Humanitarian Response to Climate Disasters
HUCE Director Daniel Schrag spoke in November with Jennifer Leaning and Michael VanRooyen, both physicians expert in humanitarian responses to disasters. Leaning, an associate professor of medicine at Harvard Medical School (HMS) and director of the Inter-University Initiative on Humanitarian Studies and Field Practice, served from 2005-2009 as founding director of the Harvard Humanitarian Initiative (HHI). Michael VanRooyen, HHI’s current director, is an associate professor of medicine at HMS and associate professor of global health and population at Harvard School of Public Health who has worked extensively in humanitarian assistance in more than 30 countries affected by war and natural disasters. What follows is an edited excerpt of their conversation, focusing on the way that extreme events are changing the way they think about disaster relief.
Schrag: When you both got into this field, with training as emergency room doctors, you weren’t thinking about the environment or climate change were you?
Leaning: I was thinking about environmental protection and conservation, but I was thinking about disasters much more from an industrial standpoint—major explosions, fires and even earthquakes—things that would require an emergency response, and definitely from the standpoint of someone in an emergency department.
VanRooyen: My work has been on both the medical response side, and also in looking at large-scale population movements. While the issue of climate itself was not on my radar at all, certainly environmental issues played a huge role: for example, drought and the Horn of Africa famines in Ethiopia and Somalia in the 1980s and 1990s. Those events were very much on everybody’s mind in terms of how environmental issues can affect populations, but we didn’t see it as an evolving, dynamic issue—something that would affect other communities as well.
Schrag: You still thought it was really affecting the poorest countries in the world and the most vulnerable?
Leaning: Right. Most of it was drought and famine. We both had public health degrees. I got involved in thinking about planning humanitarian responses in the mid-1980s with the major Ethiopian famine of ’84. I was part of a group in the U.S. that was figuring out how to disperse aid. It was a very hectic and ad hoc time; to the extent that we were thinking of large populations it was over there, not here.
Schrag: What has changed? The climate’s been changing steadily. Certainly now as a community, disaster relief experts are beginning to think about the environment in a different way.
VanRooyen: I’m perhaps representative of that relief community. We’re reactive in the way that we think about large-scale emergencies, disasters, and events such as recurrent flooding in Bangladesh, for example. It’s been a cyclical fixture of nature, not something that we thought of as getting progressively worse. It took a series of 100-year disasters—huge, epic disasters happening during a short period of time—for us to say, “Something seems different about this.”
Now it seems there is not only the interaction between population growth in vulnerable areas and the environment, but progressively worsening environmental emergencies, for a variety of reasons. For us, there has been a realization that climate issues are playing an increasingly important role, and that a lot of relief organizations’ response-planning strategies have not accounted for that.
Leaning: I agree. A pivotal time in my thinking as I got more involved in disaster planning with the Red Cross and in teaching about disasters was in 2005—fairly late. There was the Asian tsunami in late 2004. And then in 2005 we had Hurricane Katrina and the Pakistan earthquake. Hurricane Katrina in particular really began to make a lot of us think about the vulnerabilities of coastal cities to severe storms.
Schrag: Jennifer, you were working in Rwanda and other very poor countries. And all of a sudden, you were being asked to work in New Orleans. What was that like?
Leaning: Mike and I organized a public health response to that disaster by working with the Red Cross and sending members of our group to assess the capacity to deal with medical needs and overall public health structures of the shelters that were being flung up in a rapid way, well beyond what the Red Cross had ever done before on these shores. And we were struck by the extent to which the vast population movement that ensued was not well handled.
This was not a Red Cross problem. It was the overall response from FEMA on down, and also the way in which this disaster affected the vulnerable disproportionately, something we’d been talking about for years in our teaching and our observation of disasters. This event brought into harsh relief the ways in which that cohort of 100,000 people in the most flood-prone areas of New Orleans were basically abandoned by city planners and by the state, and had to fend for themselves.
It was a terrible wakeup call for all of us, not only those from the disaster and public health community, but I think also for the general public and the world at large, because it illustrated the ways in which we were not thinking ahead about population and geographic vulnerability to major floods. That event was not a once in a hundred years storm. It was just a category three hurricane when it hit a little bit off target from New Orleans.
Schrag: It hit Mississippi, not New Orleans. If it had, we could have had 100,000 dead.
