Humanitarian Assistance Operations Research Articles

On Collaboration of Local Actors With Security Force Assistance in Missions and Non-Article 5 Crisis Response Operations

Abstract This paper examines aspects of the coordination and cooperation of local actors in Security Force Assistance (SFA) missions, and in particular in Non-Article 5 Crisis Response Operations (NA5CRO). The process of building relationships with local actors and coordinating efforts with them to achieve mission success is discussed as well. This process is based on the understanding that local actors have critical knowledge of the operational environment and can provide valuable insights that enhance mission effectiveness. The need to understand the operational environment and build effective relationships with local security forces as well as other stakeholders is also addressed. The article explains how coordination and cooperation with local actors are essential to achieving mission success and can improve the effectiveness of the SFA in their participation in crisis response operations. In summary, the paper emphasizes the critical importance of coordination and cooperation with local actors in SFA missions and into Humanitarian Assistance Operations that are part of NA5CRO. This approach can enhance the effectiveness of the mission, increase situational awareness, and reduce the risk of mission failure. It requires a commitment to building effective relationships with local security forces and other stakeholders, joint coordination among all actors involved in the mission, and cultural sensitivity and awareness in the event of a crisis.

Humanitarian Assistance Lessons Learned From Providing Acute Medical Care for Afghan Nationals on a U.S. Military Base.

Operation Allies Welcome provided a unique opportunity for military medical personnel to engage in humanitarian assistance operations on military bases in the USA. With thousands of Afghan nationals evacuated from Kabul in August 2021 to various military installations across the USA, the Military Health System was tasked with health screening, emergency care, and disease prevention and surveillance in resource-limited settings. Marine Corps Base Quantico served as a "safe haven" site from August to December 2021, providing refuge to nearly 5000 travelers awaiting resettlement. During this time, active duty medical personnel provided 10,122 primary and acute patient encounters to patients aged < 1 to 90 years. Pediatrics represented 44% of the total encounters and children aged less than 5 years represented nearly 62% of the pediatric visits. In caring for this population, the authors were able to learn important lessons about humanitarian assistance capabilities, the difficulties of establishing acute care centers in a resource-limited environment, and the importance of cultural competency. Recommendations include staffing with medical providers that can see a large volume of pediatric, obstetrics, and urgent care visits, with less emphasis on trauma and surgical capabilities, which are the more traditional focus of military medicine. To this end, the authors advocate for the creation of specific humanitarian assistance supply blocks that would focus more on urgent and primary care treatments as well as an ample supply of pediatric, neonatal, and prenatal medicines. Further, early engagement with telecommunications companies when practicing in a remote location can be crucial to mission success. Finally, the medical care team should maintain continued mindfulness of the cultural norms of the population to which aid is given, particularly the gender norms and expectations of Afghan nationals. The authors hope that these lessons can prove informative and may provide increased readiness for future humanitarian assistance missions.

Trends in Surgical Case Volume During Pacific Partnership Missions Onboard USNS Mercy.

Since 2006, the U.S. Navy has conducted six Pacific Partnership (PP) missions throughout Southeast Asia on board the U.S. Naval Ship Mercy (T-AH 19). This study describes trends in overall and surgical specialty operative volumes to better understand the burden of surgical disease treated during these humanitarian and civic assistance (HCA) operations. This information can assist medical planners and surgical leaders involved in future humanitarian missions. Following approval from the Naval Medical Center San Diego Institutional Review Board, a retrospective review of surgical case data was performed for the six PP missions from 2006 to 2018. Data collected included patient demographics, Current Procedural Terminology codes, and surgical specialty. The primary outcome was surgical case volume per specialty. Secondary outcomes included surgical staffing per mission and overall trends in operative volume. A total of 3,826 operative procedures were performed during the study period. Mission years in which case volume for both general surgery and ophthalmology were below their respective medians were associated with the least total surgical services to host nations (HNs). The number of active duty Navy surgeons varied with each mission; however, the staffing for a PP mission generally included at least two general surgeons, one ophthalmologist, one plastic surgeon, one pediatric surgeon, one orthopedic surgeon, one otolaryngologist, one oral surgeon, one urologist, and one obstetrician-gynecologist. Case volume per surgeon was highest in 2006 (50 cases per surgeon) and decreased after 2006, reaching an all-time low during the 2018 PP mission (10 cases per surgeon). Pediatric surgery and plastic surgery had the highest average case volumes per surgeon at 58 and 46 cases per surgeon, respectively, while oromaxillofacial surgery and neurosurgery had the lowest average case volumes per surgeon at 9 and 14 cases per surgeon, respectively. Operative volume on military HCA missions is greatly influenced by the priorities of the HN, the mission focus, the number of individuals from the HN that present for screening, and the availability of personnel and resources available on the hospital ship. Future mission planning should optimize general surgery and ophthalmology staffing and essential equipment, as total mission case volumes were highly dependent upon the productivity of these two specialties. Careful determination of the surgical needs of HNs should serve as a guide for the selection of subspecialists to maximize effectiveness in future military HCA missions.

