In the line of fire

From the Ebola outbreak, to the fringes of the Syrian refugee crisis, International Medical Corps brings medical aid to the world’s most vulnerable people. In an exclusive interview, CEO Nancy Aossey talks risk, funding and what the global aid industry could learn from the Middle East

Health workers put their lives on the line every day. The work really is heroic. From the doctor in Afghanistan and the midwife in South Sudan, to the people who showed up at our Ebola clinic in Liberia to help, I’m always amazed at the risks people are willing to take for others. There are so many unknowns – unstable political situations, local risks – and yet, one by one, they still come forward.

“The world feels a more dangerous place now than when I started 30 years ago: it’s on fire”

Conflicts today are more complex, unpredictable and dangerous, particularly for humanitarian workers. This trend began in the 1990s, when we saw militias in the Balkans specifically attack aid workers and journalists. Where there used to be more protection for them, they are increasingly being targeted. The world feels a more dangerous place now than when I started 30 years ago – it’s on fire. In a typical year, we would experience about two major emergencies. In the last two years that number has tripled. In 2015, we reached more than 8 million people in 37 countries.

We knew from our inception that simply giving handouts is not enough. Our model is to help people to become their own first-responders by investing in training, building local skillsets, and helping communities become resilient. About 95 per cent of our staff come from local populations. We see over and over again that the best solution is always a local one.

Preparedness calls for investment, and donor resources aren’t always structured in that way. Many funding structures were designed to be short-term, and can’t support the protracted conflicts we see today. That is one of the major challenges. In Syria, we’re seeing the loss of a generation. Refugee camps weren’t meant for children to grow up in, without access to education. The impact of this will reverberate for decades.

The Ebola outbreak [which claimed the lives of more than 11,000 people] was a risky endeavour for us. We had no prior experience treating Ebola patients, but we also knew if we didn’t respond, the epidemic would explode and travel around the world.

The outbreak underscored the need to build capacity. One of the reasons Ebola wasn’t stopped earlier was because these West African countries, shattered by past civil wars, don’t have enough frontline health workers. Liberia, Sierra Leone, Guinea – they have the lowest ratio of doctors per capita in the world. That’s why investing in training a local workforce is so critical.

Arab governments have given billions of dollars to the Syria response, and there is a lot of generosity in the region. But the opportunity goes beyond funding. The reality is that the MENA region has a long history of dealing with refugees and displaced people, and we’re seeing in Europe the difficulties governments have in managing large influxes of refugees. There’s a lot we can learn from the Middle East. Arab donors and NGOs both need to be included more in the global aid architecture.

The landscape of crises is changing. We are contending not just with rapid onset natural disasters but also protracted emergencies that cross borders, in a world where aid work is increasingly politicised. Both require a flexible response mechanism that can work across cultures. It requires NGOs, the UN, governments, the private sector and civil society to work together.

We must continue to harness the power of big data. We need to be able to track the outbreaks of disease or population movements better in real-time. This data is especially important in remote areas – if you look at the source of diseases such as avian flu or Ebola, these outbreaks started in remote areas. We are working on using technology, but we need to be proactive – rather than reactive – and agile in responding to crises that cross borders. Data can help.

I worry about the rising climate of fear. Historically fear sometimes drives people to do the right thing, and sometimes to do the wrong thing. We see it in the refugee crisis in Europe – the fear that has driven governments to close borders. The best way we can tackle this alarm is with information. I believe that people are fundamentally compassionate and that with education, fear starts to go away.

Photo credit: International Medical Corps