First publication : 23/10/2017.
This is not an article about Humanitarian aid workers and persons with special needs – it is a subject of discussion about the International Humanitarian Law. We know that in several African countries Humanitarian aid workers have often been voluntarily targeted by armed groups. This has negatively impacted on their activities increasing humanitarian crisis. Also, people with special needs have not been considered in planning of activities by states and some actors leading to loss of several hundreds of lives. Powerful agents and stakeholder as well as public states should supports humanitarian activities including these categories in their programs.
Armed conflict is one of the situations which destabilize African states. During these events, the civilian population is caught between clashes from the opposing groups leading to the loss of several human lives and massive shift towards deemed stable and secure areas. During the displacement, people vacate villages leaving livestock and other valuable items. In these circumstances, the belligerents often attack humanitarians as it was reported in Somalia, Sudan, Democratic Republic of Congo and many other countries. In this regards, the looting of humanitarian facilities including hospitals and health center reduce response capacity for affected populations. Several questions arise: is it necessary to provide military escorts to humanitarian? Humanitarian principles do not permit. Should humanitarian remain and accept to be killed on field? No, because the self-protection principle does not allow it. How can you flee from the conflict zone leaving behind you several lives endangered by the lack of medical assistance? What to do? All these challenges lead to suspension of humanitarian activities when it’s necessary. Besides humanitarian personnel, there are other categories of people who cannot cope with crises in the same way as the others, simply because their physical situation does not allow it. These are pregnant women, the sick people, the older persons, and people with disabilities, who will require a particular attention. The conflicting parties and other stakeholders, should take be aware on strict measures to ensure these categories are well identified and protected. Also, even in post-conflict period, they should benefit from special programs for their integration into society.
This article does not provide detailed description of these categories and the challenges which they face during internal conflict. Instead, we wanted to reveal that in African countries these issues need more attention in order to save lives. We make a modest contribution as more researches continue to be done in this regards.
The word “Humanitarian aid workers” means of all kinds (rescue workers, relief workers, staff and administrators at refugee camps and shelters, health care workers) and those seeking to understand the causes and effects of the disaster (e.g., government officials, journalists, human rights workers, researchers).(1)
The environment in which humanitarian agencies and their staff provide assistance to populations affected by armed conflict and natural disaster has changed in significant and concerning ways over the past decade. The majority of conflicts taking place in the world today are non-international in character, with national and/or multinational forces fighting a variety of armed groups, often with significant asymmetry between the parties.1 Characteristics of contemporary armed conflicts include the deliberate targeting of civilians, large scale population displacement, grave violations of international humanitarian and human rights law, the targeting of international humanitarian personnel, and restrictions on humanitarian access to civilians. (2) Recent decades have also seen a significant increase in the number of people in need of humanitarian assistance in the aftermath of natural disaster, (3) with similar restrictions imposed upon humanitarian access. In 2004, the UN General Assembly estimated that more than 10 million people in 20 countries affected by complex emergencies (including both natural disasters and conflict situations) were inaccessible to humanitarian agencies. (4) For many of these people, restrictions on humanitarian assistance mean restrictions on the basic food, water, sanitation and shelter necessary for survival.
Humanitarian aid workers have been designated as a particular category of people that has been active in rescuing thousands of lives in most of remote areas. However, in most of rural areas deploying aid in patchwork of shantytowns is particularly complicated and thus, they do not escape from the strife. Due to a low education of belligerents as well as lack of willingness certain of Humanitarian aid workers can be blocked on their way towards or from the field. Also, they can be intimidated and prohibited of moving from their base. Most of them are often submerged by the work due to numerous IDPs reaching their humanitarian bases or hospital. In several occasions, humanitarians’ convoys, bases, edifices or residences are targeted by armed groups aiming at pillaging valuable items, medicine or other material. Humanitarian principles of providing neutral and impartial medical care constitute another issue in armed conflict zone. In several occasions, some armed groups consider that medical staff should not take care of their opponent (armed group element, civilian from a certain tribe…). Without any respect to the International Humanitarian Law, certain armed groups elements can decide to abduct, arrest a sick or wounded person from a hospital. In such cases, humanitarian staff cannot protest any more fearing for their security. Protesting can be interpreted as complicity with the enemy.
