For All in Need

Emergency Relief Operationsby Edited by Kevin M. Cahill, M.D.Fordham Univ. Press and the Center for International Health and Cooperation. 386p $37(hardcover) $20(paperback)

More and more regional and intrastate conflicts throughout the world have led to huge increases in the numbers of refugees and internally displaced persons. Their pressing needs have in turn resulted in a corresponding growth in nongovernmental organizations that attempt to provide them with basic emergency care. The mission of these N.G.O.’s—their problems and challenges, as well as the interaction of military and peacekeeping groups with whom they often work—form the subject of two valuable volumes edited by Kevin M. Cahill, M.D. An expert in tropical diseases who has worked in Africa, Dr. Cahill knows at first hand what devastation these conflicts bring in human suffering.

The two books, Basics of International Humanitarian Missions and Emergency Relief Operations, which in a way form a single whole, represent the beginning of a series called the International Human Affairs Series, published jointly by Fordham Univ. Press and the New York-based Center for International Health and Cooperation. As Dr. Cahill points out in the introduction tothe first book, the complexities involved in international relief work have become daunting. Only recently, he writes, has humanitarian assistance been perceived as it really is: “a potent political and diplomatic tool,” but also “big business.”


In addition to Dr. Cahill, over 20 other experts in their various fields of humanitarian work have contributed to these volumes. The subjects of their essays range from early warning signs of humanitarian crises to exit strategies and the transition from war to peace. What emerges in all of them is the harsh reality that, while many have natural causes, most are “human induced.” Famines, forced migration of hundreds of thousands of people, outbreaks of preventable diseases—these increasingly frequent afflictions stem primarily from armed conflicts in some of the poorest areas of the world. As one contributor points out, over two dozen wars have been fought since 1970 in Africa alone.

Because of the intrastate nature of many such conflicts, over 25 million uprooted human beings in over 40 countries have been trapped for long periods within the borders of their own countries, far from their homes and normal systems of support. And, as pointed out by Francis Deng, the U.N. secretary general’s special representative for internally displaced persons, the fact that they were prevented from crossing over into other countries has largely deprived them of the assistance that might have been theirs as refugees. Not only do their own countries lack the resources to provide for these persons, their home states themselves are often the cause of the displacement. (The large number of displaced persons in Colombia serves as a reminder that conflicts of this kind exist on other continents too.)

The great majority of displaced persons are women and children. They are subject not only to rape and other forms of physical violence, but to starvation levels of hunger too, because it is usually men who control food distribution. One author, for instance, speaks of an internally displaced persons’ camp in Afghanistan: women there hesitated to go to feeding stations—or health posts either—because of fear of sexual assault.

Aid workers themselves, whether from United Nations organizations or privately funded N.G.O.’s like the highly praised Doctors Without Borders (among the few, we are told, to have stood by Chechen refugees during the winter of 1999-2000), face deadly risks in pursuing their work. Many have been killed. On the other hand, one military officer who has worked with N.G.O.’s, while expressing admiration for the work they do, also found that many of their staff members were “young and inexperienced” and sometimes displayed “a moral arrogance and cultural imperialism that alienated local agencies.” Counterproductive competition among N.G.O.’s for funding and media attention, moreover, has at times hampered the creation of coordinated efforts to assist both refugees and I.D.P.’s.

The question of the military’s role in providing aid was already debated several years ago in Afghanistan, when U.S. aircraft dropped food rations during its bombing campaigns there. Now, in postwar Iraq, similar questions have arisen in regard to the virtual shutting out of the United Nations and all but a few private American relief agencies from the rebuilding process. Richard Ryscavage, S.J., country director of Jesuit Refugee Service/USA, examines the even more basic issue of the appropriateness of U.S. and British military intervention in such countries. In his essay “The Transition From Conflict to Peace,” he presciently observes that “external intervention...rarely succeeds in establishing a democratic culture.” (These words were written long before the war in Iraq—one of whose primary goals, the Bush administration has told us, is the establishment of democracy.) And yet, as Father Ryscavage points out in his essay in Emergency Relief Operations, the creation of a democratic culture “must come from the society itself.” To what degree the United States will allow this to happen remains to be seen.

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