They Were Just Thrown Away, and Now the World is Spoiled

March 2013

In the aftermath of violence, proper treatment of the dead provides a vital consolation for survivors and their communities. This recognition of the bonds that tie the living to the dead has become a key feature of international human rights, encapsulated in the United Nations’ Basic Principles and Guidelines on the Right to a Remedy and Reparation for Victims of Gross Violations of International Human Rights Law and Serious Violations of International Humanitarian Law. But in the case of mass killings and mass graves, there may be no consensus on what “proper treatment” of the dead entails. Drawing on interviews conducted in 2011 with survivors and leaders from Barlonyo, Uganda – the site of a large-scale massacre perpetrated by the Lord’s Resistance Army in 2004 – this report analyzes how rapid cultural transformations have complicated what proper treatment of the dead entails, and, therefore, the right to satisfaction. By paying careful attention to how death and remembrance rituals have changed over time among the Langi, the report sets out to provide a set of recommendations based on community priorities for the treatment of those who have died as a result of mass violence; and, offer insights into the cultural context in which any future programming around the proper treatment and memorialization of those killed would be undertaken.

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The Use of Evidence in Humanitarian Decision Making

February 2013

This paper reports the results of a study undertaken during 2012 by Tufts University for the Assessment Capacities Project (ACAPS), as part of the latter’s “Operational Learning” strand of work. This study is designed to complement the work of ACAPS on strengthening needs assessment by addressing the question of how assessments and other sources of information and analysis are used by humanitarian decision makers. The study is based on a combination of literature review, case studies, and key informant interviews.

The pressure to demonstrate that responses and claims about impact are grounded in evidence has been growing over recent years. Humanitarian donors are increasingly under similar pressures to demonstrate effectiveness and account for impact. This is partly a matter of showing that their decisions regarding policies and programs are well-founded and evidence-based. But, humanitarian contexts are almost by definition ‘‘non-ideal” for gathering data. Decisions often have to be made quickly, sometimes with relatively little access to current information or accurate data. The question about informed decision making may therefore come down to what constitutes a “well enough” informed decision in the circumstances; or what constitutes “good enough” information and analysis on which to base a response. Whatever the quality of information, no assumption can be made that the increased availability of good information and analysis will in itself result in better informed decisions. In reviewing the way decisions are made in practice, the study considers the ways in which such information is used (or not) at different points in the process, which varies across different kinds of decisions in different contexts.

The study is based around three main questions. First, how do decision makers in the humanitarian sector currently use information and analysis? Second, what factors, other than information and analysis, are influential in making decisions? Third, what would enable better-informed response decisions? In order to address these overarching questions, the study looks first at some of the main processes of decision-making in the humanitarian sector and the factors that appear to have most influence on decisions of different kinds. It goes on to look at the way information and analysis is currently generated in the humanitarian sector—both through formal and informal means—and related questions of relevance and credibility. These two topics are then brought together in addressing the question of the use of information by decision makers, and what might enable more informed and evidence-based response decisions.

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Refugee Livelihoods in Urban Areas: Identifying Program Opportunities

February 2013

Refugees in urban areas face a specific set of livelihoods problems, and in recent years many aid agencies have begun to try to address these problems by supporting refugees through vocational training, microcredit and other services. So far, however, there has been little evidence about which humanitarian programs work, and where opportunities for programming interventions lie. This study, funded by the US State Department’s Bureau of Population, Refugees and Migration, addresses this knowledge gap. Through case studies in Cairo, Tel Aviv and Quito, we analyzed the urban livelihoods context for refugees and identified programming opportunities and promising program initiatives. In each city, we sought to generate new ideas from related fields of inquiry, such as low-income urban development and youth employment,that could be adapted for refugees in countries of first asylum.

Our three case studies represent contrasting refugee policy contexts and livelihoods experience, and offer lessons for other host settings. Each case study begins with a review of existing livelihood programs in the country. This includes a mapping of commercial, humanitarian and governmental organizations that provide programming, advocacy or other resources that support the livelihoods of refugees, migrants and low-income citizens. We then interviewed asylum seekers and key informants to deepen our understanding of the livelihoods context in each country. Our main program recommendations, based on all three cases, are included as a stand-alone document.

