The trouble with aid
Luxury four-wheel drives are standard issue in the international aid game, so it is no surprise to see dozens of white Land Cruisers parked bumper to bumper in front of Gisenyi’s Meridien hotel like horses tethered to a hitching post in some postmodern western. The frontier image fits. After all, this leafy, lakeside town on the Rwandan border is the latest outpost for international aid workers, the rear headquarters just behind the front lines of the refugee crisis in eastern Zaire. It is a town where most Rwandans go about their business on foot and the heavy traffic of fourwheel drives must seem like an alien invasion— although Gisenyi’s rain-filled potholes do look deep enough to swallow a lesser vehicle.
But for a few days during this warm November, Gisenyi will wilt under the attentions of the Western world. Rwanda’s refugees and their biblical trek home are the international story of the moment, confirmed by the numerous satellite broadcast dishes flowering outside the town’s main hotel, their nerves of cable trailing across the grassy courtyard and their generators humming around the clock. The concentration of media, aid workers and harried diplomats has temporarily made Gisenyi and the cross-border city of Goma, Zaïre, the world’s best-known datelines. Their street scenes are projected into comfortable living rooms across the globe. They are the latest stop on the decade’s world tour of humanitarian disasters: Kurdistan, ’91, Somalia, ’92, Rwanda, ’94, Liberia, ’95.
This time it’s Back to Rwanda, and the aid agencies are well prepared for the fillip of international interest. All the big aid organizations— as well as some with newly minted charters that are eager to make a reputation—are represented in Gisenyi, their slick logos displayed on T-shirts, tents and trucks. There are the superpowers of the movement such as CARE, Oxfam and the Red Cross; the United Nations agencies that are so often mocked by the others for their Cadillac working conditions; Ireland’s gutsy and re-
spected Concern; newcomers like Britain’s Merlin; and, of course, the cowboys of the emergency aid movement: Doctors Without Borders. The “without borders” phenomenon continues to morph into new fields. There are now Pharmacists Without Borders, Lawyers Without Borders, and so on, so close to parody that when a particularly stylish blond sashays through the hotel bar, someone jokes that Supermodels Without Borders have arrived in Rwanda.
But the business at hand is serious. There have been apocalyptic warnings that possibly a million people could die on the other side of the Zairean rebel lines. Someone from Doctors Without Borders (best-known by its original French acronym MSF for Médicins Sans Frontières) has predicted that 13,000 people a week could die from cholera. The aid groups are well rehearsed at the
The Heroes of the world's war zones face growing criticism
emergency drill by now. They can move entire field hospitals from Europe to Africa overnight, and they are swift at installing enormous fresh water bladders in areas where fetid water threatens to spread cholera. These days, they are also likely to fly in their media-friendly spokesmen, who are not above getting in a dig or two at other agencies. The spokeswoman from MSF, for example, happily lambastes the United Nations for its inefficiency (all the nongovernmental organizations, or NGOs, seem to share disdain for the United Nations), and slams other groups for their “immoral” conduct over the past two years in the Zairean refugee camps.
Welcome to the booming, competitive, catty and often heroic culture of emergency relief. These days, it is an industry basking in its heightened profile—and beset by unaccustomed criticism. Aid workers were once undisputed angels of mercy at every disaster scene, bravely getting food and medicine through to civilian victims of war or famine and shouldering the messy relief chores that governments seem happy to hand off. They continue to provide numerous profiles in courage. Canadian surgeon Chris Giannou has devoted his life to aiding the afflicted in the world’s war zones. Lone American doctor Ronald Dierwechter kept Baidoa’s ghoulish hospital open during the height of Somalia’s 1992 war and famine, operating by flashlight. Last week, the agencies were gearing up for new efforts in Zaire after an MSF official reported that thousands of refugees, many in poor condition, were trekking westward in a vast column, having fled the border war zone weeks earlier. “I can’t imagine doing a runof-the-mill family practice after this,” says Dr. Leslie Shanks, a 33-year-old Canadian working with MSF in Zaïre. “At home, the shooting and shelling sounds horrible, but here you just deal with it.”
But emergency relief is an unregulated business, and the past few years have also seen an explosion in the number of new groups. Where a major disaster might once have attracted 40 or so relief agencies, the number working in Rwanda topped 200. Aid workers acknowledge that many of these agencies, smitten by the romance of rushing into a crisis to “save lives,” dispense salvation with fluctuating degrees of competence. In some cases, they say, poor treatment has cost lives. A report into the 1994 Rwandan emergency commissioned by a wide range of aid groups and donors declared that “it is unacceptable that an NGO with little or no relevant experience is able to send personnel to a relief operation, provide unacceptably poor standards of service and care, and then leave without any recourse.” Such behavior, the report points out, “would not be tolerated in Western countries where many of the NGOs in question are based.”