Impact of China’s decision-making processes on international cooperation: cases of peacekeeping and humanitarian assistance/disaster relief

ABSTRACTInternational cooperation on peacekeeping operations, and on humanitarian assistance and disaster relief (HADR) operations, is important in tackling global non-traditional security threats. It also helps China address its ‘trust deficit’ problem. While both operations seem ‘low hanging fruit’ for international cooperation, the ways in which China undertakes peacekeeping and HADR cooperation differ – the former encompasses not only cooperation for technical and capacity development but also cooperation for policy harmonisation, while China’s HADR cooperation is limited to technical and capacity development. This paper asks, ‘why the difference?’, despite the fact that they both address similar policy problems. It argues that the difference corresponds to the level of holisticity/fragmentation of China’s decision-making process. The more holistic China’s decision-making process, the deeper the international cooperation. The nature of China’s decision-making processes has international policy implications, because the fragmented nature of those processes maintains cooperation at a functional level only, and hinders the deeper development of cooperation into policy harmonisation.

Image-building as Impetus for the Growth of the People’s Liberation Army (PLA)’s Engagement in International Humanitarian Assistance and Disaster Relief (HA/DR) Operations

Abstract The People’s Liberation Army’s (PLA’s) engagement in humanitarian assistance and disaster relief (HA/DR) enables China to reassure the international community and change perceptions of its global intentions. Natural disasters are expected to increase worldwide, requiring greater PLA involvement in international HA/DR missions. However, maximising the public relations benefits of participating in such missions will require leadership to avoid short-term irritations and political speculation that often accompany China’s foreign intervention, hampering Beijing’s soft-power initiatives.

Hamiltonian dynamics and control of a joint autonomous land–air operation

Rapid technological advances in artificial intelligence and additive manufacturing have fueled the speculation that large numbers of cheap autonomous robots swarming to achieve mission objectives with minimal human control will revolutionize search-and-rescue, disaster relief and humanitarian assistance operations. These kinds of operations usually occur in a GPS-denied and communication austere environment, where only nearest-neighbors networking among the autonomous robots may be possible. Hence, the ability to predict and control the real-time global dynamic behavior of this high-dimensional, highly complex and highly nonlinear, decentralized autonomous system, immersed in an uncertain and changing environment—and yet successfully performing at the edge of chaos—will be critical. This paper proposes a rigorous computational framework for prediction and control of a large-scale joint swarm of unmanned ground vehicles (UGVs) and unmanned aerial vehicles (UAVs), performing a joint autonomous land–air operation. We present two cases for this joint UGV + UAV swarm: (1) a discrete Hamiltonian dynamics and affine control over Euclidean groups of individual UGVs and UAVs in a swarm of hundreds of vehicles and (2) a continuous 2-soliton ‘signature’ evolution of a joint UGV and UAV swarm of thousands of vehicles.

From combat to non-combat action

This paper examines the rationale and centrality of private military and security companies (PMSCs) in humanitarian assistance operations in Sudan, asking why PMSCs are involved in humanitarian assistance operations in Sudan and what the principles underlying their activities are. To answer this question, the paper draws attention to the link between humanitarian crises and PMSC interventions. Where there is no meaningful alternative intervention, undergirded by humanitarian concerns that are also profit driven, PMSCs come in to provide the needed services. The protracted and complicated internal armed conflicts in Sudan, which have lasted for over two decades, have produced as many as 4,8 million internally displaced persons (IDPs) – the single largest number in the world. The kind of humanitarian assistance operations provided by PMSCs in Sudan have become critical to the provision of much-needed services which were inadequately provided by governmental authorities at both unilateral and multilateral levels. This paper argues that the humanitarian crises in Sudan created a regime that permits humanitarian assistance operations by both state and non-state actors.

