Understanding Resilience – An Interview with the UNDP’s Samuel Doe

 Samuel Doe is the UNDP policy adviser for crisis, fragility and resilience (photo: Josh Styer/EMU)


Samuel Doe is the UNDP policy adviser for crisis, fragility and resilience (photo: Josh Styer/EMU)

July 10, 2015 – When Samuel Doe was growing up during Liberia’s 1990s civil-war he recalls aid workers distributing wheat to feed the hungry.

“Liberians never ate wheat. We had to learn to eat wheat,” he says. “It wasn’t our decision.” He also remembers mothers queuing up to receive cooked porridge to feed their babies and aid workers insisting on feeding the babies themselves. “They did not trust the mothers would feed their babies.”

“That sort of indignity is becoming less and less now,” says Doe, who is the UN Development Program’s policy adviser on resilience, an often-used and misunderstood term that is transforming the way aid and development work.

At a fundamental level, “resilience is about harnessing agency, the intentional action of human beings and believing that human beings can make dignified decisions that over time strengthen their independence, strengthen their interdependence and their self-reliance,” Doe explains.

But how does that translate on the ground for the UN and international NGO’s doing aid and development work and what were the reasons behind the shift to a resilience approach?

There are four broad reasons, Doe says.

The first is a realization that, with a lot of complex emergencies, once the response and recovery phase is over, these countries do not have a stronger society and stronger systems.

“We find them repeatedly again and again falling back onto those conditions of fragility that have been exacerbated by the crisis. Countries that have gone through war and have recurrence in 2-3, maybe 5-10 years,” Doe says. “Countries that have repeated disasters have been depleted of human resources and social capital. That is one of the reasons why people begin to ask how can we make the humanitarian response and recovery processes put countries on a path that is sustainable after a disaster.”

“The second reason behind the motivation, the push to resilience, is that prior to this thinking we have always thought in the international system that there is a sequential approach, a sequential relationship between humanitarian response and development. So there is a crisis, the first line actors are humanitarians, they do their bit then they get out and then we come in and then development people pick up the pieces. But, increasingly, depending on the quality of work that humanitarians do, they are likely inadvertently to make the development space more difficult.”

“For example in many humanitarian responses there is a tendency to develop parallel systems: we can’t work with the governments so we will establish our own coordination system, which brought about the cluster system. We will set up our own accountability system. The funding mechanism will go directly to the implementing organizations that we will work with. So government being the primary actor to responding to disaster is often left out in these emergency response.”

“Parallel systems that are developed in a crisis context that then overcrowd the local government systems over time make them almost inoperable to assume responsibility once the response is over. Many governments are saying increasingly that unless we use the country systems in preparing and responding to disasters it will be difficult for these countries to develop much more robust systems against future disasters.”

The third reason is that emergencies are increasingly slow-onset, says Doe, and aid and development work is happening at the same time.

“Take the case of Syria, the case of the Horn of Africa, or the case of the Sahel. There is no relief and then development. There is relief and then development constantly interacting because it’s a slow-onset crisis, it’s a protracted crisis. This illusion that humanitarians will do their bit, they will get out and then we’ll come in does not work. Therefore we have to cultivate a new way of working that allows development actors and humanitarian actors to work in the same space at the same time but that then puts a lot of pressure on the humanitarians who say well ‘we need the core humanitarian principles to still be respected,’ principles of neutrality, independence, impartiality. These need to be respected but they do not preclude the recognition and use of local systems. So how can local systems be used by respecting impartiality and neutrality and independence. This is the discourse we are pushing.”

The fourth reason is that the architecture of the development and humanitarian communities reflects the financial architecture of the donor communities so there are donors that fund only humanitarian work and donors that only fund development work. “There is no bridge conceptually or operationally for humanitarians to tap into development funds and vice versa,” Doe says.

But slowly UN appeals are being reconfigured to move away from short-term appeals, months or up to one year, to multi-year appeals that address both the humanitarian emergency and the underlying development issues.

So how will a resilience approach be implemented and what lessons have been learned from the past?

“Society should have the capacity to predict risk and if possible prevent risk using development, prevent the threat factors that are preventable,” says Doe. “So say, for example, we look at the Ebola crisis in West Africa, we’re saying the recovery plan should emphasize the resilience of the countries because when the crisis happened, it only took three months for Ebola to destroy the institutions the international community had invested billions into in Liberia and Sierra Leone. It took just three months for the economy to go into free fall, for the health systems to collapse completely. The highest donor support in Liberia was to the health sector. The system that we put the most money into was the system that collapsed in three months. What gave way to that?”

“Prior to Ebola, Liberia had literally 51 doctors for 4.5 million people. More than two-thirds of those doctors were concentrated in Monrovia, Although we’re investing in building the infrastructure of the health system, we’re building the clinics, but the Liberian medical school was producing less than 20 doctors every year. It’s appalling that the doctors being produced weren’t equipped to deal with very basic supply chain management, access of rural clinics to supplies, roads that were inaccessible. Even basic gloves were not in villages and clinics. So the way we invested in the health system focused a lot on payment of salaries, focused a lot on building the infrastructure but the human capital that is necessary to sustain those systems was less invested in. So our investment was sort of skewered to different priorities.”

