Navigating the Paradox and Complexity of Humanitarian Relief: Q&A with Fiona Terry

Fiona Terry speaks during an event at the International Peace Institute (IPI) in New York in November. (IPI)

Humanitarian aid organizations, while providing lifesaving assistance, must also navigate the web of ethical and logistical challenges inherent to conflict-affected environments. It is often required, for example, that humanitarian actors be escorted within a country by parties to a conflict. Talking with armed groups—especially terrorist groups, even in the context of helping civilians—can be perceived as legitimizing them. Furthermore, it is not always clear whether resources that organizations provide are reaching those they are intended for.

Few understand these dilemmas better than Fiona Terry, independent researcher at the International Committee of the Red Cross (ICRC) on healthcare in danger, whose 2002 book Condemned to Repeat? The Paradox of Humanitarian Action won the 2006 Grawemeyer Award for Ideas Improving World Order. As a former researcher with Doctors Without Borders (MSF), Dr. Terry analyzed attacks against healthcare in Somalia, the Democratic Republic of Congo, and Afghanistan and the impact of MSF’s withdrawal from Somalia in 2013. Her latest report, “The Roots of Restraint in War,” focuses on armed actors, providing possible solutions to some of the challenges aid organizations face.

Ahead of a recent event at the International Peace Institute (IPI), Dr. Terry sat down with IPI’s Annie Rubin to discuss the complexities of humanitarian relief and key findings from her latest report. Her research on when, why, and how individuals and groups choose not to use violence offers valuable insight into how humanitarian organizations can navigate impartiality and contribute to sustainable peace.

This interview has been edited for clarity and length.

What is the paradox of humanitarian action?

It’s that we are trying to alleviate suffering through our humanitarian action, but there are unintended negative consequences that can go with it and in fact we can end up prolonging the suffering that we intend to alleviate. Humanitarian actors need to have more independence in order to be able to steer their work. But I think most humanitarian organizations lack that independence, which is necessary to avoid the politicization or manipulation of their work.

Can you explain the difference between impartiality and neutrality in humanitarian efforts?

Impartiality means giving aid without any discrimination based on religion or ethnicity, but based on who needs the humanitarian action in priority. Neutrality is more that you don’t get embroiled in the politics of the conflict, and you stay out of the “rights and wrongs” in order to be able to reach as many people as possible.

When I was with MSF we debated, back in 2000, whether we should remove neutrality from our charter because at the time people—including me—were saying that neutrality is terrible. It puts the executioners and their victims on the same footing. When I worked in Rwanda during the genocide, I thought, how can you be neutral when faced with génociders killing so many people? Now I see I was mistaken because neutrality is not a moral position at all, it is simply a tool, a posture that you adopt with regards to the different parties in a conflict.

A prime example is during the Rwandan genocide when the head of delegation from ICRC, Philippe Gaillard, would take the ambulance out every day to try to rescue Tutsis by the side of the road. He would fill up an ambulance with people and then he would come back through the checkpoints manned by the armed Interahamwe, and he would get out, sit down, and have a beer with them. He would talk to them, and he would try—he hated what they were doing so vehemently, but his mission was to try—to get these people through to a hospital. And if that meant sitting down and having a beer with them and shaking their hand, then so be it, that was the lesser of evils. 

How does International Humanitarian Law (IHL) factor into navigating neutrality and impartiality?

I’m not a specialist on International Humanitarian Law. It talks about “impartial” aid organizations, while it doesn’t mention neutrality. But I do think that it provides an excellent framework through which we can try to minimize the suffering of civilians, and try to influence the bearers of arms to restrain their violence and limit the destruction and civilian casualties. You have to be pragmatic and realistic and realize that people fight, and they will fight. We’re not a pacifist organization, but we try to limit the damage of fighting.

IPI recently published a report on the tension between counterterrorism measures and upholding obligations under IHL. What are some examples of this tension?

We saw the impact of this tension very much in the response to the Somali famine in 2012. There was a lot of starvation, and the response to that starvation—because it was in al-Shabaab-held territory and because there was the risk that there would be diversion of food aid to al-Shabaab—was that a lot of aid organizations stayed away. That was really to the detriment of people who were in desperate need of humanitarian assistance. That was the first obvious impact of this legislation that criminalizes material support to so-called “terrorist groups.”

We also saw that in Sierra Leone back in the late 2000s where the peacekeeping forces said to aid organizations, “you cannot deliver food into areas held by the Revolutionary United Front,” and at the time, I was with MSF, and we said, “you cannot punish all these innocent people because they find themselves in RUF-held territory. You cannot deprive them of aid for that reason.”

