Delivering Relief in Afghanistan

Charities face many hurdles in rebuilding war-torn country

The World Food Program’s successful delivery of a record 128,000 tons of food to Afghanistan

last month — at an impressive rate of some 250 truckloads a day — illustrates how effective the international-aid system has become in recent years at helping people in need.

But continuing weaknesses in the system pose big challenges for the dozens of nonprofit aid groups working with United Nations agencies to help rebuild that ravaged country, much of which is a shambles after three years of drought and two decades of armed conflict.

Because of deteriorating security in much of Afghanistan, where bandits prey on food convoys and local warlords often demand stiff tolls or bribes, nonprofit groups have been unable to deliver food to some remote areas. Many thousands of people therefore remain at risk, some reportedly subsisting on little more than grass.

Instability resulting from the overthrow of the Taliban has complicated the work of humanitarian groups, some of which have been working in Afghanistan for more than a decade. As the interim government seeks to extend its authority nationwide, many nongovernmental organizations will now be asked to shift gears, combining emergency relief with steps to improve the country’s capacity to feed its people and provide them with education, health care, jobs, and security.

Nonprofit groups “have been the lifeblood of Afghanistan for 20 years, and instinctively are going to want to fill vacuums that the government ought to be filling,” says Randolph Martin, senior director of operations for the International Rescue Committee, in New York. It will be difficult, he says, for organizations that are accustomed to acting fairly autonomously in their relief efforts to take a subordinate role of supporting fledgling government ministries.

“We can blow this, by getting in the way of Afghanistan getting back on its feet and having the ability to serve its people, or we can facilitate that process,” Mr. Martin says. “It will all depend on our ability to change the way we operate, to think out of the box.”

Child and Maternal Mortality

The stakes are high in Afghanistan, one of the world’s poorest nations. Child and maternal mortality rates are the highest in Asia: One child in four never reaches age 5. Chronically malnourished, many Afghans are vulnerable to measles, pneumonia, and parasitic diseases. Just 39 percent of boys and 3 percent of girls attend school, while literacy rates among adults are 47 percent for men and 15 percent for women. And unemployment is endemic; many people are subsistence farmers with little training in anything other than fighting.

“It’s very difficult for people to imagine the level of poverty, violence, and drought here today,” John Watson, president of CARE Canada, said during a recent visit to Kabul. “In rural areas, it’s like a lunar landscape. There’s now just dust in what traditionally was a Garden of Eden — full of vineyards, almost like an oasis.”

Such “complex emergencies” in countries ill-equipped to cope with them require a multifaceted approach, says Nilgun Ogun, Save the Children’s program director for Asia. “You can’t just pick and choose between health care, education, or livelihoods,” she says. “You have to do all — or bring in other groups to address some issues — because the magnitude of the need is enormous.”

Lessons From the Past

Humanitarian-aid experts agree that their experience with similar situations in Angola, Kosovo, Somalia, and elsewhere in the past decade is shaping their efforts in central Asia today.

Larry Minear, who directs the Humanitarianism and War Project at the Feinstein International Famine Center at Tufts University, says that “Afghanistan represents something of a barometer for the humanitarian enterprise, both of progress made over the past decade in handling complex humanitarian emergencies and of unfinished business and lessons not learned.”

The coordination of programs to ensure that organizations collectively are making the most efficient use of their limited resources is still not being done as well as it should be, says Mr. Minear, either among charities themselves or in consultation with Unicef, the U.N. High Commissioner for Refugees, the World Food Program, or other U.N. agencies.

But nonprofit organizations have become much better, he says, at sharing information about humanitarian needs, at analyzing such crises to determine priorities for what needs to be done, and at planning for various possible scenarios.

‘Learning Curve’

Rob Williams, operations director at Concern Worldwide US, in New York, says “there’s been a huge learning curve in terms of how emergency aid is delivered.”

