|27th International Conference of the Red Cross and Red Crescent|
At the end of the 20th century, the future of our planet looks uncertain. While one half of the world is enjoying the fruits of economic integration and advances in science, technology and communications, the other half is struggling with basic issues of survival. These disparities no longer exist just between industrialized and developing nations or between North and South. They are evident in every society in every country and provide an ideal breeding ground for crime, violence - and conflict.
Forces of man and nature
Hopes that the end of the Cold War would usher in an era of peace have proved illusory. The clash of ideologies that opposed East and West has been succeeded by a host of other conflicts fuelled by nationalistic, religious or ethnic ideals or by the quest for power and resources. There are other potential hot spots, where smouldering tensions or unrest could flare up at any moment.
Many of these conflicts are conducted in a manner reminiscent of the Middle Ages, without even a semblance of order or restraint, in which murder, rape, mutilation and forced displacement of women, men and children and the looting and burning of homes and property have become everyday currency. In such contexts, local traditions and universal values, let alone humanitarian rules, hold little meaning for the plethora of factions, groups and individuals who resort to arms to further their aims. No problem getting their hands on a gun weapons are freely available on markets across the world.
People are more vulnerable today to the effects of "natural" disaster than ever before. Land exploitation and deforestation have left vast areas defenceless against flooding and landslides, and greenhouse gas emissions are eroding the earth's protective ozone layer. Although "global warming" is a gradual process, the effects are already beginning to be felt in extreme climatic events such as storms, floods and droughts causing death and destruction on an unprecedented scale. Demographic pressure is obliging people to occupy land that is at much greater risk of flooding, and the steady flow from the countryside to the cities has created massive concentrations of people in small areas. These migrants often live in substandard housing or shanty towns, with poor water and sanitation and little protection from the elements. Already there are slums with populations in excess of a million but without any basic infrastructure.
Downsizing health care
On a global level, the picture of health is not a pretty one. Far from achieving the World Health Organization's (WHO) ideal of "Health for all by the year 2000", the health situation of millions of people has worsened over the last two decades. Widespread poverty, rapid urbanization, poor nutrition and lack of clean water and sanitation have meant that many in the developing world are still in poor health and severely undernourished. Large numbers of women are dying as a result of ill health and inadequate health care during pregnancy and childbirth, and every year millions of children succumb to preventable diseases.
True, life expectancy has risen, infant mortality has decreased, smallpox has been eradicated and polio is on its way out. But few advances in medical science and technology have benefited the vast majority of people in the developing world who can ill afford such costly "luxuries".
Diseases such as tuberculosis (TB), diphtheria, meningitis, cholera, malaria and yellow fever, which were thought to be on the wane, are making a comeback, while new and even deadlier ones are appearing on the scene. HIV/AIDS is on the rise in many parts of the world. In some African countries it has reached catastrophic proportions and is offsetting the gains of the last two decades. It is estimated that this pandemic will wipe out 20 years of life expectancy in sub-Saharan Africa by the year 2020.
Many States, grappling with economic and social problems or sapped by years of internal strife, are finding it increasingly difficult to provide for the welfare of their citizens. The public infrastructure is crumbling in certain countries. Under pressure to implement structural adjustment policies, developing nations are cutting their health and social welfare budgets. In the industrialized world, governments are cutting back on their role as service providers and are privatizing health systems. As a result many of the people in greatest need of health care are often those least likely to have access to it.
The disabled, the mentally handicapped, orphans, illegal migrants, refugees and asylum seekers, battered women, single mothers, the elderly... The list of people that depend on some kind of community or social service is long indeed. The problem of elderly people living alone who just need human contact is now a problem not only in the highly commercialized world but also in more traditional societies such as those in Asia and the Middle East. People are living longer, but this brings with it a new set of needs. With shrinking health and welfare budgets everywhere, these are the people who are hit the hardest and in some countries fall outside the safety net altogether.
The millions of children growing up on the streets are perhaps the most glaring symptom of society's ills. Regarded as . and treated - little better than vermin, deprived of their childhood and education, they are prey to all manner of physical and sexual abuse, and drug dependency and HIV/AIDS are rife among them.
Rising to the challenge
For the 27th International Conference of the Red Cross and Red Crescent the scenario described above makes for a daunting agenda. But all is not doom and gloom. Humans are capable of acts of terrible cruelty and wanton destruction, but they also have a great capacity for kindness and compassion. Humanitarianism is the counterbalance to man's inhumanity to man, and there are tools for meeting some of the challenges involved, on condition there is a strong enough commitment to use them.
With both an international structure and a local grassroots presence through its National Societies, the Red Cross and Red Crescent Movement is ideally placed to take the lead in this area. By analysing and monitoring the factors that contribute to conflicts and disasters, it can look for ways to help prevent such crises and find better and more effective ways of responding to them.
The Conference is one way in which it will seek to do this.
