The first in a series of articles on volunteerism that will appear in this magazine during 2011, the tenth anniver-sary of the Year of the Volunteer

Volunteer values

World leaders are counting on volunteers to help attain the Millennium Development Goals. But why then is the volunteer contribution so grossly under-counted? What can we do to support them?

When the torrential monsoon rains caused the Indus to break its banks and rage through northern Pakistan, Fawwad Sherwani, a 36-year-old Pakistan Red Crescent Society (PRCS) volunteer from Karachi, immediately joined the relief teams.

Working both in PRCS camps and in the Karachi ‘control room’, Sherwani helped assess the needs on the ground and communicate that to headquarters. He helped establish routes to get aid to victims via boats, jeeps and helicopters.

An experienced aid worker who has responded to earth-quakes, suicide bombings and cyclones, Sherwani doesn’t think too much about the Millennium Development Goals (MDGs) when he puts on his Red Crescent vest and cap and rushes off to an emergency. He just likes to help people and, even though he doesn’t get paid, it’s his job, what he was trained for.

But as 2011 (the tenth anniversary of the first Year of the Volunteer) begins, global health and political leaders say the consistent efforts of volunteers such as Sherwani are critical to achieving global Millennium Development Goals, a series of eight development targets that governments have pledged to meet by 2015 (see box).

Take the case of polio. Health experts say that volunteer efforts — including the extensive networks of National Red Cross and Red Crescent Societies  in countries such as Afghanistan and Nigeria — are one reason why the disease’s eradication is now in sight. The network allows vaccination programmes to go the ‘last mile,’ reaching deep into communities that are often hard for outsiders to access. During a measles campaign in Mozambique’s Nampula province, for example, Red Cross volunteers helped achieve a 97 per cent coverage rate, compared to 88 per cent in other rural areas (a critical difference when fighting diseases that develop resistance and spread quickly).

Volunteers are key
With only four years left before the 2015 MDG deadline, there’s still a long way to go. Even with polio, and the advances against measles, eradication is far from assured. On issues such as poverty and children’s healthcare, there are complex obstacles — natural disaster, desertification, armed conflict, global warming, urban violence, chronic food insecurity, financial crisis — that gets in the way.

With insufficient levels of government and private sector resources available and many challenges in accessing vulnerable communities, many are turning to volunteers as a key resource. As UN Secretary-General Ban Ki-moon said recently, “Achieving the Millennium Development Goals will require the engagement of countless millions of people through volunteer action.”

Because they are rooted in their local communities, Red Cross and Red Crescent volunteers are able to bring vaccination, emergency relief or critical drug treatments even to areas of armed violence (Baluchistan province in Pakistan, in Somalia, or in remote areas of Afghanistan, where Red Crescent volunteers help deliver polio vaccine during prearranged ‘tranquility days’).

Volunteers also have a social impact, which is harder to quantify, but which contributes to community stability and recovery, particularly during conflict. A volunteer for the Red Cross of the Democratic Republic of the Congo, Patrick Zaboninka Mayara travels by bicycle and on foot to deliver Red Cross messages that keep families in touch, sometimes reuniting children and parents separated by fighting.

In Beirut, Lebanon, Mohammad ‘Frisco’ Mansour teaches other youth volunteers how to use games and simulations to bring international humanitarian law and humanitarian norms to life for 8- to 18-yearolds. “They learn, through these games, that war needs to have limits and that humanitarian values are to be respected,” says the 25-year-old Lebanese Red Cross volunteer, speaking of the youth who attend the seminars. “Otherwise the pain will be too great to suffer and the price too high to pay.”

Often, volunteers give even when they themselves have their own needs. Volunteer Morlai Fofanah dedicates time to promoting non-violence and tolerance in rural communities in southern Sierra Leone. After a road accident damaged his spine while returning from a mission, this first-aid team member now does much of his volunteer work with the aid of crutches or a wheelchair.

Gaining access
Volunteers are also able to reach into pockets of poverty or vulnerable communities in developed or transitional countries. In the quiet countryside village of Rö, for example, just outside Stockholm, Swedish Red Cross volunteer Christina Lindholm organizes summer camps for caregivers whose partners are living with dementia, Alzheimer’s disease, aphasia and multiple sclerosis. The camps’ activities and its social network contribute to improving health and reducing the vulnerability of both patients and those caring for them, according to studies by the Swedish Red Cross.

