Health and Human Rights in
Complex Humanitarian Emergencies
Jennifer Leaning, M.D., S.M.H.
FXB Center for Health and Human Rights
Harvard University
Brown University
March 2, 2013
Outline
• Forced movement of people as common
element in armed conflict and natural
disaster
• International norms that apply to armed
conflict and crisis-induced forced migration
• Major issues of health and human rights in
complex emergencies
• Examples
Forced Migration in Conflict and
Disaster
• Creates emergency needs
– Water, shelter health,food, security
• Imposes new categories of vulnerability
– Raises risk of gender-based violence
• Requires temporary settlement that may
last for decades
• Inflicts loss of family and community,
livelihoods, culture, history
Legal Rights and Norms in CHEs
• International human rights law
– Rights to life, home, property, freedom of
movement, dignity, protection against torture
and assault
• International humanitarian law
– Obligations to distinguish civilians from
combatants and protect civilians from harm
• Sphere standards
CHEs: Armed Conflict
• Conflicts 1990-2010
–
–
–
–
Number ranges from 18-33 per year
Majority in Africa and Asia
Majority last for many years
Number of internally displaced persons greater than
number of refugees
– Forced migration from war is now a prevalent feature
– Characterized by massive violations of human rights
and IHL
• Targets are civilians
Examples
• Wars
– Yugoslavia 1992-95
– Darfur 2003 to present
– Post conflict Afghanistan and Angola
• Disasters
– Hurricane Katrina August 29, 2005
Number of Refugees vs. IDPs over
Time
High Costs of Conflict:
Civilian Victims of War
WWI
WWII
1946-today
War in Former Yugoslavia
1992-95
• Estimates of 200,000 killed
• Hundreds of thousands displaced in campaigns
of ethnic terror and ethnic cleansing
• Large camps of IDPs and self settled in towns
• Concentration camps
• Wide-scale rape
• Forced migration
War in Former Yugoslavia
• Hundreds of thousands displaced in
campaigns of ethnic terror and ethnic
cleansing
• Large camps of IDPs and self settled in
towns
• UN required to participate in creating more
homogenous populations in order to
reduce killings and assault
Sarajevo 1992-96
Bosnia 1992
13
Bosnia 1993-94
Bosnia 1993-94
War in Darfur 2003-present
• Demands for regional autonomy and voice
• Armed Darfuri militias attacked Sudanese
outposts
• Aggressive state and militia-based reprisal
• Campaign of terror and destruction of
villages and community
• Catapulted over 2.5 million into IDP status
and 400,000 refugees in Chad
Darfur 2004
Darfur 2005
Darfur 2004
Darfur 2004
Darfur 2004
Darfur 2004
Darfur 2005
Post-Conflict Afghanistan 2002
Post-Conflict Afghanistan 2002
Post-Conflict Afghanistan 2002
Post-Conflict Angola 2007
Post-Conflict Angola 2007
Post-Conflict Angola 2007
Natural Disasters
• Weather instability, powerful
hurricanes/cyclones, disruptions in
monsoons and seasonal rains
• Coastal and riverine flooding
• Flood induced mountain collapse
• Sea level rise
• Water scarcity, drought, food insecurity,
drought, famine
Natural Disasters
• Increased intensity and frequency of major
water-related natural disasters
• Increasingly important factor in forced
migration
• Probably mediated through population
growth and settlement patterns as well as
through secular environmental change and
climate change
Number of Disasters over Time
Hurricane Katrina
• Major category 3 hit very close to New
Orleans, LA August 29, 2005
• City of 485,000 on US Gulf Coast with one
road north for evacuation
• Disaster resulted in rapid forced migration
within and then out of the city
• Underlying racial and socio-economic
fissures
• As of 2010, only 345,000 have returned
Hurricane Katrina 8/26/05
Hurricane Katrina 8/28/05
Hurricane Katrina 8/29/05
Hurricane Katrina 8/30/05
Hurricane Katrina 8/30-31/05
Hurricane Katrina 8/31/05
Hurricane Katrina 8/31/05 - 9/1/05
Hurricane Katrina 9/1/05
Hurricane Katrina
Health and Human Rights in War and
Disaster (CHEs)
• All follow discernible patterns of onset and
escalation
• All precipitate forced migration
• All inflict suffering on individuals and civilian
populations
• All impose loss of family and community,
livelihoods, culture, history
Health and Human Rights in War and
Disaster (CHEs)
•
•
•
•
•
•
Dynamics differ greatly
But all are very difficult to stop once begun
All with significant health impacts
All laced with significant human rights violations
These impacts and violations are tightly linked
Emphasis must be on early prevention and
mitigation