Health Diplomacy

[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

[Tom Odom]

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

Ultimately we succeeded for what it was worth, Stan. The CZSC was recruited directly from the DSP and it came with "advisors" at some of whom were Israeli.

I am fairly content that the CZSC helped keep the lid on security for the NGOs; I was and still am truly appalled angered that in the longer term, it's "success" was trumpeted by some as a working solution to the threat those camps represented.

Barnsley,

I don't have an average figure as I expect it varies from one extreme to the other. Abu Buckwheat on here has been an NGO security manager. I made it into Uganda a few times, twice on runs to Kamapala and a third to Queen E Park. And Stan and I made a loop through Kisoro counting Rwandan refugees while we were in Goma.

As for "Egos Without Borders," I know those guys quite well. They harshly criticize security forces until they themselves need them. Reminds one of Kipling's Tommy

For it's Tommy this, an' Tommy that, an' "Chuck him out, the brute!"
But it's "Saviour of 'is country," when the guns begin to shoot;
An' it's Tommy this, an' Tommy that, an' anything you please;
But Tommy ain't a bloomin' fool - you bet that Tommy sees!

Best

Tom

[Progressive Ranger]

I am not a big proponent of the ink-blot theory. I have developed one of my own that I think is more practical and explains the spread f control much better - especially in areas of some countries that are ungoverned - or undergoverned so as not to offend!

I call it the spider web phenomenon. To keep in line with the "big stick" of a group of Marines, especially in an ungoverned area, think of the Marines or other appropriate security force as a spider. Initially, the spider simply builds the spokes of its web. It remains in the center, but can travel the spokes - the initial netowrk of security and influence (Lines of communication). As time passes, the spider is able to begin to lay the circles of the web starting from the center - where things are strongest (most secure). If an event happens, say a fly gets into the ointment (uprising or security situation), the spider can still travel the spokes, but areas between the spokes at this point are still being missed.

The spider continues to spread its web, laying more concentric circles. This is the security force gaining influence, building trust and partnerships in the areas surrounding its base of operations. The more concentric rings of web, the more things the spider/security force can respond to with greater speed and efficiency. This all serves to allow for the IOs/GOs/NGOs operating there a better security blanket in which to operate.

The goal is to have multiple spiders at critical locations (the most violent and unstable) and ultimately, through their work of building trust and partnerships in the areas in which they work, build their webs large enough and over enough time, to have the webs begin to overlap.

There will always be areas that the spiders simply can't build their web for whatever reasons, but at this point, the "flies" only have so many areas they can get through the webs without getting caught, and the aid workers have much greater freedom of movement.

Anyway, just the way i think we should be trying to do things. I haven't copyrighted it yet, but if I see it in someone else's book I am gonna be pissed!

HA HA

let me know what you think...I have my kevlar vest on for protection so fire away!

[LawVol]

It's not a bad theory, but what happens when a spoke or two is removed. As you say, a spider runs several spokes out to various points and then begins connecting them into a web. If I come along early enough, I can simply remove two points of contact and the rest is swinging in the breeze. The spider has expended much energy with no results and now needs to begin again.

Move this into the COIN world and I see two or three lines of communication broken and instead of a web swinging in the breeze, there is a local population left hanging. While we established the "spoke" through their area, we established contact and perhaps instilled some hope. Once that spoke is broken, they've lost that hope. Have we then created more damage than waiting for an ink-blot?

I see the spoke as being potentially weak; perhaps too weak to defend against a serious effort. The ink-blot, however, spreads and has the ever increasing center to support the edges where the bad guys are. The spokes could be out there all alone.

[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,

[LawVol]

I agree that USAID and State are the best mechanisms for long term "teach a man to fish" projects, but what about the short-term in the immediate aftermath of combat ops or upon initial intervention for more permissive environments? Most of the time the military is the only presence and I would think that having the skill sets necessary to answer the mail from a humanitarian perspective is a crucial need. From what I'm seeing the military doesn't seem to want to put much resources into this aspect of small wars. Of course to do this, we'd need a new approach that values non-lethal power as much as lethal power and that just isn't as sexy as putting rounds down range.

