In 2020, the world was shaken by the Covid-19 pandemic and it now faces countless unknowns, with as yet unwritten scenarios. Boris Martin, chief editor of the review Humanitarian Alternatives, looks back at the impacts of the pandemic on humanitarian aid and presents the two issues that we have chosen to dedicate to this extraordinary crisis.
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The entire world has, to say the least, been “gripped” by the Covid-19 pandemic, and the “little” humanitarian world has not escaped. It was undoubtedly less surprised by this explosion, even though it is still trying to measure all the related direct and collateral damage. This is what this entire issue is about, since the resulting emergency led us to review our publication programme.
Should irony be mentioned in such a serious crisis? In February 2016, we dedicated our very first issue to the Ebola epidemic that raged in West Africa in 2014 and 2015(1)Humanitarian Alternatives, “Ebola: the end of the nightmare?”, Inaugural issue, February 2016, https://alternatives-humanitaires.org/en/category/focus-en/ebola-the-end-of-the-nightmare. Learning the lessons from this crisis (which was to continue into early 2016, before gaining new ground in the Democratic Republic of Congo in 2018), all the authors converged to warn of the emerging expectations. The epidemiologists Michael Edelstein and David L. Heymann declared that “these questions need urgent answers before the emergence of the next global health crisis”. Jean-François Delfraissy (the current President of France’s Scientific Council on Covid-19) and Benoît Miribel (Co-founder of the Humanitarian Alternatives review) warned that: “The issue of the responsibility of governments and ministries that are confronted with public health challenges must be closely examined so that political leaders have incentive and are encouraged to take measures to protect the populations under their responsibility. The health risk of countries lacking health systems is also of concern for developed countries since they can at any time be exposed to emerging or re-emerging pathogens”. In 2018, the World Health Organization (WHO) broke new ground by including “disease X” in its list of pathologies likely to represent an international threat – alongside Ebola, Zika and two coronaviruses, MERS and SARS. The WHO stated that this pathology was “included on the list not to terrify us, but to ensure that the global health community builds the resilience and capacity needed to tackle all threats – not just the predictable ones”. Since 31 December, when the first cases of an infectious disease were detected in China, 188 countries worldwide have been affected by Covid-19, with more than 13,000,000 confirmed cases and more than 570 000 deaths (at 14 July(2)Johns Hopkins University tracker, https://coronavirus.jhu.edu/map.html. Almost half the global population were in varying degrees of lockdown before the disease started to ease.
While incorporating the global time and evolution constraints of the Covid-19 pandemic, this special issue of our review aims to understand both the existing and still-emerging challenges of Covid-19 in the humanitarian field, especially those which may arise between now and the publication of a second special issue in November. Firstly, it is important to understand the origins and causes of this pandemic and the lessons to be learned from past pandemics (including those which had no lasting effects), where humanitarian workers have often been on the frontline. Then, what needs to be encouraged must be highlighted, which is a necessary international solidarity, beyond the closed national doors that this crisis has all too often created.
We needed to understand how Covid-19 fits into the long list of past and current epidemics and what the epidemiological knowledge, accumulated over the course of such epidemics, can be used to develop and the lessons from humanitarian interventions in epidemic situations. The texts by Jean Freney, Stéphanie Maltais and François Grünewald look at this and the interview with Robert Sebbag continues the discussion on our website* by reflecting on the parallel with the HIV/AIDS pandemic(3)Robert Sebbag, « Il y a eu une véritable solidarité de la peur » (only available in French) : https://alternatives-humanitaires.org/fr/2020/06/12/il-y-a-eu-une-veritable-solidarite-de-la-peur.
We will also see what role non-governmental organisations (NGOs) have been able to play in their respective countries and abroad despite their own constraints such as personnel in lockdown, reduced transport, etc. and what lessons they have already learned from this crisis. The article by Chloé Cébron, Shelley-Rose Hyppolite and Nadja Pollaert from Doctors of the World Canada addresses this by highlighting the necessary community work. Meanwhile, the article by Miriam Kasztura and Françoise Duroch from Médecins Sans Frontières Switzerland reflects on the moral challenges faced by the MSF teams. Michiel Hofman’s article addresses a largely under-determined issue (the impact of Covid-19 in war zones), just as Dominique Kerouedan does for asylum seekers in France (also on our website(4)Dominique Kerouedan, « La demande d’asile dans le contexte de l’état d’urgence sanitaire en période d’épidémie de la Covid-19 en France » (only available in French), https://alternatives-humanitaires.org/fr/2020/06/17/la-demande-dasile-dans-le-contexte-de-letat-durgence-sanitaire-en-periode-depidemie-de-covid-19-en-france).