The International Red Cross and Red Crescent Movement, a global network uniting 105 million volunteers under two of the world's most widely recognized emblems, was the initiative of one individual. Henry Dunant, appalled by the horrors he witnessed on the battlefield of Solferino in 1859, called on States to put in place measures to prevent and alleviate such unnecessary suffering. His gesture of humanity is still at the heart of the many and diverse actions of the Movement today, whether the helping hand offered by a single volunteer or a major relief operation to assist the victims of armed conflict or natural disaster.
A unique gathering
The Movement has always enjoyed a special relationship with governments. Although the fruit of a private initiative and resolute in maintaining its independence of action, from the outset it has looked to States to support its endeavours and assist in turning the humanitarian ideal into a reality, grounded in law. For the principle of humanity is also at the origin of international humanitarian law, the body of legislation of which the Geneva Conventions are the bedrock.
The most tangible expression of this partnership is the International Conference of the Red Cross and Red Crescent, the supreme deliberative body of the Movement. It meets, in principle, once every four years to discuss the development and implementation of international humanitarian law and humanitarian action carried out both nationally and internationally. It brings together representatives of the various Red Cross and Red Crescent institutions and the States party to the Geneva Conventions, as well as numerous observers with an interest in humanitarian matters.
This unique gathering is an opportunity for dialogue between people with different responsibilities but who share a common goal: to develop strategies in response to the dilemmas and challenges facing humanitarian action today.
An agenda for the new millennium
Those dilemmas and challenges are especially pertinent on the threshold of the new millennium. The world is very different now from that of Henry Dunant's day. The movement he spawned has grown beyond all imaginable proportions, many other agencies big and small are now involved in providing humanitarian aid, and new and increasingly sophisticated means and methods have completely altered the nature of warfare. And yet we are also facing an escalation of needs, and the demands placed on humanitarian organizations are growing daily, while the environment in which they work is often hostile and dangerous.
Since the 26th International Conference, held in Geneva in December 1995, progress has been made on a number of fronts. In response to a Conference resolution, the ICRC has set up an Advisory Service to advise and assist States in implementing humanitarian law at national level. The International Federation has renewed cooperation with National Societies and governments to follow up the Conference resolution on strengthening the National Societies. In 1997 the Seville Council of Delegates approved a new agreement clarifying the different responsibilities of each of the Movement's components. The Ottawa treaty banning landmines was signed in December 1997. Finally, in July 1998 the Rome Statute of the International Criminal Court was opened for signature.
The 27th International Conference will seek to build on these favourable developments, as well as to address issues that have continued to evade solution and find practical answers to some of the problems facing the humanitarian community today.
The beginning of a new era is a good time to take stock and review one's situation. This is just as true for the Movement as it is for individuals. How can the Movement change and adapt to the new landscape? How can it meet the needs of vast numbers of people beset by crisis? What role does it intend to play in the coming years? What is the role expected of it by others? The International Conference has shown in the past that it can make a difference in turning ideas into practice. It is an opportunity not to be missed.
Not only is 1999 the culmination of the millennium, it also has a special significance for the Movement, for it marks the 50th anniversary of the Geneva Conventions signed on 12 August 1949.
The 27th International Conference is therefore one of the highlights in a year of reflection, communication and action running under the banner of "The Power of Humanity" from World Red Cross and Red Crescent Day on 8 May 1999 to World Red Cross and Red Crescent Day 2000.
From words to action
Given the importance of the occasion, it was felt that the Conference itself should change to better suit the needs of the moment. The proceedings of the 27th International Conference have therefore been simplified with the aim of achieving greater visibility and a more focused outcome.
Thus, following the opening session, there will be one "plenary commission" over three days, with each day devoted to a different theme: protection of victims of armed conflict through respect of international humanitarian law; humanitarian action in times of conflict and other disasters; and improving the lives of vulnerable people. Under these broad headings, numerous specific issues will be addressed as they relate to one or more aspects of the Movement's work.
Two documents will be presented for adoption at the Conference. A Plan of Action covering the period 2000-2003 will define what actions and measures will be necessary to achieve a number of specific final goals. The Conference will also issue a Declaration summarizing its essential conclusions and reaffirming its commitment to the humanitarian agenda.
Participants will be invited to make pledges demonstrating their commitment to act on specific points raised in the Plan of Action. For instance, a National Society might pledge to start a new programme to combat HIV/AIDS or to recruit 2,000 new volunteers in the year 2000, while a State might pledge to review legislation on the protection of the emblem. The corporate sector and individuals will also be given the chance to make commitments. Pledges will be announced during the Conference and recorded in pledge documents, an honour book and an electronic register.
In the afternoons, workshops will provide a more informal atmosphere for debates to take place on given issues related to the Conference. Ideally, subjects will include those on which it may be difficult to reach a consensus, but which nonetheless merit in-depth discussion, such as the widespread availability of military-style weapons, women affected by armed conflict and the impact of climatic change on disasters.
Opening up to the public
For the first time, there are plans to involve the general public in the Conference proceedings. Following the formal opening ceremony on Sunday 31 October, there will be a public event at the Arena, the largest concert facility in Geneva. The show will be offered worldwide through global television broadcasts and seen by some 4,000 members of a fee-paying public and some 2,000 Conference delegates. All proceeds from ticket sales will go directly to the work of the Movement.
