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The Hewlett Foundation Blog




Friday Note: International Relief Workers are Doing Good Better 

August 22, 2014 — By Ruth Levine

On World Humanitarian Day this week, the world was dealing—or not quite dealing—with multiple humanitarian emergencies: Ebola in West Africa, refugee crises in Syria and Iraq, civil war in the Central African Republic and looming famine in South Sudan. USAID has more disaster response teams mobilized than at any time in its history, and the most “can do” groups, like Doctors without Borders, are sounding the alarm about the need for a larger and faster response.

This is the new normal. Many experts, anticipating a combination of climate disruption and political instability, expect that doing relief work on multiple fronts is something the world has to get used to—and has to learn to do better with the $5+ billion mobilized from public and private donors each year. There are more problems and they are more complex than in the past, and more money will be going to the immediate needs of displaced, hungry, sick, and traumatized people around the world.

Believe it or not, in this dark space there is a tiny glimmer of light, and it’s not just the glow from the halos of the amazing people who dedicate their lives to helping others. It’s the light from more systematic learning.

The humanitarian community—funders and implementers—is demonstrating an impressive appetite for using evidence from rigorous evaluations to provide more effective (and cost-effective) responses the next time around. A recent blog post by Oxfam’s Ellie Ott describes this well: “If we fail to examine the evidence, then we fail in our duty to help communities and individuals get back on their feet, and can even potentially cause harm.” She highlights the value of systematic reviews and new impact evaluations coming out of EvidenceAID, the Abdul Latif Jameel Poverty Action Lab, the Campbell Collaboration, and the International Initiative for Impact Evaluation.

The more I think about it, the more obvious it is that evaluation can be a huge benefit to humanitarian activities, as long as it’s focused on questions that matter. The outcomes are often more observable and measurable than most long-term development programs. More importantly, within global development, broadly defined, humanitarian aid is one of the most centralized and well-coordinated types of activities. Key features of humanitarian aid include chains of command with designated lead agencies, standard protocols, and a few dominant funders (including the U.S.)—all characteristics that make it reasonably likely that practices can change pretty quickly if a new approach is shown to be superior to the status quo.

One example illustrates the point: Unsure how best to treat the mental health problems stemming from rape in the war-torn Democratic Republic of Congo, the International Rescue Committee teamed up with Johns Hopkins University and the University of Washington a couple of years ago to conduct a randomized evaluation of “cognitive processing therapy,” a form of group therapy to treat anxiety, depression, and post-traumatic stress disorder. The study was funded by the USAID and the World Bank. The researchers found that after six months, only 9 percent of women participating in group therapy were suffering from feelings of shame and anxiety, while 42 percent of women who had been offered an alternative form of care were still suffering. They’d found a dramatically better way to provide care for problems that affect almost half of the women in eastern Congo where rape has been used as a weapon. Findings published in the New England Journal of Medicine and widely disseminated in the field are helping to change practice both within IRC’s work and more broadly.

We don’t fund humanitarian aid efforts ourselves, but we do support many organizations working to build a better base of evidence about what works. And we applaud loudly when aid organizations with lots of priorities to balance, like USAID, the World Bank and the UK Department for International Development, have the wisdom to invest in serious evaluation. In a small way, we’re working with others to make sure that the hardest kind of international work is also the most effective.