The crises that will keep humanitarians up at night in 2019

Unhealthy situation.
Unhealthy situation.
Image: Reuters
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As the citizens of wealthy countries reckon with political and existential angst, tens of millions in the rest of the world are facing a far more precarious year ahead.

Earlier this week, the International Rescue Committee released a watchlist of countries where the risk of “humanitarian catastrophe” will loom largest in 2019. Many of crises on the US-based NGO’s list will be depressingly familiar even to readers who haven’t paid much attention to international news this year. Years- (and sometimes decades-) long disasters predominate, including manmade famine in Yemen; grinding domestic conflict in Afghanistan, Syria, and Somalia; and the return of Ebola, this time in the Democratic Republic of Congo.

Quartz spoke with David Miliband, IRC president and former UK foreign minister, about why the same disasters drag on, and what can be done.

IRC works on the ground in dozens of countries. What larger trends have you seen this year?

First of all, the increasing scale of crisis is rising around the world. Second, the duration of conflict is lengthening, and that is compounding the problem. You see new countries in IRC’s top ten list—Venezuela is obviously a new entrant—but most have been there for quite a long time.

Third, Iraq is no longer there, reflecting the relatively peaceful election held this year; that emphasizes the point that humanitarian aid is only part of the answer, and effective diplomacy is absolutely key.

Yemen is a high-profile crisis right now. Does last week’s announcement of ceasefire at the port of Hodeidah give you hope? 

The essential step is to get humanitarian aid flowing, but that’s only possible if the war is brought to an end. We welcome the announcement of a ceasefire withdrawal from Hodeidah, but unless the larger economy gets going, we’ll continue to face a very uphill struggle. And they have not announced the reopening of Sana’a airport, which is a real blow because it’s a key gateway for commercial traffic.

What did you see on your recent trip there? 

People are starving. At the time I was there in September, 40,000 malnourished children were waiting for hospital care, where there were no places [for them.]  In Sana’a and Aden we saw the chaos of war. We were struggling to maintain the supply of drugs. We saw the economy in the north really being strangled, with cars and trucks on the side of the road either waiting for gas or having run out of gas. This is a country that was poor and water-stressed before the war—now the war is strangling the country.

Why do you think this has gone on for so long? 

There has also been an evident reluctance to challenge the war—it was only 40 days ago that [US secretary of state Mike] Pompeo and [US secretary of defense Jim] Mattis called on all parties for a ceasefire. So there’s been a reluctance to challenge the Saudi-led coalition in its war strategy. And in that sense the people of Yemen have been the victims of global political gridlock.

Obviously there is a fear of Iranian influence or engagement and I’m afraid the war strategy has made this worse. The truth is that the war is not just morally misguided, it’s strategically perverse in its effects, because what we see on the ground is a strengthening of Iranian influence, a fragmentation of the governing forces, and the danger of radicalization of the population.

Is the long duration of the conflicts on IRC’s list historically unusual? 

Yes there’s a book by David Armitage called Civil Wars which shows that there aren’t just more civil wars than there were, but that the duration of civil wars has increased threefold in the second half of the 20th century and into this century.

Civil wars isn’t a very good name for them, as they’re not very civil. But the diplomatic tools that exist at the international level are much weaker for resolving wars within states, rather than wars between states. That’s not least because there’s a big philosophical division in the international community: Many governments, notably China and Russia, say that what goes on inside a country is the business of that country.

Considering the outcome of wars in Iraq and Afghanistan, there is considerable and reasonable reluctance to intervene in what are called internal affairs. But that just means that you’ve got a danger that conflicts run on and on.

Safe to say that the world’s powers are distracted?

I think they’re in retreat, and they’re in retreat for for two reasons: The humility that comes from interventions that don’t go well as intended, as was the case in Iraq and Afghanistan. People like me would say there was insufficient attention to building credible institutions that share political power, which is an absolute prerequisite for people to lay down arms and commit to using politics as a way to resolve difference.