The show will celebrate "The Power of Humanity", which survives and triumphs in our contradictory world. The four elements - water, fire, air and earth, which are essential to life, but capable of destroying it - will provide the basis of and backdrop to the show. World famous artists from five continents will stage and interpret these symbols in music and movement.
The media will be invited to the closing ceremony, at which the Declaration will be read, the key points of the Plan of Action presented and the pledges summarized and scrolled through on a giant screen.
It is hoped that the new formula for the Conference will mean that more will be done to make tangible improvements to the situation of those suffering around the world and that many more people will be made aware of issues that concern not just the Movement but all of humanity.
The Geneva Conventions are 50 years old this year, a worthy anniversary, but the origins of humanitarian law are far more ancient. The notion that certain codes of honour should be respected on the battlefield go back thousands of years and are reflected in many diverse cultures and traditions.
In 1949, still reeling from the horrors of World War II, States agreed to revise the existing Conventions to include important provisions to protect civilians. The four Conventions now form one of the most widely ratified international treaties in existence. In 1977 two Additional Protocols were added to provide better protection for populations during hostilities of an international nature and in situations arising from internal conflicts.
Traditionally, the promotion of humanitarian law - or the law of armed conflict, as it is also known - has been based on the premise that parties to a conflict can be reached and influenced through a clear chain of command. Given that this is no longer the case in many conflicts, and that many new types of combatants are now complicating the picture, two dilemmas urgently need to be addressed: how to impose legal or moral restraints in situations where the basic distinction between soldiers and civilians is challenged, and how to regulate hostilities in situations where everyone has ready access to a weapon.
There are no quick and easy answers. Calling for new rules or revising old ones will solve nothing. The solutions lie rather in adapting the existing rules, implementing them and making them acceptable to all who play a part in armed violence.
Making the limits known
States have a legal obligation to ensure that their armed, security and police forces receive training in the law of armed conflict at all levels of the chain of command. The ICRC, with the support of the National Societies, is on hand to give them all the help they need in this respect. Besides the armed and security forces of individual States, target groups include all the key players in present-day conflicts, such as NATO (North Atlantic Treaty Organization), ECOMOG (Economic Community of West African States Monitoring Group) and forces involved in peacekeeping and humanitarian operations. Military consultants, private security firms, militias and other arms-bearing groups need to be made aware that the rules of warfare also apply to them.
The obligation to "respect and ensure respect" for humanitarian law concerns not just States and soldiers, but civil society and the whole community too. One way of increasing awareness of the limits of war is to create a bridge between the law and local traditions. In Somalia, a study into traditional ways of sorting out differences has helped to develop messages accessible to Somali audiences. A similar exercise has been carried out in Guatemala based on Mayan traditions. Innovative communication methods have also been tried, such as theatre and circus. In Liberia and Colombia, parallels have been drawn between the rules of soccer and the rules of war.
To mark the Geneva Conventions' anniversary and to gauge people's knowledge of and feelings about humanitarian law, the ICRC carried out a wide-ranging consultation in some 18 countries as part of its "People on War" project. In the process, thousands of people were asked to share their personal experiences of conflict and their views on the limits of warfare. The ICRC will also be presenting at the Conference a progress report on the study it is coordinating worldwide on customary law. The study aims to identify where current recognized practices can usefully complete written law and treaties.
Enforcing the limits
While most countries have adhered to humanitarian law treaties, the corresponding national legislation is often weak or underdeveloped and sometimes even non-existent'since its inception in 1995, the ICRC Advisory Service on International Humanitarian Law has made contact with representatives of over 100 countries and assisted in setting up some 45 national committees to advise governments on developing the necessary domestic legislation. The long-term objective is to ensure that all States have laws in place that truly reflect the commitments they have made at international level.
One priority is the national repression of war crimes. The ad hoc international tribunals for the former Yugoslavia and Rwanda were important steps in ending the reign of impunity. The Diplomatic Conference held in Rome in July 1998 went further still and adopted a new convention on the establishment of an International Criminal Court. This organ is not intended to take over jurisdiction exercised by national courts. If a State does not wish to surrender a person for trial in an international forum, it should itself develop the relevant legislation to try the person at national level.
If the people who are tempted to violate humanitarian principles during conflict know that they will not be allowed to get away with their crimes, they may think twice before committing them. And measures to ensure that they are brought to justice if they do will help to heal the wounds once the fighting is over.
The basic principle of the law of armed conflict is that all individuals who are not or no longer taking part in hostilities have the right to the protection of their physical integrity and dignity. This applies regardless of whether they are prisoners of war, wounded soldiers or civilians caught in the crossfire.
By the same token, all victims of armed conflict, without distinction, are entitled to receive neutral and impartial humanitarian assistance. Aid agencies are therefore reluctant to generalize or single out individual categories of people as having greater needs than others, as these may differ according to the context and circumstances. The only criterion is that aid should be given first where it is needed most. That being said, certain categories of people do have specific vulnerabilities and needs in times of conflict.
