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Begin New Search Author Alice Debarre Publication Year within 10 Years

1. Delivering Healthcare amid Crisis: The Humanitarian Response in Myanmar

Author:
Alice Debarre
Publication Date:
02-2019
Content Type:
Policy Brief
Institution:
International Peace Institute
Abstract:
Myanmar simultaneously faces multiple armed conflicts and crises, each with its own challenges. In Rakhine state, the government’s persecution of the Rohingya people has led to massive displacement, as have decades of armed conflict in Kachin and northern Shan states. Combined with chronic underdevelopment, these humanitarian crises have left people without access to adequate healthcare, leading international humanitarian actors to step in. The public health system in Myanmar is generally poor, and government funding for health services is among the lowest in the world. There are wide discrepancies in health services between rural and urban populations and between central and peripheral states. In Rakhine, there are only nine public health workers per 10,000 people, and access to secondary and tertiary healthcare is limited. Community-based or ethnic health organizations provide primary healthcare in many areas without government facilities. In crisis-affected areas, UN agencies and international and local NGOs play an important part in providing healthcare services. However, international action can be unbalanced both regionally and medically. In many areas, health actors have focused on responding to diseases like malaria, HIV/AIDS, and tuberculosis, leaving a critical gap in mental health services and clinical health responses to sexual and gender-based violence. Likewise, funding has been imbalanced, with Rakhine state receiving more funding than Kachin or northern Shan. This paper looks at the state of healthcare in Rakhine, Kachin, and northern Shan states, the role of humanitarian actors in the provision of health services, and the trends and challenges affecting the humanitarian health response. It provides several recommendations for improving the humanitarian health response in Myanmar, including: 1. Adjust the scope of the humanitarian response; 2. Advocate for better humanitarian access; 3. Strengthen local capacities, and; 4. Address the dilemmas inherent in providing aid amid a development and human rights crisis.
Topic:
Health, Crisis Management, Public Health, and Humanitarian Crisis
Political Geography:
Southeast Asia and Myanmar

2. Making Sanctions Smarter: Safeguarding Humanitarian Action

Author:
Alice Debarre
Publication Date:
12-2019
Content Type:
Policy Brief
Institution:
International Peace Institute
Abstract:
In recent decades, sanctions have increasingly been used as a foreign policy tool. The UN Security Council has imposed a total of fourteen sanctions regimes alongside those imposed autonomously by the EU, the US, and other countries. Despite efforts to institute more targeted sanctions regimes, these regimes continue to impede or prevent the provision of humanitarian assistance and protection. This policy paper focuses on the impact of sanctions regimes in four countries: the Democratic People’s Republic of Korea, Syria, Afghanistan, and Somalia. It aims to assist the Security Council, relevant UN organs, UN member states, humanitarian actors, and other stakeholders in ensuring that humanitarian activities are safeguarded in contexts in which sanctions regimes apply. While there are no straightforward solutions, the paper offers several ways forward: Including language that safeguards humanitarian activities in sanctions regimes; Raising awareness and promoting multi-stakeholder dialogue; Conducting better, more systematic monitoring of and reporting on the impact of sanctions on humanitarian activities; Developing more and improved guidance on the scope of sanctions regimes; and Improving risk management and risk sharing. This paper is accompanied by an issue brief that provides further detail on the types of impact sanctions can have on humanitarian action.
Topic:
Humanitarian Aid, Sanctions, and UN Security Council
Political Geography:
Afghanistan, North Korea, Syria, Somalia, United States of America, and European Union

3. Providing Healthcare in Armed Conflict: The Case of Mali

Author:
Alice Debarre
Publication Date:
01-2019
Content Type:
Policy Brief
Institution:
International Peace Institute
Abstract:
Due to ongoing conflict and insecurity in northern Mali, 1.8 million people require humanitarian health assistance, and 2.5 million are considered food insecure. Given the level of need, Mali’s healthcare system is ill-equipped to respond, and humanitarian health actors play an important role filling the gaps. This issue brief maps the challenges these health actors face and assesses their response. It accompanies a policy paper published in 2018 entitled “Hard to Reach: Providing Healthcare in Armed Conflict,” as well as another case study on provision of healthcare in Nigeria. These papers aim to assist UN agencies, NGOs, member states, and donor agencies in providing and supporting the provision of adequate health services to conflict-affected populations. This issue brief concludes with recommendations for how health actors can improve delivery of health services in Mali: UN agencies, international NGOs, and donors should continue to focus on strengthening and supporting Mali’s community healthcare structures. Military, political, and humanitarian actors need to preserve the humanitarian space in Mali. Relevant UN agencies, local and international health NGOs, donors, and the Ministry of Health should place greater emphasis on noncommunicable diseases, particularly mental health. Humanitarian health actors and donors, as well as development actors and global health actors, should improve coordination with each other on the health response. Humanitarian health actors should better ensure that they are accountable for the health services they provide, in particular to affected populations.
Topic:
Health, United Nations, Peace, and Armed Conflict
Political Geography:
Africa and Mali