Leaning: Exactly. That was when I began teaching about what were then considered outmoded approaches to disaster response that involved accommodation. In the intervening years, beginning in the 1960s and 1970s and peaking in the 1980s, planners had begun to think that we could engineer our way out of these disasters with earthquake hardening, and advanced warning systems, and so on; and that we, like the Army Corps of Engineers, were able to proactively anticipate disasters and make the environment and vulnerable cities fit for whatever nature had to send our way. But in the aftermath of Katrina, a number of us began to say, “You know what, disaster planning and our whole stance towards natural disasters has to move towards accommodation and recognition that we are not going to be able to conquer nature. We have to get out of its way or adapt.” That was a very unpopular point of view. Remember, there was a movement to “build back New Orleans,” and in fact that’s what’s been undertaken.
Schrag: Yes, except for one parish, we spent a lot of money essentially rebuilding New Orleans in its entirety. I just finished a report for the President on climate adaptation, distinguishing robustness from resilience. Resilience is sometimes misunderstood in the media, but it means increasing your ability to recover from a stress, as opposed to robustness, which is trying to withstand that stress. The relief community is really focused on resilience, right?
Schrag: Have we learned how to make communities more resilient in the face of these major disasters?
Leaning: I think we’re learning. If you look at Bangladesh, which is the poster child for resilience in terms of adaptation, the government has done a great deal during the last 25 years. With advice and help from the international community, Bangladesh has instituted improved warning systems, better evacuation directions, and shelters that are usable and within reach of people who are running or moving quickly because they have a little bit of time, given a better warning about these major cyclones.
That has led to reduced mortality from powerful storms during high tides at the time of the full moon. But there are an increasing number of people who lose their land, can’t go back, and are drifting into the low-lying cities of Dhaka and Chittagong.
With high population density my concern is that we’re going to have to adopt strategies that involve out-migration in these coastal areas.
Schrag: Displaced people are not just in Dhaka and Chittagong, right? It’s also in Houston, Texas from New Orleans.
VanRooyen: Katrina gave us a classic example of well-known vulnerability that was ignored.
I think that we’ve not come very far in the recognition of building robustness versus building resilience in many of the places Jennifer talked about. For example, even after a major catastrophe, people build on the same area again for lack of options, for lack of economic options, for lack of zoning, for a variety of reasons.
I think there are several factors at play that have continued to create more, rather than less, vulnerability. One is more urbanization and the interplay between climate, migration and urbanization. Another is that we don’t as an international community have the will to invest in either resilience or robustness.
Leaning: Yes, because it would first of all involve some very serious thinking and political persuasion based on analysis of that thinking. For instance, take New York City and New Jersey post-Hurricane Sandy. We can talk about population resilience, but Mike and I knew very well that within three or four days the population would start complaining bitterly about a range of things: electricity, transportation, food; haven’t seen FEMA for weeks; where’s the Red Cross?
Schrag: Yes. After three days of no running water and no electricity, life becomes really unpleasant.
Leaning: Right. It gets a little old. So this is a population that does not do well. They’re cut off from the life supports of 21st century East Coast America.
These supports are critical for populations that are seriously disabled and elderly and ill who, in harsher situations, would not have survived to that stage of life. Coastal Bangladesh, where they have to move fast periodically and fairly frequently, does not have many people who are unable to ambulate.
The problem with our very wealthy technological societies, and here I would include the coastal areas of the United States in general, is first, that we have pockets of poverty where almost by
definition there are fewer options. That was heralded with Hurricane Katrina. But we also have large sections of the population who cannot manage if the utilities and other engineering feats of modern cities are torn away for a week or more.
VanRooyen: An additional issue relates to that. It is not widely recognized that in the U.S., initial disaster relief is neighbor helping neighbor. It is all very local because of logistics, infrastructure, and the difficulty of reaching people.
So when people are out of power for three days or a week, the responses are local. Yet we expect to be rescued. In the aftermath of Katrina there was a huge population that essentially needed to be rescued. Whereas, if you look at places that are used to having catastrophes, they know that they are on their own for the first three days or a week anyway.
Leaning: Part of this policy work is telling people in the developed world who live in regions vulnerable to climate change that there are steps that they can take to help themselves. Of course there are things that they can ask the government to do at various stages and levels, but there are a number of things that will always remain local.
If you’re going to be resilient, that includes not only preparedness plans but also recognizing that if you’re on the 11th floor, and if that requires an elevator and you can’t walk down 11 flights, that this is a situation where you need to be thinking about other ways or places to live.
