You are here: American University School of International Service Big World podcast Episode 46: How Does Humanitarian Relief Fall Short?

How Does Humanitarian Relief Fall Short?

Humanitarian assistance tends to be associated with aid workers figuratively parachuting into a country or a region to do work in times of event-based trauma, but that conceptualization only scratches the surface of what such work entails. In this episode of Big World, SIS professor Lauren Carruth joins us to discuss a different kind of humanitarianism.

Professor Carruth discusses the issues that arise from the humanitarian responses of large relief organizations (2:03) and explains why the field work she conducted on humanitarianism, which culminated in her recent book, took place in the Somali region of Ethiopia (5:46). She also breaks down why the use of the word “industry” is at odds with what she believes humanitarian aid should be trying to accomplish (7:35).

What does the Somali word “samafal” mean, and how does it differ from what's been the norm in the humanitarian industry (13:00)? How often does samafal take place when it comes to humanitarian work around the globe (17:26)? Professor Carruth answers these questions and describes the inequitable hierarchy of the aid industry (19:15). Closing out the episode, she shares her advice for what people should do when they want to provide assistance during a humanitarian crisis (27:23).

During our “Take Five” segment, Professor Carruth shares the policies and practices she would institute to make the aid industry more equitable and more effective (11:06).

0:07      Kay Summers: From the School of International Service at American University in Washington, this is Big World, where we talk about something in the world that truly matters.

0:15      KS: Say the words humanitarian assistance to any American, and you're likely to spark images of workers from the Red Cross or perhaps the Doctors Without Borders. Both of these are large organizations best known for working in crisis or emergency situations, and while that work is critical, it tends to be associated with workers and doctors figuratively parachuting into a country or a region to do work under great duress in times of event-based trauma.

0:42      KS: That only scratches the surface of what is meant by those words, humanitarian assistance, and the model those images personify tends to leave out the contributions of the people who actually live in the place receiving the aid. So, today we're talking about a different kind of humanitarianism.

0:59      KS: I'm Kay Summers and I'm joined by Lauren Carruth. Lauren is a professor here at the School of International Service. She's an anthropologist who specializes in global health, food security, refugees, and humanitarian assistance. She focuses most of her work and attention on the Horn of Africa, and she recently published a book titled Love and Liberation: Humanitarian Work in Ethiopia's Somali Region. Lauren, thanks for joining Big World.

1:24      Lauren Carruth: Thanks for having me.

1:26      KS: I've been trying to get you on this for a while, so I'm glad you're here. In your book, which is recently out, Love and Liberation, you emphasize how media and Western donor governments use the word humanitarian in ways that evoke certain images and emotions from their audiences so that they can justify actions as well as profit off of news stories.

1:46      KS: So though phrases like humanitarian relief usually come with positive connotations, the work itself can be problematic and yield short-lived results. So, what kind of issues arise from the humanitarian responses by relief organizations like, for example, the Red Cross?

2:03      LC: What a great question. The Red Cross, first of all, does such important work around the world, but like most global humanitarian response organizations, its interventions are sometimes viewed by people on the ground as problematic and they may have unintended consequences. First of all, humanitarian crises aren't usually one-time events or isolated from more fundamental dysfunctions in political, economic, and social systems in places where crises happen.

2:34      LC: Where I've worked in the Horn of Africa, humanitarian responses have come and gone for years every few months, but most relief organizations are only funded for a few weeks or months at a time, and they can't therefore effectively address the larger longstanding problems that repeatedly place people at risk of destitution or displacement or even death.

2:58      LC: Some of the fundamental operational principles of the biggest humanitarian organizations, like the Red Cross, they include neutrality. So neutrality means that the Red Cross commits to staying out of politics and provides assistance to everyone, regardless of, for example, which side of a conflict someone's on. This has meant again and again that the Red Cross and other relief organizations stay silent when they witness the abuses of governments.

3:27      LC: They stay silent to the media and to the general public about these governmental abuses, for example, so that they can maintain access to people in need. You see this, for example, in Syria, staying silent about the abuses of the government of Syria, especially in rebel-held parts of the country. You also see it in Ethiopia today with the Red Cross staying silent about violations of international law by the government of Ethiopia.

