by marc on February 28, 2014
Let me start off with a good old American colloquialism: It ain’t over till the fat lady sings. Well, in terms of my career with MSF, the fat lady is warming up her voice. After 15 years, today is my last day. Question I am asking myself: So, Mr. Ex-Director, what words of wisdom after all that time? What is the big message? What is the meaning of our MSF/humanitarian life? Answer I keep coming to: Beats me.
Every time I feel on the verge of grasping it, waves of emails and interruptions tumble me back to the starting line. More pertinently, waves of challenges from, well, reality. I cannot understand why MSF was forced to withdraw from Somalia. Why a multi-billion-dollar aid industry struggles to provide a meaningful response to crisis in South Sudan. Or why easily preventable diseases tear through children in so many parts of the world. Humanitarian action is complex. No duh.
But there is a message. I have seen the light. Specifically, I saw the light a few months ago, cycling to work on yet another cold, damp day in London. I saw a pair of legs.
The owner of these legs was weaving in and out of the traffic (in this town where last year more cyclists have died than British military personnel in Afghanistan), those boxy black letters his well-inked press release about the power and peril to his left, right and rear. It was a message for MSF, for all of us.
Let us begin with HUMANITY, since that is the simple imperative where humanitarian action itself should begin. At once compassion for those who suffer and a declaration of our fundamental sameness. We are one family, the family of human beings, all so very different at first glance and yet blessed with an identical, universal dignity. The humanitarian imperative commands a bond with those who do not look or sound like us, believe in what we believe, or watch the same edition of Big Brother that we watch. The imperative propels us towards those who suffer not out of duty to kin, friends or clan, not out of affinity to those who share our religion or nationality, but because the suffering of one affects the whole and touches us as individuals. Because in responding to the stranger, we build our own place in the family of humanity.
On top of that, humanity has propelled me to crisis – to this career – because humanity itself is at the root of crisis. To be sick or injured and have no access to care is bad enough. All the worse when it is caused by or paired with violence, abuse, exclusion, oppression. Or greed, power, hatred. Or staggering, structural poverty. There is something compelling, challenging and sinister about that combination – of responding to crisis because something bad happened to people (e.g., rains didn’t fall) and because something wrong was perpetrated against them (e.g., displaced onto marginal lands). Compelling because that is where MSF finds those most in need. Challenging because being humanitarian requires more than therapeutic action. Sinister because it transforms medical action into an act of protest against the human origins of the harm. MSF’s very engagement levies an accusation against those who reject humanity.
And that means some people won’t like us. And that means some won’t let us do our work. So, MSF (not to mention the rest of the humanitarian system): What are you going to do? As the proficiency, ambition and impact of our medical action becomes ever greater, what will become of our commitment and courage as an organization of protest? As governments around the world become ever more cynical and capable in their manipulation/control of humanitarian aid, as they insist that we shut our neo-colonial mouths, what course will we steer? What choices will we make? Establishment aid agency or rebel humanitarian? Fractious silos of ego and power or collective voice of dissent? Muted opinion? Round after round of risk-averse calculation? Or “Fuck Taxis,” because that is the voice of a piece of humanity bearing witness to powerful pieces of its antithesis. Fuck inhumanity.
Well, MSFers? I’m leaving. So what are you going to do? The trend may be clear, but on this key question of humanitarian identity, the fat lady has yet to sing.
[I will leave MSF but Humanicontrarian will live on for a few weeks, then take a break, and then come back fresher than ever. I hope.]
by marc on February 20, 2014
Check out the new web page over at MSF UK’s website. The Name? Opinion and Debate. The Idea? Put an end to corridor and lunchroom pontificators actually defining MSF policy and practice. Let’s see these ideas. And let’s debate them.
Michiel Hofman makes a great case for thinking of us expats as “useful idiots”. The basic idea, especially relevant in conflict settings, is that expats are largely immune to the sort of local pressures that divert aid according to a personal, political or military interest.
Michiel’s piece, though, is exactly right in using the term “useful idiots”. It’s just that he draws the wrong conclusion. Of course there are pressures placed on decision-makers, and of course the safeguarding of aid’s impartiality (not to mention neutrality and independence) is vital. But what about the idiot part?
