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FoMSF Discussion Set 1: MASTER COPY

What is Humanitarianism Anyway? Who, where, what and why? Disclaimer: The Friends of Médecins San Frontières are the official, independent student support organisation for Médecins San Frontières. It is important to make clear that the following discussion set was put together by FoMSF, to be used by FoMSF groups and other students. In no way does it represent the official views of Médecins Sans Frontières.

Any Questions? Contact Joel Cunningham - or Peter Scolding –

Key Sm GROUPS2-3 – small groups of 3-4 people discussing for 2-3mins Directions in boxes with Red arrows – are suggestions for what should be written as a minimum on a white board --------------------------------------------------------------------------------------------------------------------------------------

Question: What is Humanitarianism? – Whole Group – 3mins Group discussion: Responses - broadly two groups; aspirations and actions. Examples: Aspirations might include: ‘Helping people’, ‘protecting the rights of people who have been abused’, ‘valuing life’, ‘treating everyone’, Actions might include: ‘medical treatment’, ‘vaccination’, ‘fundraising’, ‘working in disasters’,

Write up


Question: Where might ‘humanitarian action’ take place? – Whole Group – 3mins What situations? Group discussion: Potential answers broadly set into two groups; environmental disasters and complex emergencies Examples: Environmental disasters may include hurricanes, epidemics, earthquakes, Complex emergencies may include war and situations resulting from war, such as disruption of health services, rape, breakdown of vaccination programmes.


Write down answers as they come – spider diagram for each question. The core of all answers being suffering (places where it exists) and the ‘humanitarian imperative’, - the “ALLEVIATION OF SUFFERING” (to be written up on the board). (1 min)

Question: What needs and activities might exist and happen?

Sm GROUPS3-4 Question: Which actors are might be involved in a response?

Sm GROUPS3 Feedback on what needs and activities? What actors? (8 mins) Where and what needs can be done in separate columns/ paper. Actors – split into four areas on the page, then activities matched up. Potential answers around who and how set into 4 groups of actors; civil society, governments, international community, the military. Useful to write down each of the groups as headings, with actions ‘spidering’ off from these. Differences between these groups will hopefully emerge along the lines of motives and means. Examples: 1 - Civil Society: Delivering food, medicine, water, sanitation, shelter etc. For example doctors, nurses, engineers, lawyers, journalists. NGOs (Non-governmental organisations) such as Médecins Sans Frontières, Care, International Rescue Committee, Caritas, Oxfam, Islamic Relief, Save the Children, Medair, Merlin. Local Population 2 – Governments (of nation-states): Providing funding, health policy, access, peacekeeping, sanctions. Governments can therefore work within their own population (e.g. USA after Hurricane Katrina) but may also act further afield through state departments such as DfID (Department for International Development) providing funding, advice and expertise for work overseas. 3 – International Community (internationally-based organisations): Funding, distribution, administration, direct service provision, mediation, peace-keeping. Examples include United Nations agencies such as UNICEF, UNITAID, UNOCHA; European Union (European Commission for Humanitarian Aid – ECHO), ICRC (International Committee of the Red Cross). 4 – Military: Engineering, reconstruction, building hospitals, delivering and distributing supplies, protection of civilians, relieving a siege. Bombing enemy positions? ‘A humanitarian war?’ (For example Kosovo, Rwanda). --------------------------------------------------------------------------------------------------------------------------------------

Emerging themes – 2min -

Humanitarianism is broadly about the alleviation of suffering. There are many activities which can be aimed towards achieving this broad goal. Many actors can be linked somehow to these different activities.



So question arising – does some kind of link to the alleviation of suffering automatically make these actors humanitarian? Or are other things important? – where do differences between these actors emerge? The next section looks at this a bit more; a series of practical situations, looking at some dilemmas and decisions and what principles you might use to base your decisions upon.

Keep written Up: Alleviation of suffering, environmental disasters, complex emergencies, 4 actor categories. Add principles over the next section. --------------------------------------------------------------------------------------------------------------------------------------

Scenarios: What are ‘Humanitarian Principles’? Principles - What is Humanitarianism? SETTING (FICTIONAL!!!) (2 min) Ok, now we’re going to take a wander through a fictional scenario to explore some of the principles that underlie humanitarian work. Please bear in mind – this is purely fictional and is just meant to act as a backdrop to discuss some important issues. (Ie. don’t take it too seriously!) Disaster has struck. An earthquake has hit the middle of Townsville, the capital of Islandland, an island in the Pacific. The initial shock has killed or injured thousands. Tens of thousands more are left homeless, without food and clean water. Bridges have collapsed, roads have been torn apart and hospitals flattened. The health care system of the country has crumbled – whatever was left in the aftermath of the disaster has been overrun by thousands of injured citizens. The call for international aid goes out. Townsville’s needs are great. It’s time for action. We’re part of a large humanitarian aid organisation. We’re going to send a team in to Townsville, leaving on the first flight out. Cargo planes are following to take all the essential equipment – medical kits, tents, maybe even a landrover. But nothing’s ever that easy…