3:53      LC: In another way, you can think about it, they're trying to keep access to people in need and they're trying not to get kicked out of countries. This is a really important role many would say. The Red Cross tries to advocate for people like in contested or rebel-held parts of these sovereign countries, or in another example, they try to maintain access and advocate for people in secret detention centers or somewhere like Guantanamo Bay.

4:18      LC: But on the other hand, many people in need where I've worked want international organizations to advocate more for them and maybe not just sort of keep access to them. They want political attention to what they're going through, and they want organizations to get political on their behalf and to not be silent about the abuses they see.

4:41      LC: Many now view this principle of neutrality, sort of defined originally and held up by the Red Cross, as complicity in maintaining the current world order and protecting the power of abusive governments. Many people also view humanitarian organizations as themselves potentially corrupt, because in order to maintain access to countries in conflict like Syria or Ethiopia, they provide assistance to and through governments in the name of aid. They provide food, medical supplies, even cash that doesn't necessarily get to everyone in need.

5:14      LC: Humanitarian assistance can actually aid conflicts and aid governments in committing atrocities or prolonging the conflicts. So yeah, there are some problems and there's some unintended consequences.

5:27      KS: Between 2007 and 2018, you visited Ethiopia six times to better understand global humanitarian work as it played out there, and your findings culminated in this new book, you specifically focused on the Somali region of the country of the Ethiopia. Why did you pick this particular place to conduct your field work?

5:46      LC: I love Ethiopia and I have actually spent significant amounts of time in almost every part of that country. Often as part of work I did earlier before I was writing this book, between 2003 and 2005, I worked for a while with the UN World Food Programme and with UNICEF, but I chose to work and do sort of long-term ethnographic research in the Somali region, because there was in general much less research happening there.

6:12      LC: I was curious why given the enormous amount of anthropological, policy, development, and even nutrition research that had been happening throughout the rest of the country for decades, why so little academic and policy literature was produced based on field work in the Somali region, either by Ethiopians and Somalis or by researchers from other countries.

6:35      LC: I found that there was and there still is a perception among people living and working in the capital city of Ethiopia in Addis Ababa that the Somali region is more dangerous and more difficult to work in than other parts of the country, and I actually found the opposite. I made really close friends out there. I really enjoyed my time there. I brought my children there—sort of developed lasting relationships with a lot of my key informants during the research. The food was wonderful, and of course also it helped me answer my research questions about the different silences, gaps, and inequities within the global humanitarian industry.

7:16      KS: Lauren, you used the phrase global humanitarian industry, which to me, it brings to mind a business model that's predicated on continuing to exist. So, how is the word industry at odds with what you believe humanitarian aid should be trying to accomplish?

7:35      LC: I was always told back in graduate school that the humanitarian industry should always aim to put itself out of business. For one, that's clearly not how it's structured. It's structured to ensure the continuing power, authority, and funding of an international bureaucracy that is not representative of communities and countries in crisis. But aside from this critique, I think it's important to recognize

8:00      LC: there will always be crises in moments when the normal or public systems of service provision fall apart. You know, volcanoes will always explode. Wildfires will burn. Climate change will produce disasters in already vulnerable communities. Wars will break out. And we need to be able to think about how to provide services and assistance to people when governments and societies are broken.

8:23      LC: But this can't only involve a global or globally mobile elite network of response teams. And it's pretty ineffective to think about humanitarian responses as one way, unidirectional deliveries of goods and services as efficiently as possible with the least possible involvement of politic or not getting involved in why crises have happened to begin with. Humanitarian interventions aren't really effective unless they're able to help people rebuild, and perhaps reform and improve public services and get back to living their lives with dignity.

8:59      LC: Somalis I worked with who are profiled in this book had a lot to say about what was needed. Instead of thinking about a business model, they used international humanitarian donor money to build crisis response systems that involved sustainable partnerships with local and regional governments. For example, they used humanitarian responses to build the capacity of the Somali regional government, and people's trust in these governmental institutions. Second, they're building response systems that support sustainable and really compassionate relationships of care in communities.

9:36      LC: For example, rather than building a temporary clinic of some sort, or having a temporary distribution of food, they tried to use relief money to fund community-based health extension workers who would live on in their communities after the relief money subsided. And third, rather than thinking primarily about efficiency and speed and cost effectiveness, they tried to use money to build longer-term relationships of reciprocity, mutualism, and even interdependence.

