The recent assassinations of six ICRC workers in Chechnya, and three Medicos Mundi workers in Rwanda (see Regional Focus section) has brought home the dangers involved in working in conflict situations.
With the end of the Cold War, the increase in the number of conflicts and the greater willingness of relief agencies to work in conflict zones has led to a situation where relief workers regularly find themselves in dangerous situations, at risk from land-mines, armed bandits, cross-fire and now, it seems, from politically-motivated assassinations, designed to cause a withdrawal of aid from a particular region.
A number of agencies have developed security guidelines to try to minimise the possibilities of their employees being injured in the field (See the article by Koenraad van Brabant on page 6). However, even where these are well-developed, accidents inevitably occur. A few years ago, as reported in the very first edition of the RRN Newsletter, a staff member of a US NGO was seriously injured, losing a leg in a land mine incident in Somalia.
The costs of repatriating the worker, and the subsequent medical bills, totalled more than one million US dollars.
The high costs resulting from such incidents mean that aid agencies have to ensure that they plan for such eventualities, if they are to provide the best for their personnel whilst simultaneously protecting their finances.
Though rapid and unsystematic, a quick review of the situation amongst relief organisations in the UK has revealed that no common policy exists regarding the provision of insurance cover for overseas workers.
Some organisations not only have no special coverage for war risk, but have no accident insurance at all, one of the rationales being that in an average year, the costs of the premiums would be greater than the costs of any medical treatment required. For smaller organisations, however, the cost implications of a single accident could be prohibitive, and leave the injured employee and their family without any support.
Over the last few years, there have been a number of cases where, following injury or death, agencies have refused or been unable to compensate employees or their families.
Last year, for instance, a British aid worker in Kenya was abducted and killed. His agency had no insurance and made only a modest ex-gratia payment to his widow, who has two small children to bring up. Despite having worked for the agency for four years, the deceased had no pension, and his widow, on return to the UK, was unable to access state benefits for six months because of the length of time she had been overseas.
Some of the larger organisations that do not take out insurance make provision for compensation claims. However, not all accidents may be covered. The UK ODA only provides cover on overseas trips for accidents that occur while employees are working.
This means that someone on mission, hit by a car while on their way to a restaurant for dinner, would not be covered. While there may be an implicit understanding that the organisation would still pay for repatriation and medical costs in such situations, there is no guarantee of this happening.
Furthermore, it is not clear what compensation would be due if an employee was permanently disabled as a result of such an accident.
Other organisations which only cover for work-related injuries, interpret this as meaning that accidents that occur after 5pm, or during weekends, will not be covered, regardless of whether the employee is working or not. As a result of these ineffectual provisions, some employees take out their own insurance. However, it appears that many do not, and are therefore not covered for a number of possible eventualities.
Where agencies do have insurance policies, the cover they offer varies widely. Rather alarmingly, there is also a considerable degree of confusion as to the exact terms of coverage, in particular where acts of war are a factor.
In some policies, it appears that the war exclusion clause refers only to war between the five major powers, and that therefore a standard policy is likely to be sufficient for those agencies working in relief, where conflict is either intra-state or involving minor powers.
Of additional concern is the fact that an existing life insurance policy (to cover for a mortgage, for example) may be invalidated if the holder travels to a war zone. Thus, the family of an aid worker killed in the field could lose their home.
A small number of UK NGOs contacted did have special war-risk coverage for named individuals who were likely to be travelling frequently to high-risk countries. Provided trips to the field were for periods of less than one month, the agency did not need to contact the insurance company each time the named individuals were travelling. The coverage cost approximately £2,500 per annum per named individual. However, even where cover appears to be adequate, complications can arise.
In the Somalia incident mentioned above, the NGO concerned had war risk insurance but, due to a loophole in the cover, the insurance company refused to pay. They argued that, as the individual was working at the time of the incident, the claim should have been dealt with by US Workers Compensation Insurance, which covers injuries sustained while working.
However, the latter did not include cover for war risk. Since then, InterAction, the US NGO umbrella organisation, have developed a scheme for providing war risk coverage to US NGOs, though they report that very few agencies have taken advantage of the scheme.
Another complicating factor is that insurance companies may try and shift responsibility by claiming that security guidelines were not adequate, and unnecessarily exposed staff to risk, or that security guidelines were not being enforced properly.
It is extremely important that relief workers understand the extent of their coverage, for otherwise they may find that they have inadvertently behaved irresponsibly while carrying out what they considered to be essential duties.
For instance, if injured while travelling at night, or being out after curfew, even if they have not broken agency guidelines, the insurance company may refuse to pay, and may then have to sue their agency for compensation.
In certain countries, there is a high level of risk associated with all attempts to deliver assistance, and it is a matter of some debate as to what exactly comprises irresponsible behaviour.
It is also important to be aware that insurance claims may not be met where it can be shown that the injured employee had been acting under the influence of alcohol or drugs.
In addition, many insurers will not cover people for HIV-related costs. This has potentially serious implications for those working in countries where there is a high risk of contracting the virus, and where local health facilities may not have the capacity to screen blood used during transfusions. An aid worker infected as a result of receiving unscreened blood may find it impossible to arrange life insurance from then onwards. Some individuals have been refused standard life insurance on the basis that their work involved an excessive degree of risk.
Some UK insurance companies differentiate between an agencys European staff and their non-European and national staff, and will only provide cover to the former.
The complexities of the insurance world mean that, at the very least, employees should be fully briefed, before leaving their own countries, as to the extent of their coverage and details of any exclusions.
Agencies need to be sure that they have a clear and transparent policy concerning the health and safety of their overseas employees. They should strongly encourage prospective employees, particularly those with dependants, to arrange adequate pension arrangements, and to make sure that existing life insurance policies are not invalidated by travel to a particular region of the world.
Younger aid workers may be less concerned about insurance or pension cover, but if they are permanently disabled for life, they may find that state benefits are far from adequate.
Where agencies have chosen not to take out comprehensive insurance, they need to demonstrate that they have made provision for meeting eventualities.
Principle 7, of the People in Aid Code of Best Practice in the Management and Support of Aid Personnel (published as Network Paper 19 and distributed in this February mailing) recommends that insurance provision procedures are regularly reviewed and information to staff updated, and that field staff and families accompanying them receive oral and written briefing on country or regional security, emergency evacuation procedures and insurance arrangements before the assignment begins.
ODA, UNICEF and others have indicated that funding may become conditional on agencies agreeing to adhere to such practice.