Even if we agree that they are able to pack up and go home, do expats really make a good decision-makers. Here’s a few of their common traits: (a) can’t speak the local language; (b) can’t read a local newspaper (ditto for radio, TV, etc); (c) don’t know much more about the history, culture, peoples or politics of a given context than you could find out by reading the background section of a Lonely Planet Guide; (d) don’t have an established relationship (let alone hundreds of them) with a single local person; (e) have phone contact lists full of other foreigners and aren’t trusted (nor, perhaps, distrusted) by people in power etc etc. In the end, let’s admit that a relatively high level of ignorance and blindness are at least just as inimical to objectivity and sound decision-making as are pressure and bias.
Michiel makes a great argument for expats as people who can open doors. But idiots don’t build effective houses. Worse still, they have trouble even noticing if they didn’t. In the end, rather than making a case for being useful, I’d suggest a better solution would be to get rid of the idiot. The model there? Locally empowered NGO hires a few powerless, foreign front men who provide the “protection” Michiel seeks but aren’t allowed to interfere in the development and implementation of contextually effective programming.
by marc on January 23, 2014
Ten years ago I visited our projects in Pool Province in Congo-Brazzaville. It was during Pasteur Ntumi’s armed, mystical insurrection; a time when military groups chose videogame names like the “Cobras” or “Ninjas”. I heard more than once that Ntumi could levitate. But that is a different story.
We lurched down the ersatz road, passing many villages. They looked quiet. They looked abandoned. Empty, I kept being told. Empty. But they were not empty. Everyone under 45 had long bolted for the IDP camps, but the elderly hadn’t left. Occasionally I would see a skinny man, somewhat dishevelled and gray, carrying a bundle of wood or wandering the dusty alleys between houses.
If terms of vulnerability, those community guardians must have registered off the charts. And we weren’t touching them. We were driving by without seeing them, or seeing their absence in our busy health clinics.
It shouldn’t be that way. Impartiality dictates to humanitarians that we make decisions based solely on the needs of people, not their life expectancy after treatment or value to society. Attaching value to human life is inimical to humanitarian action. Ditto for medical ethics. We don’t value people based on age. Grannies are absolutely equal in value to toddlers. We don’t try to justify differentiation by arguing cost effectiveness in terms of life value. That kind of thinking will lead you down the path to hell, to saving the owner of the factory over the workers, the teacher over the vagrant, the NGO expat over the NGO local staff.
Impartiality implies that you have done a proper assessment to identify, in this population and in this crisis, those most in need. In a place where the needs overwhelm resources, it implies choices will be made. As the research shows, though, we don’t do a good enough job of assessing needs when it comes to the elderly.
The problem is not one of mere choices, but of the underlying subconscious preferences; of blinkers. Some of these blindspots have evolved within our work. For example, we use shorthands to target people/areas of greatest need: “under fives,” “IDPs,” “pregnant and lactating women” are typical proxy indicators of greatest need. And with good reason. It is true that you will find higher burdens of needs among these target groups, or overlapping needs (e.g., sick child plus no shelter or clean water), or greater severity of needs (e.g., on average, a toddler with malaria is more at risk than an adult with malaria). But has looking for proxies meant not seeing others?
The way our brains work, it seems that if you are focused on one thing you will not see something else. (Here is a great test of selective attention). The elderly have different needs from those of children, and you need to look in a different way. For example, as a starting place, you need to make sure that your assessment tools are able to ‘see’ elderly people. Much of MSF data collection puts people into boxes: < 6 months, 6 months to five years, 5 – 14 years, and > 14 years. We literally lump teenagers in with octogenarians. Where else would that happen except in wedding photos?
With data like that – with the conceptualization of our target population underlying those numbers – busy teams miss those who do not arrive. That gap in spite of understanding that elderly have special access issues. It’s sometimes really simple. If you’re sick and seventy, trekking 10 km to find healthcare is not ideal.
Research leads to calls for paying attention; for systematic consideration of the elderly in humanitarian response. But why are the decks stacked against impartiality in the first place? One reason is the way we think about children in our own societies, and in particular the way we think about their well-being. There’s a certain tragic disposability of children in places where birth and mortality rates are high. And in the West, a tragic overvaluation, with children raised in porcelain towers. (See my blog on baby helmets). Apologies, this is the slippery turf of sweeping cultural generalization, but you get what I mean.
