Thirty years ago, few people could have identified a humanitarian aid organization other than the International Committee of the Red Cross. Today, humanitarian organizations like the International Rescue Committee, Save the Children, and the Paris-based Doctors Without Borders have become household names to millions of people in Western Europe and a growing number in the United States.

In Europe, humanitarianism, as Francois Jean, a leading official at Doctors Without Borders, has remarked, "occupies a central place." The contemporary form of humanitarianism, although the brainchild of left-wing French intellectuals of the May 1968 generation, has become so mainstream that France has a junior minister for humanitarian affairs. Things have proceeded more slowly in the United States, where humanitarian organizations have tended to rely on their ties to the State Department and the Agency for International Development (aid) more than their ability to mobilize the general public.

Nonetheless, even if most Americans are not ready to accept that there is a "right" to humanitarian intervention in extreme cases, as Doctors Without Borders claims, aid organizations have captured the public imagination. Here are people engaged in an activity that is wholly admirable, and that one need not view skeptically. Even in the last Congress, where the pressure to cut the foreign aid budget and the State Department's allocations for consular offices was fanatical, appropriations for the Office of Foreign Disaster Assistance sailed through with bipartisan support. As a bitter State Department official in Rwanda recently told me, "There is money for weapons, and money for starving refugees, and that's about it."

Small wonder, then, that over the past two decades the established aid agencies have grown enormously, and new agencies, some no bigger than a half-dozen people -- there are no licensing requirements -- have proliferated. In 1982, 144 humanitarian aid agencies were registered with aid; 12 years later, the number had grown to 419. As the British journalist and observer of disaster relief operations Lindsey Hilsum wrote in 1995, "the emergency aid business" grew from "a small element in the larger package of development into a giant, global, unregulated industry worth 2,500 million pounds sterling a year. Most of that money is provided by governments, the European Union, and the United Nations."

Hilsum's comments are quoted by Michael Maren in his new book. Maren is a former Peace Corps volunteer in Kenya and aid official in Somalia. His book, although rhetorically over-the-top at times, is an invaluable corrective to the hagiographical accounts of humanitarian aid operations that have been the norm for the past decade. There are sound practical reasons why this has been so. The sites of disaster are difficult to get to, more difficult still to work in, and hardest of all to understand. The press' admiration for aid workers has been genuine and warranted. But there is no use denying that for the press corps, with the exception of the richest newspapers and television networks who can hire their own vehicles and translators, the international aid organizations have shaped coverage of their own stories. Whether it was in Mogadishu, Sarajevo, or Goma, more often than not print and television journalists turned to a member of a humanitarian nongovernmental organization (NGO) for the story on the ground -- not to mention transportation, lodging, and companionship. The situation is not all that different from the American media and the U.S. military in the early days in Vietnam before the reporters turned against the war.

As a result, the aid agencies' version of a story has often been the one transmitted from the field. Some agencies, Doctors Without Borders being the most accomplished, have become masters of spinning the story of an event to influence public opinion at home. "NGOs need nothing more than publicity," Maren writes, adding unfairly that "their prime interest is in reaching their customers, the donating public." Humanitarianism is a business, as Maren correctly points out, but for most humanitarian aid workers, their "customers," if they even see them as such, are the people they are trying to help.


Maren writes with the fury and disillusionment of intimacy. He knows from the inside how corrupt and self-serving humanitarian organizations can be. But like all jeremiads, The Road to Hell, devastating and enlightening though it is, oversimplifies the problem. For example, Maren calls what happened in Rwanda in 1994 a "relief circus." No doubt he is right. Anyone who saw, as I did, the grotesque display of humanitarian agencies' flags flapping alongside each other in eastern Zaire like so many corporate flags in some business park in Purchase, New York, or San Jose, California, realized there was more going on than the simple desire to help. The struggle to stamp out cholera, get the shelters built, and dig the pit latrines was simultaneously a struggle for market share.

In Rwanda in the summer of 1994, as Maren notes, the humanitarians descended en masse, whether or not there was something useful for them to do. Aid workers in Rwanda asserted that the headquarters of several of the most established aid organizations overruled their recommendations not to intervene, insisting that if they were not involved, fundraising would be hopelessly compromised. Most aid organizations now admit that there was far too much duplication of effort and that many agencies performed poorly. The Rwandan government expelled a number of agencies in December 1995, although the fact that those agencies were French, and viewed by the new authorities in Kigali as politically hostile, played as important a role as questions of competence.

Maren is on solid ground when he insists that such dereliction was common. From country-level directors in the field to senior staff in Atlanta, New York, Oxford, or Paris, the pressure to find funding is enormous. Without a donor, whether that donor is a national government, a U.N. agency, aid, or the European Commission Humanitarian Office, virtually all relief agencies would close down. Of the major agencies, only a few retain some real independence. The French branch of Doctors Without Borders continues to receive more than 50 percent of its donations from individual private contributors. And Catholic Relief Services, though it receives considerable U.S. government funding, is able to operate with exceptional latitude because it is substantially underwritten by the American Catholic Church.

