My favorite panel from the recent International Women’s Day Global Health Symposium was titled “Relief and Rebuilding in Times of Crisis: Refugee and Humanitarian Aid.” The speakers were Dr. Deane Marchbein, the president of Doctors without Borders (MSF), and Dr. Reza Yassari who works with The Virtue Foundation, a volunteer-based nonprofit organization that renders assistance through healthcare, education, and empowerment initiatives. This was my favorite pairing of the day, for it made a very interesting comparison between first responders and those that work with rebuilding and more sustainable long-term health services.
It was very exciting that a representative from MSF was speaking at the symposium, because I feel that its mission: to deliver emergency medical aid to people affected by conflict, epidemics, disasters, or exclusion from health care can sometimes be misunderstood. It is sometimes criticized for being “unsustainable,” pulling out of countries at the wrong time, or interfering with the native communities. Dr. Marchbein addressed many of these misunderstandings in her talk. She stated that emergencies often occur in countries where MSF already has projects, though they do begin projects in countries where the local environment is unknown. The first goal is to talk to community leaders in order to identify gaps in the available healthcare services. Dr. Marchbein recently returned from a tour in Afghanistan, where the most prominent medical issue was maternal mortality. MSF has found that secondary healthcare is often first to go awry in conflict zones and organizing the local population in response. For every one international medical worker there are 10 trained locals. It is MSF’s dedication and quality medical work that builds trust with the local population, for Dr. Marchbein rarely sees other NGOs in the conflict zones that MSF enters. Being the only NGO in a challenging conflict zone could certainly leave MSF susceptible to a great deal of criticism, but I have the utmost admiration for MSF’s bold efforts for the sake of the greater good.
Dr. Yassari spoke about his work with the Virtue Foundation, a non-profit institution that works with both short-term impactful and long-term sustainable global health solutions. Rather than delivering emergency aid, the Virtue Foundation focuses more on public-private partnerships, evidence-based interventions, and long-term development. Through his work Dr. Yassari has come to find that sustainability and infrastructure are much more important than health alone. For one thing, a certain degree of infrastructure is necessary in order for a country to train its own health professionals. Dr. Yassari emphasized how in cases of humanitarian aid, it is important that local health professionals are trained within their own country. Many that are brought to the U.S. for training find a better life here and do not wish to return to their conflicted home. Ironically, the U.S. then benefits from their medical training rather than the nation in dire need. He spoke of a number of foreign aid interventions that went wrong, including one that intended to treat acid violence victims in Cambodia. The entire community became disrupted because some of the individuals were treated while others were not. This led to unrest and disparity among the people that was arguably worse than the original injuries. Dr. Yassari attributed this to a larger problem of social and political infrastructure. His talk made it clear that foreign interventions should not simply be executed because they can be, but require the utmost anticipation and deliberation.
It was fascinating to see these two professionals, who have very different approaches to humanitarian aid, in dialogue with each other. Though their approaches may seem different, the world needs both emergency aid organizations like MSF, as well as organizations more dedicated to long-term development like the Virtue Foundation. MSF enters conflict zones that other organizations may find too hazards to begin work in. Likewise, the relative stability that MSF can instill in a conflict zone is necessary in order for organizations such as the Virtue Foundation to even step in. The two have the capacity to work in synergy.
There are other initiatives that combine these approaches, such as the Harvard Humanitarian Initiative, with the mission to develop evidence-based strategies that will assist global populations in times of disaster. It’s aim is to combine the disciplines of public health, medicine, social science, management, and other disciplines in order to pioneer new and improved operational responses. HHI’s Program on Crisis Mapping and Early Warning is using mobile information technology devices in order to identify patterns in humanitarian emergencies in order to improve response. This intensely academic approach is applying research and evidence-based approaches to what has traditionally been a more on-the-ground approach. The discipline of global emergency aid is clearly more multifaceted than it first appears. This exciting field will hopefully continue to grow, as the world will always need first responders.