National/international medical professionals working together at a clinic in Ormoc, Philippines – a model that is no longer allowed by the current WHO EMT guidelines. Photo Credit: Boaz Arad/IsraAID (2013)

In 2013, Typhoon Haiyan devastated the Philippines and galvanised the international community. Organisations, like the American Red Cross, sent full-scale field hospitals. Others, like IsraAID, despatched medical personnel and supplies, providing surge capacity to local clinics.

Integrating external resources into existing healthcare systems is an effective strategy, with potential long-term benefits. Yet, while such activities may be a model for integrating disaster risk reduction into response, World Health Organization (WHO) guidelines do not permit them.

The WHO classification system was created to counter the variation “in capacities, competencies and adherence to professional ethics” amongst Emergency Medical Teams (EMTs). Each of the three approved EMT types must operate independently and be self-sufficient for 2–4 weeks. This emphasis on independence avoids ‘burdening’ affected populations, but it leaves no room for interventions to support national/local healthcare institutions.

In fact, the WHO’s 91-page document outlining EMT minimum standards contains no reference to existing healthcare systems, let alone strategies for cooperation. This omission perpetuates the myth that ‘helpless’ disaster-affected people need international organisations to ‘save them’, instead of recognising that disaster response is often locally driven. Further, EMTs acting alone face avoidable linguistic, cultural, and logistic obstacles that hamper the quality of care provided. Setting up alternative healthcare locations, pathways, and practices may also sow confusion, thus increasing long-term vulnerability by undermining trust in the healthcare system.

Efforts to standardise EMTs and rout out malpractice and disaster tourism are welcome. But the WHO guidelines sadly disregard successful integrated models, like IsraAID’s, instead promoting foreign intervention over local capacity and prevention. If only the WHO abided by their own Health Emergency and Disaster Risk Management framework.

Written by Patrizia Isabelle Duda and Navonel Glick

War on Coronavirus poster

On March 17^th, U.S. President Trump began calling the Covid-19 pandemic a “war”, to wide acclaim by supporters and scathing condemnation by critics.

The reasons for using the war metaphor are straightforward. By calling the pandemic a war, Trump is appealing to a familiar scenario that we feel we ‘know’ how to relate to. It ostensibly simplifies the crisis, mobilises the public, and calls for unity.

The war metaphor is a powerful and effective tool that is often used in politics, but it is also pervasive in the world of disaster risk reduction and response. The historical links between disaster management and the military are well-documented. Today, from operational frameworks like the Incident Command System (ICS) that were inspired by military management structures, to the extensive use of military terminology like ‘deploy’, ‘mission’, or ‘surge’ by even the most ‘military-averse’ NGOs (e.g. IRC, Plan International), the connection remains.  Even the widely revered (and much maligned) ‘logical framework’, meant to improve transparency and accountability in the aid sector, originated in planning approaches for the U.S. military.

At first glance, the war metaphor makes sense. The chaotic images from disaster areas that make the headlines are reminiscent of war zones, and the associated urgent, high-stress, life-and-death decisions demand composure, bravery, and decision-making attributes that we have learned to equate with our armed forces.

Yet, the analogy quickly crumbles. For one, as most disaster practitioners would confirm, the period immediately following a disaster which might require such an approach, at best, represents only a fraction of any disaster response effort, let alone long-term recovery or disaster risk reduction (through sustainable development).

In addition, as our experience in the field shows, armed forces are notoriously poor at interacting with vulnerable civilian populations, particularly in complex situations of unrest. More importantly, the war analogy is plagued by a core contradiction. While it can be argued that armies engage in war to ‘defend’ or ‘protect’ a population, destruction is often their main tool for doing so. This is not what disaster response or humanitarian aid are about, much less how one reduces disaster risks and builds disaster-resilient communities.

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So why does the war metaphor continue to dominate the field? The simple answer may be because it works. It appeals to the pleasure-pain principle, triggers our basic fight-or-flight instincts, and provokes a reaction.

Yet, this strategy may be poorly suited to pandemics. We rightfully celebrate our health-care workers and other front-line personnel as ‘heroes’—yet another war term—and many of them may be faced with ‘war-like’ situations of urgency and life-and-death situations. But for the rest of us, “wash your hands” and “stay at home” are woefully anti-climatic ‘weapons’ to ‘fight’ the ongoing coronavirus ‘enemy’.

Photo credit: hairul_nizam / Shutterstock.com

Furthermore, the ‘war metaphor’ may succeed in the short-term during a crisis, but such bursts of energy (or adrenaline) cannot be maintained over time. Pandemics are not addressed by acute, short-term measures or bursts of adrenaline, but instead, by a complex web of systematic health and public health initiatives, drawn out over a long period of time.

The most damning trait of the war metaphor is, therefore, the focus on the disease itself, instead of the systemic issues that allowed it to become a pandemic. Diseases, much like earthquakes or hurricanes, are natural hazards. They only become disasters when we are left exposed and vulnerable to them by insufficient preparedness and poor risk reduction measures. Thus, tackling the underlying social, economic, and political systemic issues that drive disaster vulnerability should be our priority.

The analogy of a marathon instead of a sprint comes to mind, except that in this case the race has no end. In fact, it never was a race to begin with. This may be the biggest fallacy with using the war metaphor for disasters: wars are arguably won or lost; at least they (should) end. Disaster preparedness and reducing risks do not—they are an ongoing process of achieving and maintaining sustainable practices.

The war metaphor, therefore, from the very beginning, begs to disappoint, because there will not be the closure it promises. Calling our health workers and other frontline workers ‘life-saving heroes’ is an admirable title they deserve, but were they any less worthy of it before the pandemic? And will they not continue to perform the same essential role once the coronavirus pandemic has passed?

