The Center for Humanitarian Emergencies is a partnership between CDC's Emergency Response and Recovery Branch and the Rollins School of Public Health that drives global collaboration, research and evidence based training to improve the lives and well-being of populations impacted by humanitarian emergencies.
- Center for Humanitarian Emergencies: http://www.che.emory.edu/
- CDC's Emergency Response and Recovery Branch: http://www.cdc.gov/globalhealth/healthprotection/errb/index.html
This course covers the technical and management principles that are the basis of planning, implementing, and evaluating health programs for acutely displaced populations in developing countries. The emphasis is on refugees in camp situations. The course includes modules on assessment, nutrition, epidemiology of major health problems, surveillance, and program management in the context of an international relief operation.
Course Objectives
Upon completion of this course, learners will be able to:
1. Describe a complex humanitarian crisis in terms of magnitude, person, time and place.
2. Calculate basic epidemiology measures.
3. Evaluate the strengths and limitations of epidemiological data within the context of CHE.
4. Develop public health programs and strategies responsive to the diverse cultural values and traditions of the community being served.
5. Identify internal and external problems that may affect the delivery of essential public health services in a CHE.
6. Identify the different technical areas in a public health response in CHEs.
Na lição
Setting the Stage: Refugees, Displaced Persons, Conflict, and Complex Emergencies
Defining complex humanitarian emergencies, the top priorities and response, and main actors involved.
Assistant Professor Hubert Department of Global Health. Rollins School of Public Health. Director, Center for Humanitarian Emergencies.
Cyrus Shahpar
Assistant Professor, Adjunct Assistant Professor Department of Emergency Medicine, School of Medicine & Hubert Department of Global Health, Rollins School of Public Health
Hello, I'm Cyrus Shahpar, Deputy Team Leader for the Global Rapid Response Team
at the US Centers for Disease Control and Prevention.
My primary job is responding to global health emergencies, including infectious
disease outbreaks, natural disasters, and humanitarian crises all over the world.
Today I'm going to discuss the major actors or who's who, in humanitarian
emergencies, and the cluster system that has been implemented to coordinate them.
To start, we will review the main actors among UN agencies, US government agencies,
and international NGOs.
Next, we will describe the Inter-Agency Standing Committee and
it's cluster system and discuss some of it's strengths and challenges.
When a sudden onset emergency occurs, such as an earthquake or
tsunami, first responders act to reduce the health consequences, and
minimize their social and economic impact.
The host country government has the primary responsibility for directing and
coordinating the response, but
it is important to remember that they to may be affected by the emergency.
And systems and
staff may not be fully operational in the acute post emergency period.
So who are the first responders?
Think about what would happen if an emergency happened as you listened to
this session.
Who would be the first groups of people providing assistance?
Who would come later?
First responders typically include the local and national government,
specifically any emergency management or response personnel.
Other local groups already in the area also get involved,
including local Red Cross or Red Crescent Societies,
local non-governmental organization or NGOs and local citizens.
International groups including NGOs may already be present in the country and
provide assistance.
And the World Health Organization or WHO, often maintains a country office that
collaborates closely with national health Departments or ministries of health.
The United Nations or
UN has several agencies that may become involved in humanitarian response.
The Office for the Coordination of Humanitarian Affairs or
OCHA, works to mobilize and coordinate humanitarian action,
in partnership with national and international actors.
Depending on the type of emergency, other UN agencies who may respond include,
the United Nations High Commissioner for Refugees or UNHCR,
the United Nations Children's Fund or UNICEF, the World Food Program or WFP.
And the World Health Organization or WHO, and others.
Each of these agencies has a specific mandate in area of technical expertise.
For example, WHO works closely with ministries of health
specifically in issues related to the health sector.
UN agencies often maintain a presence around the world and
each agency has multiple levels of coordination.
OCHA for example has two headquarters offices in New York,
in the United States and Geneva, Switzerland.
They also maintain 9 regional offices and 28 field offices.
This allows them to be close to populations frequently affected by
emergencies.
Governments around the world also may have agencies or
organizations that are involved in international emergency response.
In the United States, for example, this includes the Department of Health and
Human Services and CDC.
The Department of State, the US agency for International Development or USAID and
the Department of Defence.
There are many other agencies which also participate in international emergencies.
