Health Diplomacy

[Beelzebubalicious]

So, Barnsley, you pull up to a nation, put your anchor down and wait for the diseased and debilitated to show up? Okay, I'm a bit cheeky here, but how does this work? Is this like Doctors w/out Ports?

[Barnsley]

The one i did was organized and run by SOUTHCOMM.
And advanced party had been to each of the host [target] countries months before and organized with the Mins of Hlth what they wanted and what we could provide.
We turned up on the day and did what we could for about a week at a time.
As you might guess it wasn't exactly satisfying for some of the recipients and for many of the care givers. it could have been though, it was a good idea badly executed and I am sure could be improved hugely and to the benefit of all.
There are a couple of pieces written on the COMFORT trip which might cast some light and expand the argument. One is here
www.usmedicine.com/column. cfm?columnID=251&issueID=103 - 21k -
I hope I have posted this properly and not invoked the wrath of Ted

[LawVol]

Given your experience with NGOs, I'd like to hear your thoughts. Although I am not familiar with the new "health diplomacy" concept you refer to, I have often thought that we could use military assets to address some of the human security needs in ungoverned or loosely governed regions of the world.

I think this would serve a number of purposes. First and foremost, it would get health care and other necessary aid to people that need it. Second, it would provide valuable training for the military personnel involved. Third, it would send a positive message regarding the US and its military. Fourth, when partnered with appropriate local authorities, it could help establish the legitimacy of the local government thereby denying legitimacy to any terror/insurgent organizations that exist or could exist. I think it hard for people to want to assist the US in its notions of democracy when disease and starvation are killing their kids. Fifth, in some situations it could prevent an insurgency from occuring.

I have often heard that NGOs don't like working with the military, but the military is the best equipped organization to do this. Of course, the military may need to revamp its method of conducting business and may even need to cede some control to NGOs, but given the benefits, it might be worth it.

[Barnsley]

Your basic tenets. However, i think the most vital aspect of a Mil/NGO relationship is that of security. My experience is that it is impossible to provide humanitarian aid or even day-to-day healthcare in an insecure environment. You will hear and read much about how such self-promoting organizations as "Egos Without Borders" do to save the poor and down-trodden in war and peace, but most times they find it impossible to work in an insecure environment.
As an example: Over the past few years there has been a constant state of conflict between the NGOs working in the IDP camps of northern Uganda and the Ugandan Peoples Defence Force, the Army. The NGOs have blamed the UPDF, sometimes with good cause, for all kinds of awfulness but when the UPDF was not able to guarantee the NGOs security, they didn't venture out of their compounds. I have witnessed entire kid's vaccination programs fall apart because of lack of security.
That I think is the key role of a Mil/NGO cooperative program
Anyway, enough from me. I know at least one of the Council has practical experience of the same in Rwanda
I am searching for someone who might know how much NGOs spend on their own security ( as a % of thie budget)

[Stan]

Hey Bob !
This concept merits consideration, but I remain skeptical. Not because our governments couldn’t employ/enforce said, but the players are, shall we say… historically at odds and otherwise have quite different mindsets and missions.

At one point during the Rwandan refugee crisis, my boss was asked to immediately depart the AO when it was determined he was armed. I felt that was ignorant and naive of them considering the ever present machete attacks in the same camp.

Our 3rd member (of a 3-person team (note the PC)) was a former Peace Corps volunteer and later headed the DART program both in Goma, Zaire and Kigali, Rwanda. She never really understood the Colonel and I, but would later appreciate having us around. I honestly think she felt we were basically ‘disciplined armed thugs in uniform’. But, we were American thugs

The rather small contingent of US forces ensured security patrols maintained a safe environment for NGOs, but in all honesty, that was not why they were there. If it weren’t for my boss and the US military leadership, most of the NGOs would have fallen victim to typical Zairian 'Jungle Rules'

We did try connecting potential security elements in Kinshasa with folks in Goma, but it was a politically charged and sensitive issue that nobody seemed willing to engage in. Even with their Alphas on the line, they refused to take sound advice or employ adequate security.

Regards, Stan

[LawVol]

In some situations, a military designed to address human security needs would need to go in heavy. Situations like Somalia and Iraq (immediately after the fall of Saddam) would need the ability to provide security for both the military itself and local civilians. Nothing says "check yourself" to the local troublemakers better than a battalion of Marines. I would envision the team setting up shop and then slowly spreading their influence and operations. Sort of like an ink-blot scenario.

Since NGOs typically have more experience at this stuff than us, it would be nice to coordinate the effort with them. Or perhaps we could simply contract out for an advisory team that could assist us in doing this the best way.

Barnsley, I would be interested in hearing your thoughts on what methods might be employed in your area.

[davidbfpo]

After the earthquake in Azad Kasmir (Pakistani administered) now two years ago a number of NGOs, international military teams and locally based militants all took part in providing help. The Pakistani Army took longer to help and due to politics help from India was declined.

There are reports that the local Kashmiris were impressed by the help provided by the UK and USA, notably the helicopters - moving whole villages to lower ground and engineers. Interestingly the UK effort was influenced by NGO knowledge, mainly in provision of shelter for the coming winter, which double up as schools. Building up food supplies for the winter too.

Not heard of the impact now, although the region remains on the UK "radar", partly political and a recognition of the impact of events there as Kashmiris make up the largest group in the UK's Pakistani community.

davidbfpo

[redbullets]

Since NGOs typically have more experience at this stuff than us, it would be nice to coordinate the effort with them. Or perhaps we could simply contract out for an advisory team that could assist us in doing this the best way.

I've been attending CIV/MIL conferences with increasing frequency, and am a panelist at one next Monday for AFRICOM and State. Your quote above reinforces one of the major points I'm going to try and convey.

When military entities use the term "coordinate" with NGOs, UN, what-have-you, the humanitarians immediately run screaming from the room, and will continue to do so. The result of US military "coordinating" the efforts of international NGOs in places like Iraq and Afghanistan are that these NGOs become much higher profile "combatants" to some of the actual combatants. In conflict and post-conflict situations, this is not likely to change.

That being said, what is likely to be the most effective way to improve overall interoperability (I will be waterboarded by my community for using that term here!) of military and NGO elements in relief and development situations is to let the majority of the coordiantion/deconfliction reside where it should - with USAID and State.

A greater focus by DOD, State and USAID upon improving their own coordination and deconfliction mechanisms is probably the only way to substantively improve these efforts in conflict environments.

Cheers,

[redbullets]

I am searching for someone who might know how much NGOs spend on their own security ( as a % of thie budget)

I don't know how much other NGOs spend on their security - for the larger organizations, this is more a country-by-country issue, dependent upon a very wide range of insecurity levels. An organization might be in 20 countries, but only have major security expenditures in four or five of them, or even fewer.

From my perspective of running an NGO and having to bring in the projects and funding, our donors, whether they be USG, other international governments, or United Nations, are quite tolerant and supportive when it comes to our security needs in the field. In Iraq at one point, we even had a United Nations agency insist that we somehow or another engage a PSC, though that was an exception.

Cheers,