In this time of acute crisis, when the lack of preparedness and risk reduction is painfully exposed, we may be glad to have the war metaphor for the action that it catalyses. But by continuing to prioritise response over prevention, and perpetuating the myth of the ‘race’, what social habits will we continue to reinforce, and at what cost?

What would an alternative look like?

Post written by Patrizia Isabelle Duda, PhD researcher at UCL IRDR

Fancy lodgings with outdoor Jacuzzis, brand-name clothing outlets, a Thai massage centre, restaurants offering haute cuisine, a supermarket that displays all manner of fresh food and electronics items—one would have thought that I landed in a First World urban setting. But the Norwegian-governed settlement of Longyearbyen on the Arctic Svalbard archipelago is anything but that.

Longyearbyen’s main street with fancy restaurants and hotels during Svalbard’s dark winter season – Copyright Patrizia Isabelle Duda 2019

Rather, it is a small settlement north of the Arctic Circle, the size of a thumbprint viewed from on high – plunked down in the midst of a valley, surrounded by mountain ranges and a vast road-less expanse of rock, snow, and glacial ice that is prone to avalanches, landslides, flooding and extreme weather conditions. The archipelago is roamed by polar bears, geographically isolated from the Norwegian mainland that governs it (it is halfway between Norway and the North Pole), and reliant on good weather conditions to access it. Thus, Svalbard is especially vulnerable to disasters, from which response mechanisms, no matter how well planned, may not always deliver.

The landscape of Longyearbyen – Copyright Ilan Kelman 2009

A photo of Longyearbyen taken on a winter climb to a mountain top nearby in -47 °C – Copyright Patrizia Isabelle Duda 2019

As far as disasters go, there is a gamut of factors besides its remote location and its dicey weather that impinge on Svalbard’s ability to respond. A lack of communication between its settlements is problematic. Its possible overreliance on national response structures which must both be able to react with adequate resources within narrow time frames, as well as have the political will to do so, further compounds the precarious situation. In addition, the present restricted ability of Svalbard’s small hospital to treat more than minor-level injuries, necessitates an over-reliance on aeromedical evacuation to the mainland.  Thus, the capacity for major trauma scenarios is missing.

Given both the existing gaps as well as clear developing and future challenges, it is critical that we take stock of Svalbard’s emergency preparedness and response capacity and develop robust policies that are adapted to the local realities on the island. This means that not only search-and-rescue capacities are needed, which it seems Svalbard has well understood (albeit these are and can only be imperfect); but that improved governance on a much wider scale is urgently required. It must be remembered that disaster efforts do not always happen formally. Both when formal disaster efforts fail, but also when they do not, informality is often a key element of disaster preparedness and response.  In Svalbard’s particular case, this means cooperation and coordination between the two main players on the island—formally, Norway and Russia, and informally, Norwegians and Russians—for efforts both to prevent disasters, as well as to address them when they happen.

These are the questions I pondered together with a team of nine researchers from London, Moscow and around Norway who assembled in Longyearbyen to launch our new project. Generously funded by the Norwegian Research Council, we initiated a 2-year investigation into disaster diplomacy’s potential to foster cooperation (or not) between Svalbard’s Norwegian and Russian stakeholders in their formal and informal responses to disasters. To this end, the project will be looking at three hypothetical disaster scenarios: an oil spill emergency, a crisis involving radiation release from a ship, and a disease outbreak in (Russian) Barentsburg—the second of the only two permanently inhabited settlements on Svalbard.

View of Longyearbyen – Copyright Ilan Kelman 2019

The importance of this project is startingly clear. Moving on from its early days as a coal-mining settlement, Svalbard is now home (albeit a transient one) to a growing population of scientists and tourists. Moreover, this group of islands is currently being re-imagined and re-developed into an Arctic Ocean emergency management hub.  This new hub will act like a magnet, drawing yet more scientists, tourists and job-seekers to an island of roughly 2600 inhabitants, requiring quickly built new infrastructure to support these activities. Coupled with the effects of the already changing environment, Svalbard’s vulnerable settlements, not to mention, the whole region and its ecosystems, are further at risk.

Additionally, some fear that it may also spark a new round of disputes and conflicts between Norway and Russia, (and looking out on the broader horizon, between other nations that have stakes in the Arctic region). Transnational cooperation will be more crucial than ever in tackling the already compromised possible disaster responses. Thus, from a different perspective, this emerging reality might, at least in theory, pave the way for greater diplomatic and practical collaboration on disaster issues and may, by extension, improve many aspects of relations between these two countries that share vested interests in Svalbard.

It is clear from research on disaster diplomacy in other global settings that this second idealistic and much more hopeful perspective is not supported by actual results. Disaster diplomacy has not yet been shown to lead to better relations between countries. But can these findings be applied to Svalbard, and to the Arctic in general, an area which is held to be ‘off the charts’ in so many spheres? As researchers, we hear the often-recited mantra that Arctic players have already come up with uniquely successful and often unprecedented cooperation schemes. Thus, could the Arctic prove to be an exception in the universe of unsuccessful disaster diplomacy case studies? And might the various factors that were present in the particular Arctic situation be extrapolated and applied in disaster conditions elsewhere in the world?

“Welcome” – Copyright Ilan Kelman 2019

I ask myself these questions, as I gaze out past the high-end stores and entertainment centres, to the beautiful but forbidding mountain range just behind them, looking off into the polar-night sky. Svalbard is fragile, vulnerable to disaster, and may well become even more exposed to danger.  But might it not also hold the seeds to plant future opportunities for cooperation and improvement in international relations? Or, will the research results elsewhere in the world be confirmed? Our team hopes that our research will be able to begin to answer some of these questions.