In the streets of Shenyang in north-east China, meanwhile, volunteers for a group called Fireflies (supported by the Red Cross Society of China) make house calls to HIV-infected patients who often cannot get healthcare through normal channels. “We can’t get operations in ordinary hospitals — very few places will provide treatment to HIV-positive people,” says Xiao Jie, who is himself HIV-positive. “People look at HIV sufferers as bad. They think that good people will not get this disease.”

Around the world, volunteers such as Fawwad, Christina, Xiao, Mohammad and Morlai are quietly having a powerful impact towards achieving the MDGs. But if we are to rely on these volunteers to help do what governments and the market economy cannot, what are we going to do to support and protect this vast, unpaid workforce? And if the volunteers’ efforts are so important, why is their contribution not even counted in most national measures of economic productivity and development?

Volunteers for the Nigerian Red Cross Society administer oral polio vaccine in communities where it is desperately needed. It only takes two drops of the vaccine to ensure immunization against polio.
©IFRC

Volunteer Profile

Germaine Pierre-Louis
Haitian Red Cross Society

The building housing the meeting room in the Saint-Michel Hospital in Jacmel, in south-eastern Haiti, is one of the few hospital buildings that did not collapse during the earthquake of 12 January 2010. In the room, 25 young people — some of them Haitian Red Cross volunteers, others members of youth organizations — are about to do a course on cyclone prevention with Germaine Pierre-Louis, a well-known nurse and volunteer in the Jacmel region. “Good morning,” she says briskly. “Thank you for coming this morning in the midst of the hurricane season. You must be ready to raise people’s awareness.”

Professionally, the 58-year-old nurse is head of the Ministry of Public Health’s epidemiological and statistical services in Haiti’s south-eastern department. In her spare time, she is a volunteer with the Haitian Red Cross, vicepresident of the National Society and president of the south-east regional branch. She, along with two other Haitians — Michaëlle Colin, head nurse at the Port-au-Prince Sanatorium, and Jude Célorge, a Haitian Red Cross volunteer in Martissant, one of the capital’s poorest neighbourhoods — were awarded the prestigious Florence Nightingale Medal in 2010 for their selfless work during the earthquake. They are the first three Haitians to receive this award since it was established in 1920.

An impact on MDGs?
In Jacmel, Haitian Red Cross volunteers have also conducted courses not only on hurricane preparedness, but also on HIV/AIDS prevention and good hygiene practices. These trainingsessions, aimed at young people, are designed to help preserve the living standards of the already impoverished population.

Do they help achieve the Millennium Development Goals of reducing poverty and reducing disease? “Our education work enables people to protect their goods and livelihoods,” says Pierre-Louis. “Thanks to such preventive activities, disease and accidents can be avoided. This maintains the status quo but unfortunately does not decrease poverty.”

To genuinely reduce poverty, you have to develop economic activity, for example, by assisting small businesses such as rice and coal vendors, some of whom are also living with HIV/AIDS.

Like most volunteers, Pierre-Louis is motivated by immediate needs. After the January earthquake, for example, she immediately organized search-and-rescue and relief activities for the survivors even though her own house was destroyed. What drives her? “Every morning, I wake up saying to myself that I cannot accept anyone’s suffering.”
– By Jean-Yves Clemenzo

If it isn’t counted, does it really count?

Like his volunteer colleagues in the HIV-support group Fireflies, Xiao Jie isn’t in it for money, or for any particular global agenda other than fighting HIV/AIDs in his community. When asked, however, he agrees his volunteer efforts for the group have a very real and quantifiable value: at least 1,000 renminbi (US$ 150) a month.

Like many volunteers, Xiao Jie is unsure about whether this kind of work should be reimbursed. On the one hand, it should be done by volunteers because they really want to do the work. But then again, people should be paid as it helps the government do its job.

Xiao Jie is not the only one to reflect on volunteer values these days. Indeed, there is a growing effort around the world to better quantify the volunteer contribution, which is largely left out of most countries’ gross domestic product (GDP) calculations or other key economic and development indicators.

“The problem is that often what isn’t counted, doesn’t count,” says Megan Haddock, project coordinator at the Center for Civil Society Studies at Johns Hopkins University in Baltimore, USA. “In the traditional statistical model, the contribution volunteers make to the economy is absolutely zero. It’s simply not being accounted for.”

If economists, politicians, the media and average citizens don’t understand the contributions of volunteers or the input of non-profit organizations, to which they often belong, then support and legal protection for those efforts will remain weak, she says.