Essential to understanding and managing this crisis, the analysis by researchers obviously had a place in this dossier. Whether related to gaining a better understanding of the “reception” and the representations of the pandemic in Africa, as presented by anthropologists Yannick Jaffré, Fatoumata Hane and Hélène Kane, or evaluating the humanitarian issues and the available tools as in the article by Karl Blanchet and Alex Odlum from the Centre for Education and Research in Humanitarian Action (CERAH).
These differing insights had to be put into perspective. The article by Norah Niland exploring the “war metaphor” used broadly in this unprecedented crisis, and that by Anna Khakke questioning its political and humanitarian nature are signs of the more global considerations that we will have to draw from this pandemic.
While they close this dossier, these contributions do not exhaust the collateral, yet vital subjects, which fuel it. From the now obvious links between this pandemic and the environment discussed by Jean-François Mattei to the criticism of neoliberalism outlined by Alain Caillé and Bertrand Livinec and the possible reactivation of aid localisation foreseen by Martin Viélajus and Jean-Martial Bonis-Charancle, we measure the disaster that this “corona” virus has unleashed. As if it had decided to surround humanity in its own inconsistencies, from which it really needs to escape.
* Faced with the wealth of reactions caused by this crisis, we have opened our website – even more broadly than usual – to contributions that could not find their place in the limited space of this publication. On our website the reader will therefore find an abundance of texts, interviews and bibliographic resources relating to the impact of Covid-19 in the humanitarian field. Others will be added regularly until our second issue dedicated to the same topic, next November.
Entretien avec Jean-François Mattei • président de l’Académie nationale de médecine, ancien président de la Croix-Rouge française, membre de l’Institut de France (Académie des sciences morales et politiques), ancien ministre de la Santé
The global health crisis caused by the coronavirus epidemic has confirmed that most modern epidemics are caused by cross-species virus transmission between wildlife and humans. According to Jean-François Mattei, since epidemics are the result of the imbalance caused by humankind to ecosystems which had been preserved until now, there is an urgent need to consider the environment and human health as being inextricably linked.Continue reading →
Jean Freney• Microbiologiste, professeur émérite des universités
Where do epidemics come from, how do they spread, and how do they behave? To answer these questions, and to introduce this issue’s theme, it was first deemed necessary to consider Covid-19’s place in the long line of previous epidemics and develop a better understanding of those yet to come. Jean Freney has risen superbly to the challenge.Continue reading →
Stéphanie Maltais • Docteure en développement international et chargée de cours à l’Université Laval (Québec)
Resilience can emerge from fragility. This is what Stéphanie Maltais observed from her research conducted in the aftermath of the Ebola crisis in Guinea between 2013 and 2016. Lessons that can be applied to the current pandemic.Continue reading →
François Grünewald • Directeur général et scientifique du Groupe URD
The ability to learn from previous crises and adapt those lessons to any new context is one of the keys to disaster management, including health disasters. François Grünewald’s article seeks to put the management of the Covid-19 crisis into perspective in light of the lessons learnt from previous health crises.Continue reading →
Chloé Cébron, Shelley-Rose Hyppolite et Nadja Pollaert • Médecins du Monde Canada
Might a community approach be one of the solutions for social distancing, the scope of which has been revealed by the current pandemic? This is the argument put forward by the three authors, members of Médecins du Monde Canada.Continue reading →
Miriam Kasztura and Françoise Duroch • Research Unit on Humanitarian Stakes and Practices (UREPH) MSF’s Operational Centre in Geneva (Switzerland)
The truly unprecedented nature of the pandemic has mobilised and confused humanitarian NGOs and their staff as much. Forced inaction mixed with setting up programmes within a context of high uncertainty has resulted in strong, sometimes painful, moral experiences. The research project initiated within Médecins Sans Frontières Switzerland has already made it possible to collect useful data both for the present crisis and for others to come.Continue reading →
In this article, Michiel Hofman reflects on the difficulty of implementing a health response in war zones especially in a context where States are mistrusted, where non-state armed groups call on increasing hostilities and where humanitarian actors must deal with travel restrictions, supply shortages and fundraising gaps.Continue reading →