Understanding military decisions and actions in humanitarian assistance operations

In large-scale humanitarian crises, it is common to encounter military forces as well as civilian agencies and nongovernmental organisations providing relief services. The military-civilian interface is often frustrating for all actors and viewed as problematic by both military officers and their civilian counterparts from the humanitarian response community. This paper describes the doctrine-driven military staff processes used by military organisations while conducting humanitarian assistance operations. It highlights areas in which civilian agencies and the military forces can improve their coordination. Considerations are presented for both the military and humanitarian response organisations to modify their actions in order to achieve greater shared situation awareness.

Clinical Skill and Knowledge Requirements of Health Care Providers Caring for Children in Disaster, Humanitarian and Civic Assistance Operations: An Integrative Review of the Literature

Military health care providers (HCPs) have an integral role during disaster, humanitarian, and civic assistance (DHCA) missions. Since 50% of patients seen in these settings are children, military providers must be prepared to deliver this care. The purpose of this systematic, integrative review of the literature was to describe the knowledge and clinical skills military health care providers need in order to provide care for pediatric outpatients during DHCA operations. A systematic search protocol was developed in conjunction with a research librarian. Searches of PubMed and CINAHL were conducted using terms such as Disaster*, Geological Processes, and Military Personnel. Thirty-one articles were included from database and manual searches. Infectious diseases, vaccines, malnutrition, sanitation and wound care were among the most frequently mentioned of the 49 themes emerging from the literature. Concepts included endemic, environmental, vector-borne and vaccine-preventable diseases; enhanced pediatric primary care; and skills and knowledge specific to disaster, humanitarian and civic assistance operations. The information provided is a critical step in developing curriculum specific to caring for children in DHCA. While the focus was military HCPs, the knowledge is easily translated to civilian HCPs who provide care to children in these situations.

Utilization of Surgical Resources During the USNS COMFORT Humanitarian Mission to the Americas, June to October 2007

In 2007, the United States Navy Ship (USNS) COMFORT (T-AH 20), a full-capability medical treatment facility, departed for Partnership for the Americas, her first large-scale humanitarian civic assistance (HCA) mission. Analysis of operational data describes surgical resource utilization. Lessons from previous military humanitarian assistance operations were helpful when placed in the cultural context of Latin America. Premission planning decisions that included time in each port and funding determined the services that were offered to host nations. Surgical, dental, immunizations, preventive medicine, and biomedical repair services had lasting impacts. COMFORT and similar hospital ships are a superior platform to combatant vessels in providing comprehensive surgical care. Medical planning is heavily dependent upon statistics. Collection of additional clinical data on subsequent HCA missions could aid future planning decisions regarding manning, equipment, supplies, and objectives.

Preliminary results from voices of the Mada'in: a tribal history and study of one of Baghdad's six rural districts

From July to October 2008, Human Terrain Team Iraq 6 (HTT IZ6) undertook an oral tribal study and social history project in Mada'in Qada, Iraq. During that four-month period IZ6 formally interviewed over forty tribal leaders. At the same time team members participated in humanitarian assistance operations with internally displaced persons (IDPs), as well as regular citizens of the region. In both the formal, elite-level interviews and the participant observations, four major themes became apparent: (1) The tribal law, written or oral, is often generally perceived as codes, covenants, and/or constitutions. (2) The tribal legal system and the tribal courts are an adversarial and remedial/restorative justice mediation system. (3) The Government of Iraq (GOI) is perceived as being under foreign influence. Members of the GOI are commonly referred to as Iranian agents, Iranians, Zoroastrians and/or fire worshippers (Mithraites) by both Sunnis and Shi'a alike. And (4) the dispute between Sunni and Shi'a is predominantly about resources, not religion. The purpose of this article is to describe the task order for the project, describe the oral history project itself, discuss the research challenges that arose in a semi-permissive environment, present the preliminary findings and tie them into the reality of the ongoing Counterinsurgency Operations in Iraq.

Determining Medical Staffing Requirements for Humanitarian Assistance Missions

The primary mission of hospital ships is to provide acute medical and surgical services to U.S. forces during military operations. Hospital ships also provide a hospital asset in support of disaster relief and humanitarian assistance (HA) operations. HA missions afford medical care to populations with vastly different sets of medical conditions from combat casualty care, which affects staffing requirements. Information from a variety of sources was reviewed to better understand hospital ship HA missions. Factors such as time on-site and location shape the mission and underlying goals. Patient encounter data from previous HA missions were used to determine expected patient conditions encountered in various HA operations. These data points were used to project the medical staffing required for future missions. Further data collection, along with goal setting, must be performed to accomplish successful future HA missions. Refining staffing requirements allows deployments to accomplish needed HA and effectively reach underserved areas.

