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Viewing: Blog Posts Tagged with: donor, Most Recent at Top [Help]
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1. Donor behaviour and the future of humanitarian action

By Anne Hammerstad


After a short lull in the late 2000s, global refugee numbers have risen dramatically. In 2013, a daily average of 32,200 people (up from 14,200 in 2011) fled conflict and persecution to seek protection elsewhere, within or outside the borders of their own country. On the current trajectory, 2014 will be even worse. In Syria, targeting of civilians and large-scale destruction have led to 2.5 million (and counting) refugees fleeing the country since 2011. The vast majority shelter in neighbouring Lebanon (856,500), Jordan (641,900), and Turkey (609,300). As I write, hundreds of thousands are fleeing the advancing forces of the Islamic State in Iraq and al-Sham (ISIS) in neighbouring Iraq. And civil wars and ethnic violence have resurged in many parts of Central Africa and the African Horn.

What future for humanitarian action in this dire scenario? This question was raised on the fifth of May by the UN Secretary-General, Ban-Ki Moon, when he launched a programme of global consultations, which will culminate in the first ever World Humanitarian Summit in Istanbul in 2016, poised to “set a new agenda for global humanitarian action”. The UN has raised four sets of challenges, to deliver humanitarian aid more efficiently, effectively, innovatively, and robustly.

The launch of these consultations is timely, but it avoids an important challenge to the future of humanitarian action: the policies of donor governments.

United Nations Geneva

At first glance, this may seem like a strange assertion. After all, although needs continue to surpass the ability to provide, donor funding for humanitarian operations has skyrocketed. From less than US$1 billion in 1989, the global humanitarian budget stood at US$22 billion in 2013. Most of these funds come from a small number of Western donor states. But coupled with this rise in funds comes a donor agenda that risks, even if unintentionally, undermining the humanitarian ideal. This challenge is far from the only one posed to humanitarian action — much worse for the security of humanitarian workers are the terrorist groups that target them, leading to the killing of an estimated 152 aid workers in 2013. But because humanitarian action depends on a moral consensus over its meaning and worth, the current trajectory of donor policies is worrisome.

The humanitarian ideal is based on international solidarity: that outsiders can and should provide aid and protection in a principled, non-partisan, needs-based manner to civilian casualties of war and political violence. This ideal of politically disinterested solidarity with fellow human beings caught up in war and violence, regardless of who or where they are, has always been at some remove from the reality of humanitarian operations, but a consensus has nevertheless existed that it is an ideal worth aspiring to. Recently, though, donor governments have been increasingly open and unapologetic about using humanitarian aid to further their own political or security objectives.

One such objective is to keep immigration down. Since most man-made humanitarian crises have displacement as a core component, one objective of Western donor support of humanitarian aid to refugees is to contain population movement. The vast majority of refugees — people who have fled for their lives across international borders — remain within their near region, in camps or regional cities. Only a small proportion attempt the long journey to Europe, Australia, or North America in hope of jobs and a better future. Western humanitarian donors would prefer that even fewer asylum seekers make it to their own shores, while refugee host states in the Global South would like burden-sharing and solidarity to mean more than monetary charity from the well-off to the poorer.

Containment strategies seem to be working. While refugee numbers are increasing overall, including in industrialized states, the proportion of refugees hosted by developing states has grown over the past ten years from 70 percent to 86 percent. In Lebanon, there are 178 Syrian refugees for every thousand Lebanese inhabitants (in Jordan, the number is 88 per thousand). But efforts by the UN High Commissioner for Refugees (UNHCR) to resettle particularly vulnerable Syrian refugees have had lukewarm responses. This donor attitude of charity from afar coupled with hostility to asylum seekers and unwanted migrants in general, undermines the moral underpinnings of humanitarianism. After all, the Good Samaritan, often put forward as the embodiment of the humanitarian spirit, did not leave a few coins with the battered traveller he found by the wayside. He took him home and nursed him.

