The international humanitarian aid system was designed to reduce suffering and loss of life in extraordinary circumstances through immediate and short-term interventions. In reality, however, situations of crises and insecurities have become the norm rather than the exception for the people in these environments. In protracted or recurring crises, continued short-term relief means applying a band-aid solution to a chronic disease. Instead, a more holistic, collaborative and long-term oriented approach that accommodates the immediacy of the initial response, is required. This factsheet explains why linking Relief, Rehabilitation and Development is challenging and presents principles to achieve greater humanitarian sustainability and effectiveness in water, sanitation and hygiene (WASH).
Humanitarian crises occur when human, material, economic or environmental impacts of natural or man-made disasters exceed the coping abilities of the affected community. People fight for survival in times of wrecked livelihoods, rampaging diseases, mass displacement and ever-limited supply of fundamental natural resources (JOHANNESSEN AND BIKABA 2009, JOHANNESSEN et al 2012, GEORGE 2014). In 2015, a record high 65 million people were forcefully displaced by armed conflicts, left vulnerable and in need for humanitarian assistance (UNITED NATIONS 2016, DEVELOPMENT INITIATIVES 2016).
The Middle East and Northern Africa (MENA) region is currently most affected by human displacement. Recent instabilities have caused the region’s largest crisis of forced migration since the First Arab-Israeli War in 1948. The situation has escalated into the highest level of humanitarian emergency as rated by the United Nations. In the Syrian conflict alone, an estimated 400,000 people were killed and another 11.8 million Syrians forcefully displaced (FDFA 2015, AL JAZEERA 2016, UNHCR 2016, UNICEF 2016; see The Humanitarian Crisis in the Middle East factsheet).
Provision of adequate access to Water, Sanitation and Hygiene (WASH) services presents one of the most pressing issues in response to sudden or protracted onsets of humanitarian crises to prevent dehydration and to reduce the risk of water-borne disease, diarrhoea, cholera and other epidemics (IOM 2017). Humanitarian WASH interventions are designed to ensure unrestricted access to sufficient and safe drinking water, to clean facilities for safe excreta disposal, waste management and bathing, as well as to hygiene items that reduce health threats. They also aim to encourage the affected communities to take up safe hygiene practices (IOM 2017).
Interventions typically include the set-up of Surface Water Treatment Systems (SWATs), extraction of groundwater from protected sources, water trucking, distribution of water purification / filtration items, training on Point-of-Use (POU) treatment methods, water quality monitoring, construction and maintenance of sanitation facilities, solid and liquid waste management, training of hygiene promoters, hygiene promotion communication campaigns and distribution of hygiene items (IOM 2017).
Depending on the ways they are delivered, WASH services can support or undermine future development of the region in crisis (UNITED NATIONS 2016). The international humanitarian system was designed to address exceptional circumstances: it aims to immediately reduce suffering and loss of life in challenging contexts shaped by ongoing violence and marked by a general lack of adequate resources. As KOPINAK (2013) sums it up, emergency relief «is fast-paced, reactive, short-term, focused on meeting immediate basic needs and preventing morbidity and mortality». Targeted at short-term impacts, humanitarian funding does not allow for long-term investments in services and capacities and links to fundamental objectives and sustainability considerations are often overlooked or postponed (DELMAIRE and PATINET 2012; MOSELLO ET AL 2016). Sanitation and water management, for instance, are often not considered a priority (compared to water supply) and aid agencies tend to implement well-known, short-term solutions for excreta containment, without considering long-term effects (JOHANNESSEN et al 2012).