In 2008, 260 humanitarian aid workers were killed or injured in violent attacks. Such attacks and other restrictions substantially limit the ability of humanitarian aid agencies to provide assistance to those in need, meaning that millions of people around the world are denied the basic food, water, shelter and sanitation necessary for survival. (5)
In 2009, in the Northern side of D R Congo, in Goma city and rural areas, the trend suggested that NGOs were at higher risk when working in rural areas (86%) comparing with UN staff (14%). It has been understood that the use of military escort by UN has worked as a deterrent against criminal activities. The NGO community was more affected than UN agencies by security incidents in North Kivu because of their greater physical presence at the field level and their strict adherence to humanitarian principles (e.g. no use of military escort).When looking at security incidents in urban areas of Goma city it appeared that any staff, UN or NGOs, were at high risk of criminal activities. Nonetheless, NGOs (59%) continues to be the most vulnerable and affected comparing with UN staff (41%). (6)
In Soudan, in 2009, targeted attacks against humanitarian personnel in Darfur – including physical and sexual assaults, hijackings and abductions – increased dramatically in the years leading up to the expulsions. In November 2008, Under-Secretary- General for Humanitarian Affairs John Holmes reported that attacks on humanitarians had reached ‘unprecedented levels,’ (7) 38 with 11 staff killed, 189 staff abducted, 261 vehicles hijacked, 172 assaults on humanitarian premises and 35 ambushes and lootings of convoys in 2008 alone. (8) Holmes noted that in most cases it was the rebel movements that appeared to be responsible for the attacks, (9) but as one well known Darfur commentator pointed out, ‘assaults on humanitarians, their vehicles, compounds, and equipment must be understood for what they are: actions that are the clear responsibility of the Khartoum regime in areas controlled by Khartoum nothing happens that is not implicitly or explicitly sanctioned by the regime”. (10) From 2011 and 2012 humanitarians witnessed severe incidents when clashes between the South Sudan army, the Sudan People’s Liberation Army (SPLA) and a militia group in Jonglei were taking place. Staff faced the repeated looting, damage and destruction of medical facilities in Jonglei, including Pieri in August 2011, Pibor and Lekwongole in December 2011, Lekwongole in August 2012 and Gumuruk in September 2012. This disturbing trend of targeting medical facilities constituted a major concern to access to healthcare by the people already vulnerable. (11)
Humanitarian staff can be also be abducted or by armed groups aiming at receiving ransom or discouraging other humanitarians to continue in conducting activities in the conflict area. In October, two MSF staff members were abducted from a refugee camp in Kenya, where thousands of Somalis had fled. (12) Following the situation in eastern Dr Congo, Colette Gadenne, MSF head of mission in Goma declared “We strongly condemn the intimidation of humanitarian workers and cannot accept threats directed at our staff,”. (13)
Furthermore, armed groups hate humanitarians on ground because they witness all the suffering of people in areas under their control, and thus, their evacuation and suspension of activities gives them an opportunity to operate and forcibly rule over poor civilians far from vigilant humanitarians. One humanitarian declared: “It is now critical that everyone work together to identify and meet the population's needs, while remaining very watchful. The deadly attack reminded us that periods of calm are often temporary in Mogadishu”. (14)
It is better known that the voluntary sacrifice in reducing suffering of population exposes humanitarians and especially “Medical staff”. Nevertheless, crucial decisions need to be taken when the situation becomes more critical. Suspension of activities! Sometimes, humanitarians suspend activities after death or attack against their staff of premises. Several cases were observed in Somalia, Soudan, Democratic republic of Congo and other countries. This measure leads to challenges and defies in term of lack of continuation of humanitarian responses while belligerents are not competent to continue with humanitarian actions.
Reasons, challenges and defies
Due to the insecurity, the populations of Gumuruk and Lekwongole fled their homes to seek refuge in the bush during August and September. MSF was forced to suspend temporarily its medical activities in Lekwongole and in Gumuruk. These two health facilities provided the sole medical care available to 90,000 people in these outlying and difficult-to-access areas of Pibor County. People from these areas and patients had walked for 5 to 7 days before being able to reach MSF in Pibor health center four weeks after being attacked, and arrived with badly infected wounds. Other patients expressed fears about military presence on the roads in remote areas outside Pibor town. Where people hesitated to travel to seek medical care, they reported turning to various different strategies for accessing care safely, including waiting for a larger group to travel together, travelling early in the morning or self-medicating. (18)
To face challenges and defies in regards to the population and humanitarian affected people in armed conflicts, agencies and all stakeholders included de facto authorities should be involved in reducing suffering of population.
