Global interest in humanitarian response is high – after a string of sudden, large-scale disasters triggered by the Indian Ocean tsunami, the South Asian earthquake and a record hurricane season along America’s Gulf Coast in 2005. But high-visibility catastrophes overshadow more chronic – and often more deadly – humanitarian crises. Neglect takes many forms: some crises may be unreported, unfunded, uncounted, or triggered by a secondary, unanticipated event. Other crises are neglected because governments keep them secret, or aid organizations find it awkward to operate, or decision-makers misunderstand appropriate responses. Beneath all such crises is a deeper neglect of social vulnerability to disaster. Humanitarian organizations, donors, governments and the media must address all types of neglect to ensure people are not abandoned to unnecessary, silent suffering.

Malawi, one of the poorest countries in the world, faced a severe food crisis in 2005 and 2006, with 40 per cent of the population - nearly 5 million people - in need of food aid as a result of poor rains and insufficient access to food, seeds and fertilizers. Many poor households had not been able to rebuild their reserves after previous food crises. They coped by selling belongings, cutting meals, eating leaves, taking children out of school, engaging in sex work and stealing. When a state of emergency was finally declared, food aid flooded in but appeals for the seeds and fertilizers needed to boost recovery were neglected. The best way to avoid future food crises in the region is to help governments invest in sustainable agriculture and rural livelihoods. Otherwise the cycle of recurrent hunger and short-term response will continue.

Torrential rains that accompanied Hurricane Stan affected over a third of Guatemala's total area. Indigenous people living in extreme poverty were hardest hit. This tragedy exposed the risky conditions in which millions of Guatemalans live today and the complexity of factors that make people vulnerable to disaster, including: political instability, violent crime, discrimination, social exclusion, environmental degradation and migration of workers to the United States. To protect people, disaster risk reduction must become a priority across all institutions including government agencies, community organizations and schools.

Globally, unsafe motherhood silently steals over half a million lives a year. In Nepal, between 5,000 and 6,000 mothers die each year in childbirth. This death toll of one woman every 90 minutes makes Nepal one of the deadliest places in the world to give birth – yet their plight goes unreported. Meanwhile, an estimated 30,000 babies a year die before they are a month old. Behind these hidden tragedies lie delays in seeking care, delays in reaching a healthcare facility and delays in accessing adequate treatment at the facility. Reasons for the delays include discrimination against women, conflict, rugged terrain and poor transport systems, poverty, a shortage of medical staff and a simple lack of awareness. Solutions are complex and long-term, but urgently needed. They include improving the healthcare system and tackling socio-cultural barriers to a greater awareness of maternal and neonatal health.

Drawn by the prospects of employment and driven by failed development, poverty, insecurity and hopelessness, many migrants are prepared to risk their lives to reach Europe. At least 2,000 irregular migrants are estimated to drown every year attempting to cross the Mediterranean in small boats – while yet more perish during the journey across the Sahara desert to the African coast. But no organizations are measuring the humanitarian impact of this crisis regionally. The long-term answer to irregular migration is to improve economic development in source countries, to give people a reason to stay. The short-term answer to preventing deaths at sea includes gathering accurate data so public information campaigns can warn would-be migrants of the risks of illegal boat migration. Meanwhile, states must crack down on criminal people-smugglers, while allowing migrants access to fair asylum procedures.

In a disaster, gender concerns might seem a luxury that can wait while more urgent matters are addressed. Yet the failure to address gender-based inequalities immediately after disaster and throughout the response can condemn women and girls to less aid, fewer life opportunities, ill-health, violence and even death. To reduce future suffering during disasters, aid organizations must ensure full respect for women’s and girls’ human rights – civil, cultural, economic, political and social, including the prevention and prosecution of gender-based violence.

Humanitarian aid from Western governmental donors alone reached over US$ 12 billion dollars in 2005 – the highest since records began. December 2004's Indian Ocean tsunami prompted unprecedented donations with over US$ 14 billion raised, about a third of it from individuals. Yet aid is spread unevenly. UN appeal contributions ranged from US$ 3 per targeted beneficiary in Guyana to US$ 310 per head in Sudan. Asia is comparatively neglected, receiving less than 30 per cent of global aid. Food is the best covered sector; but economic recovery, shelter, protection, water and sanitation, health and agriculture are all on average less than 40 per cent covered. Aid must be adequate as well as fair. Aid organizations and donors must agree on a standard way of measuring global needs and ensure that aid responses meet all priority needs. A closer integration of humanitarian and development responses is needed to tackle recurrent, chronic crises.