10:08      LC: There was this common insight or realization that we're all in this together. Today, maybe a mother in a drought-stricken part of Ethiopia, where there are outbreaks of deadly diarrheal diseases—maybe she needs help today. But tomorrow, there'll be someone else maybe there, and maybe in another place in the world. Folks said to me that we need to build a humanitarian system that takes lessons and resources from one program and can apply them to help people in other places wherever it's needed.

10:46      KS: Lauren Carruth, it's time to take five. This is when you, our guests, get to reorder the world as you'd like it to be by single handedly instituting five policies or practices that would change the world for the better. Specifically, what five policies or practices would you institute to make the aid industry more equitable and more effective?

11:06      LC: The first change my work suggests is the need for workers' rights, workers' protections, and sustainable professional opportunities to be both core to humanitarian missions, and core to current reforms happening within the global aid industry. Second, along with this, there needs to be a recognition and a redressing of racial and ethnic inequalities within the humanitarian industry. This needs to happen globally, as well as within countries like Ethiopia.

11:38      LC: Number three, we also need gender parity in the humanitarian industry. Far fewer women get the kinds of educational opportunities in Ethiopia, and in other countries, that enable them to have the kinds of careers they dream of, including in humanitarian work. Educational systems need to work better for women in Ethiopia and elsewhere.

11:59      LC: Fourth, recognition of legitimate and effective ways of doing crisis response and being humanitarian that are grounded in non-Western, anti-capitalist, anti-imperialist ethical frameworks. And finally, recognition that humanitarian crises aren't one-time or isolated events and that effective humanitarian responses almost everywhere anytime require long-term investments in public services where crises recur as well as trust in affected communities where people there already know best how to accomplish this.

12:38      KS: Thank you. You center your research on how Somali aid workers in Ethiopia enact an alternate version of humanitarianism known as Samafal. What is Samafal, and how does it differ from what's been the norm in the humanitarian industry and the fact that the word "industry" is attached to it?

13:00      LC: Samafal translates loosely from the Somali language as humanitarianism or general assistance to someone in need. Helping someone in crisis. It's used differently in Somali from the words people use to talk about the global humanitarian industry, actually, which is totally separate. As well as that they refer to NGOs in human organizations not as Samafal, but they have other words—more specific words for them. Samafal, I'm showing in this book, is what local aid workers—Somali aid workers—are enacting in part through their work with the global humanitarian industry but not entirely. They're doing Samafal at work, within clinics, within offices but also outside them.

13:45      LC: And yes, it's guided by some different ethical principles. For example, people care for others in crisis as part of their religious duty and as an act in service of God. Being a good Muslim means recognizing when people have needs and caring for them. And for many people, their work in relief organizations was therefore profoundly meaningful. It wasn't just a good job with a good salary. It was also part of their religious practice.

14:13      LC: Second, Samafal meant treating people like family, with love and compassion. Like religious duty, this aspect of humanitarian work as Samafal wasn't ever part of global relief organizations, fundamental principles, or missions like the Red Cross, but it was really central to Somalis' work in Ethiopia. For an example, let me tell you about Abshir, this guy who's a program director for a major UN organization in the capital of the Somali region, a city called Jijiga.

14:42      LC: For many years, he's been instrumental to this really successful relief operation called Mobile Health and Nutrition Teams. And this is where three workers—usually two nurses and either a community health worker or pharmacist—they travel out to remote communities where there've been upticks in acute malnutrition or cholera or some other emergency situation. And they serve for a period of six months. Abshir coordinated several of these mobile teams around the Somali region.

15:13      LC: A few years back, one of Abshir's mobile teams, they were assigned to go out to this really remote part of the Somali region—really far south close to Somalia where the Marehan family group, or what most people call in English "the Marehan Clan," where they lived. And Abshir and the guys on this mobile team, they're all Somali, but they were from the Ogaden Clan. And the guys on the mobile team really pushed back about having this assignment. They said they were so afraid to be deployed out there, that the Marehan is a minority clan, but it's also really infamous for being where the former Somali dictator Mohamed Siad Barre was born. And they've really criticized Ogaden politicians in the region over the years, too, and they threatened revolt. Abshir, again,

16:00      LC: he's Ogadeni and he said to me, "I understand how they feel down there about us Ogaden people coming all the way from here in Jijiga." But then he pushed his staffers. He pushed the mobile team. He required them to stay in the Marehan community, stay overnight there. And gradually over time, he said, first following a successful polio vaccination campaign, and this was back in 2006. And then after another clinical response to measles over the border, misgivings between the aid workers from Jijiga and the patient population noticeably relaxed.