In reality, however, situations of crises and insecurities have become the norm for the people in these environments rather than an exceptional circumstance. In these protracted or recurring crises, continued short-term relief means applying a band-aid solution to a chronic disease (GEORGIEVA AND BRENDE 2015). Additionally, the phases of relief, rehabilitation and development often move unpredictably, in opposite directions and in an overlapping manner rather than following each other in a linear sequence. This causes the fundamentally different assumptions, values, core missions and ways of working of the humanitarian and the development communities to collide. Humanitarian actors are faced with a critical trade-off between addressing urgent humanitarian needs and promoting sustainable development in a long-term and multi-dimensional approach, considering and addressing a broad range of complex parameters and factors in long project cycles and by using elaborate monitoring and reporting mechanisms (KOPINAK 2013, MOSELLO ET AL 2016). Neglecting either of the two adversely impacts on aid effectiveness and weakens the life-saving prerogative of humanitarian interventions (MC LARNAN 2012, GEORGE 2014).
There is a widespread awareness that the trade-off between the concepts must be overcome and that the respective principles and practices must be aligned to form a contiguum, where better development reduces the need for emergency relief, better relief contributes to development and better rehabilitation eases the transition between the two (EUROPEAN COMMISSION 1996 cit. in KOPINAK 2013). The goal is to steer humanitarian aid towards the implementation of sustainable solutions without compromising too much on the immediacy of the intervention (JOHANNESSEN AND BIKABA 2009, MOSELLO ET AL 2016). UNEP and OCHA (2014) go as far as describing the consideration of sustainability criteria a «humanitarian responsibility».
Translating the theory of «Linking Relief, Rehabilitation and Development” (LRRD) into practice is albeit difficult, as the transition at the most appropriate stage requires knowledge and skills on the policy, operations and funding level to flexibly adapt to the particular context. Things are complicated by the often siloed and project-based thinking of donors that lack the necessary understanding of or attention to the bigger picture and lead to «stop-go» services that are inconsistent with the comprehensive and transitional model of LRRD (KOPINAK 2013). The reluctance of international donors to invest in long-term facilities is partly caused by the general instability and uncertainty regarding the length of time that camps exist. The high turnover of management staff within humanitarian organisations complicate the situation further (DELMAIRE and PATINET 2012). Additionally, there are frequent failures in programme design (such as an insufficient analysis of the local situation, culture and capacities, inadequate consultation, a lack of a clear transition and exit strategy as well as inadequate resource allocation to operation and maintenance) that hamper smooth transitions and sustainable solutions (KOPINAK 2013, JOHANNESSEN et al 2012).
In a period where the prevailing development agenda calls for a comprehensive, holistic and interlinked approach that “leaves no-one behind”, meeting the basic needs is no longer enough. Instead, the actors on the international, national and local level working in fields of development, climate change, gender equality or peace building are required to collaborate and together work towards reducing vulnerabilities and addressing the root causes of conflicts and crises (UNITED NATIONS 2016). The long-term nature of contemporary humanitarian crises requires humanitarian actors to adopt new roles (such as addressing prolonged displacements, filling gaps in social safety nets, dealing with changing levels and natures of violence and hazards, promoting preparedness as well as coping with urbanisation trends) (UNITED NATIONS 2016).
According to the United Nations (2016), greater humanitarian effectiveness requires five overarching shifts in mindset and practice:
While these considerations are valid for any type of humanitarian intervention, the cognitive shift towards a model that strengthens response and adapts to anticipate future disasters must also penetrate humanitarian WASH interventions. Owing to the specific contexts of humanitarian crises (which each present different challenges and opportunities that require specific skills and capacities), a silver bullet solution for planning sustainable sanitation and water management interventions does not exist. However, the International Organisation for Migration (IOM 2017) recommends the following principles to achieve humanitarian sustainability and effectiveness in WASH and for ensuring that the systems remain functional in the long-term and that they are robust enough to buffer against changing environments (UNEP and OCHA 2014, JOHANNESSEN AND BIKABA 2009, JOHANNESSEN et al 2012):
Market-based programming (provision of vouchers or cash-transfers instead of traditional bulk purchase and distribution) is increasingly seen as an effective response to address the needs of the affected people. Drawing upon local markets to deliver assistance can complement development interventions, as well as existing social protection systems in middle-income countries like in the Middle East. Market-based programming in the humanitarian WASH sector is still in its infancy and more empirical evidence that illustrates effectiveness is required. The specific needs of the affected population, as well as intra-household dynamics and local market conditions must be well understood for such interventions to be functional and adequate (CATHOLIC RELIEF SERVICES ET AL 2016).
