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N'zerekore, Guinea, on 9 January 2015 N'zerekore, Guinea, on 9 January 2015 Photo credit: UNMEERMartine Perret

Exposed by Ebola: what the epidemic tells us about aid

by Marc DuBois
5 May 2015

Saying goodbye to MSF’s Head of Mission in Liberia and thanking her for hosting me during my research visit. As I leaned in for the double cheek kiss that we Anglophone aid workers are so fond of displaying – a badge of cool and humanitarian familiarity that breaks with the sterility of the brisk American handshake – she leaned back. Her face was slightly horrified, her expression confused. Even as I leaned in further, confused myself and self-conscious of making a mistake, she pulled another step back. And then it clicked: No Touch Policy.

There you have it. One small perversity of the Ebola outbreak. One small particularity in a field of many, and yet also representative of a human crisis where humans are prohibited from touching one another in their blackest moments of need, fear and grief. The sanctioned protocol of bumping elbows – or perhaps fists – just doesn’t allow for the level of human connection that people working in such an unforgiving setting deserve.

A plethora of differences set the humanitarian intervention in West Africa apart from those mounted in response to other major crises, whether in Haiti, Syria or the Central African Republic. Some might find that reason enough to question the wisdom of a research project that aims to draw out lessons for future emergency responses from a black swan of a crisis. I would argue just the opposite – by catching the humanitarian aid system off balance, the Ebola epidemic has thrown the system into high relief, magnifying both strengths and weaknesses that might otherwise have gone unnoticed.

The goal of my research with ODI’s Humanitarian Policy Group (HPG) is to use the international response to the Ebola outbreak in West Africa as a critical lens for scrutinising the ‘humanitarian aid system' as a whole. We hope to avoid duplicating the multiplicity of other assessments, evaluations and reports by focusing on the big picture, at how the fundamental contours of the aid system result in advantages, as well as shortcomings or gaps. We are interested in the power dynamics which govern the aid system’s architecture, culture and identity, and how these shaped the intervention. Hopefully, this research will contribute to ongoing efforts to improve the system's response capacity, such as informing HPG’s position towards next year’s World Humanitarian Summit.

For now, though, we must come to terms with the immensity and unprecedented nature of the response, which was not just a colossal humanitarian deployment but also a military and scientific one. To begin with, many viewed this solely as a health emergency, some still do. But when was the last time the aid system confronted a ‘health crisis’ that decapitated local health system systems, shut down schools, postponed elections, gutted economies and shook the stability of nations? Sounds more like a classic complex emergency. Yet beyond MSF and a few specialist NGOs, we consistently hear the same refrain: “We wanted to do something but we didn’t know what to do. We aren’t medical. And we were frightened. Really frightened.” Not the best of starting points for what has become a billion-dollar intervention.

Understanding these dynamics and comprehending how an aid system that was so woefully slow to react has managed to produce such a broad, creative response is part of our task. As is figuring out why some of the mistakes made amount to an almost clichéd repetition of blunders that we have seen over and over again. Do we really need a piece of research to tell us that we are better at identifying lessons learned than implementing them?

Marc DuBois is the former Executive Director of MSF-UK and an independent researcher with the Overseas Development Institute’s Humanitarian Policy Group (HPG). He blogs at Humanicontrarian and tweets as @humanicontraria. Marc’s research on Ebola and the ‘humanitarian aid system’, co-written with HPG’s Caitlin Wake, is due for publication this summer.

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