16:38      LC: And Abshir was telling me the story and he concluded by saying to me, "People need to go. Just go. Be present there." And he took his index finger and he pointed at his eye and he repeated, really insistently. He said, "They must look the other people in the eye. It makes a difference. It makes a real difference."

17:00      KS: Lauren, when you talk about that, it makes all kinds of sense. Just intuitively the idea that building relationships in communities is going to go a long way toward having that relationship when you need it, when there is a more time-bound crisis, but how prevalent is the idea of Samafal in humanitarianism at large? How often do we see this type of work?

17:26      LC: One of the main arguments of my book is that Samafal is already very commonplace. And so, yes, maybe it's also a norm, even though we don't really see it that way from our vantage point, sitting here in Washington, DC. The vast majority of the humanitarian workforce, somewhere in between 92 and 98 percent of the workforce, depending on the kind of organization you're looking at, is staffed by people from crisis-affected countries and communities. Not Americans or Europeans or ex-pats. The humanitarian industry is already localized. We just need to recognize and adjust to the fact that people are providing assistance based on alternative and even multiple models and principles of humanitarianism. Ones that perhaps often resemble Samafal more than the humanitarian forms of action defined and regulated by organizations like the Red Cross, with its ideas about neutrality, apolitical action, and dispassionate and efficient one-way distributions of goods. I don't think Samafal is unique or only Somali. Samafal signifies, or it describes, a form of humanitarianism that's guided by principles of compassion, care, mutualism, global interdependence, political engagement, and yes, often religious duty. I think it's really common around the world. Not just in Ethiopia or the horn of Africa, but around the world.

18:58      KS: Lauren, I know that you've spent a lot of time. You've gotten to spend a lot of time with Somali aid workers over the years, and it is your belief that they've experienced the inequitable hierarchy of the aid industry firsthand. So describe that, if you would, what is this hierarchy like?

19:15      LC: Well, it's interesting to think about who benefits. I think we often assume that the quote, the so-called beneficiaries of aid benefit the most—the people who are receiving goods and services as part of relief operations. But when you look at the labor hierarchies that constitute the global humanitarian industry, it reveals a lot of other actors who benefit far more from the continuation and design of relief operations, at least as they're currently structured. What I found was that the industry was characterized by these really steep gradations in income, job security, global mobility—like the ability to travel and work and be seen as an expert in different country. Language, like from major international languages, like English and French to national languages like Amharic and Ethiopia down to minority languages like Somali. And then finally gradiations in whiteness. So employees are mostly white and from North American and European countries at the very top echelons of the industry, but mostly people of color, indigenous people, or people from ethnic and racialized minorities constitute the local and subnational offices in field operations in humanitarian responses.

20:36      LC: I guess it would look like a giant big triangle with the apex, the point at the very top. That small bit of the triangle would contain the ex-pat staff in the headquarters and offices of major relief and donor organizations like the Red Cross, but also doctors out borders, USAID. And in these offices, they're disproportionately white and male. The bottom sections of this, the biggest, the bottom sections of this triangle then would contain the legions of local aid workers. The real subject of this book who are staffing the NGOs and the governmental relief organizations. And that would also include then below them, the locals who are taking informal ad hoc subcontracts with these locally based agencies. And it's this bottom of the triangle, I think, that is not just the majority, but it's also really the heart and the backbone of the humanitarian industry. These local staffers of all types are a really interesting group to look at.

21:42      LC: Many of them are what I like to call humanitarian delalas. Delala in the Amharic language or Somali language is the word you would use for like a broker or a guide. Like if you need an apartment in Addis Ababa, you would get a delala. If you need to migrate across an international border, but you don't have a passport or visa, you would hire a delala. They get stuff done. These people are fixers, they're trusted locals, they know people. They know about local histories, they are familiar with local politics, and every relief operation has to hire lots of these delalas. They're logistics managers, survey enumerators, translators, drivers, security details, they do the monitoring and evaluation often, et cetera. But these are also really precarious workers.