If you can point me to any good website discussing approaches to distributing humanitarian aid (from food to schools to health care, etc.) especially those looking at military involvement, I'd certainly appreciate it.
-john

[redbullets]

From what I'm seeing the military doesn't seem to want to put much resources into this aspect of small wars. Of course to do this, we'd need a new approach that values non-lethal power as much as lethal power and that just isn't as sexy as putting rounds down range.

If you can point me to any good website discussing approaches to distributing humanitarian aid (from food to schools to health care, etc.) especially those looking at military involvement, I'd certainly appreciate it.
-john

I don't think the military would need to value non-lethal power as much as lethal power - just value it more, as a contiguous part of overall military operations. Additionally, I think it would help if DOD accepted that the NGOs are never going to act the way that DOD seems to think they should/will. Accept the reality of the environment, and adapt accordingly (kind of like they should have done earlier in Iraq, at least at the senior levels).

There are a variety of good sources of relief and development thinking out there. You can check out the SPHERE standards (http://www.sphereproject.org/), they've been around for a while. InterAction (www.interaction.org) publishes its Monday Developments, which is both industry news/opportunities and more in-depth writing on program delivery and outcomes. There's also the European version of InterAction, the International Council of Voluntary Agencies (http://www.icva.ch/). I have found the Humanitarian Practice Network (http://www.odihpn.org/) to often contain a lot of useful information and articles - a lot of folks in our community seek to publish there. There are also many sector- or cluster-specific publications. The Humanitarian Mine Action (demining) community has the Journal of Mine Action published by James Madison University's Mine Action Information Center. The Journal of the American Medical Association (JAMA) regularly publishes results of public health surveys and other efforts from various crises. There's a periodical called Disasters out there, that we've even published in, but I can't find the link to it. Some of my guys feel its a pretty good publication.

Cheers,

[Barnsley]

I agree that USAID and State are the best mechanisms for long term "teach a man to fish" projects, but what about the short-term in the immediate aftermath of combat ops or upon initial intervention for more permissive environments? Most of the time the military is the only presence and I would think that having the skill sets necessary to answer the mail from a humanitarian perspective is a crucial need. From what I'm seeing the military doesn't seem to want to put much resources into this aspect of small wars. Of course to do this, we'd need a new approach that values non-lethal power as much as lethal power and that just isn't as sexy as putting rounds down range.

If you can point me to any good website discussing approaches to distributing humanitarian aid (from food to schools to health care, etc.) especially those looking at military involvement, I'd certainly appreciate it.
-john

John
look for anything by Hugo Slim
Particularly a piece called 'The Stretcher and the Drum'

[Nathan Hale]

Forget teaching men to fish; repairing a man's hairlip, cleft palate or cogenital birth defect so that he can finally get a date is going to generate more soft power and long-lasting good will towards the United States than all the fish in the world.

NGOs, State Dept, and USAID are (as others have noted) often better-suited for long-term contributions, but for quick, short-term operations, the military possessess the logistical capabilities and manpower necessary to excel where others struggle. The US Navy can port at a remote Indonesian island, perform surgeries and provide medical examinations for local children, then depart entirely on their own power. An NGO seeking to do the same would have a nightmare trying to arrange transportation, secure lodging for the doctors, etc.

[Barnsley]

I have been out of touch for a few weeks. I have just read up to date the comments on this whole health diplomacy issue and the civ/mil relationship quandry.
i am trying to write a paper on the subject right now. I am probably going to steal the best quote I have heard to date as the title, 'When Bloody Hands Meet Bleeding Hearts'
Thanks for the lead to Proceedings!
i will write longer later. This site is truly a great help in sorting out my often muddled thinking. Thank you all.

[Barnsley]

If you have a continuing interest in this subject, you might want to take a look at the following URL www.stabilisationunit.gov.uk/
It is the new Brit approach to civ/mil ops
The short speech by the boss has some good thoughts.

[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,