission as much as limited it and
had the perverse effect of fuelling corruption and violence. The article
documents and analyses contradictions in MSF’s moral and technical
positioning, and the complicated relationship between the organisation and the
international and Congolese institutions leading the response. It argues that
the medical and social failure of the response was the result of an initial
belief in a strategy designed at a time when the only realistically attainable
outcome was to relieve suffering, and of the later inability of the organisation
to convince the authorities in charge of the response to adjust their approach.
It suggests that for future success new protocols must be elaborated and agreed
based on a better social and political comprehension and a better understanding
of the tools now available.