Sm GROUPS3 + 2 Feedback What kind of problems might our team encounter when setting up camp and starting to offer out aid? (LEFT GROUPS = PRACTICAL PROBLEMS, RIGHT GROUPS = MORAL PROBLEMS) Practical answers: Sanitation/poor hygiene, violence, looting, not enough resources, too many injured people, poor facilities, overcrowding, theft, black market, weather, psychological issues, aftershock, spread of waterborne/airborne disease Moral answers: ‘quality of service’, ‘non-discrimination’, ‘advocacy’, ‘good relationship with beneficiaries’, ‘religion’, ‘funding’, ‘priorities’, ‘access’, ‘knowledge’, ‘non-bias’, independence, neutrality, impartiality. ------------------------------------INTRODUCTION (cont’d) (3min) Bit of a mess isn’t it? How would our team begin to deal with these problems in an organised manner, whilst still keeping the ‘alleviation of suffering’ as their top priority? Well, over the years, a number of key ‘principles’ have emerged which are essential in working towards the ‘alleviation of suffering’. The three core principles in humanitarian action are INDEPENDENCE, NEUTRALITY and IMPARTIALITY. These are useful for guiding decisions, both in a moral and a practical way. We’re now going to talk through this hypothetical storyline in Townsville. During this scenario, we will pick apart these key principles and discuss their use in practical situations. -------------------------------------


SCENARIO Part 1: (2mins) We’re going to start with INDEPENDENCE. Our team have arrived in Townsville. The local government heard of their arrival and sent an envoy to welcome them on the airstrip. After briefing our team on what has happened, the envoy says that the government wants to help them. They offer our team the use of some undamaged government buildings to use as a medical centre in the centre of town. They’ll also send over one of their officials to help our team navigate around town to see the damaged areas.

Sm GROUPS3group+3feedback

What are good (LEFT GROUPS) and bad (RIGHT GROUPS) points to the government’s offer? Possible ‘bad’ points: they’ll only show what they want to show, they’ll hide shortcomings, they’ll hide particular populations, they might have ulterior motives regarding how aid is Using Gov. distributed, it sets precedent for not making independent decisions. GOOD: can use existing infrastructures and can supplement government’s own services. offices & Remember, in most cases, the government wants to help its own people! guide: +ves BUT…the government might hide its own shortcomings, and may want to direct aid to particular parts of the town. /-ves LOSING ALL INDEPENDENCE: limits the ability of the team make decisions which drive them towards the ‘alleviation of suffering’. RETAINING SOME MEASURE OF INDEPENDENCE: would allow our team to make their own assessments of suffering, and would allow them to make their own decisions and priorities in order to maximise the attainment of the alleviation of suffering. (2mins) So, the best way forward could be compromise. One option in this scenario would be for our fictional team to negotiate with the government to use the building in the town centre, but politely decline the offer of a government aide to help guide them around town. It would be important to work with the government – it would be wasteful to set up parallel, overlapping services in a hospital outside of town. But retaining the ability to make independent assessments of need could equally be important. Our team quickly set up and start helping people in their clinic. ------------------------------------SCENARIO Part 2: (2 mins) However, our team learns that there have been gangs controlling certain areas of Townsville for the past few years. The tension since the earthquake has led to some violent clashes between the gangs and the government. A government official pays the team a visit to ask if they could appear on TV to endorse the government’s efforts in the aftermath of the quake, and to condemn the gangs for causing violence during these tough times.

Sm GROUPS3group+3feedback What’s good (right groups) about this offer, and what’s bad (left groups)? Possible ‘bad’ points: threats from the gangs, violence, kidnappings, access to areas controlled by gangs are limited, gangs blockade areas to stop aid getting through, worsens gang violence towards government, stops local people volunteering to help your team. GOOD: opportunity to condemn human rights abuses and to appeal for peace. Also, might raise the profile of the disaster and the aid project to the wider international community and help with fundraising. BAD: giving an impression of taking sides, angering/ distancing different groups. Restricts area of operation, limiting the number of patients who you can access to alleviate suffering. May jeopardise the operatives and patients in the town, and may exacerbate violence between the government and gangs, furthering the suffering.


