CAMBRIDGE, Massachusetts – According to the United Nations High Commissioner for Refugees, or UNHCR, more than 105,000 refugees have fled Burundi to escape the political violence triggered by the president’s decision to run for a third term in office. Al Jazeera reports that, “Humanitarian agencies are struggling to cope as tens of thousands of Burundian refugees stranded on Kagunga Island in Tanzania face worsening medical conditions.”
Unfortunately, this is not an isolated incident. Waves upon waves of people have sought and still seek safety from the political turmoil in their countries. Reports on refugees from Syria, Ukraine, Sudan and so many other parts of the world have filled the news over the years.
Catering to this influx of tens of thousands of people is a daunting task. In over-crowded camps, injured and travel weary refugees are often in dire need for health care, food, water and shelter. Sufficient aid and humanitarian assistance pours or, in some cases, trickles in to help with disaster relief. However, the coordination among the various aid agencies, NGOs and government authorities can sometimes be the weak link in efficient delivery of critical assistance.
Médecins Sans Frontières (MSF) was bluntly critical of the lack of coordination in Maban County in South Sudan, the isolated region that received thousands of refugees from Sudan. The poor condition of the refugees on arrival, the lack of water supply and the Hepatitis E outbreak contributed to a high death rate of around 1.8 per 10,000 refugees per day.
MSF writes that UNHCR’s external coordination of the crisis response did not use the existing cluster system and instead, set up different organizational structures which caused confusion. Several NGOs that delivered services were unable to fulfill their commitments and UNHCR’s role as both donor and coordinator created a ‘culture of blame and competition.’
From 2011 to the time of the report in 2013, MSF had to provide emergency drinking water, in addition to setting up hospitals and out-patient centers, until International Committee of the Red Cross (ICRC) intervened to build a 15 kilometer water pipeline. MSF questions why it proved so difficult for humanitarian agencies to reach acceptable levels of service delivery in a region where many of the organizations had operated previously.
Disbursing information to the refugees on where to go to receive health care, rations and aid, is also a challenge. In Dadaab, Kenya, Somali refugees were not helped because they did not know where to go to receive that aid. UNHCR, operating via Lutheran World Federation and community networks, distributed information about the aid available but such systems are slow, particularly when there are so many other functions that each node in the supply chain is responsible for.
Speedy delivery of information is critical when so many people need healthcare and shelter in the first few weeks after their arrival. Coordinating a strategy, perhaps with more channels on the ground, to make sure refugees know about the resources available to them will make the humanitarian aid go a longer way. U.N. Refugee Agency has set up an Information Dissemination Group to deal with this issue.
Many other challenges like these present themselves in such situations. Crisis management is a difficult problem complicated by terrain, language, cultural factors and infrastructural deficiencies. Fast coordination among the multiple groups on the ground will enable all groups to work seamlessly to deliver on their mission.
UNHCR has set out guidelines for the roles of public health officers in coordinating epidemic preparedness and response at the camp, district and national levels. Defining specific roles for each party in the response team in this manner will reduce confusion and responsibility overlap, allowing for smooth inter-organizational collaborations.
MSF has also set out recommendations for coordinated response stressing the importance of clear leadership and specific roles for host government authorities, UNHCR and NGOs. It describes the importance of the coordination body recommended by UNHCR with representatives from each contributing organization to define the priorities of the relief work.
As these organizations conduct their relief efforts, different and new challenges will be encountered. Efficient coordination also allows for the opportunity to build on and learn from the solutions generated by a contributing agency so that there is reduced duplication and with every crisis handled, relief efforts can become more effective and efficient.
– Mithila Rajagopal