4. Providing Healthcare in Armed Conflict: The Case of Nigeria

Author:
Alice Debarre
Publication Date:
01-2019
Content Type:
Policy Brief
Institution:
International Peace Institute
Abstract:
The humanitarian situation in Nigeria’s northeast is deteriorating, with more than 5 million people in need of healthcare and over 800,000 out of the reach of humanitarian actors. Given this level of need and the poor state of the healthcare system in northeastern Nigeria, humanitarian and other nongovernmental health actors play an important role. This issue brief maps the challenges these health actors face and assesses their response. It accompanies a policy paper published in 2018 entitled “Hard to Reach: Providing Healthcare in Armed Conflict,” as well as another case study on provision of healthcare in Mali. These papers aim to assist UN agencies, NGOs, member states, and donor agencies in providing and supporting the provision of adequate health services to conflict-affected populations. This issue brief concludes with recommendations for how health actors can improve delivery of health services in northeastern Nigeria: Humanitarian health actors should improve coordination both with each other and with global health actors working in northeastern Nigeria. Relevant UN agencies, local and international health NGOs, donors, and the Ministry of Health should scale up the response to under-prioritized health services. Humanitarian and development NGOs, donors, and the Ministry of Health should focus efforts to implement the humanitarian-development nexus for health services on areas where it is relevant and feasible. Humanitarian health actors should improve their accountability for the health services they provide. Humanitarian donors need to ensure that counterterrorism clauses in their funding contracts are not overbroad and do not impede neutral, independent, and impartial aid.
Topic:
Health, Humanitarian Aid, and Conflict
Political Geography:
Africa and Nigeria

5. Pursuing Coordination and Integration for the Protection of Civilians

Author:
Alice Debarre and Namie Di Razza
Publication Date:
02-2019
Content Type:
Policy Brief
Institution:
International Peace Institute
Abstract:
In recent years, the UN and its member states have promoted comprehensive approaches and integrated structures and processes to improve coherence and consistency between political peacekeeping, humanitarian, human rights, and development efforts undertaken by the UN and its partners. For POC specifically, coordination between the military, police, and civilian components of peace operations; between peace operations and UN agencies, funds, and programs; and between the UN system and other protection actors has been pursued to maximize impact in the field. Joint planning, analysis, and action at these three levels are key to leveraging different types of expertise, tools, and responses in a holistic way in order to better prevent and respond to threats to civilians. However, while the UN’s normative and policy frameworks provide the basis for coordination and organizational arrangements have been set up to facilitate integrated efforts at these three levels, recent developments in the peace and security sphere have reinvigorated the debate over the costs and benefits of integration. Coordination for POC has proven to be increasingly difficult in non-permissive environments where, for example, peacekeepers may be perceived as party to the armed conflict or as having too close or tense a relationship with the host state or non-state actors. Integration in such contexts has led to debates around the preservation of humanitarian space, the independence of human rights advocacy, and the security of actors too closely linked to peacekeeping efforts. This issue brief analyzes the costs, benefits, and challenges of coordinated and integrated approaches to POC in peacekeeping contexts. It considers the added value of mission-wide and system-wide coordination for POC and concerns over comprehensive coordination between peacekeeping and humanitarian actors, which have different rationales and methodologies for protection. In a context of UN reform emphasizing prevention and political strategies, it questions the political and institutional push for more comprehensive POC strategies and reflects on the associated risks. It also offers considerations for how to coordinate and integrate multi-actor efforts in order to better protect civilians.
Topic:
Human Rights, United Nations, Peacekeeping, and Civilians
Political Geography:
Global Focus