TV - Praise Gov. Condemn Gangs: +ves /-ves

(2 mins) Here, we’re talking about the principle of NEUTRALITY. By clearly declaring support for one side over another in a conflict, neutrality is lost. If an organisation is perceived to be supporting one ‘side’ to a conflict, it is therefore perceived as being against other parties. Losing neutrality limits the ability to work free from restriction, threats, and violence in an area. ------------------------------------SCENARIO Part 3: (2mins) A week after setting up, the number of people flowing through the doors is not letting up – diseases have broken out in the temporary camps. Unfortunately, resources are still scarce and the one functioning airstrip is getting clogged up by all the different actors coming to ‘join in’. The team gets another visit from a government official. They give the team a list, and say that they need the team to set aside a portion of their supplies for the people on this list. If the team refuses, then the government will ask them to leave the buildings that they’re currently using and give it to an organisation that will do as they ask.

VOTE: who would do as they asked? – Whole Group discussion – 5mins What decision would you make and why? Possible answers: accept their request as it’s important to keep the facilities so that you can still treat some people, decline their request and move out – it’s more important to treat people in order of medical need rather than any other factor. GOOD: retain facilities within the centre of town to treat patients, keep good communications with the government. May also help keep the infrastructure and governmental services running in the city. BAD: the criteria for treating patients are NO LONGER BASED UPON NEED. It is influenced by bias (who the government favours), and is no longer based upon purely alleviation of suffering.

Prioritise List? +ves /-ves

(2 mins) This is testing the final ‘principle’ of today’s session – that of IMPARTIALITY. The government is asking the team to treat people according to their association with the government, rather than their medical need. The ‘humanitarian’ organisation is being asked to prioritise its distribution of aid. To do this they are being asked to judge people by something other than how sick they are, something other than their objectively measurable medical need. They are being asked to judge by other criteria, set by the government. Remember that the fundamental humanitarian goal is to ALLEVIATE to alleviate suffering only in those who are judged to be ‘worthy’.


Conclusions (6mins) We started by breaking down what ‘humanitarianism’ meant. We then looked at some of the what’s, where’s, and who’s of humanitarian action around the world. We discussed how a variety of different actors can be involved in the situations where there is humanitarian need. We came across the concept that humanitarianism has “the alleviation of suffering” as a core aim. Then, we took our fictional aid organisation through a hypothetical scenario. We encountered a few dilemmas, dilemmas which had both practical and ethical elements. We’ve then brought in a few key ‘principles’ to guide us in our decision making. These were the principles of INDEPENDENCE, IMPARTIALITY and NEUTRALITY. How do these aims and principles actually help us?  Firstly, they provide MORAL DIRECTION to help keep to the ‘alleviation of suffering’ the paramount aim. 5

Then, on a more pragmatic level, these key principles provide a PRACTICAL TOOLKIT with which to make practical decisions to help weigh options and best work towards the goal of alleviating suffering.


To return to some of the actors mentioned in the introduction: Angelina Jolie, NATO and MSF – the point of this workshop is not to tell you that one or other of these is or isn’t ‘humanitarian’ – it is to get you thinking about things like motivations, the situation, different actors, principles of action etc.


So the next time you see the word ‘humanitarian’ attached to something in the news, you question it – and these are some of the things to thing about – why is this actor there, what are they trying to achieve and are they guided by principles such as independence, neutrality and impartiality? What does ‘Humanitarian’ mean for you? --------------------------------------------------------------------------------------------------------------------------------------

Suggestions for further reading -


Pictet, J. (1979) The Fundamental Principles of the Red Cross: commentary. Available at [Accessed 12.12.09] Mackintosh, K. (2000) The Principles of Humanitarian Action in International Humanitarian Law. Humanitarian Policy Group

Definitions Independence: - The ability of an actor to determine their own path, free from political, religious and economic direction or influences. Therefore, with the power to make its own decisions, assessments and actions directed towards achieving the humanitarian imperative, the alleviation of suffering. Neutrality: - Not taking sides in a situation, this is often broken down further into two aspects. a) Military: Not allowing the aid an organisation is providing to give a military advantage to either side. For example an ambulance smuggling weapons, fighters hiding in a hospital, storing arms in aid warehouses, using a hospital as a lookout. b) Ideological: Not allowing the provision of aid or the actor themselves to ‘endorse’ a particular viewpoint or ideology within a conflict, for example by publically coming out in favour of one party to a conflict. Impartiality: - Providing assistance proportionally, according to need and without bias. - For example treating two patients (i.e. a member of a militia and a child), according to which has the greatest need, giving them the aid required by their condition and not discriminating against either on the grounds of subjective bias (e.g. deciding that one is good and the other bad) or objective bias (e.g. deciding to treat on the basis of an objective difference, for example religion, or race). --------------------------------------------------------------------------------------------------------------------------------------


Discussion Set - Master Copy - What is Humanitarianism Anyway?