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Humanitarian Response to Natural disasters Submission by Merlin to the International Development Select Committee
About Merlin
1. Merlin is the only UK specialist agency, which responds worldwide with vital healthcare and medical relief for vulnerable people caught up in natural disasters, conflict, and disease and health system collapse. Merlin's aim is to ensure that vulnerable people who are excluded from exercising their right to health have equitable access to appropriate and effective healthcare.
2. This aim is inspired and underpinned by the World Health Organization (WHO) declaration[1] that "the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without discrimination of race, religion, and political belief, economic or social condition". In support of this aim, Merlin works in partnership with global, national and local health agencies and communities to strengthen health systems and build community resilience to better prevent, mitigate and respond to health outcomes.
Initial Disaster Response and the Humanitarian System
3. In terms of initial disaster response, DFID has a strong record particularly within the context of sudden onset disasters. Early logistical support, coordination and engagement with UK NGOs were critical activities undertaken by DFID during the first stages of the response to the Tsunami in December 2004. However donor responses to 'slow burning' natural disasters that occur as a result of high levels of vulnerability are less predictable. In a statement to the House of Commons in October 2005 on the food crisis in Niger, the International Development Secretary highlighted the failure of early warning systems to provide the critical information needed to trigger an earlier international response to the crisis. Merlin is concerned that DFID remains reliant on early warning mechanisms that fail to deliver critical information required by donors to take action. Although the department's responses are not at fault per se, the mechanisms on which they rely have, in the case of Niger, proven themselves faulty. DFID must seek urgent reform to ensure that the appropriate institutional structures are in place to support their decision-making and responses as donors.
4. The emergence of the cluster approach[2] to disaster response presents a clear opportunity for humanitarian actors to draw on lessons learned and make improvement for future action. The response to the South Asia Earthquake was the first time that the cluster approach was used in a disaster response situation and a real-time evaluation of the approach[3] has been open and honest about the shortcomings. The issues raised by the evaluation about the strategic coordination of the response will have policy and operational implications for further humanitarian responses, if the lessons learned are properly implemented. DFID must seek to use its influence within the respective clusters to ensure this happens as fully as possible.
5. An historic lack of indicators, against which humanitarian responses can be measured, has meant that valuable lessons have not always been taken on board, certainly with respect to donors. The Good humanitarian Donorship (GHD) Initiative will have an important role to play in this respect given its plans to develop performance indicators. In Merlin's view it is too early to assess the impact of the GHD on existing practices.
6. The current aid architecture was established more than half a century ago and is no longer fit for the global political and developmental challenges it faces. Merlin strongly supports the Secretary of State's commitment to secure reform of the UN. It is important however that this reform is closely monitored and reviewed and DFID must ensure that a sustained and in depth review of the new reform mechanisms is undertaken to ensure they are fit for purpose and to work to adjust them as required.
7. Merlin welcomes UK commitments by the Secretary of State to strengthen the capacity of the UN to provide logistical support, such as helicopters and aircraft for the benefit of the humanitarian community; the absence of Standard Operating Procedures for the military in crisis situations means that they are often deployed beyond the immediate delivery of direct assistance. DFID must seek to address this within the UN and lobby for the introduction of SOPs. In addition to causing confusion amongst beneficiaries and concern amongst NGOS about the erosion of humanitarian space, it is unclear whether any cost benefit analysis has ever been carried out to assess whether the delivery of humanitarian assistance by the military is an effective measure. DFID should be urged to look at this issue of cost benefit and seek to clarify whether these monies are allocated from the UK's humanitarian assistance or defence budgets.
Vulnerability and Disaster Preparedness
8. In terms of disaster preparedness and vulnerability, Merlin's key concerns centre on the current common definition of disaster, adopted by DFID, which does not incorporate health. Although DFID have highlighted critical infrastructure such as hospitals and clinics as vital elements of risk mitigation, the growing burden of disease and its impact on and the coping capacities of individuals is not adequately addressed. In Merlin's view, DFID must review this as a matter of urgency to ensure that health is not excluded from disaster risk reduction strategies and potential funding streams.
9. Many good practice public health interventions implemented by humanitarian organisations such as Merlin routinely improve the health and resilience of populations. Following the Tsunami in December 2004, Merlin implemented community level programmes to reduce vulnerability including health education and promotion, infection prevention at hospital level and waste management programmes. Merlin took steps to improve the diagnostic capacities of laboratories and disease surveillance monitoring to enhance early warning systems and provided support to the district health secretariat to develop disease outbreak plans and position first aid kits in schools.
Development and Humanitarian Assistance
10. Merlin has extensive experience of working within the context of transitional environments. Transition from conflict and relief to peace and development is rarely a linear process. In situations where countries remain unstable and within a 'humanitarian' remit, NGOs work on a succession of short grants for prolonged periods. The current emphasis by DFID and others on short term, unpredictable funding remains a significant barrier to improving equitable access to basic health services and strengthening health systems. Longer-term, predictable funding to enable pro-poor system development is critical.[4] In addition we believe that longer term funding would also improve responses through reducing competition between actors on the ground, thereby promoting coordination and better working practices.
11. Policy stewardship and implementation during transitions is often absent as host governments lack political will or capacity to bring about improvements to basic health services. Donors and humanitarian agencies must start with the assumption that in states where country led partnerships are not possible, interventions should shadow align with systems and processes wherever possible. In our view, ddonors must be prepared to compromise national agendas and interests. The GHD initiative to promote harmonization of management requirements and the acceptance of a common reporting format is a significant step forward in this regard and should be strongly supported by DFID.
12. In terms of monitoring and evaluation, as highlighted previously, Merlin is concerned that a lack of non-comparable indicators makes it difficult to evaluate humanitarian agencies contribution to pro-poor government systems. Aligning behind national indicators and systems and harmonizing donor criteria would enable comparisons across interventions and DFID could play an important role in encouraging and facilitating sectoral change.
[1] As reflected in the WHO constitution (1946), Alma Ata Declaration (1976) and World Health Assembly (1998). [2] The Cluster approach is an integrated thematic (e.g. Health) response that draws on the comparative advantages of humanitarian actors, funds and programmes. It ensures coordination among UN agencies by promoting joint programming, information and knowledge sharing on technical and policy issues and joint formulation of sectoral strategies. Merlin is a member of the World Halth Organisation's global health cluster. [3] IASC Real-Time Evaluation Cluster Approach - Pakistan Earthquake. http://www.unhic.org/pakistan/uploaddocuments/1808IASCEvaluationofClusterApproach-Pakistan%5BFINAL%5D.pdf
[4] Laurence C; Poole L (April 2005) Service Delivery in Difficult Environments (Merlin)
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