Alone and without support
Of all people, the elderly are the most oft-neglected and forgotten victims of armed conflict, and yet they suffer the consequences in a very dramatic way. When populations flee their homes, the elderly may be unable or unwilling to follow - too weak to undertake such an arduous journey or preferring to stay behind to protect their homes from looters. If they do leave, they may die on the way from exhaustion or hypothermia. Those that stay survive as best they can in the midst of hostile communities, with no family and no social protection. Although they present no threat to anyone, they become the victims of intimidation and gratuitous violence.
More attention is now being paid to the special needs of women during armed conflict. Rape and all forms of sexual violence have been roundly condemned as war crimes and as totally unacceptable in all situations, including conflict, during which they are often used as a means of humiliating and subjugating the enemy. Even so, such incidents continue to occur with alarming frequency.
Women are commonly presented as victims, but less is said about the role they assume as heads of the family when their men go off to fight or are killed. Not only must they care alone for their children and elderly relatives, but they also become responsible for earning enough to ensure the family's survival. Despite their needs, they often have difficulty obtaining credit in order to purchase tools or land. Women also play an important part in the restoration of peace and organize many initiatives designed to deal with the lingering consequences of a war. This multifaceted role deserves far more recognition, with women given a greater say in the decisions that will affect them and their families.
Conflict can permanently damage children, both physically and mentally. They may witness their parents being tortured or murdered, see their mothers raped or be raped themselves. Too often they are killed or wounded, mutilated by anti-personnel landmines or found lost or abandoned with no idea what has become of their families sometimes they are abducted and themselves trained to perpetrate atrocities. In the absence of any positive value system, force becomes the only art they know to survive. They learn that guns give them power, and they may be loath to hand in their weapons at the end of hostilities, instead turning to crime as a means of feeding themselves.
Every day in the life of a child is vital for his or her intellectual and physical development, and any loss of educational and recreational opportunities can never be adequately compensated for states must do everything possible to minimize this loss, and must not recruit children into their armed forces or allow them to enlist voluntarily. Along with many other groups campaigning to end the scourge of child soldiers, the Movement advocates that the minimum age for all participation in hostilities be raised from 15 to 18 years.
Two aspects of the weapons issue are of particular concern from a humanitarian point of view. First, are they indiscriminate and therefore more likely to cause civilian death and injury? And second, do they inflict more suffering than required for a given military purpose? The first is an argument for limitation, the second for prohibition. These norms were the basis on which a large part of the international community has banned landmines.
In addition, there is strong evidence to suggest that the widespread availability of military-style weapons is having a detrimental impact on respect for humanitarian rules, on the people whom those rules seek to protect and on the safe conduct of relief operations.
Landmines: maintaining the momentum
The campaign to ban anti-personnel landmines reached its peak in Ottawa in December 1997 with the signing of the Convention on the Prohibition of the Use, Stockpiling, Production and Transfer of Anti-Personnel Mines and on their Destruction (more commonly known as the "Ottawa treaty"), which entered into force on 1 March 1999. The overwhelming public response to the campaign, in which the Red Cross and Red Crescent Movement played a decisive part, and the fact that to date 133 States have signed the treaty itself unthinkable three years ago is a lasting testament to the power of humanity.
The first step to end the carnage caused by landmines has been taken, but the road is yet long. Governments that are hesitant or unwilling to sign the new treaty must be persuaded to do so. Those that have signed, need to translate their commitment into national legislation and enforcement measures. Moreover, each State has certain obligations to fulfil under the treaty, including mine clearance, stockpile destruction, support for mine victims and mine-awareness programmes.
The ICRC and the Movement as a whole can play a key role in the implementation process alongside their more traditional activities to address the devastating consequences of anti-personnel mines. It is expected that a long-term Movement strategy on landmines will be adopted by the Council of Delegates shortly before the Conference.
SIrUS Project: drawing the line
Even in military circles, certain types of warfare are considered abhorrent and inhuman. Designing weapons with specific intent to burn, blind, poison or cause infectious disease or inevitable death is one of them, and various steps have been taken over the years to ban the use of such weapons on the battlefield. Yet ever more sophisticated technologies are constantly under development, and each time a particularly nasty weapon comes along the whole process of finding new arguments to prohibit it has to begin once again.
The SIrUS Project was the fruit of a symposium held in Montreux, Switzerland, in 1996 on "The medical profession and the effects of weapons". Its purpose was to develop a baseline for determining which weapons, by their design, cause "Superfluous Injury or Unnecessary Suffering" (hence SIrUS). The Project does not aim to impede the achievement of legitimate military objectives. Rather, it is a tool for reinforcing a part of international law that is specifically designed to protect the soldier on the battlefield.
Drawing on data from the records of army medical services and the ICRC's surgical database, which documents the cases of 28,000 war-wounded patients in its hospitals, a group of medical, legal and weapons experts looked at ways of measuring the foreseeable effects of new weapons against the known effects of weapons commonly used in conflicts over the last 50 years.