Success in Kashmir: a positive trend in civil–military integration during humanitarian assistance operations

The modern cast of disaster relief actors includes host nations, non-governmental organisations, private volunteer organisations, military organisations and others. Each group, civilian or military, has valuable skills and experiences critical to disaster relief work. The goal of this paper is to supplement the study of civil-military relief efforts with contemporary anecdotal experience. The paper examines the interaction between US military forces and other disaster relief actors during the 2005 Kashmir earthquake relief effort. The author uses direct observations made while working in Pakistan to contrast the relationships and activities from that effort with other accounts in prevailing scholarly disaster literature and military doctrine. Finally, this paper suggests that the Kashmir model of integration, coordination and transparency of intent creates a framework in which future humanitarian assistance operations could be successfully executed. Recommendations to improve civil-military interaction in future relief efforts will also be addressed.

Implementation of Evidence-based Humanitarian Programs in Military-led Missions: Part I. Qualitative Gap Analysis of Current Military and International Aid Programs

A recent Department of Defense instruction mandates country-specific assessments, identification of interventions, and development of guidance for Department of Defense to plan, train, and prepare for the provision of humanitarian assistance in stability operations. It also directs the use of outcome-based measures of effectiveness and the establishment of processes facilitating transparency of information. Whereas this would align military-led projects closer to the standards of the international aid community, how this process will be developed and implemented within the military has not yet been determined. To begin developing an evidence-based program for military-led humanitarian aid, we conducted a qualitative gap analysis comparing information from a Web search of Department of Defense medical after-action reports, lessons learned, and expert interviews with the internationally accepted standards in humanitarian assistance impact assessment. There is a major gap in the ability of the Department of Defense to assess the impact of humanitarian assistance in stability operations compared with international development standards. Of the 1000 Department of Defense after-action reports and lessons learned reviewed, only 7 (0.7%) reports refer to, but do not discuss, impact assessment or outcome-based measures of effectiveness. This investigation shows that the Department of Defense humanitarian assistance operations are, historically, recorded without documentation using quantifiable health data identifying which aid activities contributed directly to desired outcomes or favorable public opinion, and rarely are analyzed for effectiveness. As humanitarian assistance operations assume an ever greater role in US military strategy, it is imperative that we investigate useful impact assessment models to meet mission directives and, more important, to maximize coordination in a necessarily integrated and cooperative development environment. These findings provide baseline knowledge for the implementation of an evidence-based impact assessment process to validate future Department of Defense humanitarian assistance operations.

Implementation of Evidence-based Humanitarian Programs in Military-led Missions: Part II. The Impact Assessment Model

The Department of Defense does not implement health-sector humanitarian assistance impact assessments to complement those of the international humanitarian aid community. This oversight fails to meet the recent Department of Defense Directive 3000.05 mandate calling for the application of measures of effectiveness. The decision by the Department of Defense to incorporate humanitarian assistance in stability operations should be supported by evidence-based impact assessments. This article proposes implementation of an impact assessment model in Department of Defense humanitarian assistance operations. The use of an impact assessment model will refocus previously identified information gaps from traditional military input-output management toward a greater emphasis on outcomes. This will help answer which humanitarian activities are successful, which are not, and why. Over time, the use of an impact assessment model will ensure that the Department of Defense and its operational units are learning as an organization while applying evidence-based lessons learned to future stability operations. Most important, the use of this model will both provide better understanding of the role that the Department of Defense has in humanitarian activities and help interpret and transfer these activities to the host nation and international aid community in a timely and efficient manner.

