John Tipper reviews the challenges of choosing how to respond to difficult humanitarian situations and outlines two different frameworks for action: classical and naturalistic decision making. The article concludes with an exercise to illustrate how relief workers can build up experience in making difficult decisions in situations where not all the information is available and every option has drawbacks.
You’re faced with an aggressive, armed militia member who wants $50 before he’ll let you deliver your cargo of medicine to a war-torn town’s clinic. Your agency prohibits paying bribes. If you don’t pay him, people will almost certainly die. If you do pay him, you’re supporting the very people who are attacking the town.
What would you do?
Anyone who has spent time working on the frontline of humanitarian response will have encountered challenges like this. In the aftermath of natural disasters, the problem may be a corrupt official wanting to make personal gains from a position of power. You yourself may not be in personal danger but there will be a clear risk to those who depend on your services. Although in complex emergencies, the threat may very well be directly aimed at you or your co-workers. Nice-sounding concepts such as ‘the law of war’ are quickly seen as irrelevant when over-vigilant young recruits stop you on a lonely road passing through militia-held areas.
Challenges also come from within. Sometimes the hardest decisions are how to respond in light of the actions of other aid agencies working alongside you, or to internal policies that seem out of touch with your daily reality.
For a long time, there was very little formal guidance for people making these difficult decisions at the operational level of relief work. If you were fortunate enough, you would have been through similar situations with more experienced colleagues, watching how they handled them and picking up a few skills. Or you might have come to know a particular context especially well and learned how to competently navigate those local challenges.
But what if you hadn’t had good mentoring or much experience? Or if you were moved across the world to an unfamiliar situation? Given the complexity of challenges facing frontline relief workers and the number of lives that depend on good decision making, why isn’t it taught more?
Recently there have been some encouraging developments. This year, the Active Learning Network for Accountability and Performance in Humanitarian Action (ALNAP) published a briefing paper on decision making in humanitarian coordination and HPN released a Network Paper by Humanitarian Outcomes Partner Katherine Haver on ethical decision-making.
However, a gap between developments at the headquarters and field levels still exists. As Haver acknowledges, the decisions examined in her paper ‘are mainly organisational … and [focused] at the strategic and programme-design level, rather than lower-level, tactical or operational decisions.’ Yet there is a critical difference between the types of decisions that have to be made at the strategic level and those that have to be made by relief workers at the coalface of disaster response.
Generally speaking, the challenges encountered at the operational frontline of a relief response will include: ‘ill-structured problems; uncertain dynamic environments; shifting, ill-defined, or competing goals; time stress; high stakes; [and] multiple players.’ Judith Orasanu and Terry Connolly, ‘The Reinvention of Decision Making,’ in Decision Making in Action: Models and Methods, eds. Gary A. Klein et al., (Norwood, NJ: Ablex, 1993), 7 Familiar to experienced relief workers, these factors highlight a fundamental challenge – how do you make decisions when key pieces of information are missing? In order to respond effectively, aid workers should be aware of two different decision-making processes – the classical and the naturalistic approaches – and understand when to apply each one.
Classical decision making
At a non-operational level, we tend to see ‘classical decision making’ taking place. This approach involves outlining the potential outcomes of the options available and then comparing outcomes to determine which is best. The table below gives an example, showing how this approach would be used by an aid agency to account for relevant factors on the ground and weigh up risks, in order to determine where to concentrate its relief efforts following a large natural disaster. In the example, the over-riding factor turns out to be the security threat and this drives the eventual choice of programme location.
In many ways, the classical decision-making process is suited to these types of decisions. The process can reassure agencies that they are systematically fulfilling their duty to their beneficiaries and staff, by making the optimum choices with regards to programme efficiency, coordination and staff welfare. Risks can be identified, classified and compared to make a choice between acceptable and unacceptable outcomes.
Naturalistic decision making
However, in recent decades, groups from the military to the emergency services have started to embrace an alternative approach, known as Naturalistic Decision Making (NDM). At the heart of the NDM approach is an acknowledgement of the complexity of real life crises.