A major push behind resilience thinking is strengthening local governments as they are the front-line responders to a crisis.

“If we do risk sensitive development we need to emphasize local government systems, emphasize working with local governments, making sure local governments and administrative bodies are strong, that local governments have their own preparedness capacity in place,” Doe says. “That there is a strong, fluid, very active supply line, a communication line that runs across local and central governments. We’ve  seen that in the Ebola crisis, we’ve seen that in other crisis: when the local systems are functioning, when the local communities are actively engaging the systems, the response capacity is fast and is effective.”

The resilience approach is now being used for the Syrian crisis and Doe explains the thinking that lead to this.

“There was tension between humanitarians and the development people. At some point the humanitarians said this is a humanitarian crisis, we want to focus on humanitarian issues. we do not want the development actors to confuse this, but over time we all realized that this crisis is going on years and it’s transnational. Turkey is affected, Jordan is affected, Lebanon is affected. They all have refugees. The refugees are not all in camps, they’re in homes, some are working. So you can’t use the way we do humanitarian response in that setting.”

“In Lebanon for example you have two shifts of schools, morning and in the afternoon, so maybe you have to increase the salaries of teachers. Paying that cannot come through a humanitarian fund, it goes through the government. That is the kind of thing that is happening. Strengthening systems of governments so that they deliver on a humanitarian crisis. Rather than strengthening humanitarian systems so that they deliver only humanitarian aid. So that is the distinction that is being made in the Syrian situation.”

Prepaid cards distributed to Syrian refugees in Jordan.

Prepaid cards distributed to Syrian refugees in Jordan.

Another example Doe gave is the credit card system used in Jordan where Syrian refugees are given prepaid cards instead of aid workers determining what goods and services the refugees need, the refugees decide for themselves.

“They have credit cards now, they can go to a bank, use their credit card and get their funds for their own welfare. That’s an example of choice, of empowerment. So giving them choice giving them the freedom of choice is an important outcome or characteristic of building resilience. It’s dignity,” says Doe, who was instrumental in designing the 3RP plan for Syria.

Although resilience has been a buzzword for the past few years, it is only now that it is being codified. The United Nations is about to release its UN System Principles on Building Resilience, a document two years in the making that involved not just the UN’s humanitarian and development arms but also international NGO’s working on the ground.

“It’s an amazing process, just to have a blueprint, something that is codified,” Doe says. Now the hard work starts. “Multi-year appeals, getting donors to  change their way of thinking, trying to really get governments thinking too that this is about ownership: this is your crisis. Working together more coherently getting coordination systems way ahead of time, making sure we have preparedness -  we spend billions of dollars on response but less than one percent on readiness of countries, changing that paradigm, making sure we spend a bit more money on getting people ready. Are these schools ready, are they producing the right human capital?”

Doe also says a more integrated early warning system, not just for food and conflict, but also pathogens is needed. He said there’s currently a push to get the EU to develop its own Center for Disease Control so that it too can provide global disease surveillance.

The stark reason why the UN is changing the way aid and development is done is simply because natural disasters are increasing and new conflicts continue to emerge and escalate at an alarming rate. This underlies the resilience approach.

“We will not be able to deal with all of these exogenously, just from outsiders going in,” Doe says. “That’s not going to work.”

- Denis Fitzgerald
On Twitter @denisfitz

Related Stories:

Tough Task Awaits New UN OCHA Chief

South Sudan’s Expulsion of UN Official Brings Controversial Integrated Approach Into Focus

UN ‘Dysfunction’ at Heart of Slow Response to Humanitarian Crises

The Politics of Humanitarian Intervention Detailed in New Book by Former UN Aid Chief

UN Investigators Find Numerous Flaws With WHO’s Ebola Response

Ebola_Virus_TEM_PHIL_1832_lores

May 11, 2015 – The World Health Organization is ill prepared to respond to international health emergencies and poorly managed the initial response to last year’s Ebola outbreak in West Africa, an independent team of investigators appointed by the UN has concluded.

The esteemed panel of investigators, in an interim report, said the WHO did not seek support early enough from other United Nations agencies that have experience in emergency response, did not engage with local communities early enough on changing behaviors that spread the disease, and its authoritative status was undermined by a combination of the above as well as fluffed communications including belatedly declaring Ebola a Public Health Emergency of International Concern.

“At present, WHO does not have the operational capacity or culture to deliver a full emergency public health response,” the investigators concluded. Among their recommendations are establishing a new agency for emergency health response or reforming WHO.

The latter is preferable, the investigators said, because “establishing a new agency would take time to put in place and substantial new resources would be required to establish its basic administrative systems, and operational response capacity.”

“A new agency would, in any case, have to rely on and coordinate with WHO for public health and technical resources, creating an unnecessary interface,” the report says. “A WHO that is capable of adequately responding to public health emergencies requires deep and substantial organizational change.”

Although WHO leads the health response cluster during humanitarian emergencies, the investigators write that “it is unclear…how a public health emergency fits into the wider humanitarian system and at what point an outbreak becomes a humanitarian emergency that requires a broader United Nations-wide response.”