The present toolbox compiles approaches and methodologies that can help field practitioners in humanitarian aid to enhance the effectiveness and sustainability of their water, sanitation and health interventions. This includes appropriate sanitation options, viable solutions for water supply and purification, planning tools that support a more long-term perspective, as well as approaches for hygiene promotion.
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ALJAZEERA (2016): Syria death toll: UN envoy estimates 400,000 killed. Doha: Aljazeera. URL [Accessed: 01.11.2016].
CATHOLIF RELIEF SERVICES; DEUTSCHE GESELLSCHAFT FÜR INTERNATIONALE ZUSAMMENARBEIT; EUROPEAN COMMISSION DIRECTORATE GENERAL FOR HUMANITARIAN AID AND CIVIL PROTECTION; GERMAN FEDERAL DEPARTMENT OF FOREIGN AFFAIRS; SWISS FEDERAL DEPARTMENT OF FOREIGN AFFAIRS; GERMAN WASH NETWORK; GLOBAL WASH CLUSTER; OXFAM AND SUSTAINABLE SANITATION ALLIANCE (2016): Opportunities of Market-Based Programming to Address Humanitarian WASH needs. 2016 World Water Week Programme. Stockholm: Stockholm International Water Insitute. URL [Accessed: 23.02.2017].
DELMAIRE, A.; PATINET, J. (2012): Humanitarian Crises and Sustainability Sanitation. Lessons From Eastern Chad. In: Humanitarian Aid on the Move. Plaisians: URD Groupe. URL [Accessed: 09.02.2017]. PDF
GEORGE, M. (2014): Shaping the future of aid effectiveness by mainstreaming environmental sustainability. London: Overseas Development Institute, Humanitarian Practice Network. URL [Accessed: 09.02.2016].
GEORGIEVA, K.; BRENDE, B. (2015): The growing need for humanitarian aid means we must find a new approach to development. London: The Guardian Global development professionals network. URL [Accessed: 09.02.2017].
JOHANNESSEN, A.; PATINET, J.; CARTER, W.; LAMB, J. (2012): Sustainable sanitation for emergencies and reconstruction situations. April 2012. Eschborn: Secretariat of the Sustainable Sanitation Alliance. URL [Accessed: 22.02.2017]. PDF
JOHANNESSEN, A.; BIKABA, D. (2009): Sustainable Sanitation for Emergencies and Reconstruction Situations - Factsheet of Working Group 8 (draft). Eschborn: Sustainable Sanitation Alliance SuSanA. URL [Accessed: 23.04.2012]. PDF
KOPINAK, J.K. (2013): Humanitarian Aid: Are Effectiveness and Sustainability Impossible Dreams?. In: The Journal of Humanitarian Assistance, Field experience and current research on humanitarian action and policy. Bradford: University of Bradford. URL [Accessed: 09.02.2017].
MC LARNAN, L. (2012): Balancing Humanitarian Aid and Sustainable Development. In: Chicago policy review. Chicago: University of Chicago. URL [Accessed: 09.02.2017].
MOSELLO, B.; MASON, N.; ALUDRA, R. (2016): Improving WASH service delivery in protracted crises. The case of South Sudan. London: Overseas Development Institute ODI. URL [Accessed: 16.02.2017]. PDF
SUDETIC, B. (2017): Water Scarcity Will Exacerbate Humanitarian Crises in the Middle East. 02.21.2016. New York: Huffington Post. URL [Accessed: 22.02.2017].