In the end, it is not accidental that the humanitarian project prioritises children. What is the UNICEF equivalent for the elderly? There is none. Why is Save the Children so much larger than HelpAge? The quantity of Western NGO resources essentially devoted to children in other parts of the world reflects a very Western valuation of children. That institutionalization of our value system produces a certain set of programme activities, the organisations that deliver them and, ultimately, that thing we call the humanitarian system.
Inherent in those values is the feminisation and infantilisation of victimhood. Powerlessness plus victimhood equates innocence, and that underpins why people give money to a cause. You can sell starving babies – we do it all the time. Try geriatrising it. Pause the camera on the face of an old man. You won’t run a billion-per-year NGO on that face.
by marc on January 6, 2014
Poor George Clooney. He’s such a busy guy. What with making blockbusters, Nespresso ads and all those mystery women, it’s a wonder the actor has had time to throw himself into the quagmire of Sudan.
South Sudan isn’t doing too well these days. Arguably, the mess is George’s fault. If we hadn’t all suffered the delusion of Sudan’s bright future, we might have been busier dealing with its complex faults. That’s what Daniel Howden insinuates. He takes Clooney (among others) to task now that the South Sudan house of statehood has collapsed faster than Anthony Weiner’s political career. Howden writes that “actors were highly effective at communicating a narrative about the new country that borrowed from a simple script.” That narrative (i.e., all problems were caused by the Wicked Witch of the North) was, unfortunately, “part truth, part wilful misunderstanding” and “deeply flawed”.
Let’s give George some credit. He is not a phoney when it comes to playing savior. He didn’t just show up at a fundraising dinner, or make one self-aggrandizing visit. The man has invested something of himself. He even got arrested for the cause. But there are limits to that credit.
Howden is right to call out the overly simplistic narrative, but let’s not blame actors for the superficial script. As I’ve blogged (e.g. cleansing conflict from the ‘perfect storm’ of factors causing famine in Somalia in 2011), the entire international community – politicians, aid NGO agencies, UN officials – seems dependent upon simple scripts. The only time we embrace complexity is in explaining our failures. (Of course, academics ply a healthy trade in the complexity of places like Sudan, but who really listens to academics besides other academics?).
You can’t sell complexity. No funding, no donations, and no political support. It’s even a hard sell within an agency. Try getting MSF to add some nuance to its analysis of Syria! And maybe that’s not such a bad thing, given the need for action rather than endless deliberation. Complexity is a cousin of perfection – it can be an enemy of the good.
As for Clooney and the celebrification of the aid business, maybe I’ve been wrong in the past. Maybe it’s wrong to begrudge him the attention he and other celebrities get. Sure, NGOs across the spectrum have sold out to the celebrity culture in the hope of increasing attention to our causes. But maybe celebrities really do make more effective champions than we activists. Maybe humans are hardwired to follow the opinions of celebrities. See this article. Apparently, it has to do with something so academic sounding as the anthropology of prestige.
How about that! Evolution has left us biologically inclined to follow the political analysis of celebs, not to mention their fashion tastes, recipes and personal grooming tips. Can somebody please get Miley Cyrus to say something about CAR?
by marc on January 2, 2014
I have posted a rather depressing rumination on 2013. See the Huffington Post UK site. Here’s a teaser:
Though certainly depressing, the observation that 2013 was a bad year is fairly unimportant. More worrisome is the prospect that 2013 signals a dangerous trend, even while experts tell us there has never been so much peace in the world. I see a mounting number of places that have reached a critical mass of disrespect for international law and universal ideals, or their outright rejection; and where rudimentary compliance is no longer deemed useful.
by marc on December 24, 2013
Painlessly short ideas for your holiday pleasure…
1. Development aid is like a kid getting a pair of goldfish for her birthday. In those first days, you can spend hours looking at the tank, watching the fish go about their business. Not much happens. You can even talk to them, or tap on the glass. Still, not much happens. Take a pinch of food flakes and toss it onto the surface of the water. The fish dart to the surface and begin inhaling the flakes from underneath. Press your forehead against the glass. That’s better than Jacques Cousteau.