The SIrUS Project's approach to arms, based on their effect on health, has been endorsed by a large part of the medical profession. It is hoped that States attending the Conference will agree to use the baseline as a reference framework for evaluating both existing weapons and future designs.
Military-style weapons: curbing the free-for-all
In most conflicts during the 1990s, death and injury have resulted less from the major conventional weapons associated with modern-day war, such as missiles, tanks, aircraft and warships, than from small arms and light weapons. The global proliferation of weapons like assault rifles, machine guns, mortars and rocket-propelled grenades, to name but a few, has led to an increase in tension and facilitated the recourse to violence.
These weapons are becoming available to ever-expanding segments of societies, including private armies and militias, insurgent groups, criminal organizations and other non-State actors. In addition to the increase in the number of producers of small arms and light weapons, millions of such weapons have been sold or given away as the world's major military powers reduce their forces or find themselves with excess production capacity following the end of the Cold War.
Unlike major weapons systems, small arms and light weapons are extremely durable and require little maintenance or logistical support. They are simple to handle, necessitate little or no training, and in most cases can be easily carried by an individual - even a child. Often they can be obtained at a price well below the cost of manufacture, in some countries for as little as a bag of maize.
An ICRC study commissioned by the 26th International Conference highlights the price civilians have paid in recent conflicts. Civilian casualties outnumber those of combatants in many internal conflicts. Disease, starvation and abuse increase when aid workers have to down tools and leave a country because they are attacked or threatened'suffering can often continue for years after a war is over, as arms continue to circulate, making it difficult to impose law and order and undermining efforts at reconciliation. In one specifically documented case, arms-related casualties were found to have decreased by only 33% during the 18 months following the end of hostilities.
While primary responsibility for compliance with humanitarian law rests with the end user, arms-producing and exporting States and companies bear some responsibility towards the international community for the use made of their weapons and ammunition. Measures can be introduced to limit the transfer of arms: more care can be taken to stop them falling into certain hands, to ensure their collection and destruction after a conflict is over and to prevent surplus arms from being recycled from one conflict to another.
States represented at the Conference will be encouraged to take humanitarian law into account in their decision-making on arms transfers, and the Movement will be called upon to raise public awareness of the cost to human life when arms and ammunition are too widely available.
While laws can be made to regulate the conduct of human beings in war, the same cannot be said for the natural phenomena that trigger many disasters. Where, when and how they strike is dependent on many factors that are usually outside immediate human control. The damage and suffering they cause are, however, very much in our control.
In 1998 alone, natural disasters such as floods, hurricanes, drought, earthquakes and landslides wrought havoc in 121 countries, left some 60,000 dead and affected some 126 million people, not to mention the economic cost, which ran into billions of dollars.* All the evidence suggests that these numbers will rise inexorably, if action is not taken now to address some of the root causes and to put in place local, national and international mechanisms to prevent naturally occurring phenomena from reaching cataclysmic proportions.
Just waiting to happen
The rapid, uncontrolled growth of the world's major cities has put many more people at risk in the event of a disaster in an urban environment. People living in high-rise concrete buildings are especially vulnerable, as was tragically demonstrated by the Armenian earthquake in 1988 in which 100,000 died. Rich, developed nations are not immune either: some 6,000 people died in the earthquake that shook the Japanese city of Kobe in 1995.
The most serious crises occur, however, in the thousands of small cities and shanty towns across the world. Although hurricanes are a frequent occurrence on the southern and eastern coasts of the United States, they rarely claim many lives. But when Hurricane Mitch battered Central America, Nicaragua and Honduras had fewer resources to warn or protect or rescue their people. The toll of dead, injured and homeless was correspondingly high. The devastation caused by the central European floods in 1997 also shows how a weakened infrastructure in countries in economic transition seriously undermines their ability to withstand disaster.
* source: World Disasters Report 1999, International Federartion
The key to containing the worst effects of naturally occurring hazards is to remain one step ahead. By definition disasters occur when events exceed the capacity to respond. The better this capacity, the better the chances of averting a catastrophe.
Disaster preparedness involves identifying, assessing and targeting the most vulnerable communities and formulating disaster plans that allocate roles and responsibilities and outline the human, material and financial resources required.
In disaster-prone regions, the ability of a community to survive, regroup and help itself is directly linked to the extent to which it has planned ahead and to the strength of its initial response. Floods, hurricanes and landslides all immediately generate urgent needs'search and rescue, medical assistance, shelter, food and water are all crucial within hours or days, not weeks. Local capacities need to be strengthened to provide these first vital ingredients. There must then be back-up by way of a planned central government response. well-trained, well-organized and well-resourced. National Societies can play a crucial role both by assisting with disaster preparedness at local level and by cooperating with the government in rescuing survivors and delivering aid.
In the Caribbean, which is highly vulnerable to a wide range of disasters, the concerned National Societies, with Federation help, pooled their experiences to come up with a community-based disaster preparedness plan covering such areas as logistics, the pre-positioning of emergency supplies, communications and the training of volunteers. Most of the region's National Societies were active in urging their governments to review and update contingency plans. In most cases they were designated a specific role to play, and many governments recognized their value by supporting them financially through an annual subsidy. As a result, when Hurricane George, one of the worst storms to hit the eastern Caribbean in recent years, struck in 1998, the response was good. Most people knew it was coming and were ready for it.
