By General Lieutenant Louis Lillywhite

The vulnerability of humanitarian workers has been highlighted in 2010 by the killing of nine aid workers off the Gaza coast by Israeli Commandos, of ten medical aid workers - six of them Americans - working in Afghanistan, and of Britain's Dr. Karen Woo and co-workers.

Such vulnerability has been the subject of an annual United Nations (UN) resolution since 1998, but whilst there is no authoritative central database, data held by Humanitarian Outcomes and two scientific studies point to an increase in violence, including deaths, amongst humanitarian workers. The International Federation of Red Cross and Red Crescent Societies (IFRC) is making the protection of volunteers, who are frequently involved in delivering humanitarian aid, one of its major themes for this year's tenth Anniversary of the International Year of the Volunteer (IYV). The International Committee of the Red Cross is also developing a project on 'Healthcare in Danger in Armed Conflict and Other Situations of Violence' in view of concerns on violence related barriers to accessing healthcare.

As well as affecting individuals, such violence poses problems for the national governments of expatriate humanitarian workers - especially when they are kidnapped - and diverts funding from the main humanitarian purpose. It endangers the 'Comprehensive Approach', which is broadly defined as 'the coordination of a wide spectrum of civil and military instruments to enhance the effectiveness of a government's activity in a wide range of conflict management or peace support operations.' This is because civilian humanitarian workers, paid and unpaid, expatriate and local, play a major role in development programmes considered essential for establishing governmental legitimacy and stability. For example, it was estimated in 2007 that there were approximately 14,000 aid workers in Darfur (the majority Sudanese) working for foreign NGOs and UN agencies and delivering one billion dollars a year in aid. Whilst the Global Fund used World Vision International to successfully deliver its tuberculosis programme in Somalia across three zonal 'governments', only one of these was internationally recognised. The withdrawal of volunteers and of humanitarian organisations thus adversely impacts development and thus stability.

In his 2009 report to the General Assembly, Secretary General Ban Ki-moon appears to have identified two threat environments, differentiated by the lack or presence of political motivation. The first is in areas of general unrest where attacks on UN and humanitarian personnel are an extension of the violence being experienced by the civilian population, either as the target of local criminals, organised crime or by individuals in an unending search for survival.

It is the second environment which should be of particular concern to the international community. It is in these zones, where the threats are essentially political or politically related, that UN and humanitarian personnel are increasingly targeted by extremists, armed groups and disenfranchised elements in multiple areas of operation. This situation is further exacerbated by a disinformation campaign undertaken by extremists urging violence against humanitarians. Further, the Secretary General notes that the propaganda campaign against the United Nations initiated by notorious terrorist groups in 1998 evolved into a 2006 declaration that the organisation is a part of a global international conspiracy. Put simply, those that seek to undermine international order have declared that humanitarian organisations in general, and the UN humanitarian organisations in particular, are part of the forces opposing them. From the perspective of insurgents this is entirely rational. In current conflicts, such as Afghanistan and Somalia, all the legal entities (UN and recognised interntional governments) support one particular faction or 'government'. By extension, from the insurgents' perspective, the Agencies of the UN and most of the humanitarian actors who are perceived as 'western' are seen at best as passively supporting the 'enemy'. Even an organisation such as Médecins Sans Frontières, which is often critical of 'official' policy and states that it cannot be a part of the Comprehensive Approach, is inadvertently so in Afghanistan by working in areas of the country of lower priority to western forces. In essence, the formal intrusion of UN and major western nations into non-international conflicts has, from the insurgents' perspective, compromised the neutrality that existed during the cold war era when humanitarian aid was perceived as being neutral. There has been a blurring between neutral 'humanitarian aid' directed solely at the relief of suffering and 'development aid' intended to give legitimacy to a country's recognised government. The increasing use of military resources in providing development within what was seen as the 'humanitarian space' has further contributed to the perception that humanitarian activity is partisan.

What then can be done to address the increased vulnerability of humanitarian organisations in areas of conflict? A number of options - some of them already attempted - present themselves, although none on its own is likely to be effective.

Simple measures, such as avoiding travel during periods of the day with the highest risk and learning how to behave when confronted with potential violence, has been shown to help in both threat environments. Hiring local guards and gaining support from elements of the local population are also sometimes effective. Some humanitarian organisations have tried to reduce violence by replacing ex-patriot workers with local workers managed remotely. Whilst this clearly reduces the incidence of violence against ex-pats, it has not been shown to reduce overall risk and may actually increase it, as local workers are seen as an easier target. The UN has also taken a proactive approach, including sponsoring collaboration between NGOs and IGOs under the framework of 'Saving Lives Together' that includes some fifty dedicated global security focal points which disseminates essential security information daily. It has also recognised that it must continue to deliver its mission in spite of increased threat based around three principles: 'how to stay' (a change of emphasis from 'when to leave'), 'no programme without security', and 'no security without resources'. However, it is questionable as to what impact these measures will have in the area of an insurgency. 'Militarising' humanitarian aid by providing armed protection, either using military forces or private security organisations, is one response.

However, this would be anathema to a number of humanitarian organisations and may emphasise their role in stabilisation, reducing the scope opportunity for local negotiations to gain local and acceptance. Using humanitarian organisations from similar cultural backgrounds, such as BRAC - the Bangladesh Rehabilitation Assistance Committee, might reduce the association with the UN and western nations, but this assumes that sufficient NGOs exist and that their use in places such as Somalia and Afghanistan does not disadvantage their own country. And, even if the use of third party NGOs was feasible, such NGOs would still need the endorsement of the legally recognised government, as was the case with BRAC in Afghanistan, which would immediately associate it with one side in the conflict.

An alternative to the militarisation of humanitarian support would be to seek to once again make it, or elements of it, neutral. Actively negotiating with insurgents to promote the meaning of, and gain acceptance for, 'neutrality' and humanitarian principles is one approach. Not withstanding some success with this approach by the International Committee of the Red Cross (ICRC), which seems to still occupy a unique position as not being recognised as an instrument of the UN, in an active insurgency this could bring the humanitarian organisations into conflict with the recognised government over issues such as the approach to insurgents seeking humanitarian aid. Certain organisations could gain some degree of protection from using a protective emblem such as the Red Cross insignia, but currently would require the authority of the recognised government or a de facto authority of armed groups, and this continues to suffer from the disadvantage of association with one side or the other.

The only remaining approach would seem to be to establish or empower a 'neutral' international organisation to assume responsibility for the delivery of humanitarian aid, or the accreditation of organisations delivering such aid, or elements of it, under given circumstances. Such an approach would face significant obstacles, from the practical (which international organisation, what enforcement powers would it have to ensure humanitarian organisations were acting in a neutral manner, what would be the approach to combatants, and how would humanitarian assistance interact with local governmental organisations), to the legal, as there would probably be the need for new Treaty Law, and political, as nations would not wish to lose authority over the work of the major UN humanitarian agencies that they collectively fund. Perhaps such an approach might be possible for those organisations providing health support where there is a stronger and well-established tradition of neutrality.

The bottom line is that humanitarian aid has been 'politicised' in the context of the current conflicts by becoming part of the Comprehensive Approach. The outcome has been increased violence against humanitarian workers which, if not addressed, will lead to a reduced ability to provide relief, as well as a contrary outcome to that intended when the 'Comprehensive Approach' was formulated as a NATO strategy.

(Lieutenant General Louis Lillywhite is the former Surgeon-General of the British Armed Forces.)