PHM-Exch> Humanitarianism ‐ Moving Beyond Medical Rescue to Poverty Reduction, Sustainable Development and Justice?

[Claudio Schuftan]

*Humanitarianism **‐** Moving Beyond Medical Rescue to Poverty Reduction,
Sustainable Development and Justice?  [excerpts]
*

*David McCoy*

*Peoples Health Movement, NHS London, Centre for International Health and
Development, University College London.*



I want to place humanitarianism ‐ defined simply as the relief of human
suffering ‐ within a political and global economic context. I want to
extend the concept of humanitarianism beyond the common frame of rescue,
relief and aid (often by the rich for the poor; or by those who can for
those who can’t; and usually in conflict zones and at the scenes of natural
disasters) to a view of humanitarianism that incorporates social and
economic justice; and the relief of suffering caused by chronic poverty;
chronic

food security; chronic violence; chronic unemployment; the massive
exploitation of people’s labour; and the theft of their lands. Put another
way, this is a humanitarianism that goes beyond the *relief *of human
suffering to include the *prevention *of human suffering.

The world we live in is far from perfect; but may be the best of all
possible worlds.

For many it justifies and excuses the neoliberal foundations for our
political, social and economic relations. Because the implication is that
we don’t need radical or

revolutionary change ‐ we merely require a humanitarian and welfare
industry; and some green regulation to address the problems associated with
war; famine; natural disasters; and disease. Such people would say that we
can do better at making our world safer, fairer and more sustainable.

My expectations for the human race are simply much higher. I expect a much
better world; ‘another world’ is not just possible, but is desirable and to
be strived for; it requires change though. Real change. And it is change
that demands a broadening of our conception of humanitarianism.

We frequently hear that the world has made astounding progress in reducing
global levels of poverty; and that we may even be on track to reach the MDG
poverty targets. Triumphalist rhetoric often accompanies the facts and
figures used to describe the absolute and relative reduction of people
living on less than $1/day.

But let’s consider a few alternative facts. In spite of three decades of
global economic growth, the burning of fuel at a rate greater than at any
other time in human history and an explosion of scientific and
technological advancement ‐ the number of people living in poverty has
actually grown over the last three decades ‐ but only if you use a $2/day
measure of income poverty. In this instance, nearly half the world’s

population lives in poverty.

Furthermore, we know that the income poverty line of $2/day is a poor and
crude measure of poverty and that it uses a methodology that is biased in
favour of an under‐counting of people living in poverty. And if we consider
what Peter Edwards has called an ethical poverty line which is defined as
“the income level below which further income losses materially shorten life
expectancy” and which is calculated to be between $2.80 ‐ $3.90 / day, it
would not be unreasonable to argue that the majority of the world’s
population lives in poverty.

On the other side of the coin, we have the most incredible concentration of
private wealth. For example, here are some facts taken from an annual
publication produced by MerrylLynch in which you will find a categorisation
of human that does not appear in any UN report: *“*the high net worth
individual” and the “ultra high net worth individual”.

According to Merryl Lynch’s World Wealth Report, in 2009 there were 8.6
million ‘high net worth individuals’ identified as having investable
(financial) assets over $1 million (excluding primary residence,
collectibles, consumables, and consumer durables). Together, they own $32.8
trillion (or 35% of total global wealth). And there were 78,000 ‘ultra‐high
net worth individuals’ defined as having investable (financial) assets over
$30 million.

It is no wonder that inequality is so high. According to the World Bank,
the gini coefficient for income inequality at the global level is higher
than for any individual country. And even higher for wealth inequality.

But this inequality is not produced by accident; or through inevitable or
natural processes. For sure, there are certain geographical and natural
factors. But much of the inequality, dispossession and deprivation that we
see today is produced or sustained through violence; oppression; theft;
bio‐piracy; tax evasion; fraud; and corruption. And

increasingly, it is being reproduced through the degradation,
commodification and destruction of the planet.

The very same processes that result in widespread human suffering existing
side by

side with immense wealth and overconsumption, are the ones that have
possibly

brought us all to the brink of cataclysmic climate change. The rise in
frequency of severe

weather events; the projected migration and displacements of peoples as a
result of sea‐level rise and failings crops; and the conflict that will be
spawned by ecological disruption and collapse threatens to literally drown
the humanitarian community with a deluge of human suffering.