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Refugee Livelihoods in Urban Areas: Case Study Egypt

February 2013

Refugees in urban areas face a specific set of livelihoods problems, and in recent years many aid agencies have begun to try to address these problems by supporting refugees through vocational training, microcredit and other services. So far, however, there has been little evidence about which humanitarian programs work, and where opportunities for programming interventions lie. This study, funded by the US State Department’s Bureau of Population, Refugees and Migration, addresses this knowledge gap. Through case studies in Cairo, Tel Aviv and Quito, we analyzed the urban livelihoods context for refugees and identified programming opportunities and promising program initiatives. In each city, we sought to generate new ideas from related fields of inquiry, such as low-income urban development and youth employment,that could be adapted for refugees in countries of first asylum.

Our three case studies represent contrasting refugee policy contexts and livelihoods experience, and offer lessons for other host settings. Each case study begins with a review of existing livelihood programs in the country. This includes a mapping of commercial, humanitarian and governmental organizations that provide programming, advocacy or other resources that support the livelihoods of refugees, migrants and low-income citizens. We then interviewed asylum seekers and key informants to deepen our understanding of the livelihoods context in each country. Our main program recommendations, based on all three cases, are included as a stand-alone document.

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Refugee Livelihoods in Urban Areas: Case Study Ecuador

February 2013

Refugees in urban areas face a specific set of livelihoods problems, and in recent years many aid agencies have begun to try to address these problems by supporting refugees through vocational training, microcredit and other services. So far, however, there has been little evidence about which humanitarian programs work, and where opportunities for programming interventions lie. This study, funded by the US State Department’s Bureau of Population, Refugees and Migration, addresses this knowledge gap. Through case studies in Cairo, Tel Aviv and Quito, we analyzed the urban livelihoods context for refugees and identified programming opportunities and promising program initiatives. In each city, we sought to generate new ideas from related fields of inquiry, such as low-income urban development and youth employment,that could be adapted for refugees in countries of first asylum.

Our three case studies represent contrasting refugee policy contexts and livelihoods experience, and offer lessons for other host settings. Each case study begins with a review of existing livelihood programs in the country. This includes a mapping of commercial, humanitarian and governmental organizations that provide programming, advocacy or other resources that support the livelihoods of refugees, migrants and low-income citizens. We then interviewed asylum seekers and key informants to deepen our understanding of the livelihoods context in each country. Our main program recommendations, based on all three cases, are included as a stand-alone document.

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Refugee Livelihoods in Urban Areas: Case Study Israel

February 2013

Refugees in urban areas face a specific set of livelihoods problems, and in recent years many aid agencies have begun to try to address these problems by supporting refugees through vocational training, microcredit and other services. So far, however, there has been little evidence about which humanitarian programs work, and where opportunities for programming interventions lie. This study, funded by the US State Department’s Bureau of Population, Refugees and Migration, addresses this knowledge gap. Through case studies in Cairo, Tel Aviv and Quito, we analyzed the urban livelihoods context for refugees and identified programming opportunities and promising program initiatives. In each city, we sought to generate new ideas from related fields of inquiry, such as low-income urban development and youth employment,that could be adapted for refugees in countries of first asylum.

Our three case studies represent contrasting refugee policy contexts and livelihoods experience, and offer lessons for other host settings. Each case study begins with a review of existing livelihood programs in the country. This includes a mapping of commercial, humanitarian and governmental organizations that provide programming, advocacy or other resources that support the livelihoods of refugees, migrants and low-income citizens. We then interviewed asylum seekers and key informants to deepen our understanding of the livelihoods context in each country. Our main program recommendations, based on all three cases, are included as a stand-alone document.

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Food by Prescription

December 2012

Great strides have been made over the last 20 years in the long-term management of HIV infection in developing countries, resulting in improved immune function, reduced mortality, and prolonged survival. However, underlying malnutrition continues to impede positive health outcomes, and HIV infection in turn worsens malnutrition. The Ethiopia Food by Prescription (FBP) program, implemented by Save the Children US (SC US), USAID/Ethiopia, and the Ethiopian Ministry of Health since 2010, provides therapeutic food along with nutritional assessment and counseling to malnourished HIV+ individuals. The Tufts University Friedman School of Nutrition Science and Policy was contracted by SC US to research the effectiveness and cost-effectiveness of this intervention, in order to contribute much needed evidence to guide programming and policy, both in Ethiopia and worldwide.

