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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 neglect.
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.
In 2017, the UN raised the alarm on famines in North-east Nigeria, Somalia, South Sudan and Yemen. Starvation has been used as a weapon of war in Syria, and the Democratic Republic of the Congo currently has among the largest numbers of severely food-insecure people of any country assessed by the Integrated Food Security Phase Classification (IPC) system. Each of these sites of mass starvation or famine can be understood as a ‘political marketplace’. They are characterised by the dominance of transactional politics over public institutions, and elite politics is conducted for factional or personal political advantage, on the basis of monetised patronage. This paper examines the relationship between these systems of transactional politics and famine and other forms of mass starvation, and outlines the implications of the political marketplace framework for humanitarian action. It argues that both transactional politics and mass starvation emerge from particular political-economic configurations characterised by economic precarity and mismanagement, violent forms of peripheral governance and war economies. Applying the political marketplace framework can help improve humanitarian information and early warning systems, as well as programme decision-making, while helping humanitarians think more carefully about the constant trade-offs they are forced to make.
Two experimental Ebola vaccines were deployed during the tenth Ebola epidemic (2018–20) in the Democratic Republic of the Congo (DRC). The first, the Ervebo vaccine manufactured by Merck, was used as part of a ring vaccination in the epicentre of the epidemic in North Kivu. In 2019, the prime- (Ad26.ZEBOV) and boost- (MVA-BN-Filo) vaccine manufactured by Johnson & Johnson (J&J) became the second vaccine against Ebola, deployed by the DRC-EB-001 vaccine trial in Goma, North Kivu. There was international debate as to the value and ethics of testing a second vaccine in an epidemic context. This article examines how this debate unfolded among actual and potential DRC-EB-001 trial participants in Goma. Drawing on ethnographic observation, interviews and focus groups, it explores how the trial was perceived and contested on the ground and situated in broader debates about the ethics of clinical trials, especially during the COVID-19 pandemic. We illustrate how debates around the ethics of clinical research are not simply centred on bioethical principles but are inseparable from local political dynamics and broader contests about governance, inequality and exclusion.
This review essay focuses on two books, Heide Fehrenbach and Davide Rodogno’s Humanitarian Photography: A History (2015) and Lasse Heerten’s The Biafran War and Postcolonial Humanitarianism: Spectacles of Suffering (2017). It situates the books in relation to broader debates about similarities and differences between humanitarianism and human rights practice, with a particular focus on the visual cultures of and ethical debates surrounding representations of suffering.
As the production, content and display of humanitarian images faced the requirements of digital media, humanitarian organizations struggled to keep equitable visual practices. Media specialists reflect on past and current uses of images in four Canadian agencies: the Canadian Red Cross, the Multicultural Council of Saskatchewan, the World University Service of Canada and IMPACT. Historically, the risk to reproduce the global inequalities they seek to remedy has compelled photographers, filmmakers and publicists in these agencies to develop codes of visual practice. In these conversations, they have shared the insights gained in transforming their work to accompany the rise of new digital technologies and social media. From one agency to the other, the lines of concern and of innovation converge. On the technical side, the officers speak of the advantage of telling personal stories, and of using short videos and infographics. On the organizational side, they have updated ways to develop skills in media production and visual literacy among workers, volunteers, partners and recipients, at all levels of their activity. These interviews further reveal that Communications Officers share with historians a wish to collect, preserve and tell past histories that acknowledge the role of all actors in the humanitarian sphere, as well as an immediate need to manage the abundance of visual documents with respect and method. To face these challenges, the five interviewees rely on democratic traditions of image-making: the trusted relationships, both with the Canadian public and with local peoples abroad, which have always informed the production and the content of visual assets. For this reason, humanitarian publicists might be in a privileged position to intervene in larger and urgent debates over the moral economy of the circulation of digital images in a globalized public space.
From June 1918 to April 1919, the American social photographer Lewis Hine made photographs of refugees in Europe. Refugees emerged as an unexpectedly humanitarian subject during World War I. Care for them was part of the American Red Cross’ (ARC) overall war relief activities, which Hine was hired to visually record. In this paper, I present the way in which refugees went from being framed in the ARC’s mass-circulated popular Red Cross Magazine as unique, innocent, idealized war-affected civilians to eventually being visually displaced in a shifting humanitarian landscape. For refugees who were, by 1920, making their way across the ocean to North America, visual displacement from the humanitarian visual sphere was tantamount to territorial displacement. Anxieties and negative rhetoric of the unassimilated alien prevailed, resulting in the temporary ‘closure’ of America’s borders and the ARC’s growing American-centric relief activities. Entwined with anti-Bolshevism, American immigration, and isolationist politics of the early twentieth century, Hine’s photographs and the ARC’s role in contributing to humanitarian photography are an early example of a rise and fall in sympathies towards refugees that would continue throughout the century.
This article introduces you to the general themes and questions of this special issue. We argue that history and visual media have long been central to humanitarian communication, but that the overlaps between history, visual media, and humanitarian communication have seldom been addressed. A focus on those overlaps, we suggest, not only demonstrates that critical historical inquiry has much to offer for professional communication specialists, it also sheds new light on the workings, changes and persistence of humanitarian narratives over the twentieth century.
Interpreting Red Cross museums as a visual medium, this essay explores the visual politics of Red Cross museums through the twentieth century. The essay puts particular emphasis on the entanglements between the visual politics and humanitarian narratives of Red Cross museums and identifies three major narratives that museums promoted through the times: a heroic narrative, a narrative of civility, and a volunteer’s narrative. Last, the essay argues that Red Cross museums may offer a fruitful field to encourage more engagement between (public) historians and humanitarian practitioners.