Of man's making
Conflict, internal strife and economic crisis can also lead to or exacerbate disaster. This has been the case with the repeated famines in southern Sudan. In the Democratic People's Republic of Korea, a decline in the economy and in food production, coupled with floods and drought, has brought starvation to millions. For two winters running, the Federation has had to intervene in the republics of the former Soviet Union to counter the severe effects of economic crisis, which has placed hundreds of thousands of people in an extremely precarious situation. Indonesia has been similarly affected by structural upheaval, which has threatened to destabilize one of the world's most populous nations. The socio-economic dislocation at the root of such disasters is hard to address because its causes lie in the political sphere. In these cases, the Movement can only respond to the immediate needs while working with others to seek longer-term solutions.
The increasing complexity of disasters means that no single organization is able to meet the diversity of needs and the ever greater demand for skills. The proliferation of human rights and humanitarian agencies in the field can therefore only be hailed as a positive development. There is a danger, however, that it could lead to confusion, duplication, competition and misunderstanding. Under the constant media microscope, there is enormous pressure on humanitarian agencies to be seen to be doing something. This can unfortunately mean doing the wrong thing or, possibly, the right thing at the wrong time.
Some hard lessons have been learned from certain complex emergencies such as the Rwandan refugee crisis in 1994, where the response was assessed as being inadequately organized and coordinated.
In order to avoid such incidents and to ensure a consistent quality of work regardless of the agency concerned, the Sphere Project has been launched by a group of like-minded organizations. The aim of the Project is to devise a set of common standards governing the provision of humanitarian aid, so as to minimize undesired effects, improve the professionalism of the response and make humanitarian action more accountable to its stakeholders, i.e. beneficiaries and donors.
Following an unprecedented degree of collaboration involving over 700 individuals from 228 organizations (including NGOs, the Movement, academic institutions, the UN and government agencies), the preliminary edition of the Humanitarian Charter and Minimum Standards in Disaster Response was completed and distributed to NGOs, international and government agencies and other humanitarian groups in December 1998.
The first part of the publication sets out, in the form of a charter, the basic rights of all who have a legitimate claim to receive humanitarian assistance at times of disaster. The second part establishes the basic standards that must be met to guarantee victims' dignity. These standards and the technical indicators for measuring them are dealt with under five headings: water and sanitation, nutrition, shelter and site planning, food aid and health services.
The Sphere Project also offers agencies a means by which to define the scope of their assistance and firmly assign the primary responsibility for preventing and mitigating conflict and disaster to political players.
When a crisis erupts, more time and effort are also now spent on consultation and coordination between the different agencies. Greater emphasis is placed on training, on the mutual understanding of roles, working methods and mandates, and on joint operations.
The Movement has been at pains to put its own house in order. The Seville Agreement, approved by the Council of Delegates in 1997, is part of this initiative. It establishes a framework of cooperation and defines the tasks and responsibilities of the ICRC, the Federation and the National Societies in emergencies of different types, so as to ensure a more complete response to need.
Since the Agreement was adopted, the Movement has had several opportunities to put it to the test. In Afghanistan, the ICRC, the Federation and the Afghan Red Crescent worked closely together to bring relief to the victims of two successive earthquakes that struck a remote region made even less accessible by an ongoing conflict. In the case of the Movement's joint operation for the victims of the recent Balkan crisis, an integrated appeal allowed operations conducted by the Federation and the ICRC to be better coordinated and more effective in meeting needs through National Societies on the ground.
The shrinking world, combined with economic hardship, rapid urbanization and environmental factors, has given a wide range of diseases a new lease of life. Population movements and ease of travel help to spread epidemics; respiratory infections, diarrhoeal diseases and TB prosper in densely populated urban areas - and in refugee camps; untreated water and poor sanitation are the major factors in the high incidence of water-borne diseases; and the rise in average temperatures means that malaria is now found at higher altitudes and in countries where it was previously unknown.
Newly emerging diseases such as Ebola and other haemmorhagic fevers are becoming more common. HIV/AIDS will most probably remain one of the major public health concerns of the coming decade. Meanwhile, certain infectious diseases are re-emerging. Not only are they back with a vengeance, but the development of drug-resistant bacteria is now further complicating treatment. TB has become a serious threat to public health, and together with malaria has been identified by WHO as one of the major global challenges of the future. There has been a marked increase in the incidence of diphtheria, particularly in countries of the former Soviet bloc.
At the same time, as a result of the increased burden of disease and economic constraints, health care institutions find it increasingly difficult to meet even patients' basic needs. The cocktail therapy for HIV costs $15-20,000 a year per person, while the annual per capita health budget in many countries is only $10-20. The prophylactic use of AZT to reduce the risk of vertical transmission to infants during birth costs $50 per woman. Even that amount far exceeds the national capacity in most developing countries, particularly in Africa.