Patients who received food were significantly more likely to recover from malnutrition than those who did not receive food, and treatment with supplementary food was much more successful, and more cost-effective, when malnourished individuals were identified and treated early. Additionally, patients who recovered through the addition of supplementary food experienced long-lasting positive effects on their health and nutrition status. While the marginal cost per patient recovered in the FBP program was high, the marginal cost of improving nutritional status by at least one BMI point was much lower—an important finding considering the link between weight loss and increased risk of mortality. In addition, our hypothetical costing models show that a focus on improving supply (health service delivery) and demand (client adherence, participation, compliance) would further strengthen the effectiveness and cost effectiveness of this strategy, and this study makes several recommendations as to how this might be done. In light of these results, the authors recommend that nutritional assessment counseling and support remains an integral component of ART programs in Ethiopia. The current (2008) version of the National Nutrition Program in Ethiopia supports the implementation of nutrition support for pre-ART/ART HIV/AIDS patients, and this should remain a priority in the 2012/13 version being developed by the Ministry of Health now.

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Afghanistan: Humanitarianism in Uncertain Times

December 2012

The Afghan crisis, now well into its fourth decade, has many layers. The military and political dimensions of the crisis grab the headlines. But the structural violence and poor governance that underpin it—grinding poverty, rampant abuse of power, criminalized economy, parlous condition of women and girls, poor access to health and other services—receives much less attention.

This report focuses on the lives and vulnerabilities of those affected by the crisis and on the attempts by local and international agencies to mitigate these vulnerabilities within the fraught and volatile Afghan context. It presents an analysis of the humanitarian situation on the ground and of the challenges and constraints faced by the humanitarian community in a fast-moving environment. Its conclusions point to urgent changes required to improve the response to a severe and deepening humanitarian crisis and to protect humanitarian agencies, to the extent possible, from overt politicization and manipulation.

In the context of the so-called “transition”— that is, the significant reduction of foreign troops and probable decrease in aid and international engagement in Afghanistan—it is important to take stock of the humanitarian situation and to review how humanitarian agencies are preparing for a future that is bound to be of great uncertainty and that might well result in an escalation of conflict, lawlessness, displacement, and humanitarian need.

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Tradition in Transition: Customary Authority in Karamoja, Uganda

November 2012

Customary authority in the Karamoja region of Uganda has undergone profound shifts in parallel to the changing livelihoods and security conditions in the region over the past several decades. This study, funded by Irish Aid Kampala, examines the evolution of customary authority among four population groups, the Jie, Dodoth, Matheniko and Tepeth. Overall the study finds that customary mechanisms have been slow to adapt to the changes in the region and have seen decreased influence over the day-to-day legal, economic, diplomatic and ritual affairs of local communities. Interrelated factors contributing to this decrease in influence include the loss of livestock in the region and the shift away from pastoral livelihoods; modern influences of education, migration and commoditization; the delay in succession of authority from one generation-set to the next; the rise in criminal behavior by young men; the erosion of external peacemaking by male elders; and the expanded reach of state institutions of governance.

Customary authority mechanisms do, however, continue to play an important role in the region and are often the preferred avenues for redress for specific complaints and violations. In particular, customary systems are seen as more transparent and more appropriate in their focus on compensation and the reconciliation of communal relations when compared to the official state law and order systems. This study examines the perceptions of male elders, male youth and women regarding the status of customary institutions within their community. The study also investigates the interaction between official and customary systems and offers recommendations for national and international actors working in the Karamoja region.

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Executive Summary of Tradition in Transition: Customary Authority in Karamoja, Uganda

November 2012

Customary authority in the Karamoja region of Uganda has undergone profound shifts in parallel to the changing livelihoods and security conditions in the region over the past several decades. This study, funded by Irish Aid Kampala, examines the evolution of customary authority among four population groups, the Jie, Dodoth, Matheniko and Tepeth. Overall the study finds that customary mechanisms have been slow to adapt to the changes in the region and have seen decreased influence over the day-to-day legal, economic, diplomatic and ritual affairs of local communities. Interrelated factors contributing to this decrease in influence include the loss of livestock in the region and the shift away from pastoral livelihoods; modern influences of education, migration and commoditization; the delay in succession of authority from one generation-set to the next; the rise in criminal behavior by young men; the erosion of external peacemaking by male elders; and the expanded reach of state institutions of governance.

Customary authority mechanisms do, however, continue to play an important role in the region and are often the preferred avenues for redress for specific complaints and violations. In particular, customary systems are seen as more transparent and more appropriate in their focus on compensation and the reconciliation of communal relations when compared to the official state law and order systems. This study examines the perceptions of male elders, male youth and women regarding the status of customary institutions within their community. The study also investigates the interaction between official and customary systems and offers recommendations for national and international actors working in the Karamoja region.

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