Humanitarian groups are now much more sensitive about engaging local residents in relief efforts, he says, working through village elders or other leaders rather than setting up an independent distribution structure. That helps strengthen local institutions instead of eroding their authority. And groups are also careful to give free food only to those who have no other means of support, so as not to create dependency on relief supplies and lure people away from their homes to food distribution sites.

Wherever possible, charities offer their help in exchange for work, as a way of promoting self-respect among their beneficiaries and minimizing the possibility of dependency.

CARE has recently started projects to give families some income. One project employs more than 3,000 residents of Kabul to clean up the streets, hauling trash to the dump in a city that has had no garbage pickup for more than a decade, as well as digging drainage ditches and repairing roads. The men earn the equivalent of about a dollar a day, which is enough to buy a six-pound bag of flour in local markets.

In two other CARE projects, women earn money either by sewing school uniforms for children whose families can’t afford to buy them, or by working as health educators, teaching other women basic hygiene measures to help keep their families healthy.

Nonprofit groups are not immune to the tribal factions that divide Afghan society at large. But Mercy Corps, which employs about 400 Afghans, believes that promoting and valuing diversity in its staff makes for a stronger team. “A lot of them are very much tied to their ethnic backgrounds and don’t always understand the other side,” says Kim Johnston, director of program operations. “But if we can’t create peace within our own team, it’s pretty hard to do so in the wider community.”

Role of Women

Working in a conservative Muslim country like Afghanistan poses special problems for aid organizations, particularly with regard to gender issues. Since Afghan men and women are virtually barred from communicating with each other unless they are related, Save the Children has hired teams of relatives — mothers and sons, for example, or sisters and brothers — to conduct household surveys to assess local needs.

The simple process of hiring local staff members or renting office space can itself be problematic, however, in Afghanistan, with an unemployment rate estimated to be as high as 65 percent.

The Afghan Support Group — 16 countries that provide aid to Afghanistan — recommended when it met in Bonn last month that nongovernmental organizations subscribe to a code of conduct regulating how they hire and compensate their local employees and discouraging the poaching of staff.

“NGO’s are concerned,” the group reported, “that a money-intensive rehabilitation and reconstruction process may pull vital human resources and institutional memory away from civil authorities and NGO’s” if aid agencies try to outbid one another for the services of guides, translators, and education, health-care, or other professionals.

What’s more, the group said, “we must avoid the creation of parallel, duplicative, and inefficient aid and development management structures” by making better use of systems already in place. “The intention should be to build and shift management, coordination, and regulation of these structures to state institutions and Afghan civil society.”

Indeed, only by operating in ways that strengthen local institutions can humanitarian groups achieve lasting success, say some nonprofit officials. But that task is complicated by the nation’s recent history.

“In countries like Afghanistan, which has been at war for more than 20 years, no men between ages 15 and 40 have ever known their country at peace,” says Mr. Martin, of the International Rescue Committee. “They don’t know how to be farmers or carpenters or teachers. The only skill they have is fighting. So it’s not surprising that they use the skills that they have to survive.”

Adds Mr. Minear: “Afghanistan is a country in which all the actors — both political and humanitarian — carry a lot of institutional and political baggage. The same people who are now coming to power in the new government are experienced manipulators of humanitarian assistance and abusers of human rights, so the whole question of how you start out on a new footing and maintain independence and accountability is a serious one.”

Long Experience

Nonprofit groups have a great advantage in coping with the recent crisis, however, in that many of them have been working in Afghanistan for a decade or more, and collectively have thousands of trained workers in place, either inside Afghanistan or in neighboring Iran or Pakistan, where an estimated 2 million or more Afghan refugees now reside.

After the Taliban took power in 1996, many groups devised ways of continuing their work under that regime.