Humanitarian aid also has the potential to complicate political solutions to a crisis. Conflicts in the 1990s are increasingly within—rather than between—states, with civil society often descending into near anarchy and combatants operating within civilian enclaves. Victims are often indistinguishable from villains. And where handing out humanitarian aid was once a neutral act, choosing who gets to receive can now be a very political one. Some critics even accuse aid agencies of sustaining conflicts, because the food, water and medicine is sometimes given to, “taxed,” or stolen outright by warring factions, helping them to fight on.
Aid workers hotly debate these emerging controversies among themselves. But other than to draft voluntary codes of conduct, the humanitarian agencies have no answers to the question of whether their Band-Aid to the world’s sores has become bad aid. Meanwhile, as emergency relief captures a larger share of the First World’s shrinking aid budgets, few pass up the chance to show their logos at a major
disaster. While total government aid spending by rich countries has fallen by 9.3 per cent since 1994, to $72 billion, spending on emergency relief has multiplied fourfold in the past decade, to more than $8 billion. That emphasis on the crisis of the moment, and the need to appeal more and more to private donors, compels agencies to be everywhere the television cameras are, to send at least a few workers to the scene in order to buy themselves a “field presence.” It also accounts for the high number of groups choosing to focus on donorfriendly activities such as orphanages, rather than less glamorous tasks like sanitation. “There is less funding, so there’s more competition,” says Christine Stewart, Canada’s secretary of state for Latin America and Africa whose pre-political career was spent in the development field. “And that’s why you get this high concentration in disaster zones.”
But Alex de Waal of the human rights group Africa Rights calls it “the counterfeiting of humanitarianism,” where “agencies feel compelled to be present in front of the TV cameras,” whatever the ethics or consequences. De Waal and a chorus of others argue that there are times where emergency aid does more harm than good. And when that is the case, they contend, the angels of mercy must fold up their wings and walk away.
Leslie Shanks sits in an elevated gazebo on a mountainside above Gisenyi, silhouetted against Lake Kivu’s choppy waters and the azure haze of Zaire’s hills and volcanoes be yond the far shore. Many of what the United Nations estimates to be 1.2 million Rwandan refugees are in those hills, hunkered down in the lava field known as the Mugunga camp.
But Shanks and her MSF colleagues cannot get to them. They are blocked by a rebel army that still has unfinished business with the Hutu militias that control Mugunga. By the next morning, the rebels would break the militias’ spine and Shanks would find herself in Mugunga’s chaotic field hospital, knee-deep in sick, wounded, crying people. But this day is still as peaceful as a sleepy summer afternoon on Lake Simcoe near her home town of Barrie, Ont., and Shanks has a chance to reflect on the way her business is changing.
“Look, there are a lot of people who do this because they can’t get a job at home, or at least they can’t get an interesting job at home,” says the outspoken family practitioner who admits to a sarcastic streak. “Over here, people in their 20s are handed huge responsibilities: a chance to manage huge budgets, big staffs.
“But there aren’t many naive idealists in MSF,” she continues. “Nobody comes here to help ‘the poor and the suffering’ any more, and I’m so tired of people asking me, ‘How can you do this?’ We like this work. We like the lifestyle. It’s a culture of its own. I find it so difficult with my friends in Canada when I go back because they don’t follow what goes on in these places. That’s why a lot of people in this business sign on for mission after mission—because they find you just can’t go home.”
Shanks traces her own drive to do relief work back to a church group exchange in Central America as a teenager, when she recalls learning that “getting pimples was no longer the biggest thing in your life once you had been in places without running water.” But people
'I always had it in my head to get into the action'
end up doing emergency work on different impulses. “I cried when I saw the misery on TV when I was younger, and I always had it in my head to get into the action,” says Montreal’s Catherine Taillefer, 33, who has done relief work for 10 years and managed the CARE Canada camp in Uvira, Zaire, until the war came this fall. “I adore the work, but I’m not a dreamer now. Zaïre is hell. And you get fewer and fewer people coming in thinking that they will be spoon-feeding babies.” In fact, “there are many different ways to reach Rome,” says Roland Sidler, a 48year-old Swiss who has been on the front lines with the International Committee of the Red Cross since 1981. “Some people are altruistic. Some want to do something positive with their lives. But I’m not so sure that these gestures don’t do more for the person who is doing the giving, than for the refugee who is receiving.” Certainly the recipients of aid seem to pay little attention to the brand competition between various agencies. Studies have found that Rwanda’s refugees, for example, generally lumped all assistance received as coming from the “Red Cross.” This lack of differentiation can hamper aid workers in the field. Some organizations have decided that when their convoys are confronted by soldiers demanding a percentage of the food or medicine as the price of crossing a checkpoint, they will pay the “toll.” The Red Cross, however, refuses. ‘Try convincing some kid with a gun that you’re not like those other agencies that pay,” says the Red Cross’s Sidler. “They’re young, they can be drunk, they’re bandits, and they figure that their gun gives them the right to make policy and get what they want. And then there’s another checkpoint 200 m down the road, where those soldiers are making their own rules, too. It’s not for nothing we have a high turnover of workers.”
