Major Reports Say Global Health Community Struggles to Cope with a Rise in Violence

Yida refugee camp, South Sudan. © V. Wartner/20 MINUTES.

Tara Ornstein, Contributing Blogger

On July 7, 2014, the United Nations (UN) released a new report describing the world’s progress in achieving the Millennium Development Goals (MDGs) and noted several positive developments. According to the report, the proportion of people living in extreme poverty has been halved five years ahead of schedule, 90 percent of children receive primary school education, child mortality under age five has been reduced by almost 50 percent, and the goal of halving the proportion of people who lack access to improved water sources was met.

But a rise in armed conflict is one of the most serious obstacles to achieving all of the MDG targets and has the potential to roll back the progress already made. The authors of the MDG report say that in 2013 the conflicts in the Central African Republic, the Democratic Republic of the Congo, Syria, and the border area between South Sudan and Sudan forced an average of 32,000 people per day to abandon their homes and seek protection elsewhere. Armed conflict threatens development in a variety of ways, such as impairing access to water and sanitation, forcing children to stay out of school, and reducing the effectiveness of anti-poverty initiatives, among other consequences.

The same day as the MDG report was released, Médecins Sans Frontières (MSF) published a report critical of the UN’s humanitarian response in areas affected by armed conflict. The report, “Where Is Everyone?,” concluded that “the current UN system inhibits good decision-making, in particular in displacement crises where a number of UN agencies have a responsibility to respond”. In MSF’s view, “the triple role of key UN agencies, as donor, coordinator, and implementer, is causing conflicts of interest, especially in recognizing and correcting mistakes”. MSF’s report illustrated these assertions with three case studies describing the emergency response in South Sudan, the Democratic Republic of Congo, and Jordan.

These three emergencies were only the tip of the iceberg, however, according to data released by the United Nations High Commissioner for Refugees (UNHCR). In the foreword to its 2013 Global Report published on June 20, 2014, the UNHCR stated, “More people were forced to flee their homes in 2013 than ever before in modern-day history”. This publication further described how “the international humanitarian system was tried by several simultaneous major crises” and how “approximately 43 million people—the highest number ever—relied on UNHCR for support and protection”. Although MSF maintained that a lack of funding was not a determining factor in the poor response witnessed during the 2013 emergencies, The New York Times wrote that international donors have not provided sufficient support to the UN to support people fleeing armed conflict. According to the article, the UN Office for Humanitarian Affairs received only 30 percent of the US $16.9 billion requested for emergency response.

The point on which everyone agrees is that these crises that have worsened extremely quickly. As António Guterres, the High Commissioner for Refugees, explained, Syria went from being the second largest refugee-hosting country in the world to the second largest refugee-producing country in the world in just five years. The rapid deterioration of the situations on the ground presents grave security risks to both UN and MSF staff working in conflict areas. The UNHCR confirmed that a total of 116 personnel affiliated with the UN, the International Organization for Migration, the International Committee of the Red Cross, and the International Rescue Committee were killed in 2013, with many dying as a result of “deliberate and targeted attacks on the international community”. In addition, MSF staffers have lost their lives while trying to provide health and other services. Violence caused MSF to cease all operations in Somalia in 2013, to close a hospital in Syria after the abduction of five of its staff members and the murder of a surgeon, and to withdraw its staff from a clinic in the Central African Republic in April 2014. While it is clear that violence against aid workers negatively affects both emergency responses and long-term development, viable solutions to this problem have yet to be defined. In the meantime, 43.7 million refugees and internally displaced people urgently need the global health community’s support and assistance.