But for most agencies, in both the United States and Europe, institutional grants pay for almost everything: salaries, vehicles, housing, and project costs. Agencies boast that they allocate very little to overhead, but what they mean by overhead is usually the cost of running their headquarters. Some groups have small discretionary funds for launching pilot projects, but they are rarely large enough to obviate the need for aid groups to solicit funds through advertising. And sometimes their haste to do so is, to put it kindly, unseemly.

A telling example was the recent decision by the British branch of Save the Children to launch an appeal for Rwandan refugees in Zaire at a time when their fate, and, by extension, what role the aid agencies would play, was unclear. Nonetheless, Save the Children ran an advertisement with a photograph of a pathetic-looking African child that read in part: "Zaire: Desperate children need your help." That was doubtlessly true. But the ad continued, "Save the Children is able to help these children. We are providing high protein biscuits, medical supplies, and blankets to help save lives." That may have been the agency's intention, but when the ad ran in the British press the children in question had been cut off from aid for weeks, and it was by no means clear when or if that would change.

It is this sort of pious hyperbole, what Maren calls "exploitation of children for fundraising," that provokes his indignation. Right or wrong, the agencies usually get away with it, although recently the Rwandan government expelled a European agency for using a pathetic photograph of a Rwandan child in one of its campaigns without first consulting the Kigali authorities. The agency's officials were flabbergasted. No "beneficiary" country had ever dared demand that kind of respect. But then, the experience of Rwanda has been chastening for many agencies, not only because the government has kept the NGOs on a short leash, but because it became apparent that humanitarian intervention in the absence of a political solution solves nothing.

In eastern Zaire, the aid agencies found themselves in the position of feeding not only innocent refugee women and children, but their sons, fathers, brothers, and husbands, many of whom had participated in the 1994 genocide. The aid allowed those loyal to the old regime to survive, regroup, and launch guerrilla attacks from the refugee camps into Rwanda. This realization caused a number of agencies, notably the French branch of Doctors Without Borders and the International Rescue Committee, to withdraw in early 1995. But while courageous, this withdrawal was little more than a symbolic gesture; other agencies, including other national branches of Doctors Without Borders, were more than willing to fill the "vacancy" left by the departing NGOs. No better proof exists of how delivering humanitarian aid has become a business.

That lesson was driven home last October, when the Rwandan government first orchestrated a guerrilla uprising in the Zairean provinces where refugee camps were located. The aid agencies had been providing the camps between 8,000-9,000 tons of food per month since 1994. As the refugees were driven out, a spokeswoman for the World Food Program warned that more than 150,000 refugees, including 80,000 children, could die within the month. The head of one refugee advocacy group assured a Washington audience in early November that at least 1,200 people were dying every day.

That same week, Alex de Waal, co-director of Africa Rights, a London-based advocacy group, wrote presciently that in Africa people "never, never die in the numbers predicted by the aid agencies." As it happened, when the refugees finally did begin to move by the hundreds of thousands, U.N. and NGO officials conceded that they were in remarkably good shape. It is extremely difficult to estimate how many people will die during an emergency or even establish how many died after it has ended. But few NGO representatives are willing to admit as much publicly. An exception is H. Roy Williams of the International Rescue Committee, a man who has probably thought more deeply about humanitarian relief than any other senior American aid official. During the run-up to the intervention in Somalia, Williams told a Washington Post reporter, "I don't think anyone has a clue how many people have died."


Maren's book went to press before the events in eastern Zaire played themselves out, but they only buttress his argument. In The Road to Hell, he writes eloquently of our "sensory confusion," engendered partly by television's sentimental depictions and partly by the fact that since the end of the Cold War most people do not really know how to think about international affairs. In this context, humanitarianism's appeal is obvious. The humanitarians act in our stead, and we have the satisfaction of feeling that humanitarian aid remains an effective response in a world where every gesture seems compromised.

This is the world viewed as a morality play. There are people in need, people from abroad who want to help (and need funding to do so), and the thugs and militia bosses who have caused the suffering in the first place. As President Clinton said when he finally announced that the United States would join the multinational humanitarian military mission in Zaire, "The world's most powerful nation must not turn its back on so many desperate people and innocent children who are now at risk."

In reality, the United States seems to have acted in response to pressure from governments, advocacy groups, and an intensifying media focus. Maren argues that the same pressure drove the humanitarian efforts in Ethiopia and Somalia. In Somalia, too, apocalyptic death tolls were predicted by the U.N. and aid agencies, and American television nightly showed scenes of despair and lawlessness in the streets of Mogadishu. Senator Nancy Kassebaum (R-Kan.) visited the region, as did Bernard Kouchner, then French minister of humanitarian affairs. The media attention eventually forced President Bush's hand.