A recent Johns Hopkins study, based on data from 37 countries, found that indeed the volunteer contribution was grossly underestimated. Roughly 140 million people, or 12 per cent of the population in these countries, engage in some volunteer activity,  according to the research. Together, they represent nearly 21 million full-time workers, making an economic contribution worth roughly US$ 400 billion annually. They also make up some 45 per cent of the non-profit workforce.

This volunteerism takes many forms. Mexico, for example, has a long tradition of informal volunteerism — it just doesn’t call it that. Voluntary acts of ‘solidarity’, as they are called, are simply considered part of life; they usually occur informally within communities and not in connection with any particular non-profit agency (though much of it may be church related).

Added up, however, the time spent by people doing various voluntary acts of solidarity comprises roughly 1.4 per cent of Mexico’s GDP, according to Jacqueline Butcher Rivas, who studies volunteerism in Mexico. Herself a volunteer, Butcher says a better understanding of this contribution could leverage greater investment and legal protection for volunteers. “This sector is greatly under-appreciated,” she says.

During the 2011 tenth anniversary of the Year of the Volunteer, the Red Cross Red Crescent Movement is hoping to highlight these issues. While it’s generally believed that its volunteer network gives the Red Cross Red Crescent unparalleled access, the Movement itself has not fully quantified the social and economic value of its volunteers — though many studies commissioned in recent years have tackled related issues.

In December 2010, the IFRC expects to release a study to help fill that knowledge gap. Following the methodology developed by Johns Hopkins and the International Labour Organization, the study surveys a representative sample of National Societies on the financial, economic and social contributions of volunteers.

In an era of increased competition for volunteers and their time, the IFRC hopes the data can be used to help National Societies garner more resources for volunteer efforts, inspire and recruit more volunteers, improve volunteer support systems and convince governments to enact stronger legal protections for volunteers.

The humanitarian shield
According to a 2009 report by UN Volunteers, Law and Policies Affecting Volunteerism since 2001, there have been about 70 new national laws or policies enacted to encourage or regulate volunteering in the last ten years. Burkina Faso, for example, created policies to promote volunteerism as a way to reduce unemployment through professional training and national service.

“There’s been a lot of progress,” says one of the report’s authors, Catherine Shea, vice president of the International Center for Not-for-Profit Law, based in Washington DC.

In 2001, when the Year of the Volunteer was launched, a lack of enabling legislation at the national level often stymied volunteerism. “Several countries’ employment and minimum wage laws failed to distinguish between volunteers and employees, making unpaid volunteer activity technically illegal,” the report notes.

The problem now is that not all the new laws are comprehensive or strong. In some cases, good laws are on the books, but the government is not acting. “There’s still a way to go,” says Shea. “It’s really important what happens after the law is enacted. Does the government really implement?”

Consider the case of Bolivia’s 2005 national volunteer legislation, which also highlights the dangers volunteers face. Violent political unrest in 2002 and 2003 led to the “mobilization of volunteers with Bolivia’s Red Cross and fire and rescue squads”, the UN report notes.

“At one violent protest, a volunteer fire and rescue worker, Daniel Manrique, was shot in the face. As a volunteer, Manrique had no insurance, no health coverage and no way to pay for the multiple medical procedures he needed.”

The resulting outcry led to demands for a national law, which gave volunteers’ extensive rights and protection. The effort lost momentum after subsequent elections and the provisions were never fully adopted.

The irony is that even while working to provide victims with shelter or basic medical services, the volunteers themselves don’t have access to healthcare or health insurance. In many countries, the cost is prohibitive or national laws don’t provide the framework for affordably insuring non-profit organizations.

While the IFRC’s volunteering policy calls for National Societies to provide “appropriate insurance protection”, the approaches vary widely throughout the Movement. The Swedish Red Cross provides accident insurance for its 40,000 volunteers, while other National Societies insure volunteers through an IFRC programme. When the earthquake hit Haiti in January, for example, the Haitian Red Cross Society was already preparing to adopt insurance for its volunteers. The IFRC then provided the insurance as part of its emergency response.

“The important thing”, says volunteer specialist Stefan Agerhem, seconded to the IFRC by the Swedish Red Cross, “is that if something goes wrong, the volunteer’s National Society takes care of him or her, whether it is through an insurance system or providing psychosocial support.”