Generally, armed conflicts oppose visible groups supported by invisible actors, known or not known who often communicate with them even secretly. Through negotiations, key messages should be addressed to belligerents via Medias and other means of communication.
In Somalia crisis of 2011, in the Afgooye corridor, where close to half a million people have sought refuge, MSF supported the district hospital, covering the needs of 180 surrounding villages. Staff conducted more than 27,000 consultations and treated over 3,300 malnourished children in Afgooye. (19)
2. Vulnerable populations and persons with special needs
Although armed conflicts affect all people, most of aware people agree that there is a certain category of persons considered as persons with special needs. This is based on the fact that they cannot react to the strife equally as the other affected people. Their physical status, environment increase their vulnerability leading to high risk in facing the danger. This category includes women, girls and pregnant women inmates, people with disability, sick people and old person. On 15 March 2002, the Security Council adopted an aide memoire (S/PRST/2002/6) as a means to facilitate its consideration of issues pertaining to protection of civilians, and decided to review and update the document as appropriate. The aide memoire contains a section on 'vulnerable populations' in general. So far, in his report on the implementation of the Millennium Declaration, the UN Secretary-General has drawn attention to the needs and contributions of older persons as a vulnerable group and has called on the international community to make full use of their capabilities and talents. (21)
Researches as well as experience have shown that female prisoners have different needs than male prisoners. Also, female inmates experience high rates of rape and sexual violence while incarcerated. Research documents numerous cases in which women are at a significantly higher risk than men for being sexually abused before and during prison. Sexual aggression and abuse by male prison staff is widespread. The majority of women incarcerated experience abuse before prison and while incarcerated and suffer from post-traumatic stress disorder. (22) Sexual offenses against women prisoners can include rape, assault, and groping during pat frisks.
The needs of mothers during of pregnancy and childbirth often conflict with the demands of the prison system.Very few of these women receive prenatal care, which can be very detrimental to both the mother and child, especially when coupled with inmates’ histories of inadequate health care as well as sexual, physical and substance abuse. Most of these pregnancies are deemed as high risk. Additionally, a lack of maternity clothes and resources to deal with premature births, false labors, and miscarriages pose serious challenges to prisoners. Furthermore, incarcerated women are a source free labor for detainers.
Persons with disabilities include those who have long-term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others. (23)
During armed conflicts, people with disability can be jailed following ethnic, political or other reasons. The absence of trained people to deal with their case during incarceration and no access to justice as well as lack of State authority in the area constitutes major concern. (24) Most of them do not withstand conditions and face death before any rescue reach them.
People suffering from chronic diseases (such as diabetes, heart disease, and hypertension) and older people might suffer until death. Also, “The Prison Act” requires the segregation of sick prisoners from other prisoners. (25) Furthermore, the confinement leads to contamination and potential death. All patients with terminal illness, whether in prison or not, have special medical needs related to their disease, as well as psychological and spiritual support needs related to the prospect of impending death. Such needs are intensified in the isolating environment of prisons, where the requisite medical and psychological care is most often lacking. (26). Thus, prisoners with a terminal illness need to be accommodated in an environment that does not exacerbate the suffering inherent in their condition and that enables ongoing medical supervision.
In African rural areas, old persons represent the history and other cultural traditions. Some of them represent the customary authority and keep the secret of myths and other customary habits. Also following their ages, old persons are often consulted by people in regards to land conflicts and other matters, and thus become opinion leaders. In armed conflicts, these people are mostly targeted either by armed groups. Besides this, old persons have special needs that have to be taken into account.
Some instruments of humanitarian law allow for special consideration to be given to age in certain circumstances (Third Geneva Convention, arts. 16, 44, 45 and 49; Fourth Geneva Convention, art. 27 para.3, 85 para.2, and 119 para.2). The Fourth Convention also includes special protections for older persons with regard to the establishment of hospitals and safety zones (art. 14, para.1), and evacuation from besieged areas (art.17). The Refugee Convention provides for inclusion of refugees in old age pension schemes in the host country (art. 24(b)).