The other reason is the 2008 financial crisis: Since then, pressure has been to focus on the home front rather than on foreign policy or diplomacy. The truth is that governments should be able to be effective diplomats abroad while fixing their infrastructure, education and healthcare at home. But there has been a dangerous lapse in the idea that because charity begins at home, it should end at home.

In an interdependent world, that’s a dangerous thing to do, not just morally but also for your interest.

What are you watching out for in Syria, in 2019?

Now that the government has taken over parts of the country, notably in the southwest around the Jordan border, there are three big issues in Syria from a humanitarian perspective in 2019:

The fate of 3.5 million people in Idlib, the northwest of Syra, where a standoff was agreed between Russian and Syrian forces which wanted to attack the province. The Turkish government prevailed on them not to do so for fear of the refugee flow and humanitarian danger would eventuate as a result.

In the northeast of the country, often called the Kurdish area, there was a flutter that US president Donald Trump wanted to withdraw troops. However, now that seems to have long-term commitment from the US, so its relative stability presents an opportunity to restore more normal life.

And what’s happening in the areas of the country controlled by Syrian president Bashar al-Assad, especially the areas that were previously under rebel control. What kind of services are being provided in those areas? We’re hearing from a range of people that there’s limited provision for the people who formerly lived under rebel control. And [IRC] has been blocked from working in those government-controlled parts of Syria.

The greatest needs are education, and what we call protection, which is the management of severe trauma and abuse for displaced people. There are about 1 million displaced people from other parts of Syria in Idlib; many have been moved multiple times from other parts of the country in the course of a seven-year war, and so many are in a terrible state.

The Ebola outbreak in the Democratic Republic of Congo doesn’t seem to have attracted nearly the attention that the 2014-2015 West Africa outbreak did. What are you seeing there?

The DRC was on our top ten list of countries to watch last year, but has moved up the table precisely because of the Ebola risk. There was a prompt response by the DRC government, World Health Organization and others, but we have never seen a situation like this: Ebola spreading in an active conflict zone makes this especially dangerous.

The WHO have said there’s a high risk of Ebola spreading nationally and regionally, which speaks to your point that it deserves far more attention than its got. I think it probably hasn’t been much covered in the US because people are consumed by political conflicts here. Because it’s a war zone, it’s much harder for journalists to get there, too.

However, we have also learned lessons from the Liberia and Sierra Leone outbreaks in 2015. Globally, in a paradoxical way, the fact that the lessons were learned from 2015 means that the disease hasn’t spread and created the same sense of alarm that would be in some ways justified by the risks.

Is there anything you see on this list as particularly dangerous for the rest of the world, in terms of exploding beyond a single country’s borders?

Venezuela I would highlight. I mean 2.5 million refugees, 1.2 million in Colombia. 1.3 in the rest of South America. That’s a tinderbox really. Colombia has been really open and supportive but that’s a big load to take on.

Also it’s important not to forget what’s happened in Myanmar, and its refugee flows into Bangladesh. Impunity for the kind of crimes clearly committed against the Rohingya has global, if not regional, significance.

The power of effective peace processes has been shown in Ethiopia and Eritrea, one of the biggest diplomatic breakthroughs in 2018: You could consider that a regional de-stressor next year.

What role do you see climate change and the environment playing into these crises? 

We see a lot of climate evidence as indirect cause of problems we’re dealing with. The environment is a stress multiplier in conflict situations.

I don’t talk a lot about climate refugees because people who move as a result of climate change often stay within their own countries. So they are climate IDPs [internal displaced persons] rather than crossing borders. But in many of the places where we see poverty and conflict, climate change is a reality and driver of stress, so I think it’s well worth raising.

Yemen is one of the first places that was forecast to run out of water. There’s also definitely a climate element in conflict in the Central African Republic, Ethiopia and Somalia. One of the big challenges for 2019 will be for people concerned about climate and humanitarian need to come together, as alarm rises on the climate front.

I’m always hopeful that more privileged people will realize that it makes sense to respond to these issues, as a matter of head as well as heart.