The next day your mother catches you feeding the fish again. She warns against over feeding. But you can’t quite hold back. You wait for your mother to disappear and then show friends how it works. This is the thrill of your hand at work. This is the reward and psychological satisfaction of causation. And pretty soon your fish are belly up.
2. Good to see more awareness of the alarming persecution of homosexuality in places like Uganda, South Africa and Jamaica (e.g., here or here). Typical reaction here is to think of that anti-gay violence as barbaric, as inherent in “their” lack of civilization. Well, it is barbaric. But is it something so comfortably foreign? On the news today I learned that the Queen used the Royal Prerogative of Mercy to issue a posthumous pardon for a 1952 conviction for homosexuality. British war hero (codebreaking) and mathematician Alan Turing was punished by chemical castration. Why does such a pardon require an act of mercy? There is nothing merciful about it. And why does it require 51 years? As human rights campaigner Peter Tatchell opines: “I do think it’s very wrong that other men convicted of exactly the same offence are not even being given an apology, let alone a royal pardon.”
3. Nice piece of journalism in yesterday’s Guardian (some interesting comments as well). Title: The State that Fell Apart in a Week. Plenty of chatter in the twittersphere on the suddenness of the collapse. My own rather sarky take on it: If it falls apart in a week, it wasn’t a state. I’m not sure how to build a state, but you can cross ethically [oops, I meant "ethnically"] fuelled civil war off the list. Ditto for destroying your oil industry and an outbreak of atrocities.
Without trying to sound either uncaring or self-absorbed, there is something quite telling and terrible about the impact of this emerging catastrophe on the international community. Lots of international blood, sweat and tears, not to mention dollars, have poured into South Sudan. It is fine to expect that the humanitarian community must once again muster a Herculean effort to feed the hungry, shelter the displaced, and set up a healthcare system; or that international militaries must enforce peace between the warring parties. But let’s not begin with the World-has-failed-the-people-of-SouthSudan line of self-flagellation. The South Sudanese have failed themselves. And they’ve laid to waste an awful lot of hard work.
4. And because self-flagellation (or, at least, self-reflection) is often a valuable commodity … The international community constructed South Sudan’s house of cards nationhood through an almost comprehensive “partnership”. Many will opine that the fickle finger of fault should be pointed in the direction of everyone from the UN to the US Government to all the big NGOs to George Clooney. Many will opine that we must draw lessons and do it better in the future. But I would go back to the goldfish story above before jumping onto the bandwagon of building a better South Sudanese state (or Somali, or Afghan, etc).
by marc on November 22, 2013
Riddle me this: What’s not funny about the following infographics? Anyone feeling queasy? I’m not talking about the fact that OCHA so hilariously set out to use images of aircraft carriers, cruisers and destroyers that look completely harmless. Can anyone imagine the MOD using a war deployment graphic with images of fishing charter vessels? Those little boats aren’t going to scare bad guys. Where is the fierce show of killing hardware; the projection of might? They look like the Minnow! Designed to cause no more harm than strand seven castaways on an uncharted desert isle.
So what is this response to the Philippines typhoon? Branding exercise of a new world order in humanitarian action. That’s what.
If you don’t see an OCHA infographic immediately below, click here to go it.
FYI, that third graphic isn’t the Philippines, it’s Libya.
[Thanks S for the help]
by marc on November 14, 2013
Can the blogosphere survive another set of random thoughts on Typhoon Haiyan?
1. Check out any decent post-Armageddon flick. Try The Road. Or for a classic, and one of the first great zombie flicks, try The Omega Man. How do the heroes survive and feed their families? It’s an old routine. They help themselves. No way Charlton Heston would do it if it were looting. The guy was Moses and then President of the National Rifle Association. That gives him more law and order cred than Wyatt Earp, Serpico and Judge Dredd combined.
I’m glad to see some journalists questioning the use of the term “looting”, as if bread for a child on Day Five without food were somehow akin to a burglar’s cartoon sack marked $$$. We can’t condone guys walking out of shops with plasma TVs. But without aid, without food, shelter, water or information on when/how it is coming, can we really equate this scavenging with acts of lawless criminality? More importantly, can we base policy choices on it? (hint hint, see below).