And so we come to the perpetual need for ‘humanitarian and development
aid’; and its perpetual inadequacy. But how does the humanitarian community
address this state of affairs? Before I answer this, I think it needs to
ask some questions about humanitarian assistance itself.

Here are a few questions we might consider:

 To what extent is the current practice of humanitarianism effective?

 To what extent is humanitarianism an expression of political or moral
conviction?

 To what extent is it an act of solidarity or an extension of the social
justice movement?

 And to what extent might humanitarianism be part of the problem ‐ not so
much an extension of

social justice; but an extension of the machinery, systems and vested
interests that create the crises

in the first place?

These are of course rhetorical questions. In any case, there could never be
a single answer to these questions. The humanitarian complex – consisting
of many different NGOs, as well as the UN, military establishments; donors
and governments ‐ is not homogeneous. It consists of different interest
groups; different value systems; and different motivations. There is the
good, the bad and the ugly. Many of us will have witnessed the co‐existence
of cynicism; hypocrisy; deception and abuse of power with many and
extraordinary examples of solidarity; courage; and generosity within the
humanitarian complex.

Aid and charity can be and is at times captured by ‘un‐humanitarian’
political and military interests; or distorted and corrupted by
commercialisation, competition and self‐interest.

I suppose the main message is that there is a constant need for critical
self‐reflection in what we do as humanitarians ‐ whether it’s in the field
of emergency humanitarianism or more long term development.

But this critical self‐reflection requires a political analysis and a clear
moral framework. The solutions to the problems described within the
humanitarian complex is only partly about creating new structures and
systems; or better accountability frameworks; or more effective performance
management indicators.

More fundamental solutions include speaking the truth to power; drawing
lines in the sand beyond which you will not compromise even if it means
reducing your chances of funding or being kicked out of a country;
recognising that noble and well‐meaning intentions can have harmful and
unintended consequences; and truly considering how we can give the
dispossessed and deprived not just relief, but also power and agency. This
means not using charity as a means to reinforce hierarchies and dependency;

but rather replacing it altogether with solidarity and real development.

But critical self‐reflection in the way we deliver relief and humanitarian
aid needs to

be linked to a broader effort at addressing the *causes *of human
suffering. Here again,

there is no political, managerial or technological blueprint for addressing
the

problems we face.

I am often struck by the sense of how, for vast numbers of the western
public, we have out‐sourced our global politics to the NGO sector. It seems
to me that we need to reconceptualise the role, place and function of
professional NGOs; and to see how they relate to civil society more
generally. We need a revolution of thought; new ways of doing politics; a
redistribution of power, wealth and property. It is so often said that the
revolution will not be funded. But the professional NGOs that *are *funded,
have an

important role to play in the popular struggles that are going on all
around the world today.

A second element of a political strategy must be to build horizontal
linkages between the progressive elements of the NGO community and civil
society. Break out of our silos. Those of us working in global health and
humanitarian relief need to forge links with those political struggles
designed to reform global governance institutions; the banking and credit
system; tax evasion; the utterly discredited regime of intellectual
property rights; the corporate media; and so on and so forth.

And at the same time we need to build the global community; strengthening
our cross‐border and transnational allegiances. I

If we look closely enough, it is the same struggle of millions of people
living in refugee camps across the world.

Independence, neutrality and impartiality – these are the cardinal
principles of humanitarian relief.  I fully appreciate the principle of
neutrality and impartiality on the battlefield and in the conflict zone;
but in most other instances, humanitarianism involves taking a side. Being
neutral and impartial is far too often used as an excuse for not taking
sides; or worse still, used to camouflage the reality that sides have been

taken either unconsciously, inadvertently or covertly.

We can and we must find ways to combine rescue, relief, charity and aid
(some of which may be provided neutrally and with impartiality) with a
political agenda that is NOT neutral but which sides firmly with the
interests of the oppressed; the exploited; the poor. Perhaps this needs to
be another element of the political strategy – how do we do both; without
one compromising the other.

The unique role and position of the humanitarian community – operating at
the coal face of human suffering  means that your voice and actions may be
more important than most. Not just in providing relief to human suffering.
But also in preventing human

suffering and acting upon its root causes.
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