Another trend undermining the humanitarian ideal is the increased, and increasingly unapologetic, strategic use of aid to further donors’ own foreign and security policy objectives. There is a clear increase in the past couple of decades in the earmarking of funds and channelling of resources, not necessarily to the neediest of humanitarian victims, but to those deemed more relevant to donor interests. The ‘hearts and minds’ campaigns in Afghanistan and Iraq in the 2000s are the starkest representatives of this trend. As US-led intervention forces aimed to win over local populations by disbursing aid, the overall share of US overseas aid channelled through the US Department of Defense rose from 5.6 percent in 2002 to 21.7 percent in 2005.

These donor trends of openly pursuing domestic, foreign, and security policy goals through humanitarian aid are detrimental to the long-term future of humanitarian action, since they undermine the consensus and the ethical values underpinning the humanitarian ideal. While other challenges also loom, the strategies (and strategizing) of donors should have been included as a core topic of the Global Consultations.

Dr Anne Hammerstad, University of Kent, is author of The Rise and Decline of a Global Security Actor: UNHCR, Refugee Protection and Security. She writes and tweets on refugees, humanitarianism, conflict, and security. You can follow her on Twitter at @annehammerstad.

To learn more about refugees, conflict, and how countries are responding, read the Introduction to The Rise and Decline of a Global Security Actor: UNHCR, Refugee Protection and Security, available via Oxford Scholarship Online. Oxford Scholarship Online (OSO) is a vast and rapidly-expanding research library. Launched in 2003 with four subject modules, Oxford Scholarship Online is now available in 20 subject areas and has grown to be one of the leading academic research resources in the world. Oxford Scholarship Online offers full-text access to academic monographs from key disciplines in the humanities, social sciences, science, medicine, and law, providing quick and easy access to award-winning Oxford University Press scholarship.

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Image: United Nations Flags by Tom Page. CC-BY-SA-2.0 via Wikimedia Commons.

The post Donor behaviour and the future of humanitarian action appeared first on OUPblog.

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2. Organ donor shortage versus transplant rates

By David Talbot

The article in this week’s Times with the commentary written by Chris Watson illustrates the significant changes that have happened in transplantation over the last two years. In 2008, the Organ Donor Taskforce (ODTF) came up with 14 recommendations to address the problem of donor shortage, and then UK Transplant (which then changed to Blood Transplant) acted upon these.

In addition to these changes, organ donation surgery became restricted to six zones whereas before the ODTF recommendations, all 26 transplant units in the country contributed to cadaveric organ donation. Also, the national sharing of organs (which had been voluntary, in so far as we aimed to serve our own community primarily and additional organs were shared only in certain cases) became enforced. This essentially was because there was a postcode imbalance, and some kidney failure patients waited six years for their transplant whereas in the northeast, patients generally waited only for 18 months.

The reasons for this imbalance were complex and were partly influenced by certain ethnic minority populations who didn’t support cadaveric donation while simultaneously making up a significant percentage of the number of patients who needed a transplant.

Additionally, different transplant unit structures had varying degrees of enthusiasm for donation. The work force obviously recognized these problems and tried to unify the approach and also ensure equality of access.

On a personal level, I was reluctant to throw my lot in with these national developments because our transplant population had a good deal! Indeed, with the national sharing mechanism, our local transplant rates initially fell, resulting in an increased waiting time.

The ODTF 14 point plan was, to me, an experiment which should be abandoned if it didn’t work. However, its effect was to promote donation by embedding Transplant Coordinators in most hospitals, thereby insuring that potential organ donors are not overlooked. In addition, numbers of Non-Heart-beating donors (aka donor after cardiac death), thanks to our pioneering work, have really taken off, accounting for 37% of cadaveric kidney transplants nationally. So although from a local level the national sharing scheme was a bad idea at the time, because of the promotion of donors through the enactment of the ODTF plan, the transplant numbers have now increased nationally, so my concerns for the future have proved wrong.

For example, I was on call for the week between Christmas and New Year and we did six kidneys and two liver transplants. Last week, I was again on call, and we did a liver, a kidney/pancreas, three live donor kidneys, two double kidney transplants, and an islet transplant! On the background of this our unit did 135 cadaveric donors last year.

Our next pressing problem is surgical exhaustion!

David Talbot is a Consultant Transplant Surgeon at Newcastle Hospitals NHS Trust and co-author of Organ Donation and Transplantation After Cardiac Death.

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