Two of the largest international organisations working in emergencies,
are the International Committee of the Red Cross or ICRC.
And the International Federation of the Red Cross and Red Crescent Societies or
IFRC.
ICRC is an impartial, neutral, and independent organization
that focuses on victims of armed conflict and other situations of violence.
IFRC is the world's largest humanitarian organization and
carries out relief operations to assist victims of disasters.
International non-governmental organizations typically provide
a large portion of the operational response.
There is tremendous diversity within the international NGO community and
each organization has a specific mission, target population, and scope of work.
Some of the largest NGOs include MSF, Save the Children,
the International Rescue Committee and World Vision.
Donors are another important actor in humanitarian emergencies.
This includes both national and multinational donors, foundations and
private donors.
A critical international partner in public health response is
the Global Outbreak Alert and Response Network or GOARN.
Which is a collaboration of more than 120 public health institutions and
networks, who are constantly ready to respond to emergencies.
This network pools human and technical resources for rapid identification,
confirmation, and response to outbreaks of international importance.
They are many other responders that are often present in humanitarian emergencies.
These includes small civilian groups and individuals,
remote responders such as crisis mappers and military groups.
Civilian military coordination is especially important in large natural
disasters, where the militaries typically have logistical capacities
that often exceed those of their civilian counterparts.
As you have heard, there are hundreds of organizations that are typically
present in a large humanitarian emergency.
With so many organizations present, coordination is a frequent and
ongoing challenge.
The Interagency Standing Committee, or
IASC, was formed in 1992 to improve the delivery of humanitarian assistance.
IASC has several objectives in complex and major emergencies, including developing
humanitarian policies, allocating responsibilities among agencies,
developing an ethical framework for humanitarian activities, identifying and
addressing areas where gaps in mandates or lack of operational capacity exist.
IASC is chaired by the emergency relief coordinator, currently Stephen O'Brien.
The members of the IASC are the heads or their designated representatives of the UN
operational agencies relevant to those sectors.
In addition, there is a standing invitation to other groups such as ICRC,
IFRC, and the World Bank.
NGO Consortia are also invited on a permanent basis.
IASC classifies emergencies based on five criteria, including scale or
the size of the affected area, number of persons or countries affected.
Urgency is also considered.
And this can be represented by the size of the population displaced,
the intensity of armed conflict or crude mortality rates.
Complexity including how many layers exist in the response, are there
multiple countries effected or multiple actors that need to be coordinated.
Capacity, is there a low national response capacity, is it a weak or fragile state.
And do the needs outweigh the capacity of the country in regional offices to
respond.
And reputational risk, is there a media and public attention invisibility and
are there donor expectations of the humanitarian system.
In this classification,
level three is the most severe emergency according to the IASC.
This means that the emergency requires a system wide mobilization
to ensure an effective response.
In 2005, after identifying coordination gaps in the Indonesian tsunami response,
IASC developed a cluster lead approach for humanitarian emergencies.
This approach was developed to address identified gaps in response, enhance
quality of humanitarian action, ensure greater predictability and accountability.
And strengthen partnerships between NGOs,
international organizations, IFRC, and UN agencies.
The goals of the cluster approach were to strengthen overall humanitarian system
preparedness and capacity at the global level, and
strengthen response in all sectors of the country level.
In the cluster approach, specific sectors or clusters were identified, along with
agencies who would be responsible for coordinating work in these areas.
Examples of cluster leads, and the clusters they are responsible for
include the World Food Program for logistics.
UNICEF for nutrition, water sanitation and hygiene, and with Save the Children for
education.
The World Health Organization for health and UNHCR for protection.
Cluster lead agencies have many responsibilities once activated.
Including coordination with local authorities,
since they have the primary responsibility for directing the response.
Conducting a needs assessment, periodically done to understand what
resources are required, whether they be human, material, logistical or financial.
Monitoring periodically done to understand if the activities or
resources available are sufficient, and whether they are making a positive impact.
And providing assistance, only when needs outstrip the capacity of local resources.
Perhaps the most significant is that the cluster leads are the provider of
last resort.
For example, when there is a health problem in an emergency,
then WHO is the ultimate group responsible for the health cluster response.
The cluster system is not perfect, but provides a necessary framework for
coordination in a complex setting.
Since first implemented, stakeholders have continuously worked to improve the system