Maren is not alone in suggesting that the death toll in Somalia was exaggerated, and that, by the time the intervention was under way, the mortality rate from famine and disease was already declining. He is an expert debunker. Yet while The Road To Hell is a useful antidote to the hyperboles of humanitarian aid, the flaws he discerns are not as damning as he imagines. In his obsession with examples of waste, graft, and misrepresentation, there is something of the Pentagon whistleblower's inability to see that although an arms procurement program is corrupt, it does not make weapons systems any less necessary.


The presence of humanitarian aid workers has meant the difference between life and death for tens of thousands of people. Would it have been better if the International Rescue Committee, say, had not restored the electrical system of Sarajevo? I saw the project, which took two years and was accomplished in circumstances of great danger, transform the lives of the people there. Would it have been better if the U.S. military had not been involved in the Goma refugee camps in Zaire in 1994, when the cholera epidemic was at its height? It hardly seems likely, although, as Rony Brauman, one of the founders of Doctors Without Borders, has argued, it might then have been preferable for the aid agencies to withdraw en masse, rather than stay on in part for the entrepreneurial reasons Maren excoriates.

What excites Maren's ire is the gap between what the humanitarians claim they accomplish and what they actually do. There certainly are scoundrels in the NGO world, though surely no more than in medicine, law, or other professions. Indeed, it could be argued that in a culture as besotted with money as ours, people who are willing to shelve their careers or perhaps even briefly defer them by serving a short stint doing sanitation work somewhere in Africa are nothing less than remarkable. Most Americans or Western Europeans cannot imagine visiting Burundi or Tajikistan, let alone living there in circumstances that may be privileged by local standards, but are hardly comparable to the lifestyle they could enjoy at home.

My own experience is that while relief workers are too often woefully ignorant of the history and culture of the places in which they work, their dedication and wish to contribute something of value is genuine. That does not mean humanitarianism is the panacea that some of its advocates claim, nor that humanitarian interventions in what are essentially political crises are always wise. The tendency, which Maren identifies, of humanitarian aid agencies to campaign for military intervention is one of the most worrying developments on the international political scene. The idea that troops should be sent to protect relief workers wherever people are dying can lead only to more Somalias or to a kind of Group of Seven military takeover of failed states. Neither is practical or desirable unless one wants to reproduce the entire experience of nineteenth-century colonialism, which, it should be recalled, was also often justified on humanitarian grounds.


This is not to question the basic value of the humanitarian exercise. If there is a profound critique of humanitarianism to be made, it revolves less around the points that absorb Maren and more around H. Roy Williams' compelling insight that the dilemma for humanitarian relief organizations is that they "have no idea how to match our material means to our moral and emotional aspirations." Maren is right to remind us how far the humanitarian organizations have overreached, but in fairness to them, this fact already pervades their own internal debates. Indeed, in France these debates are public, and there is much talk within Doctors Without Borders and other NGOs of the "humanitarian alibi" -- the misuse of the humanitarian idea and humanitarian workers by governments eager to do as little as possible in economically unpromising regions like sub-Saharan Africa.

There are those who believe, and there are moments in The Road To Hell when it seems like Maren may be among them, that the world would be better off without the fig leaf that modern humanitarianism increasingly provides, with the humanitarians serving as our designated consciences. Perhaps. But it is at least as likely that nothing positive would replace the humanitarian system, however flawed and, in some cases, destructive it can be. The dilemma is real, and there is no clear answer. Perhaps the real problem with modern humanitarianism is that it has exceeded its limits, and that, with all its talk of the right of intervention, its campaigning for military deployments, and its indulgence in the worst kind of disaster pornography in advertising campaigns, it needs to become more modest in its ambitions and expectations. A remark by a delegate of the International Committee of the Red Cross in Bosnia in 1993 is worth recalling here. The mission of the Red Cross, he said, is "to bring a measure of humanity, always insufficient, into situations that should not exist."

If West European and North American humanitarians could reliably provide that measure of humanity, they would already have accomplished a great deal. The engaged humanitarianism of the past 25 years is an attempt to go beyond the Red Cross' mission. The French tradition, exemplified by Doctors Without Borders, is an example. The Red Cross is hardly without its faults. During World War II, its tradition of discretion and its refusal to imperil its other activities prevented the organization from going public with information about German death camps. Nonetheless, its ideals and commitment remain coherent. It is doubtful that NGOs that depend on governments for their funding can aspire to the Red Cross' strict neutrality. Perhaps, after a long period of untrammeled growth, aid agencies now need to take a more cautious approach and realistically reassess what they can and cannot accomplish.

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  • David Rieff is a Senior Fellow of the World Policy Institute at the New School for Social Research. He is currently writing a book on humanitarian aid.
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