6. Safeguarding Humanitarian Action in Sanctions Regimes

Author:
Alice Debarre
Publication Date:
06-2019
Content Type:
Policy Brief
Institution:
International Peace Institute
Abstract:
There are currently fourteen UN sanctions regimes, which member states are legally required to implement. Many of these are implemented in the context of armed conflict, where international humanitarian law outlines obligations to protect the provision of and access to principled humanitarian action. But despite efforts to make sanctions regimes more targeted, they continue to have unintended consequences, including impeding or preventing the provision of humanitarian assistance and protection—particularly when they coexist with counterterrorism measures. This issue brief explains the various ways in which sanctions regimes can impact humanitarian action. Acknowledging that this is not a new issue—though one that may be of increasing concern—it identifies several factors that make it challenging to resolve. Finally, it lays out some avenues for progress, pointing to existing efforts and highlighting where more could be done. Given that sanctions regimes are mostly targeted and that member states are bound to uphold the principles in the UN Charter and international humanitarian law (where it applies), sanctions should protect and not inhibit humani­tarian action. Where sanctions hinder aid, the impact on civilian populations is immediate, and efforts to backtrack will always come too late. Going forward, member states, the UN, financial institutions, and humanitarian actors should proactively and preventively tackle this problem. While the most effective courses of action will require political will, stakeholders at all levels can take incremental steps to help mitigate the impact.
Topic:
Humanitarian Aid, International Law, Sanctions, Conflict, and UN Security Council
Political Geography:
Global Focus

7. Safeguarding Medical Care and Humanitarian Action in the UN Counterterrorism Framework

Author:
Alice Debarre
Publication Date:
09-2018
Content Type:
Policy Brief
Institution:
International Peace Institute
Abstract:
In the past decade, counterterrorism measures have had an increasingly adverse impact on the provision of medical care and the conduct of principled humanitarian action in armed conflict settings. Whether inadvertently or not, they have impeded, and at times prevented, the provision of essential and lifesaving aid, often in violation of international humanitarian law (IHL). This paper aims to assist the Security Council, relevant UN organs, UN member states, and other stakeholders in upholding their obligations under IHL. It maps the UN counterterrorism framework and looks into the extent to which it guides states in complying with these obligations. In doing so, it offers several recommendations for the way forward: All UN resolutions and other UN and national policies that pertain to counterterrorism should contain an exemption for humanitarian activities. Every relevant UN counterterrorism measure should continue to reiterate that counterterrorism efforts need to comply with international law. Humanitarian actors should engage with UN counterterrorism structures more actively, strategically, and systematically. UN bodies that engage in counterterrorism should systematically include humanitarian actors in relevant conversations. The UN Counter-Terrorism Committee’s Executive Directorate and Office of Counter-Terrorism should better integrate IHL considerations into their work. Member states, UN entities, humanitarian actors, counterterrorism and sanctions experts, and other stakeholders should step up efforts to start a wide political discussion on tensions between counterterrorism and humanitarian action.
Topic:
Health, Humanitarian Aid, United Nations, Violent Extremism, and Counter-terrorism
Political Geography:
Global Focus

8. Hard to Reach: Providing Healthcare in Armed Conflict

Author:
Alice Debarre
Publication Date:
12-2018
Content Type:
Policy Brief
Institution:
International Peace Institute
Abstract:
Armed conflict is a global health issue. Long-lasting and protracted conflicts in particular have consequences not only for the war-wounded but also for the health of entire communities. Over the years, global health actors and humanitarian health actors have developed health policies, guidelines, frameworks, and structures to improve delivery of health services in emergencies or humanitarian crises. Despite these advancements, however, the international health response in conflict-affected settings still faces gaps and challenges. Some policies and frameworks need to be rethought or redesigned, while others need to be better implemented. This paper explores challenges to healthcare provision in conflict-affected settings. These challenges are broadly broken down into three categories: constraints related to the health system and damaged health infrastructure, difficulty for health workers to access populations in need, and restrictions to healthcare provision intentionally or accidentally placed by donors or states engaged on humanitarian and health issues (e.g., through the securitization of healthcare). Tackling these challenges will have a direct impact on the lives of people in conflict-affected settings. However, doing so requires a radical shift in mindsets and the incentives that guide the actions of international health actors. Even so, more incremental changes can also be beneficial. To that end, this report puts forth the following recommendations: Improve coordination between and among humanitarian, development, and global health actors; Respond to context-specific needs; Hold health actors accountable to affected populations for their performance, and; Make responses sustainable. This work is based on a combination of desk research, interviews with more than seventy key informants, and an expert meeting bringing together key stakeholders and experts on global and humanitarian health.
Topic:
Health, Humanitarian Aid, and Conflict
Political Geography:
Global Focus