“We had a carefully negotiated arrangement with the Taliban to support an enormously large and sophisticated infrastructure operating to serve the needs of 3.5 million people,” says Raymond C. Offenheiser, president of Oxfam America, in Boston, describing the scene before September 11. After U.S. and British forces started their bombing campaign in October, non-Afghan staff members of nonprofit organizations decamped to Pakistan or elsewhere, leaving humanitarian operations in the hands of the groups’ local workers.

Since the overthrow of the Taliban, international staff members have been trickling back into Kabul, the capital, and other key cities. Action Against Hunger, for example, has sent some expatriates back into Afghanistan, but not its Britons or Americans, who are perceived to be at somewhat greater risk of becoming victims of violence.

“The humanitarian infrastructure in the major hubs is back in place already,” Mr. Offenheiser reports, “but the capillary structure at the town and village level has been much harder because of security concerns.”

New Government

Indeed, restoring and maintaining security throughout Afghanistan is seen as the basic prerequisite for any robust and effective campaign to rebuild the country. Many nonprofit officials hope that the international security force now deployed only in Kabul will be broadened to include other cities as well, and that the country’s new government moves quickly to establish a competent police force.

Still, the fighting that has focused the world’s attention on Afghanistan has also prompted much larger offers of support from the United States, the European Union, and other major donors.

“One of the ironies of the U.S. intervention is that, although it exacerbated problems on the ground temporarily by displacing more people and disrupting relief supplies, it brought a level of attention and commitment from the international community that made it possible to overcome a lot of the difficulties,” says Hiram Ruiz, communications director at the U.S. Committee for Refugees, in Washington.

Yet while the trend among many aid groups themselves is to blur the line between relief and development, donor governments and U.N. agencies have not kept pace in how they finance humanitarian projects, says Ms. Ogun, of Save the Children.

“Donors still think of emergencies as being short-term,” she says, “whereas they can last decades.”

Relief vs. Development

Countries that support humanitarian assistance generally offer two pots of money: one for short-term relief, another for longer-term rehabilitation and development. At the U.S. Agency for International Development, for example, the Office of U.S. Foreign Disaster Assistance usually supports relief efforts lasting up to a year, for example, while other offices underwrite multiple-year projects.

Such distinctions are less and less relevant, nonprofit officials say, as groups increasingly try to incorporate elements of development into even the earliest phase of relief operations. Yet narrow and inflexible guidelines may bar emergency health-care money from being spent on immunizations or reproductive health, Ms. Ogun says.

“In complex emergencies,” she adds, “you need to combine short-term aid with longer-term developmental components.”

Mr. Watson, of CARE Canada, points out that in many rural areas, roads and fields must first be cleared of land mines and unexploded bombs and ammunition before people can return to their homes. Then the underground irrigation conduits that were destroyed during decades of fighting must be rebuilt to give farmers a more reliable source of water needed to make their fields and orchards flourish once more. And schools and health clinics must be built and equipped, too.

“It’s a years-long process that has to occur in stages,” says Mr. Watson.

Maintaining Interest

The scope of the task is daunting. “No matter how much aid goes into Afghanistan, it can’t begin to make a dent in the identifiable need,” says Mr. Ruiz, of the U.S. Committee for Refugees. “Probably every district in every province is going to need agricultural help, their irrigation systems improved, food assistance until people can grow their crops, education, and health care.

“How do you look at the pool of resources available and figure out how to distribute it among so many places of need?”

Nancy Aossey, president of the International Medical Corps, in Los Angeles, is guardedly optimistic that Afghanistan can bounce back — so long as the country does not splinter again into chaos. She says: “My biggest worry is that I hope the political situation holds, because that will impact on every other single thing that happens.”

At a meeting this week in Tokyo of donor countries, Afghanistan’s interim government was expected to ask for $22-billion to help rebuild the country over the next decade — and some groups expect to remain there for at least that long.

“The biggest fear of the Afghan people,” says Ms. Johnston, of Mercy Corps, “is that donors will get tired of it, because something else will come along to attract their attention.”