By Marilyn McHarg, Executive Director
Médecins Sans Frontières / Doctors Without Borders Canada

Since the media recently renewed its interest in the decades-old crisis in and around Somalia, we’ve seen a surge of advertisements from aid groups, featuring starving children with visible ribs and staring eyes. The subtext to these ads is that if you don’t donate, you’re abandoning these children and they will die. It’s that simple. Médecins Sans Frontières / Doctors Without Borders (MSF) is one of the international aid agencies struggling to respond in Somalia and refugee camps in Ethiopia and Kenya. We’re also struggling to define responsible fundraising within a discourse that relies on guilt and superficial messages. Fundraising experts warn us that offering a more complex picture of the difficulties of delivering aid will lead to cynicism and donor fatigue: it’s shock value that works.

At the risk of losing some donations, MSF believes that we must realistically represent what Somalis are facing, and our limits in assisting them. Simplifying the message may boost revenue, but if it comes at the expense of presenting a realistic picture, then the cost is too high.

Aid is difficult.

Things go wrong all the time. Particularly in war zones, non-governmental organizations (NGOs) continually fall short as we face massive challenges in accessing people who need us most. In all my years as a humanitarian aid worker, I’ve yet to see a comprehensive response that succeeded in meeting all the needs. We’re always overwhelmed, always facing painful choices that involve doing the best we can with what we have. It’s never enough, even in the most straightforward emergencies.

Somalia: A complex emergency

Of all the places I’ve seen, Somalia is among the most complex emergencies. Working there requires an in-depth understanding of local political players, a capacity to constantly negotiate with warlords, and the drive to keep projects running despite security threats. While visiting one of our teams in 2006, we had to travel from one town to another across a front line. The usual MSF procedure is to travel in our own vehicle, well marked with our insignia and signs that we are unarmed, with our own driver who can speak local languages. But this was Somalia. In order to get the agreement of the rival clans to move back and forth, we had to use the car and driver of one group and the armed protection of the other. Two armed guards flanked me in the back seat, while a driver from the opposing clan sat in front. I tried to imagine how that driver felt as he left the security of his own territory. Despite the unorthodox arrangement, it worked – all to simply go from one place to another.

Since then the conflict in Somalia has worsened significantly, making movement across front lines almost impossible. It prevents aid organizations from getting staff and supplies to those suffering the most. Somalis who can make the journey come to aid delivery points inside the country, or across the border in neighbouring countries. Those who can’t make it, perish. Families are forced to leave loved ones behind when they lack the strength to go on. The current crisis in Somalia is the product of 20 years of war. Even before the recent drought, it was estimated that there were only four doctors for every 100,000 people. Most health workers were based in cities, not rural areas. One in ten women died in childbirth, and as many as 25% of children under five never saw their fifth birthday. The average life span was 47 years. Of course drought has exacerbated the crisis: harvests have failed, livestock have died. But this is on top of war, violence, lack of access to aid, and some of the worst health indicators in the world, as well as high food prices and transportation costs.

More to the story than just famine and drought

Advertisements and headlines that label the crisis “Famine in the Horn of Africa” or the “East Africa Drought” reduce the plight of people struggling to survive decades of the harshest circumstances on earth, brought on by political chaos and military agendas, to something that can be solved with food and water. Giving to save the life of the starving child in the photo, to alleviate your guilt, won’t take Somalia very far. That’s not to say that donations are not important; rather, that there’s more to the story. Your generosity will save lives. There is nothing more important. At the same time, let’s be honest in admitting that humanitarian aid won’t solve Somalia’s problems, beyond keeping people alive for better times in the distant future. Aid is a temporary measure until more permanent solutions can address root causes, and the downward spiral can be reversed.

Donors can handle this complexity. I know this because many MSF donors demand this complexity. Aid organizations, all of us, need to openly confront the story behind the tragic, if successful, fundraising images. If we can share our pain and disappointment more, we can break through the illusion we have inadvertently created that we are here to cure what ails the world. Yes, we will lose some donors. But I am convinced that most will continue to support aid, and will do so from a much stronger foundation, one that makes room for error.  If aid organizations, all of us, were bolder about the realism of our communications, we could foster groundbreaking levels of transparency and accountability.

Despite all the shortcomings of aid organizations, they offer the best hope for millions of people in crisis. This is about a duty to respond, and doing all that we can. No matter the obstacles, this duty must outweigh cynicism. People’s lives depend on it. The current crisis is not affecting the entire Horn of Africa. It is not simply caused by drought. What differentiates the people affected by the crisis? Years of suffering through war and violence, and limited access to healthcare and other essential services compounded by drought. With an expectation that we will alleviate our guilt and solve the crisis by feeding the starving children in the photos, the subsequent and inevitable rounds of suffering will only be met with a stomach-churning “not again,” and perhaps a cynicism that was intended to be avoided in the first place. Some of our colleagues from other NGOs have chafed against our criticism, going so far as to call it “not helpful.”

We in the aid industry seldom openly criticize one another’s practices out of concern that it merely denigrates the entire sector in the public’s mind. There are times, however, when lifting the cone of silence on debates like this will help influence our philanthropic culture so that Canadians can make informed and meaningful choices.

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