Many of the world's current health problems are related to poor water and sanitation. It is not only in the burgeoning slums that basic amenities are lacking, for access to water is deteriorating everywhere. This precious commodity, on which all life depends, needs to be used carefully and wisely. The Federation is therefore increasing its attention and resources in this domain.
The Federation and National Societies have also made significant contributions to the control of epidemics. During the Ebola crisis in the former Zaire in 1995, before the outbreak was finally suppressed, five volunteers themselves died from contact with the disease. In response to a diphtheria epidemic in Ukraine, Belarus and the Baltic States in 1995-1996, the Federation and the concerned National Societies joined forces with UNICEF and WHO to implement a massive immunization campaign reaching 23 million people. Similar successful operations have been conducted to control meningitis in Africa and measles, showing that National Societies do have the necessary capacity and are of tremendous value to their governments.
Good health practices
Containing epidemics when they arise is all well and good, but there is truth in the old adage that prevention is better than cure. Education is the first step towards bringing about the behavioural changes necessary to stop the occurrence or spread of disease. Drinking safe water, building latrines, protecting food from insects, using mosquito nets, limiting alcohol consumption, changing nutritional habits - these are all things that we as individuals can do to improve our own health.
One of the Movement's greatest strengths lies in its volunteers, a vast human resource, and in its grassroots presence, which makes it enormously effective as a means of communication. National Societies can play a very dynamic role in health education and the promotion of a healthy lifestyle.
Many countries where HIV/AIDS is prevalent cannot afford to provide treatment or a long-term hospital stay. The sick person is therefore left in the care of the family, which is ill prepared to take on the task of nursing. One role for Red Cross and Red Crescent workers is to visit terminally ill patients in their homes and show their carers how best to meet their needs, thereby contributing to "death with dignity". However, the surest way of stemming the spread of HIV/AIDS is still to promote knowledge leading to changes in behaviour.
TB is linked to poverty, poor living conditions, poor nutrition and certain behavioural patterns. As well as providing direct treatment, National Societies can help to alleviate the root causes. This can be done in a number of ways: through health education, nutritional assistance (e.g soup kitchens), and ensuring that patients complete their full course of treatment, since failure to do so is the major cause of development of drug-resistant strains of the disease.
National Societies can also promote the timely and proper use of health services. All the technology, training and refrigeration of vaccines will serve no purpose if a mother does not bring her child to the health centre for immunization. National Society volunteers can spread the word and, if necessary, act as partners to the health authorities on any monthly vaccination days.
Cholera and other diarrhoeal diseases can be prevented by improving hygiene and providing safe drinking water. Here again, National Societies can play a vital role, in terms both of promoting hygiene measures and teaching people how to administer oral rehydration salts.
Most health problems in under-served communities can be resolved with minimal input and personnel with basic skills. This is the basic tenet of primary health care. The concept was enthusiastically embraced in the seventies along with the notion of "community participation", whereby the local community was encouraged to recognize its own health problems and develop appropriate responses. To educate and train everyone in the community to deal with their own basic health problems is a Movement strategy of the highest importance, relieving many unnecessary patient visits to medical facilities.
But investment in primary health care does not yield instant results, and may therefore take second place to investment in the economic sector. Needless to say, this view is short-sighted. Ill health means an economic loss, in terms both of the direct cost of medical care and the indirect cost of decreased productivity. Malnutrition stunts not only physical growth but also mental development, meaning less brainpower to fuel a country's future economic development.
Reproductive health is also an area requiring increased attention. Programmes developed in recent years have focused on specific areas, such as the needs of raped women, safe motherhood, protection against HIV/AIDS and family planning.
Primary health care and the provision of basic health services are both a humanitarian issue and one way of contributing to the well-being of human resources - a fundamental factor in national development.
First comes first aid
First aid is about preventing, preparing for and responding to acute health risks and life-threatening situations. During a major emergency, there is a critical period between the time when an accident or disaster occurs and the arrival of organized help. It is therefore essential to develop not only effective response mechanisms and emergency services, but also the capacity of each person to serve the community.
First aid is a tool for people to help others and provides the basic skills needed to respond to the day-to-day threats of life. It can also be a vehicle for health education and prevention. Because it is simple and adaptable, it can be taught to schoolchildren. It can be tailor-made to different populations of the world as well as different environments and needs.
In a country where an ambulance is a short drive away, it is useful to teach cardiopulmonary resuscitation, because those ten minutes gained can save someone's life. In a community where children die from diarrhoea, just instructing people to boil water and how to administer oral rehydration salts is more likely to prevent unnecessary death than teaching cardiopulmonary resuscitation. The administration of proper first aid following road accidents could save many lives and reduce the risk of permanent and/or debilitating disabilities.
The Movement is present worldwide and has a long history of providing first-aid training. Given the right opportunities and circumstances, it can do a lot more by, for example, gaining permission to enter schools. First-aid instruction could be included as a subject in civic studies, made a prerequisite for getting a driver's licence or made compulsory in the workplace.