In regards to their age and lack of force, old persons are sometimes left behind by fleeing population. Neither their families nor other actors satisfy completely their needs since they are separated from their families. Challenges and defies in the context of conflicts were revealed recently by the international community that has begun to take action to redress this neglect. In 2001 the UN High Commissioner for Refugees adopted a policy on older persons and in 2002, the Second World Assembly on Ageing adopted specific policy commitments concerning older persons in emergency situations. (27)
In armed conflicts situations old persons are exposed to danger like other civilians, but in addition, they have vulnerabilities and needs associated with ageing that place them at particular risk. Also, incarceration of older persons far from their family members constitutes a major concern. The loss of family links and the death of family and friends, influence the mental well-being of older prisoners and their prospects of successful resettlement following release. Older female prisoners suffer particularly from separation from their families and communities, and especially in societies where the family, extended family and the local community are essential elements of the social fabric, in which women have the central role as caregivers. (28)
For any humanitarian response, several defies should be considered especially:
The intercommunal attacks of 2011 and early 2012 in Jonglei have had a devastating impact on communities. Whole villages have been destroyed and livelihoods affected, as people have lost their homes and belongings. During the attacks, food reserves, crops and seeds were burned and many people feared tending their fields as a result of the insecurity. As was the case during the last peak of violence in 2009, (29) villages, in addition to cattle camps, were attacked, and many women and children were wounded in the attacks.
Humanitarian and all actors including public services should take action to ensure that the specific rights and needs of older persons for assistance and protection are addressed before opening of hostilities. They should provide responses in term of protection, equal access to food, shelter, medical care and other services primarily preventive evacuation. In response to increased international concern about the plight of older persons in conflict situations, both ICRC and UNHCR have adopted a number of concrete initiatives to improve awareness of needs and strengthen protection that need to be experienced in several African zones. (31) Such strategies will be implemented prior to the opening of hostilities, during conflict and in the post conflict period.
The intensification of armed conflicts in many African countries is a concern requiring a particular attention from all actors. Internal armed conflicts have trained enormous difficulties caused by not groups operating without compliance with any standard of international humanitarian law or human rights. This situation leads to generalized attacks and without distinction between humanitarian personnel, unarmed civilians and public buildings several atrocities affect the humanitarian situation of civilians. Although most of civilians are concerned in this regards, we focused on the situation of humanitarian personnel working in conflict zones through an insecure environments. The suspension of humanitarian activities often appear as a crucial decision; and that, advocating for the reopening of humanitarian activities should take in consideration all challenges mentioned. Another part of the article has been consecrated to a particular category of people named “persons with special needs”. This includes pregnant women, girls, and people with disabilities, sick people, and older persons. Due to their incapacity to face violent and generalized situations as other people; a particular attention is required in planning of humanitarian activities. This includes strategies of saving their lives before the opening of hostilities as preventive measure, during flight as protection actions and in post conflicts periods through recovery programs. This needs collective intervention of all actors namely the public state, humanitarians and the international community.
Knowing that several researches have been done in this field, we cannot pretend to have developed all aspects. We managed to provide a modest overview indicating how these categories of people need a particular attention.
3. ABOUT THE AUTHOR
Patrick Girukwayo, is from the DR Congo. At 48 years old, he is a jurist from the Goma University (UNIGOM). Since 2014 he joined the Atlantic International University (AIU) where he is completing a Master Degree in Business and Economics studies, precisely in "Strategic Planning and Leadership". In addition, he has another master degree from the Institut international d'Ingénierie de l'Eau et de l'Environnement (2IE) of Burkina Faso. He has over 24 years of combined research, teaching (1992-2017) and field experience in humanitarian policy and practice, protection, conflict management, projects management and advocacy. He published five books on “Understanding the behavior” (2003- up to now). From 2004 - 2006, Patrick Girukwayo has worked with Children Voice as a Juridical Counselor in Protection of Children in charge of training and sensitization on Children’s rights. From 2007-2008, he worked in European Union/IEDDH projects with GRACE NGO as Human rights Advisor and Trainer in North Kivu D R Congo. In 2008, he worked in UNDP project with GRACE NGO as Trainer in Conflict Management in North Kivu D R Congo. From 2009-2011, he worked as a Principal Juridical Reporting officer in Monitoring Protection projects of NRC and UNHCR in North Kivu D R Congo. During the same period, he was admitted to the North Kivu Bar as Advocate. Later on, in 2011, he joined the United Mission of Stabilization of D R Congo (MONUSCO) as a Protection Assistant in charge of Analysis and reporting.
4. END NOTES
http://www.doctorswithoutborders.org/publications/ar/report.cfm?id=6243,02 September 2013.
http://www.doctorswithoutborders.org/publications/ar/report.cfm?id=6243, 02 September 2013.
http://www.doctorswithoutborders.org/publications/ar/report.cfm?id=6243, 02 September 2013.