A New Cold War? The Consequences of China Rising

Rising Star: China's New Security Diplomacy. By Gill Bates. Washington, DC: Brookings Institution Press, 2007. 267 pp., $28.95 (ISBN: 0-8157-3146-9). On September 15, 1999, the United Nations Security Council, with China voting in favor, authorized the establishment of a multinational force, the Australia-led International Force in East Timor (INTERFET), to restore peace and security in East Timor, to protect and support the UN Mission in East Timor (UNAMET), and to facilitate humanitarian assistance operations. The resolution authorized the multinational, non-UN force “to take all necessary measures to fulfil this mandate” (p. 119). The incident, which is alluded to by Bates Gill in Rising Star , exemplifies China's efforts to reassure the international community about its role as an emerging and responsible power with a proactive approach to multilateral security diplomacy. Gill's book is part of a growing body of literature that focuses on China's post-Cold War foreign policy dilemma, namely, how to reconcile its desire for increased influence on international security arrangements given its growing economic, military, and political power and its need to devote more resources to its mounting domestic social, economic, environmental, and political challenges (other works include Deng 2004; Goldstein 2005; and Shambaugh 2005). Indeed, in recent years, Chinese diplomacy has attracted enormous attention on the part of academics, policymakers, and the general public alike, as the world seeks to understand the likely consequences of China's growing international assertiveness. Rising Star looks into the contents and causes of China's new security diplomacy. It also asks whether …

The Defense Forces and the NGOs: A Cultural Collision or a Meeting of Minds?

Numerous conflicts since the end of the Cold War, in many parts of the world, have seen military and civilian assets deployed side by side as part of an overall UN-mandated solution. Though great cultural differences exist between the military and NGOs, a level of compromise has been demonstrated in an effort to provide solutions. The skills required to operate in alignment with the changing role of UN operations present a challenge to professional defense forces. The military officer must recognize this challenge, particularly in the area of humanitarian assistance operations, and move to meet it. To do this effectively, he/she must study the other players on stage. Ireland has international credibility, hard-won over the last fifty years of peacekeeping operations, but the Irish Defense Forces, accepting that peacekeeping and humanitarian assistance missions have changed, must also be cognizant of the dilemmas that confront both the military and NGOs in their uneasy alliance on shared turf. The military commander will, by virtue of training and education, understand the problems faced by the military in conventional operational situations. Understanding the problems that confront NGOs is more difficult for military officers, given the limited opportunities to interact with representatives of that world. This essay attempts to lay the groundwork for greater interaction by asking the question, How can the Irish Defense Forces interact to best effect with NGOs in humanitarian assistance operations? By understanding this question and all it implies, a policy of training that incorporating inter-agency cooperation might be initiated, to the benefit of all concerned.

Bridging the gap: remote sensing and needs assessment—a field experience with displaced populations

Displaced populations present difficult challenges for humanitarian assistance organizations. Not least are the tasks of locating, denominating and assessing the needs of the displaced when they flee danger and ground access is difficult. Remote sensing can help accomplish these tasks, but is infrequently used in humanitarian assistance operations. The paper uses a displaced-population needs assessment in Liberia to identify key points on how remote sensing can contribute to the assessment process. The points include the need for good operational and strategic planning, the use of appropriate data collection methods (particularly video cameras) and the need to involve a broad group of knowledgeable people in data analysis (which is greatly facilitated by the use of video). The paper is of particular interest to two groups: humanitarian assistance personnel, as an example of a successful use of remote sensing; and remote sensing specialists and commercial service providers, as an example of low technology, low cost, low complexity, rapid aerial data collection.

What's so special about Humanitarian operations?

Many civilians and military officers working on humanitarian assistance (HA) operations appear convinced that such operations are completely new and different from traditional military operations, and thus require significant changes to military doctrine, organization, training, and equipment. This article challenges that assumption by demonstrating that most of the capabilities required for HA operations are also required for combat operations, especially low‐intensity conflicts. Thus the military already possesses (or at least should possess) these capabilities, including how to escort convoys, perform civil affairs tasks, and deal with restrictive rules of engagement in ambiguous situations. Although the skills that make up these capabilities are difficult and require more emphasis, they are not new. To address requirements for future HA operations, civilian and military analysts may have to jettison the assumption that such operations are inherently different and examine more closely the issues surrou...

Afghanistan and beyond: Reflections on the future of warfare

Abstract : The author provides an historical analysis of lessons from the war in Afghanistan so that policymakers and analysts alike will better understand the nature of operations other than war in multiethnic states. Many fear these wars will set the paradigm for future wars and will exert pressure on U.S. forces to conduct peacekeeping, peace enforcement and humanitarian assistance operations in especially dangerous areas. Yugoslavia and Somalia bear out the ubiquity of these wars and the pressures upon the United States to act. Hopefully mechanisms can be devised to forestall and avert future wars, or to bring them to the speediest possible conclusion. Should those mechanisms fail and troops have to be committed, this analysis should enable commanders to have a better grasp of the nature of the war they will fight. Understanding the war and the theater should facilitate a solution more in keeping with U.S. interests and values.