First aid is the demonstration of an altruism and true sense of helping one's fellow human beings - a simple gesture of humanity that can save a life.
Governments around the world are increasingly reassessing their role as service providers, as many either cannot or no longer wish to bear the burden of health and welfare. For organisations like National Red Cross and Red Crescent Societies this is opening up new opportunities and challenges on which they can build and for which they can seek support.
National Societies have a long tradition of providing health care and social services to the most vulnerable members of the community. As the needs of this sector of society grow and governments become less willing or less able to provide direct services, National Societies can look at how they might use the resources they have available or those they can mobilize to fill the gap.
It is a condition for a National Society's recognition by the ICRC and admission to the Federation that it be formally recognized by the government as a "voluntary aid society, auxiliary to the public authorities in the humanitarian field." The meaning of "auxiliary" has, however, changed over time.
The original concept was in relation to the medical services of the armed forces. The need for this dimension of a National Society's work has changed and varies from country to country. National Societies today are also auxiliaries to governments in the provision of basic health and social services, such as ambulances or blood transfusion. In a number of countries, these services are large-scale and financed by the government; in others, the focus is more on volunteer involvement in first aid and community health.
In times of crisis, the need for these traditional programmes is vastly increased. Following the embassy bombings in Kenya and Tanzania, Red Cross volunteers worked round the clock for days on end confronting and dealing with tragic scenes at every turn. After the crisis had passed, they helped families who had lost a breadwinner and people suffering secondary effects from the attack. Not surprisingly, the volunteers themselves came to need counselling something that is becoming more common among aid workers and that the Movement is taking very seriously. Trauma counselling is also increasingly being provided as a service for the victims of terrible events and for their families.
The National Societies' role is not limited to service provision; many now advise governments on policy and practice in responding to the needs of vulnerable groups, such as refugees and people suffering from HIV/AIDS.
In many ways, National Societies could take greater advantage of their privileged status vis-à-vis their governments. By the same token, some governments have yet to recognize the value of Red Cross or Red Crescent Societies as partners. Now is the time to take a good look at existing practices, relevant legislation and National Society statutes so as to develop the respective roles and relationships for the greater benefit of the world's most vulnerable people.
All action carried out by the Movement is deeply rooted in the seven Fundamental Principles: Humanity, Impartiality, Neutrality, Independence, Voluntary Service, Unity and Universality. Some of these, for example unity and universality, are specific to the Red Cross and Red Crescent; others, such as impartiality, govern the endeavours of many in the humanitarian field. There is one universal concept, however, that is at once the founding principle of the Movement, the guiding force behind all humanitarian action and what distinguishes all of us as human beings: humanity.
Humanity is not necessarily about great acts of heroism or even about doing good works. It is about respect for one's fellow human beings. This can be manifested simply by acceptance of someone's right to be different. It is no coincidence that the same word is used to describe humankind. No one has a monopoly on human values and the very fact that the Red Cross and Red Crescent Movement is so far-reaching, and that 105 million people representing every race and culture in the world volunteer to work to uphold those values, is proof enough of their universal nature.
The Movement promotes this clear set of humanitarian principles through a vast outreach network. It cites the numerous international agreements which exist to protect the individual's physical integrity and dignity - the treaties of humanitarian law and human rights law are some obvious examples. But is it enough just to quote rules and regulations? Is it not also possible to influence the way people think and behave and to foster a climate of tolerance, mutual acceptance and peace?
There are a number of ways in which the Movement can contribute to a culture of humanity and non-violence and promote the principles and convictions which we all share. First and foremost, we have to set an example. Within the Movement, we need to be very clear about what we are and what we stand for. More emphasis should be placed on internal communication and training so that every single person who bears the red cross or red crescent emblem is fully versed in the Fundamental Principles and demonstrates them in his or her work. Equally, our partners need to know why we work in a given way and understand and respect our modus operandi.
States must respect the National Societies independence. National Societies must be open to all communities and remain neutral in the event of a conflict, especially if they want to be effective during a conflict and after it is over. An area in which National Societies can exert an important influence is reconstruction, which is not just about rebuilding houses, but also about rebuilding bridges between people. Hostile communities can be brought together to organize humanitarian projects such as reuniting dispersed families and the exchange of news, mine-awareness programmes and camps for disadvantaged children. One such project involved encouraging dialogue between young Serbs and Croats in the Srem-Branja region of Croatia in the aftermath of the civil war that pitted the two communities against each other.
What better place to start than with young people? They are naturally idealistic and enthusiastic. There is currently a decline in membership of all formal organizations, and Red Cross and Red Crescent Societies are not exempt. Interestingly, the decline is stronger in industrialized countries than in the developing world, where some National Societies are recruiting widely among young people. A better understanding of why people volunteer and how to keep them motivated could help to reverse the trend. There is also a need to develop a language and approach that is sensitive to young people. Not only should they be encouraged to volunteer, but youth members should also be full partners in a National Society and have a say in the decision-making process. Their contribution and commitment to the humanitarian ideal are vital to the future of the Movement.