Disaster Health Management:Disaster Health Management:

Role of NGOs in DisastersRole of NGOs in Disasters

Dr Peter A. LeggatDr Peter A. LeggatMD, PhD, DrPH, FAFPHM, FACTM, FACRRMMD, PhD, DrPH, FAFPHM, FACTM, FACRRMAssociate Professor and Deputy DirectorAssociate Professor and Deputy DirectorAnton Breinl Centre for Public Health Anton Breinl Centre for Public Health and Tropical Medicine and Tropical MedicineJames Cook UniversityJames Cook UniversityTownsville, AustraliaTownsville, Australia

About the authorAbout the author

Dr Peter Leggat is co-ordinator of the postgraduate Dr Peter Leggat is co-ordinator of the postgraduate course in disaster and refugee health at James Cook course in disaster and refugee health at James Cook University in Australia. He has also served on the University in Australia. He has also served on the World Safety Organization (WSO) Board of World Safety Organization (WSO) Board of Directors from 1989-1999 and from 2003-Present. Directors from 1989-1999 and from 2003-Present. He was Director General of the WSO from 1997-He was Director General of the WSO from 1997-1999. He is currently assisting with their terrorism 1999. He is currently assisting with their terrorism and counter-disaster initiative. Dr Leggat undertook and counter-disaster initiative. Dr Leggat undertook his studies in disaster health as part of his his studies in disaster health as part of his postgraduate studies in aeromedical evacuation at postgraduate studies in aeromedical evacuation at the University of Otago, New Zealandthe University of Otago, New Zealand

In this session, we willIn this session, we will

Revisit the potpourri of NGOs definitions Revisit the potpourri of NGOs definitions and acronymsand acronyms

Examine some of the core values of NGOs Examine some of the core values of NGOs and how NGOs operateand how NGOs operate

Gain some insight into new directions in Gain some insight into new directions in accountability of NGOs accountability of NGOs

Examine the civil-military relationshipExamine the civil-military relationship Appreciate how NGOs may fit into the Appreciate how NGOs may fit into the

disaster health management equationdisaster health management equation

What are non-governmental What are non-governmental organisations (NGOs)?organisations (NGOs)?

In the current context:In the current context: A civic or public advocacy organisation, which A civic or public advocacy organisation, which

generates, transfers, or administers humanitarian generates, transfers, or administers humanitarian and other aid (development / relief)and other aid (development / relief)

Generally, NGO's are organised as nonprofit Generally, NGO's are organised as nonprofit corporations (charities)corporations (charities)

Can be local or international (INGOs)Can be local or international (INGOs) May work with or independent of governmentMay work with or independent of government Generally, do not include professional Generally, do not include professional

associations, businesses, and foundationsassociations, businesses, and foundations

Examples of NGOs involved in disaster Examples of NGOs involved in disaster & humanitarian crisis response& humanitarian crisis response

CareCare MSFMSF OxfamOxfam Red Cross (not ICRC)Red Cross (not ICRC) Save the ChildrenSave the Children St John AmbulanceSt John Ambulance World VisionWorld Vision

Who are the other players in Who are the other players in disaster health management?disaster health management?

GovernmentGovernment• NationalNational• State/ProvincialState/Provincial• LocalLocal

United NationsUnited Nations DonorsDonors Hybrid organisations with own defined statusHybrid organisations with own defined status

• International Committee of the Red Cross (ICRC)International Committee of the Red Cross (ICRC)

Related AcronymsRelated Acronyms CBO: Community-Based OrganizationCBO: Community-Based Organization CSO: Civil Society OrganisationCSO: Civil Society Organisation DONGO: Donor-Organised Non-Governmental Organisation DONGO: Donor-Organised Non-Governmental Organisation GONGO: Government-Organized Non-Governmental Organisation GONGO: Government-Organized Non-Governmental Organisation IO: International OrganisationIO: International Organisation NGDO: Non-Governmental Development Organisation NGDO: Non-Governmental Development Organisation PDO: Private Development Organisation PDO: Private Development Organisation PSO: Public Service Organisation PSO: Public Service Organisation PVO: Private Voluntary Organisation PVO: Private Voluntary Organisation QUANGO: QUasi-Autonomous Non-Governmental Organisation QUANGO: QUasi-Autonomous Non-Governmental Organisation VO: Voluntary OrganisationVO: Voluntary Organisation

Every NGO is different and is Every NGO is different and is governed largely by their own governed largely by their own individual charterindividual charter

How do they operate?How do they operate?