To pay or not to pay
The issue is complicated by the fact that many volunteers are in fact paid per diems or small stipends aimed at defraying transportation expenses or a meal during the workday. In times of emergency, such as the Haiti earthquake, many volunteers are paid a small daily or weekly wage.

“For a major relief operation where you need to have plenty of hands available to do relief work, instead of just relying on a volunteer for a few extra hours a week, you need to engage the volunteers more seriously,” says Agerhem.

In this case, it’s critical that Movement actors understand and follow local labour laws. In recent years, there have been a few cases in which volunteers have taken their National Societies to court for not paying entitlements such as pension funds. Accident insurance might also be mandatory to people on the payroll.

The pay issue presents a dilemma, however. On the one hand, it potentially undermines the spirit of true volunteerism. On the other, it’s perhaps unreasonable to expect people to work 12- or 18-hour days bringing relief to others if the volunteers have no means of support.

As Haitian nurse and Red Cross volunteer Germaine Pierre-Louis (see profile) notes, it’s unacceptable to ask volunteers to spend all day working on food, health and shelter for others, when they themselves have no place to sleep.

“During the earthquake,” says Pierre-Louis, “the volunteers worked just as well as the professional humanitarian workers,” bringing the wounded to health centres and distributing food, hygiene kits and water. “They did a colossal job.” Pierre-Louis was frustrated that, at times, she had to lobby Movement colleagues simply to get tents for some of those volunteers, who themselves had also lost everything in the quake.

Dangerous work
In the end, no amount of laws, insurance or pay will protect or compensate volunteers for the dangers they face. Considering the environments in which many volunteers work, deaths are relatively rare. But they do occur.
 
In May 2009, for example, an Afghanistan Red Crescent volunteer was killed along with 13 others during an air strike by coalition forces reportedly attempting to target Taliban fighters. In March 2009, three Mozambique Red Cross Society volunteers were killed by an angry mob that mistakenly thought the aid workers were poisoning a water supply. And in January 2010, a volunteer with the Kenya Red Cross Society, Michael Wafula Sululu, was shot and killed by a policeman as he responded to the scene of a car crash. The policeman was subsequentlycharged with murder.

In theory, existing national, local or international laws should have protected these volunteers. In reality, there are no guarantees. New laws and insurance will only go so far. According to some volunteers, one of the most important things the Movement can do to protect volunteers is to remain steadfast to principles of neutrality and impartiality.

In the highly polarized Swat valley of Pakistan, where military forces and Taliban insurgents vie for power, volunteer Hashmat Ali says that the Red Cross Red Crescent’s commitment to neutrality is its greatest asset. “I feel safe volunteering with the Red Crescent,” explains Ali. “It does not get involved with all this politics business and that is its strength. This is why I will continue volunteering.”

Ali first encountered the Red Crescent after the 2005 earthquake when he helped German and Netherlands Red Cross workers distribute aid in farflung mountain hamlets. Continued collaboration led to the development of a medical clinic that now serves 100 to 150 patients each day in the Swat valley. According to Ali, the biggest contribution of Red Cross Red Crescent staff and volunteers in Swat is decreasing the maternal mortality rate — which relates to the fifth MDG.

Ultimately, most volunteers say they will do the job — insurance, laws, tents, stipends or not. For Fawwad Sherwani, the call to volunteerism is not a rational calculation based on economic goals or global development agendas. “It’s a feeling,” he explains. “You cannot have as much happiness as when you help a person suffering and he says ‘Thank you’.”

This story was reported by Deena Guzder in Pakistan, Jean-Yves Clemenzo in Haiti, Robert Few in China and Malcolm Lucard in Geneva.

Members of an all-volunteer group supported by the Red Cross Society of China distribute condoms, lubricant and information on HIV at a local park in Fu Shun city, in the north-eastern province of Liaoning.
©Robert Few/IFRC

Germaine Pierre-Louis, a volunteer and nurse for the Haitian Red Cross Society, looks out at where Jacmel’s former health facility once stood.
©Olga Miltcheva/ICRC

Volunteer Patrick Zaboninka Mayara delivers Red Cross messages deep into DR Congo’s forests.
©Deena Guzder

Mohammad ‘Frisco’ Mansour teaches schoolchildren and teenage trainers to respect humanitarian values.
©Lebanese Red Cross

Hashmat Ali stands outside a clinic where he volunteers in Pakistan’s Swat Valley.
©Pedram Yazdi/ICRC