For those working on the frontline of aid work, a more useful approach to decision making may be found by following a sub-strand of NDM known as Recognition-primed Decision Making (RPD). Gary Klein Sources of Power. How People Make Decisions. Cambridge, MA: MIT Press, 1999. See also the more recent: Gary Klein, Streetlights and Shadows: Searching for the Keys to Adaptive Decision Making. Cambridge, MA: MIT Press, 2011. This approach involves selecting the first option that comes to mind, then quickly evaluating it to see if it will lead to a successful outcome. If it does, no further deliberation or option-generation is required. Only if it doesn’t is a subsequent option mentally generated. The whole aim is to find a ‘good enough’ outcome. Options are never compared, but rather generated one at a time only until the point where one which is good enough emerges. Time pressure is a constant presence during the early hours and days of a disaster response, increasing the value of making a rapid decision that may not be perfect but gets the job done.
Building experience in decision-making
Experienced aid workers will recognise the validity of the NDM approach. But since NDM relies on the accumulation of significant experience – which the decision-maker can quickly draw on to come up with a possible solution to a problem – acknowledging NDM’s importance may be disheartening for newer aid workers.
This need not be the case. Many airlines now rely heavily on simulators to fast-track their trainee pilots onto large passenger aircraft, foregoing the long hours of flying light aircraft previously considered essential. In a similar way, newer relief workers can quickly build experience of using the RPD approach by putting themselves through simulated activities, which recreate the realities of frontline humanitarian work. Below is an example of these types of simulated activity.
Imagine you are in charge of delivering supplies in an insecure setting.
Read the introduction and opening challenge, then consider the first suggested solution. Stop and tell yourself the story of what may happen if you take this approach. If the outcome of your self-generated narrative is acceptable to you, then select the option. Only if it’s not acceptable should you choose otherwise.
Remember that you have the final say on decisions and are only aiming to generate a good enough solution.
Work through the numbered challenges as directed by your choice of options; do not read the story in numerical order.
Delivering medical supplies: an exercise
Your team of four is delivering medical supplies to a remote town, three hours’ drive away. The insulated boxes should just about keep the medicine cool that long.
An hour away from the town, you reach a checkpoint. Several soldiers sprawl around under a huge tree. Empty beer cans litter the floor. The soldier at the checkpoint asks for your vehicle papers. He checks, then points out a small mistake on the paperwork.
Do you turn around to get the paperwork fixed? Yes: go to 4 Otherwise: go to 5
- In a small roadside village, your gaze turns to several villagers as they walk along the road. You’re quite surprised at the hard glares being directed at your vehicle. You’ve always found people in these roadside villages to be friendly in the past.
Thirty minutes later the soldiers get out and walk away.
Go to 3
- You explain to the group of soldiers that you’re not allowed to carry weapons in the vehicle.
The soldier on the checkpoint gets quite upset. ‘It looks like we might have an issue with your paperwork after all’, he growls.
Then one soldier speaks up. ‘I can leave my rifle’, he says. ‘But I really need to get to the base to go to a clinic.’
You’re starting to get very concerned about how long the medicine will remain cool. You agree to let one, unarmed soldier join you and quickly continue driving.
Thirty minutes later the soldier gets out and walks away.
Go to 3
- Soon you reach another checkpoint. By now you’re concerned for the state of the medicine.
One soldier leans in through your open window. ‘I see you’re bringing medicine. It’s good that you want to help these people. But my men need medicine too.’
You start to explain that the clinic decides who gets the medicine.
‘No’, he says, bringing his gun up. ‘I decide. Give me what I need or go back to the city.’
Your colleague wants to give him some. ‘We’re so close, at least the clinic will get most of the medicine. Otherwise it will all be ruined.’
Another team member disagrees. ‘This group have attacked the people of these villages. If we help them, we’re just assisting them to commit more crimes. If they stay sick, they can’t harm the people of the villages.’
Your third team member is a nurse. ‘When we trained, we were taught to give assistance based on need, not on our judgement of the person. If these soldiers are sick we have an obligation to help.’