2. Ever watch news coverage of rioting or protests in your home town and have others call to see if you’re OK, when you were out having fun with friends? Images of localized, small-scale disorder, demonstration, crime create a perception of the situation that is distorted well beyond reality. More than that, we seem to imagine ourselves in those places and (a) feel the fear all those millions of people must be feeling then (b) cry out for somebody to put an end to it.
Note here the entry into the perception game of Western society’s own hyperbolized sense of security and risk (see e.g., my post on helmets for babies) and a view of the Global South as primitive bedlam-filled Bongo Bongo lands. So my mother wants me to stay inside and lock the door when 200 protesters at Parliament toss stones, and she wants a soldier on every corner in Tacloban.
This distorted image matters. Law and order are indisputably important. But threats to law and order have a long history of provoking overreaction on the part of authorities, whether for political gain against enemies or simply to preserve face. As is often the case, in these early stages of catastrophe response prioritization has to be spot on, and it has to place saving lives at the top. With heavy loss of airport capacity coupled with the necessity of an airborne aid armada, every flight counts. Every cubic meter of cargo, every ton of supplies, every single landing slot has lives attached to it. So what does it mean to fly in armoured personnel carriers and security forces?
Cue here a story of prisoners breaking out so we imagine the islands of the Philippines resemble the anarchy of life in a Mad Max movie, and are grateful for soldiers “retaking control” of the place. I am not at all against priority given to military relief capacity, I’m talking about the idea that life-saving assistance must be displaced to establish law and order (a particularly ironic conclusion where a primary driver of “crime” and “disorder” is the absence of aid). Perhaps it is necessary for aid to flow. Perhaps it’s not, and aside from a few hot spots the impact quite minimal. Hence the weight on figuring out to what extent is this real and to what extent is it misperception and a knee-jerk reaction to fears.
In Haiti, arguably, the world got that balance wrong. Fears of looting or the descent into anarchy were exaggerated, decisions consequential (e.g., see here on WFP reports of looting being “overblown”, or this MSF denunciation of its surgical capacity circling overhead and then diverted to Santo Domingo while the US military landed planes full of troops). My experience is that disasters force communities to come together, that people are remarkably supportive of one another and fair. The people in Cebu and Samar are neighbours and families. Social networks distribute relief with stunning efficiency and effectiveness and zero fanfare.
Of course there are criminal gangs. Of course water distribution to thirsty people can resemble a scrum. Experienced aid agencies deal with this all the time, delivering aid in war zones and in the midst of sectarian violence or everyday desperation. We do it all the time because waiting for somebody to put an end to the war and violence is, well, absurd. Aid delivery in crisis will always be imperfect. Nobody wants aid convoys getting attacked, but the risks are often manageable under far worse conditions than in the Philippines. So unless the threat is substantial risk, establishing “law and order” to ensure the arrival of assistance may come with a heavier cost than benefit to those who are waiting for said assistance in frightened, rain-soaked desperation.
3. On the surface, the aid industry is treating the typhoon emergency as the second coming of the December 2004 Indian Ocean tsunami, with all the expectations of another once-in-a-decade event. In other words, expectations of all-hands-on-deck to get aid to the millions of desperate Filipinos, of a large dose of the aid circus and calls for better coordination, and of a fundraising/branding extravaganza. Certainly some of the destruction we have seen on our screens warrants such an investment in the emergency response. But other factors instil us with an uneasy feeling: the creeping signs that the worst of the destruction affects a large but not massive number of people coupled with a world that is no longer helplessly waiting for the NGO saviours to arrive – first, because the Philippines is not Haiti and second, because other actors, most notably the military, are now in the saviour business. Will we succeed in being the stars of the show? Tune in these coming weeks.
by marc on November 1, 2013
Having swapped his political fez for the humanitarian beret of the International Rescue Committee, David Miliband is calling world attention to the spectre of polio outbreak in Syria. He has seized on a tragic development. Rising polio numbers play out like a dead canary in a coal mine. At once powerfully symbolic of the calamity of Syria today and a frightening omen of Syria tomorrow.
Coincidentally, polio confirmation comes just as chemical weapons inspectors have declared that equipment for producing, mixing and filling chemical weapons has been destroyed. Cut to fist-pumping Western nations? I mean, progress on CWs is relatively good news, no?