They add that “one of the difficulties is that the risk assessment of public health emergencies and so-called humanitarian emergencies differs, because of uncertainty in assessing the likelihood of disease spread.”

Among other recommendations are that WHO should have used medical anthropologists for developing communications strategies for changing traditional burial and funeral practices that contributed to the spread of Ebola and that UN member states should increase their contributions to WHO so that it can effectively respond to public health emergencies.

“Now is the historic political moment for world leaders to give WHO new relevance and empower it to lead in global health,” the report concludes. “In response, the (WHO) Secretariat needs to take serious steps to earn this leadership role in relation to outbreaks and emergency response and to regain the trust of the international community.”

Full report is below.

Denis Fitzgerald
On Twitter @denisfitz

 

Ebola Interim Report on WHO Response

Slowdown in Ebola Cases as Funding Increases

Ebola_Virus_TEM_PHIL_1832_lores
Nov. 5, 2014 – The World Health Organization on Wednesday said that incidences of the Ebola virus appear to be on the decline in Liberia, stabilizing in Guinea but increasing in Sierra Leone, particularly in the capital Freetown.

The latest WHO situation report shows 398 new cases in Liberia in the past 21 days out of a total of 6,525 cases that have resulted in 2,697 deaths so far.  In Guinea, 256 new cases have been recorded in the past three weeks bringing the total to 1,731 cases with 1,041 deaths.

However, Sierra Leone has reported 435 cases in the past week alone. “Much of this was driven by intense transmission in the capital of Freetown, which reported 115 new confirmed cases and remains one of the worst affected cities in this outbreak.”

Sierra Leone has the second highest incidence of Ebola, after Liberia, with 4759 cases resulting in 1,070 deaths. More than a quarter of the country’s Ebola cases have been recorded in the past three weeks.

The WHO also said that the number of beds in Ebola Treatment Centers (ETCs) has increased from 284 at the beginning of August to 1,047 at the end of October with 593 in Liberia, 294 in Sierra Leone and 160 in Guinea.

“The establishment of more beds is in part held back by challenges in finding sufficient numbers of foreign medical teams to operate ETCs,” the WHO said.

The outbreak of Ebola in the Democratic Republic of the Congo, which is separate and unrelated to the outbreak in West Africa, is almost under control. There have been no new cases in the past 24 days, WHO said, and if no other cases are reported in the next 18 days the country can be declared Ebola-free.

Meanwhile, funding to combat Ebola is increasing with more than $1 billion committed so far according to UN figures. The top five contributors are the United States, which has given $313 million; the UK, $95 million; Canada, $51 million; China, $41 million; and Sweden $34 million.

Russia is the only permanent member of the Security Council that has not yet donated funds to combat Ebola.

A list of all contributions and pledges made so far is here and includes funds given directly to the UN appeal as well as money donated bi-laterally to an affected country.

- Denis Fitzgerald
On Twitter @denisfitz

France Absent From Donors to UN Fund for Combatting Ebola

Ebola_Virus_TEM_PHIL_1832_lores
Oct. 8, 2014 – France has yet to contribute to the UN fund to combat the Ebola virus outbreak in West Africa.

The most recent list of contributions to the fund, which is seeking $988 million, shows that the US has contributed $113 million of the $391 million so far committed, making it, by some distance, the biggest country donor.

The UK is next with $7.8 million contributed, then Australia at $7 million, followed by Kuwait, $5 million, Canada, $4.2 million, and Germany $3.2 million.

Twenty-two countries in total have contributed to the fund. Besides the six above, the others are:

Switzerland $3 million
Japan $3 million
Norway $2.2 million
China $2.2 million
Denmark $2.2 million
Italy $2.1 million
Ireland $1.2 million
Netherlands $1.2 million
Finland $1 million
South Korea $600,000
Spain $540,468
India $500,000
Luxembourg $269,054
Austria $263,505
Estonia $80,600
Andorra $20,053

Russia is the only other permanent member of the Security Council besides France to not yet contribute.

A list of all contributions and pledges to the United Nations Ebola Response Fund, as compiled by the UN Office for the Coordination of Humanitarian Affairs, is here.

France is the former ruler of Guinea, which is the epicenter of the Ebola virus outbreak. The first case in the current outbreak, the biggest ever, was diagnosed there in March 2014. The country has registered 1,298 cases, resulting in 587 deaths, according to the World Health Organization. Twenty-five percent of the cases in Guinea have been diagnosed in the past three weeks.

The total number of cases for Liberia, Sierra Leone and Guinea has topped 8,000 resulting in 3,800 deaths.

The US, Spain, Senegal and Nigeria have also recored cases while a recent study suggests there is a 75 percent probability of the virus spreading to France in the next twenty days. The UK and Belgium are also at high risk of the virus spreading there at 50 percent and 40 percent respectively, according to the study.

The study, by researchers from Boston University, also found that a travel ban on flights from affected countries would delay international spread of Ebola by three weeks and concluded that the best intervention is on the ground assistance in the affected countries.

- Denis Fitzgerald
On Twitter @denisfitz

Image: US CDC