Do you let him take some of the medicine? Yes: 8 Otherwise: 7
- Your colleague disagrees. ‘I don’t think another two hours of the heat will be good for the medicine’, she says. ‘Can we try to find a way through?’
Do you follow her suggestion? Yes: 5 Otherwise: 6
- ‘It’s fine’, the soldier says, ‘We can see that you’ve got important goods on board. So we’ll let you keep going’.
As you thank him, he continues, ‘Since we’re helping you, you can help us. These two soldiers need to get back to our base. You can give them a lift’.
As you start to discuss amongst your team, the two soldiers come up. They reek of alcohol.
One of your team doesn’t want to take them. ‘There’s no-one to help us if they start trouble’, he whispers. ‘Besides, we’re not allowed to carry weapons. They each have a rifle.’
Your second team-mate feels differently. ‘There are bandits on this road. If these soldiers are with us, the bandits won’t attack us.’
Your third team-mate seems uncertain. ‘I’m worried about people in the places we’re passing. Weren’t they attacked by these soldiers recently? What will they think if they see us together?’
Do you give the soldiers a lift? Yes: 1 Otherwise: 2
- ‘No’, you say. ‘We’d better go back. The medicines should be okay a bit longer than we planned.’
‘Can we at least ring the hospital and check what they want us to do?’ your colleague asks.
You call and the hospital director talks to the soldier by phone. Then she tells you it’s okay. Relieved, you get your paperwork back from the soldier.
Go to 5
- You decide to return to your main base, hoping that some of the medicine will still be useful, even if some is heat-damaged.
As you turn around, another NGO vehicle pulls up. The passenger quickly hands over two large boxes from the back of the vehicle. The soldier waves the new vehicle through.
‘It looks like they’re okay with it’, one of your teammates mutters. ‘Shouldn’t we do the same?’
Do you reconsider your approach? Yes: 8 Otherwise: 9
- You let the soldiers take some medicine. To your surprise, they only want four boxes. You give them the top boxes, keeping the well-cooled items for the town clinic.
As soon as the soldiers have their medicine, you drive away and soon reach the clinic.
You and your team quickly unload the boxes. To your relief, all the medicine contained in the boxes is in good condition.
- You realise that no matter what other agencies do, you can’t help those who are responsible for the conflict.
You decide to return to your main base, and hope that some of the medicine will still be useful elsewhere, even if some is heat-damaged.
Two of your colleagues object strongly. They want to push through. You explain firmly that as leader you have the final call. You spend the first half hour driving back in a heated discussion. Your colleagues finally go quiet but the long drive home is filled with a sullen silence.
Throughout the exercise, you are forced to make decisions in the absence of a considerable amount of information that would have been helpful. It’s quite possible that with more information you would make different choices.
It’s important to note that where a decision is going to be reviewed – by your peers, your agency, or by an outside authority – the value of classical decision making increases. In such cases, the need to make a decision that will stand up to scrutiny may outweigh the need to act rapidly. However, in situations where it is generally acknowledged that doing something is better than waiting or doing nothing, the value of the RPD approach increases.
Decision making in high-pressured situations is not an exact science but rather an art form. It is influenced by a range of factors including: your own values, understanding of compromise, ability to understand other cultures and level of cooperation with other responders, as well as your colleagues’ behaviour and agency’s values.
Even very experienced decision-makers may respond in different ways in quite similar situations. For newer aid workers the aim is to build up expertise, since the more familiar you are with a situation, the less foreign it will feel when you actually encounter it.
Several programmes support this kind of exercise. A number of courses on the DisasterReady.org website allow anyone to practice this type of decision making, and the quick-fire demands of DTS and RedR’s Mission Ready video-based security courses replicate the time pressures often faced in humanitarian responses. By practising intuitive decision making at every opportunity, you’ll be better equipped to make solid, effective decisions when you come face-to-face with these challenges in the field.
John Tipper is the Director of Disaster Preparedness and Response for the Swedish NGO Operation Mercy. He is the author of Decision Making in Disaster Response: Strategies for Frontline Humanitarian Responders, available in paperback, with a Kindle version scheduled for January 2017.