The “diversion” of aid is not a completely new phenomenon. Some food and medicine with aid markings have always shown up for sale outside the refugee camps where they had been delivered. But the systematic pilfering of supplies by armies caused alarm in Bosnia, where many UN peacekeepers questioned whether aid was merely
a lifeline to keep the armies in fighting trim. That debate was amplified in Zaire. Many camps were controlled by the same Hutu soldiers and freelance killers who attempted genocide against Rwanda’s Tutsis, and who continued to launch guerrilla attacks on Rwandan towns across the border from the camp sanctuaries. But in camps that bristled with intimidation, aid groups consciously decided to distribute food and medicine through those same leaders. After several months, MSF pulled out of Mugunga, protesting loudly against other agencies’ willingness to co-operate with killers.
MSF seems to have a knack for annoying other organizations. Relief work was once the purview of British organizations like Save the Children or Oxfam, which came out of the world wars, or church groups doing missionary work. But secular agencies like MSF began to emerge at the end of the 1960s, especially following the Biafran 2 crisis 27 years ago, which spawned I both MSF and Ireland’s Concern S Worldwide. But whereas Concern op“ erates in the “refined, British tradition,” says its director, Father Aengus Finucane, “MSF likes to exercise their flair. In Bangladesh, they blazed in against everybody’s wishes, and ran roughshod over local officials with the blessing of the French diplomats. It distresses me that groups which claim to be all things to all men disrespect local protocols.” MSF’s behavior, says the Irish priest, has made him “disgustingly pro-British.”
If Bob Geldof’s 1985 Live Aid concert became an epiphany by revealing the celebrity appeal of relief work, the Kurdish crisis following the 1991 Gulf War marked a sea change in the industry’s philosophy.
Those were the heady early days of the New World Order, says Angela Penrose, policy director at Save the Children in London, “and there was a genuine belief that we in the West now had a right to intervene.” Suddenly, MSF-style attitudes were ascendant. ‘They have a different ethos,” Penrose says. “On the Continent, humanitarianism is regarded as a political ideology, and suddenly there were all these young people rushing in with a genuine belief that only people matter, that you can ignore sovereign states.”
At their peril. By the time of the 1994 Rwandan crisis, with newly minted agencies arriving by the planeload, the industry bordered on out of control. “It was an incredible circus in 1994,” says Shanks. “Once the pictures hit television, people were pouring in. Agencies would send doctors in without any backup, no car, and often without a job to do.” Several aid groups bluntly refused the Rwandan government’s insistence that they register, and were subsequently tossed out of the country. “Just because you dislike a government is no reason to disregard that government,” says Canada’s Stewart, who has been on both sides of the fence. “NGOs have to grapple with whether they’re really on side with civil society.”
Correspondingly, a backlash against the aid workers’ white-hat image emerged. News conferences in Gisenyi were marked by newfound hostility and tough questioning, especially when the returning refugees did not seem to be dying at anywhere near the rate predicted by the relief agencies.
And yet, in all these desperate ends of the earth, it is the aid workers alone who clean the wounds, feed hungry mothers, and try to reunite lost children with their parents. “Sure there’s some elbowing between NGOs, but that’s reality,” snaps CARE’s Taillefer. “In the field, we do a good job.” Shanks agrees. “We can sit around and debate should we stay or should we go, but in the end we’re health-care workers,” she says in Mugunga’s crowded hospital. “And in these camps, we look after malnourished kids and sick, vulnerable people.”
On the rocky road outside the camp where she’s working, a woman has just given birth to a sickly infant boy, whose raspy breaths barely come. A journalist, having spotted the mother and suffering baby, waves down a passing aid truck. Journalists cannot save this child. No story filled with outrage will help. “Can I go now?” the journalist asks the aid workers, her eyes seeking permission. They have been apprised of the situation. The reporter drives on, her moral duty completed. And the aid workers bundle the baby into their van, to get him some care. □