In an astute exchange on BBC Radio 4’s Today programme (yesterday, around the 2:10 mark), Miliband and John Humphries aired the rather stunning conclusion that the world has breathed a sigh of relief since the chemical weapons deal has been made. Guard down. Attention elsewhere. Result: in the hoo-hah around chemical weapons – well-deserved though it may have been – Assad found a “licence to carry on what he was doing – slaughtering an awfully lot of people” (Humphries). This analysis, shared by many others, makes for a cautionary tale.
The only law left standing in Syria today may be the law of perverse consequences. MSF played an instrumental role in sparking attention/reaction to the chemical attacks (see my previous blog). As if Western governments justifying potential retaliatory strikes were not enough of an unintended consequence, there is also the sidelining of a truly unprecedented humanitarian crisis. As Christopher Stokes eloquently explains: Syrian people are now presented with the absurd situation of chemical weapons inspectors freely driving through areas in desperate need, while the ambulances, food and drug supplies organised by humanitarian organisations are blocked.
Absurd? Yes. Predictable? Why not? What chunk of this hindsight should not have been foresight? We all knew that U.S. or French militaries would twist the outcry against chemical weapons to suit their own ends. We should also consider it no surprise that Western governments, desperate for a chance to demonstrate action/resolve/victory will jump on any issue that masks their protracted, utter inability to do something about the horrors of Syria. Action is generic in that regard. Action acts as a pressure release. Action is solution. No need for further attention. Chemical weapons? Sleep easy. Mission accomplished. You could airlift 2 million ab-tronic exercise devices to Syria and the US public would coo in the comfort at good being done.
And it is not just governments. It is no surprise that the media needed a new angle to this Syria tale, that NGOs needed to show success, that we were all emotionally drained by trying to think of the ever-worsening big fat disaster. In other words, did we not know enough to understand that one major risk of speaking out against chemical weapon attacks was that the international effort would be diverted away from the millions of starving, abused, sick, wounded and frightened people? Absurd = perverse, does it not?
Now: what of polio? In one breath, Miliband laments the negative impact of chemical weapons as distraction and then raises the issue of polio. Obviously, it may turn out differently. And obviously, dealing with polio is a good thing. But this is Syria 2013. We ignore the law at our peril.
In the end, it is quite sad that ten cases of polio are able to generate more attention, and perhaps more momentum for change, than massacre after massacre, month after month, million after million. A new outcry: Stop the killing! Humanitarian ceasefire! We need to stop the polio!
Miliband is shrewd. He comprehends the symbolic value in a polio outbreak. He trumpets the potential for a polio campaign to give rise to a new “humanitarian bridgehead” inside Syria. Polio vaccinations as a silver bullet? That makes for a nice soundbite, but it ignores the governing law of the land. The risk is that depoliomacy produces a great campaign and an even greater distraction.
by marc on October 28, 2013
They won’t start talking until we put all our phones in the refrigerator. Dennis McNamara, of the Centre for Humanitarian Dialogue, talking about sensitive negotiations.
A year or so ago I posted a blog about the risks of being infiltrated by spies. I seem to have missed the point. True enough, we humanitarians should do more about stopping NGO penetration by the Felix Leiters and Carrie Mathisons of the world. If we want to safeguard trust in our intentions, trust in our essential harmlessness, then we need to keep the spies out.
But that misses the point driven home, driven right into my breast pocket, by Edward Snowden. The revelations about NSA spying make it clear, the spy is I. It is no longer a question of keeping spooks-people out, it is a question of the degree to which they have transformed us into spooks-people in. The unwittingness of our role is of no relevance. Ditto for our pure hearts. It is no longer about deliberately passing information back to spy agencies, it is about their routine extraction of sensitive information from our everyday work.
What to do given the lack of convenient refrigerators? Negotiating access requires daily contact with armed groups, many of whom have so-called terrorist or similar status. We must talk to them. We must phone them to ask if it is safe to travel, safe to deliver care, safe to transport a wounded child. Who needs a mole when our Nokias and Thurayas provide such an effective set of eyes and ears?
Decades ago I thought (briefly, very briefly) about working for the CIA. I never thought I would be doing it for free.