NGOs vary greatlyNGOs vary greatly Organizational structure is similar to Organizational structure is similar to

businessesbusinesses• Usually non-rigid hierarchy; significant Usually non-rigid hierarchy; significant

flexibility and authority at the field levelflexibility and authority at the field level International NGOs often team up with International NGOs often team up with

local NGOs or have regional or local local NGOs or have regional or local branchesbranches

Core valuesCore values

NeutralityNeutrality• Aid will not be used to further a particular political Aid will not be used to further a particular political

or religious standpointor religious standpoint ImpartialityImpartiality

• Aid is given regardless of race, creed, or nationalityAid is given regardless of race, creed, or nationality• Aid is based on need aloneAid is based on need alone

IndependenceIndependence• Aid agencies shall not act as instruments of Aid agencies shall not act as instruments of

government foreign policygovernment foreign policy

Core valuesCore values

Core values may impact on NGO’s Core values may impact on NGO’s willingness to work with other agencieswillingness to work with other agencies• Even perception of value violation will be Even perception of value violation will be

avoidedavoided

What do they do?What do they do?

Operational verses AdvocacyOperational verses Advocacy Grassroots, long-term projects, Grassroots, long-term projects,

development workdevelopment work Willing to work in high risk areas; not Willing to work in high risk areas; not

constrained by sovereigntyconstrained by sovereignty In theory, emphasis on sustainabilityIn theory, emphasis on sustainability Full integration with local populationFull integration with local population Good positioning for disaster responseGood positioning for disaster response

What do they do well?What do they do well?

Usually have excellent advocacy or Usually have excellent advocacy or lobbying capacitylobbying capacity

Can fill gaps-specialised skills/capacityCan fill gaps-specialised skills/capacity Usually mobilise quicklyUsually mobilise quickly Often well connected at local levelOften well connected at local level

What don’t they do well?What don’t they do well?

Can duplicate servicesCan duplicate services Turf wars can eruptTurf wars can erupt May step outside their areas of specialtyMay step outside their areas of specialty Often overcommit/overextend capacitiesOften overcommit/overextend capacities May not be so good at sustainabilityMay not be so good at sustainability

The extent to which an NGO The extent to which an NGO can contribute to any disaster can contribute to any disaster relief operation is often dictated relief operation is often dictated by contextby context

What is the context?What is the context? What is the situation?What is the situation? Who is there? What is Who is there? What is

their capacity?their capacity? Are their tensions Are their tensions

between players?between players? How well are they How well are they

recognised there?recognised there? What frameworks are in What frameworks are in

place on the ground?place on the ground?

How robust or resilient is How robust or resilient is the community?the community?

Are there plans in place?Are there plans in place? Are the roles clarified?Are the roles clarified? What voice does the NGO What voice does the NGO

have? Are they have? Are they recognised by other recognised by other NGOs?NGOs?

How are they funded?How are they funded?

Who pays them?Who pays them?

Funding sourcesFunding sources• Private Donations (citizens, businesses and Private Donations (citizens, businesses and

foundations)foundations)

• International Organizations (UN)International Organizations (UN)

• National GovernmentsNational GovernmentsPerceptions are importantPerceptions are important

• Importance of public relations and the Importance of public relations and the MediaMedia

Where international assistance Where international assistance required in disastersrequired in disasters

Donors also rely on NGOs, because of Donors also rely on NGOs, because of their access to the populations in needtheir access to the populations in need

• And again, their access is dependent on And again, their access is dependent on their neutralitytheir neutrality

• NGOs, as implementing partners of NGOs, as implementing partners of donor organisations, are donor organisations, are the legsthe legs on on which disaster response standswhich disaster response stands

AccountabilityAccountability

How do we know that NGOs are doing How do we know that NGOs are doing the right thing?the right thing?