SWISS RED CROSS (2010): Concept on LRRD Linking Relief, Rehabilitation and Development. Bern: Swiss Red Cross. URL [Accessed: 06.02.2017]. PDF
UNEP; OCHA (2014): Environment and humanitarian action. Increasing effectiveness, sustainability and accountabily. Geneva: Joint UNEF/OCHA Environment Unit, OCHA Emergency Services Branch. URL [Accessed: 09.02.2017]. PDF
UNHCR (2016): Syrian Refugees – Iraq. Humanitarian Inter-Agency Interventions. Information Kit No. 15. Geneva: United Nations High Commission for Refugees. URL [Accessed: 10.08.2016]. PDF
UNICEF (2016): Syrian Crisis. September 2016. Humanitarian Results. Geneva: UNICEF. URL [Accessed: 01.11.2016]. PDF
UNITED NATIONS (2016): Leaving no one behind. Humanitarian effectiveness in the age of the sustainable development goals. Geneva: United Nations Office for the Coordination of Humanitarian Affairs. URL [Accessed: 16.02.2016]. PDF
BANZET, A.; BOUSQUET, C.; BOYER, B.; DE GEOFFROY, A.; GRUENEWALD, F.; KAUFFMANN, D.; PASCAL, P.; RIVIERE, N. (2007): Linking relief, rehabilitation and development in Afghanistan to improve aid effectiveness: Main successes and challenges ahead. Plaisians: URD Groupe. URL [Accessed: 16.02.2017]. PDF
This report contains 5 papers on the main findings on Linking Relief, Rehabilitation and Development in Afghanistan for the following sectors: urban, water/irrigation, agriculture, nutrition, health and education. The last part of the report is dedicated to a multi-sector paper with the main issues at stake.
CATHOLIC RELIEF SERVICES (2017): Operations Guidance for Cash Based Programming. Emergency Capacity Strengthening Catalogue. Emergency Capacity Strengthening Catalogue. Baltimore: Catholic Relief Services. URL [Accessed: 23.02.2017].
The Emergency Capacity Strengthening Catalogue provides staff with access to all relevant emergency capacity strengthening training materials, tool, and resources. It includes tools and approaches for marked-based programming, including risk assessment checklists, guidance for beneficiary and vendor selection, guidance for handling vouchers and payments etc.
DIMARZIO, N. (2013): The Humanitarian Response to the Middle East Refugee Crisis. Brooklyn: Diocese of Brooklyn. URL [Accessed: 21.09.2016]. PDF
The violence in Syria has contributed to the mass displacement of the civilian population of that country. In the two years since the conflict began, at least two million persons and possibly a far larger number have been forced to flee to surrounding nations in search of safety and another 4.5 million have been displaced internally. The internally displaced are particularly vulnerable, given that they are stuck in the midst of the conflict and at the mercy of combatants on both sides. While international aid organizations remain active in parts of Syria, providing to resources to displaced populations is an immense challenge.
EUROPEAN COMMISSION (2014): Water, Sanitation and Hygiene. Meeting the challenge of rapidly increasing humanitarian needs in WASH. DG ECHO Thematic Policy No.2. Brussels: European Commission. URL [Accessed: 31.10.2016]. PDF
This thematic policy document provides information on meeting the challenges of rapidly increasing humanitarian needs. It provides information on basic principles of humanitarian response, emergency response and preparedness and response in acute, post-acute, protracted, and chronic crises, key determinants for interactions, guidance on coordination, advocacy, decision trees, and technical guidelines. It provides various insights on operations and maintenance planning for humanitarian crisis needs. The EC humanitarian WASH assistance follows the following objectives: 1) To ensure timely and dignified access to sufficient and safe WASH services for populations threatened by on-going, imminent or future humanitarian crises, and to increase their resilience to withstand water stress and shocks. 2) To implement measures to prevent the spread of WASH related diseases in populations threatened by on-going, imminent or future humanitarian crises. 3) To enhance the impact, relevance, efficiency and effectiveness in the delivery of WASH assistance by strengthening the capacities of the humanitarian aid system, including its coordination mechanism.