So the constraints have real consequences on how possible it is to provide aid in these contexts.

Yes, and this is where my book comes in. There are unintended negative consequences in these environments, but sometimes we have to live with them.

Working in Somalia during the famine in the early 1990s, we contributed enormous amounts of money and food to an aid effort where a lot of that was diverted—a lot of it went into the pockets of the warlords. Now, to have done nothing would have meant hundreds of thousands more people would have died. It’s a hard balance sometimes. I think that the starvation was so great that we had to do it, but we had to try to curb the diversion of funds to warlords as much as we could.

You also have to be creative in trying to ensure that your aid is benefitting those that need it most and not going to the people causing the problem in the first place. For example we used to cut the blankets given out to people in two to ruin their commercial value on the market. But even then it didn’t work. I was doing a distribution of blankets in a camp for internally displaced persons and still the armed guys came in and ripped the blankets literally out of the hands of the women and children, even though they had been cut in half.

In your latest report, you talk about the roots of restraint in war. What does restraining from violence look like?

For this project we were influenced by the work of Scott Straus, who is an expert on Rwanda and looks into why Rwanda descended into genocide and Côte d’Ivoire did not. Elisabeth Wood’s work was also very influential for us because she has looked at sexual violence and rape in armed conflict and why, for example, the Tamil Tigers in Sri Lanka did not engage in a lot of rape whereas other armed groups did.

I find this work very useful because, as horrific as it is, the reasons why people commit atrocities have received a lot of attention. What has received much less attention is when it doesn’t happen and why it doesn’t happen.

The Kodok Hospital in South Sudan is a great example. Our [ICRC] office there received notification from three different armed parties to the conflict that were about to have a big clash in town. We were warned to evacuate the hospital, and they did so. As patients and staff left, they put padlocks on the doors, not believing that it would withstand the attack that was about to happen. They were extremely surprised, when they came back, to find that the outer ICRC compound was looted completely, but the hospital was not. That enabled the office to take a step back and ask, in whose interest was it to keep this hospital going? We could then start to piece together the roots of why armed parties showed restraint.

But I think the biggest thing we learned is that the discourse around South Sudan and other places is that these are uncontrollable fighters, that they are acting with wanton violence, and it all just spirals out of control. This experience showed us that, no, actually, there is a lot more control that leaders can wield if they choose to.

What are the main roots of restraint and how did you determine them?

To determine this we looked at organizational structure of state- and non-state armed groups. In the US or Australia or the Philippines, state armed forces are very hierarchical, where the law is set in place and then the whole structure of orders goes down. We try to make sure that law is incorporated into training and doctrine and compliance mechanisms. The training is one root of restraint.

But we know there are limits to even having rules in place, because we see the persistence of sexual violence in state armed forces and the persistence of hazing techniques even when the military has tried to stamp them out. There are a lot of informal norms and informal socialization mechanisms at play that are beyond the control of law.

So we also looked at community-embedded groups, like the cattle-guarding groups in South Sudan: the Dinka and the Nuer. It was very interesting to see the mixture of competing interest over their behavior. There were the politicians that wanted to perhaps mobilize them for some reason, there were the business people who did as well, the prophets had quite a lot of influence, waning over time, because the availability of guns has shifted the power balance away from traditional leaders and more into the hands of the gun-toting fighters. We tried to piece together this patchwork, which, in the end, shows a level of complexity that scares people to a certain extent, but it’s better to at least know that there is no one size fits all, there is no one approach, we really have to try to unpack context-by-context what works and who has influence over behavior.

That sounds like a novel approach. How do you think, through better understanding the roots of restraint, humanitarian actors can contribute to peace?

I think certainly humanitarian action can set the scenes, it can establish trust. Humanitarian actors don’t really get into the machinations of mediation and peacebuilding because it’s a very political process and there are always winners and losers. We try to stay out of that to a certain extent. But I think humanitarian action contributes to peace just by virtue of the respect that we give people: through talking to them, through providing humanitarian assistance to their families, to keeping links together between people who are in prison and their families on the outside through Red Cross Messages, through looking at the treatment, etc.

I think that humanitarian actors garner a lot of respect that can definitely help to produce an environment that is more conducive to peace. I think that the human dignity we try to uphold is very, very important. 

In October 2018, Dr. Terry started an operational research center within the ICRC, called the CORE: the Center for Operational Research and Experience, where she will continue to run research projects. One project tries to measure the quality of dialogue with non-state armed groups and the objective impact of asking these questions.