As a follow-on from our 2018 Geopolitical Reading List, in this piece we review Ayesha Ahmad and James Smith’s “Humanitarian Action & Ethics“; a challenging piece that explores the multiple dilemmas facing the humanitarian sector on a daily basis.
Nobody is under the illusion that humanitarian work is easy or convenient. What Ayesha Ahmad and James Smith have achieved in this volume, moreover, is a powerful challenge to the idea that it is unquestionably ‘right’. It is, as they intended to make it, “a deconstruction of an illusory vision of absolute goodness and justice.”
Quite aside from the clarity of its language and the sheer intrigue of its topic, it is the interdisciplinarity of Humanitarian Action & Ethics that makes it stand out from other books in the emerging literature. (See, for example, the excellent Disaster Medicine edited by David Nott and David MacGarty, and Humanitarian Ethics: A Guide to the Morality of Aid in War and Disaster by Hugo Slim.) Comprising 17 chapters by over 30 authors – academics, ethicists, doctors and activists – this work expounds the ‘granularity of humanitarian ethics’ at a surprising number of operational levels. For those of us who only encounter this field of work through televised appeals and newspaper articles, the humanitarian sector is exposed as a labyrinth of organisational, cultural, and medical dilemmas.
How can ten thousand human beings be ethically ranked by the type of aid they require? Which is more important, medicine or clean water? Which is cheaper? How can you tell a parent not to approach their Ebola-stricken child? And how do you treat a traumatised survivor of rape, if the disclosure of such an attack might mean the person is culturally condemned for life? Fascinating, provocative, harrowing, and laudably explicit in its criticisms, Humanitarian Action & Ethics will justifiably feature in geopolitical reading lists for years to come.
Co-editor James Smith (a physician at the London School of Hygiene and Tropical Medicine and former Médecins Sans Frontières advisor) opens the volume by explaining how ‘tragic choices’ and moral distress are inevitable in an international system where international development funding is invariably tight. With this backdrop, he describes how humanitarian workers are required to act beyond their capacity, beyond their culture, beyond their competence, and beyond their context. In the chapters that follow, each of those limitations is explored in depth, and each through a different professional lens.
A number of chapters are particularly thought provoking. Bio-ethicist Katarina Komenska writes about how utilitarian necessity often clashes with human dignity in the triage of refugee camps. Sociologist Jan Wörlein covers the power structures of the aid community after the Haitian earthquake, and justifies its labelling as an example of humanitarian failure. Academic Jane Freedman offers, in light of the crises that are perpetuated by our own political decision-making, the damning adage that the neutrality of Western humanitarians is “no longer morally sustainable”. Furthermore, Ayesha Ahmad provides an excellent insight into the ethics of countering gender-based violence. Ideas of trauma, risk, vulnerability, and, in particular, the decision-making around disclosure of sexual assault, all need appropriate navigation in future humanitarian projects.
In easily the strongest chapter, Peter Hughes makes a personal and reflective contribution. A disaster-zone psychiatrist with professional experience in Chad, Sierra Leone, the West Bank, Haiti, Iraq and Syria, Hughes provides an honest and engaging account of the ethical maze that is humanitarian psychiatry. In so doing, he echoes James Smith’s earlier claim that humanitarians must act ‘beyond their culture’. “For a Western health worker with a privileged background working in the United Kingdom’s NHS,” he writes, “there is an ethical bias from the very moment of arriving in the field… To a significant extent, health is both beyond politics and imprisoned by it.” His chapter addresses Psychological First Aid (PFA), and in particular, the moral difficulties in providing treatment for the mentally ill in national cultures where understandings of the human brain are radically different. In a section that presents itself right now as highly pertinent, he also outlines in no unclear terms his exasperation with the medical infrastructure available to Palestinians.
Conversely, John Pringle (an epidemiologist and nurse) and Toby Leon Moorsom (a labour activist) co-author the book’s most challenging chapter. They present a neo-Marxist thesis of endemic ‘philanthro-capitalism’; a striking account of wealth accumulation, and intentional cycles of crisis and charity. On the one hand, some of their arguments benefit from apparent accord with their peers: like other authors, for example, they insist on political responsibility for suffering and they express how values are dependent on context. On the other hand, however, one suspects that their overall worldview would grate against some of their in-field co-authors. That may well have been their intention, and at the very least their chapter is eloquently argued.
In closing, one image painted by Jan Wörlein was particuarly poignant. Graffiti on the streets of Haiti’s disaster-stricken capital, she writes, offers mixed messages to the international community: some slogans read ‘ABA U.N.!’ (Down with the UN), while others cry ‘We Still Need Help’. Needless to say, most of us can afford to only think about the 2010 earthquake there when it suits us, but its consequences remain a daily reality for Haitians. Taking that into consideration, we need not say that this book came out ‘at the right time’. Rather, that there is never a ‘wrong time’ to educate ourselves on its subject. Humanitarian Action & Ethics is sorely needed.
Encyclopedia Geopolitica were kindly provided a copy of Humanitarian Action & Ethics by ZED Books. Founded in 1976, ZED is an internationally-comprised and collectively-managed publishing group, which specialises in under-represented issues and voices.
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John Scott is a Scottish security analyst with expertise in counter-narcotics and non-state groups. John has degrees in Political Science from St Andrews and Glasgow University, and recently completed a NATO Military Security course in Lithuania. He has contributed policy research for a political group in the Central African Republic, and currently focuses on organised crime analytics for Intelligence Fusion.
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Photo credit: Chris Morrow