The humanitarian aid system is growing and expanding, and so surely its capacity to meet these challenges should also be growing. Yet despite the enormous resources, in the more complex, less high-profile and difficult contexts, MSF teams in the field have seen that humanitarian responses to displacement emergencies have not occurred in a timely and effective way. This is especially the case in conflict areas. These observations have prompted MSF to conduct this review, to better understand how the humanitarian system is responding to acute displacement emergencies. The review is based on three case studies: • the refugee emergency in Upper Nile state, South Sudan, starting in November 2011 to November 2012; • the emergencies related to the M23 mutiny in North Kivu, DRC, from April 2012 to April 2013; and • the massive influx of Syrian refugees into Jordan from July 2012 to June 2013. The review confirms that emergency response suffers from several recurrent problems which need to be addressed. Rather, while it is core business for the humanitarian system, emergency response capacity has been undervalued and under-prioritised. In all of the problems identified in the three cases, the main issue appears to be the level of prioritisation attached to emergency response and in particular the level of willingness to try to address the needs of people who are the most difficult to reach. The following common themes stood out: • While external constraints on emergency response, as security, access and cost, were certainly significant, in all cases, there was more than could have been done to reduce the external constraints that did exist. Further, it cannot be said that the main barrier to better response is lack of funding – in all three cases reviewed, the funding situation was adequate. • The UN was at the heart of the dysfunction in each of the cases reviewed. There, historical mandates and institutional positioning have created a system with artificial boundaries (for example, between the coordination roles of UNHCR for refugees and OCHA elsewhere), to the detriment of those needing assistance and protection. Further, the triple role of key UN agencies, as donor, coordinator and implementer, is causing conflicts of interest, especially in recognizing and correcting mistakes. Funding systems, in particular, are problematic, slow, cumbersome and not fit for emergency situations. • NGOs make their own choices about how to respond in emergencies – and so must also bear their own responsibilities for how they respond. In some cases, we found that technical capacities were not as they should be, for example, in health, water and sanitation, or assistance to victims of sexual violence. Many agencies had great trouble reorienting longer-term humanitarian programmes to re-adapt to emergency needs. Risk aversion was pervasive within the NGO community, not only in relation to security but also to programming, meaning that agencies were choosing to prioritise the easiest-to-reach over the most vulnerable. • As for MSF, we found that, while the organisation has made significant efforts to prioritise emergency response, it was not immune to many of the same criticisms. In all three cases, in MSF, just as everywhere else, much came down to the nimbleness and reactivity of field leadership, of how well they were able to see changing needs and react accordingly.
Where Is Everyone? Responding To Emergencies in The Most Difficult Places