Who monitors NGOs?Who monitors NGOs?

Who monitors NGOs?Who monitors NGOs?

Little External MonitoringLittle External Monitoring Self-Regulation: NGO StandardsSelf-Regulation: NGO Standards

• Red Cross Code of ConductRed Cross Code of Conduct• InterAction PVO StandardsInterAction PVO Standards• Sphere Minimum Standards in Sphere Minimum Standards in

Disaster ResponseDisaster Response

Sphere ProjectSphere Project www.sphereproject.orgwww.sphereproject.org Launched in 1997Launched in 1997 Humanitarian NGOs and Humanitarian NGOs and

related organizations, related organizations, including Red Cross and including Red Cross and Red Crescent movements Red Crescent movements

Three elementsThree elements• HandbookHandbook• CollaborationCollaboration• Expression of commitment to Expression of commitment to

quality and accountabilityquality and accountability

Sphere ProjectSphere Project

www.sphereproject.orgwww.sphereproject.org IncludesIncludes

• Humanitarian CharterHumanitarian Charter• Minimum standards in Minimum standards in

disaster responsedisaster response One example of a One example of a

standard to aspire to/be standard to aspire to/be measured againstmeasured against

NGO CultureNGO Culture

Independent: need to cooperateIndependent: need to cooperate Decentralised authorityDecentralised authority On-the-job training (changing however)On-the-job training (changing however) Often develop a range of field guidelines, Often develop a range of field guidelines,

e.g. MSF, Red Crosse.g. MSF, Red Cross Hopefully develop long-term perspectiveHopefully develop long-term perspective

How do NGOs coordinate? How do NGOs coordinate?

Australian Embassy teamAustralian Embassy team Other Government AgenciesOther Government Agencies UN Coordination Entities [UNHCR, WFP, UN Coordination Entities [UNHCR, WFP,

UNDP, UNICEF, OCHA, Special Humanitarian UNDP, UNICEF, OCHA, Special Humanitarian Coordinator]Coordinator]

NGO-Only Coordination Bodies/Field-level NGO-Only Coordination Bodies/Field-level coordination meetingscoordination meetings

Host Government Ministries / AuthoritiesHost Government Ministries / Authorities Civil-Military Cooperation or Operation CentresCivil-Military Cooperation or Operation Centres

Military UN/IOs

Religion Business

HostCountries

Government

NGOs

Zone of Collaboration/Coordination

Civil-military cooperationCivil-military cooperation

Most disasters and humanitarian Most disasters and humanitarian emergencies do NOT involve the militaryemergencies do NOT involve the military• The need for civil-military cooperation may The need for civil-military cooperation may

be the exception rather than the rulebe the exception rather than the ruleHowever the logistic support provided by However the logistic support provided by

larger NGOs or the military in support of larger NGOs or the military in support of smaller NGOs can be invaluablesmaller NGOs can be invaluable

Civil-Military Co-operationCivil-Military Co-operationServices typically requested by NGOsServices typically requested by NGOs

Security ServicesSecurity Services Landmine LocationsLandmine Locations Security Briefings Security Briefings Convoy SupportConvoy Support Guidance on Local SecurityGuidance on Local Security Technical Assistance Technical Assistance Access to Remote Areas, Ports, and Access to Remote Areas, Ports, and

AirfieldsAirfields

How effective are NGOs?How effective are NGOs?

What have they chosen to do?What have they chosen to do? What is their mandateWhat is their mandate Do they add value?Do they add value? What will the other players allow them to What will the other players allow them to

do?do? How do you measure these? Are they How do you measure these? Are they

accountable?accountable?

The capacity of an NGO to The capacity of an NGO to contribute to disaster response contribute to disaster response depends on their own ability todepends on their own ability to

Define their role within the broad context Define their role within the broad context of disaster health management, of disaster health management,

Effectively communicate that role Effectively communicate that role (are other players aware?), and (are other players aware?), and

Ensure that they add valueEnsure that they add value