Access to Healthcare

Insecurity - always an insurmountable obstacle?

Civilians in the most insecure regions of today's armed conflicts are often those most in need of humanitarian assistance. They are also the least likely to receive any. That humanitarian agencies struggle to be relevant where it matters most is hardly news.

The recently published research study provides the evidence for what many humanitarians have suspected for a long time: too few humanitarian agencies manage to provide meaningful assistance in the most insecure areas, leaving many people without the aid they need.

This paper, drawing partly on some of the findings of the study, attempts to offer a reflection on the subject of risk acceptance, and some of the underlying factors that – apart from the actual security threat – influence security decision-making in the humanitarian sector.

Why, despite the significant investments and the professionalisation of the sector, do humanitarians continue to fail to deliver in the hardest-to-reach places? It is too easy to put the blame on the external security environment alone. Instead, humanitarian organisations need to examine how they fare in terms of their institutional willingness and capabilities to accept and manage security risks, which are, after all, an inherent part of humanitarian action.

Has institutional willingness to accept risk been affected by growth, professionalisation and the increasing importance of institutional risk management? Has the humanitarian imperative – the moral obligation to assist others in desperate need – faded as the driving factor in operational and security decision-making, and is it increasingly being replaced by institutional interests? Risk management should be an enabler of humanitarian action. But it can easily turn into a disabler, if the humanitarian imperative is not at the forefront of an organisation's ambition and culture.

Other key enablers for operating in insecure environments – negotiated access, meaningful and principled action, and independent logistics capacity – are not sufficiently developed and applied in the sector. In part, this is a result of the humanitarian architecture that prioritises the coherence agenda over the facilitation and safe-guarding of independent humanitarian action. Perhaps it is worth considering supporting some organisations to develop the capabilities to operate in the toughest contexts, operationally and politically independent from the system. The investments in the sector have had little impact for those they were meant for. It may be time to review the approach.

Another element that is rightfully gaining increasing prominence in the sector, is duty of care. It is also an important enabler of humanitarian action, but it inherently comes into tension with the humanitarian imperative when overwhelming need – a certainty in the most insecure humanitarian crises – forces humanitarians to stretch available resources to the maximum. That duty of care is an employer's moral and legal obligation is not disputed, but its application in the messy, dilemma-filled reality of humanitarian action is more complex than it appears on the surface.

MSF's experience in the most insecure contexts shows that the organisation also struggles to reach those most in need. It illustrates that, even with many of the enablers in place, there is no guarantee for safe access.

That is no reason not to try though, but rather a reason to try harder. For organisations that claim a humanitarian mandate, the bar is high. It entails the moral imperative to help others stuck in dangerous places, in desperate need of assistance. It means putting them at the forefront of our decision-making. Failure to do so means failing them.

Insecurity – always an insurmountable obstacle? pdf — 999.35 KB Download