Schrag: You’ve both been teaching a course on migration, again focused on places like the Sahel region of Africa, drought-stricken areas with extreme vulnerability because they’re just on the edge of existence to begin with. Disaster response has traditionally focused on what happens afterwards. But in this class you are calling for preemptive interventions and migration.
Leaning: We’re thinking about anticipatory things first. Part of our work involves preparedness and planning, working on steps that you can institute ahead of time if you can’t prevent the flood to mitigate its impact on the population; how you can get people out of the way or strengthen systems so that the impact is not so terrible and the required response so vast, so expensive, and costly in terms of lives lost.
VanRooyen: We both work largely in the reactive community, and the heavy lifters in the humanitarian response structures, particularly around emergencies, have not sunk a lot of money, effort, or innovation into preparedness or resilience.
The best defense against vulnerability due to disaster is large-scale, well-thought out development. The relief providers have never been very good at thinking about preemptive planning insofar as building structures for resilience. They’re good at preemptive planning for staging responses to emergencies. That is their business.
I’m on the board of the International Rescue Committee, and we talk about this fairly frequently. I don’t see huge moves with many of the United Nations agencies such as the Office for the Coordination of Humanitarian Affairs, for example, taking major steps in thinking about building resilience. They’re thinking about building better coordination and communication structures around response.
Schrag: Harvard hosted a Humanitarian Action Summit: Climate and Crisis workshop in May that brought together relief organizations, academics from the relief community, and climate scientists to discuss the intersection of climate change and humanitarian aid. What does the relief community need to think about moving forward?
Leaning: I think the message is going to have to be something along the lines of improved capacity to handle larger scale displacement in longer duration distress—in other words, to build up and enhance the response capacity. And then at the headquarters or policy level, I think we should be talking about having an increasing number of agencies working with others who are beginning to assess possibilities for this mix of robustness and resilience.
Schrag: Twenty years ago, food security was at the top of the international relief community’s agenda. Do events such as the 2010 Russian heat wave or the drought this summer in the U.S. that caused corn prices to spike raise the issue of food security again for the international community?
VanRooyen: Food is always a dominant issue. There are still many billions of dollars of food aid that go out every year.
Leaning: I agree. The intersection with food and security and climate change is one that needs considerable unpacking because the areas of the world that are becoming increasingly food insecure are the areas where drought and population growth are colliding. And the reliance on food aid from the United States and other parts of the world is wearing thin because there are periods when the United States is not producing all that much food for surplus exports, although the stockpiles are great.
Schrag: Do we have an opportunity to put adaptation and preparedness firmly on the agenda for the relief community?
VanRooyen: What will drive resilience planning will be the funders; if USAID, for example, makes it a priority to put money behind it and says we need organizations that have learned this and are going to step forward and build this kind of capacity.
Leaning: The humanitarian community has become moderately stereotyped in its response. It is financed by government aid primarily. It has packages of delivery that the government says to get out there. It is overseen by its own sets of communities and a series of standards around how to bring down indices of morbidity and mortality and how to provide good food and potable water in sufficient amounts—but it is not local. And that’s the point that Mike was getting at. The development agencies that are there all the time have more enduring, stable relationships with the communities across the nonemergency periods. This is where the resilience has to be built in.
Even when ready and predeployed as a disaster is impending, the humanitarian community is positioned to arrive mid crisis, and to tide people over until the crisis abates. The structure, the mindset, the skill set and the entire body of functions of the humanitarian community are a bit wrong- footed for building in resilience. It’s not that we don’t know what needs are there, but the humanitarian organizations are not structured to be in the right position all the time.
VanRooyen: That’s exactly right. NGOs and a large swath of nongovernmental agencies don’t have independent lines of funding for doing preemptive work unless it’s identified. They propose programs. They get them funded. They do them. They do the next one. The real work that needs to be done is convincing the donor or the community of funders that this kind of work is important.
Leaning: Part of what Mike and I have been involved in is preparing the next generation of humanitarian responders. We’re in a position to affect some of the best and brightest who come to Harvard. We also have convening power, to bring to Harvard people who are excellent and in leadership positions, which the summit exemplified. Our curriculum is being adjusted to proactively recognize the need to build resilience. And HHI already has a big project on urban disasters and distressed migration to cities.
These are issues that we talk about and teach in the disaster and forced migration classes that I run, and that are being institutionalized in the Humanitarian Academy at Harvard, where we’re bringing all of the different scholars and practitioners who are interested in these issues together with students. We have the opportunity to craft a curriculum that will have a policy impact down the road.