22:32      KS: I'm listening to you describe this hearing about some of these racial and gender inequities in the upper echelons and even colorism. It almost sounds as though there is some sort of unspoken belief that if you have the bad luck to be from a place that needed a lot of aid, you are always assumed to not be capable or worthy of being moved up within these organizations, which are led by people who by and large are from places that didn't suffer these types of problems. So I'm wondering, first of all, do you think that's somewhat true? And if so, is there any way to have some of a pipeline, like you talked about for professional mobility, for people who have worked on the ground in the field and have done this type of valuable logistics work for them to move up through a pipeline that would help them get more recognition and professional remuneration for what they've been doing?

23:40      LC: I mean, I definitely think so. And so many of the aid workers that I spoke to for this research said as much. One guy that I call Aden, he works for a major UN organization there in Jijiga, and he was relatively very successful. I mean, he lived a middle class life. He

24:00      LC: had worked for the same organization for 15 years and had done so much, he was professionally very successful and yet he could not get a job either at the national office, the capital city of Addis Ababa. And he had applied again and again, to get jobs elsewhere like in Nairobi, Kenya, or in Geneva, or in London. And he was really frustrated by this glass ceiling that he perceived to exist for people who were pigeonholed or labeled as local. He was seen as just a local Somali expert and not really someone who was worthy of the investment in his education or training for elsewhere. And yet he could see his skillset having designed and run polio and measles campaigns, vaccination campaigns very successfully and brought religious elders into projects to improve women's reproductive health and rights in the Somali region.

25:03      LC: He'd had all these successes and he thought that would be just as valuable in Sri Lanka or in the United States or elsewhere. And I tend to agree with him. He actually said, I'll quote him here. He said, "Staff also have rights and staff want to be developed too." We're always talking about the beneficiaries of aid, that they need so much. And yet in the Somali region, it seemed like Somalis were always sort of stuck with not development, not long term investment, but relief aid and humanitarian assistance. And they point to really tangible things that could be done to ameliorate this, which is sort of investing in professional development, making sure that people from subnational offices have the opportunity to work elsewhere in their own countries as well as outside their own countries when sort of building skillset in humanitarian response.

26:05      LC: And I really think what you point out is so important because when we think about Somalis and when we think about locals, local residents in the places where humanitarian emergencies happen, we sort of come away with this false impression that those guys are just lucky to be employed at all. I mean, look at the economy in the Somali region. And therefore it seems like they're not sort of capable of being developed too in Aden's words, but they're seemingly rescued once again and again and again by the benevolence of others like Americans, donor organizations, humanitarians, and not sort of by the dent of their own hard work.

26:52      KS: And Lauren last question, when people want to help other people, we're often simply encouraged to donate money. And generally we're told when there's been some sort of natural disaster or outbreak of a terrible disease, we're told to donate to the Red Cross and in terms of how the average person could best channel their compassionate and humanitarian instincts to both do good and to not perpetrate a bad cycle, what would you suggest that people do?

27:23      LC: Maybe two things. Usually providing assistance in the form of cash is typically the best way to go. In almost all disasters or emergencies or conflicts, the donation of material goods from individuals is not usually helpful, and it requires a lot more logistics to accomplish. It's usually not what people need either, but cash can sort of help local economies as well as individuals and households recover from crisis. So that's the first thing. And second is to look for local organizations to support.

27:59      LC: It's harder. It may require more research, but it is really important to support the organizations that have long existed in communities in crisis and have long been doing work that is important to people who are in crisis. At the very least, look for larger international organizations who are always partnering with local organizations and that these local organizations have been around for a long time. You can easily look up the history of 501(c)(3) nonprofit organizations and major relief organizations to take a look at their history in particular countries and communities. Make sure that they have longterm commitments to places and to people. And that they're not just parachuting in because there's suddenly an opportunity. But the best thing is providing cash to local organizations that have a long history of providing care in the communities where crises are happening.

28:59      KS: Lauren Carruth, thank you for joining Big World and me today. It's been a pleasure to speak with you.

29:04      LC: Thanks so much for your thoughtful questions.

29:06      KS: Big World is a production of the School of International Service at American University. Our podcast is available on our website, on iTunes, Spotify, and wherever else you listen to podcasts. If you leave us a good rating or review, it'll be like finding out that that comic book you've been hanging onto since fifth grade is worth a lot of money. Our theme music is "It Was Just Cold," by Andrew Codeman. Until next time.

Episode Guest

Lauren Carruth,
professor, SIS

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