PUERTO COMEZ, M.; CHRISTENSEN, A.; YEHDEGO ARAYA, Y.. (2011): The Impacts of Refugees on Neighbouring Countries: A Development Challenge. World Development Report 2011. Washington, D.C.: The World Bank. URL [Accessed: 20.09.2016]. PDF
This report shows the distribution of refugees in asylum countries using a series of graphs and tables which highlight the fact that the largest percentage of refugees are found in countries neighbouring their country of origin, most of which are middle-income countries. However, in some of these middle- income host countries, refugees are located in low-income and fragile border regions. The second section discusses how neighbouring countries that host refugees for protracted periods experience long-term economic, social, political, and environmental impacts. The study has two main sections. The first section describes trends in distribution of refugees in asylum countries whereas the second section discusses how neighbouring countries that host refugees for protracted periods experience economic, social, political, and environmental impacts. The brief lastly discusses examples of global experience of development interventions that have focused on mitigating the negative impacts of large-scale and protracted displacement.
The UNHCR Emergency Handbook is the 4th edition of UNHCR’s Handbook for Emergencies, first published in 1982. This digital edition is primarily a tool for UNHCR emergency operations and its workforce. It contains entries structured along seven main topic areas: Getting Ready, Protecting and Empowering, Delivering the Response, Leading and Coordinating, Staff Well-Being, Security and Media.
SWISS RED CROSS (2010): Concept on LRRD Linking Relief, Rehabilitation and Development. Bern: Swiss Red Cross. URL [Accessed: 06.02.2017]. PDF
This document establishes the frame of reference for the systematic incorporation of the LRRD approach into the Swiss Red Cross (SRC)’s humanitarian aid operations, its re-construction/rehabilitation activities and its development cooperation programmes, and supplements their specific strategic- conceptual foundations. The concept is the outcome of broadly supported SRC internal processes and provides SRC international cooperation staff with guidelines for planning and implementing the LRRD approach in programmes. It also serves as a basis for dialogue within the International Red Cross and Red Crescent Movement and with partner organisations, authorities and other interested institutions.
www.ecompendium.sswm.info [Accessed: 22.02.2017]
This is the interactive version of the Compendium of Sanitation Systems and Technologies by TILLEY ET AL (2014), a compilation of appropriate sanitation technologies, plus a tool for combining technologies in a full system. The compendium’s popularity is due to its brevity - ordering and structuring a huge range of information on tried and tested technologies in a single document. As in the first edition only proven technologies that are appropriate for low- and middle-income settings are presented. Also, only "improved" sanitation technologies, featuring safe, hygienic, and accessible sanitation are included. The whole range of urban, peri-urban and rural technologies (e.g. from simple pits to conventional sewers) is presented in the eCompendium.
Humanitarian information source on global crises and disasters. It is a specialised digital service of the UN Office for the Coordination of Humanitarian Affairs (OCHA). It provides reliable and timely information for humanitarian workers to make timely decisions to plan an effective response.
www.emergency.unhcr.org [Accessed: 16.08.2016]
The UNHCR Emergency Handbook is the 4th edition of UNHCR’s Handbook for Emergencies, first published in 1982. This digital edition is primarily a tool for UNHCR emergency operations and its workforce. It contains entries structured along seven main topic areas: 1) getting ready, 2) protecting and empowering, 3) delivering the response, 4) leading and coordinating, 5) staff well-being, 6) security and 7) media.
www.unocha.org [Accessed: 19.09.2016]
United Nations Office for the Coordination of Humanitarian Affairs (OCHA) is the part of the United Nations Secretariat responsible for bringing together humanitarian actors to ensure a coherent response to emergencies. OCHA also ensures there is a framework within which each actor can contribute to the overall response effor