Chapter 6
Box 6.2 Military and private sector challenge established aid providers

Rising involvement of the military and private sector in the humanitarian response to Kosovo’s refugee crisis contributed overwhelmingly to a confusion of roles in health assistance. Never before have military disaster relief operations been of such size. In many instances, theirs was the first emergency medical assistance available – something which military public relations departments covet. There is nothing like media images of military helicopters, vehicles or medical teams helping refugees or bringing assistance to old-age pensioners too scared to leave home.

In Macedonia, the German military operated a camp for 3,200 refugees, including an eight-tent hospital with operating and emergency rooms, separate wards for men and women, and a staff of 20 medical professionals, among them four doctors. Italian, Spanish, French, and other NATO military components (including the Israelis, not members of NATO) were also involved in providing health care to refugees.

The International Federation refused to rely on the military for support as did other relief agencies. However, the Austrian, Belgian, German and Italian Red Cross Societies worked individually beside the military – but not without problems. International Federation represent-atives said they had advised National Societies only to accept security from the soldiers.

Toby Porter, emergency programme coordinator for Oxfam in Albania, pointed out that NATO forces tended to establish camps without the input of experienced site planners. Latrines were often poorly sited and tents placed too close together. Such mistakes could have been avoided had aid agencies been involved earlier. And, maintained Porter, the “guiding principle for many donor governments was to pour as much money as possible into ‘their’ camp, and to try and attract the maximum number of refugees there.” This exacerbated coordination problems as camps were often prepared without informing UNHCR.

There is no doubt the military are far better equipped than most aid agencies to cope rapidly and effectively with war injuries under certain circumstances. But their facilities are not fully geared to deal with civilian requirements. In Albania and Macedonia, for example, they had no incubators to handle newborn babies, but this did not prevent them from improvising.

NATO forces eventually handed over their camps and medical responsibilities to aid organizations such as the Red Cross Red Crescent Movement. NGOs were often selected and funded by NATO country donors based on shared nationality with the camps. While the military, with vast and costly logistical resources at their disposal, performed a remarkable job, the involvement of uniformed NATO personnel in humanitarian assistance has raised some very pointed and uncomfortable questions for the aid community.

Leading aid representatives have repeatedly pointed out that the military cannot be considered impartial. The presence of uniformed NATO personnel acting as aid workers in refugee camps or clinics, while their forces were also caught up in military action, threatened the neutrality of aid workers, they warned. “The two need to be kept clearly separate,” said James Orbinski, president of MSF International. If not, he warned, belligerents may regard civilian relief operations, such as aid convoys or medical teams, as legitimate targets.

Both during emergency and reconstruction phases, private business has been seeking contracts for everything from medical kits and sanitation facilities to the setting up of refugee camps, mobile communications centres and even fully equipped mobile hospitals.

Some may find commercialism within humanitarian relief unethical, but many analysts consider it inevitable that private business will adopt a higher profile in such humanitarian interventions. Not only will companies seek to perform more competitively and efficiently than NGOs, but the lines between charity-based organizations and corporations will become steadily blurred as donors look to bottom-line efficiency of delivery.

While profits may be made, the private sector is probably more interested in the good will and high-profile publicity to be gained. When Nokia and other companies distribute their merchandise free to refugees, it not only looks good in the annual reports, but also when broadcast on the television news.