In 2016, I was working at a UNHCR clinic in a refugee camp in South Beirut, Lebanon as a medical assistant. I remember throwing out suitcases full of donated medications, which were all outdated, or otherwise uselessbecause they were not addressing the health problems that we were seeing in the population. What good is a suitcase full of medications for rheumatoid arthritis if most of the patients being seen have diabetes? Why would we distribute cough drops when people really just need blankets? The problem is, when aid workers in the field look to the literature for guidance on the health needs of this population, there really is nothing to be found.
Nearly 13 million Syrians have been forcibly displaced after eight years of war and conflict in their country. No nation in recent decades has had such a large percentage of its population displaced [1]. Billions of dollars have been directed towards aid and resettlement of Syrian refugees, and hundreds of thousands of NGOs have organized to provide humanitarian assistance to the war-torn country [2]. But how effective are aid efforts when there is insufficient data to inform them?
There is a severe lack of rigorous academic studies in the Middle East and a paucity of data on the prevalence of various health issues and unmet healthcare needs. Such a dearth of data results in unguided clinical care and haphazard allocation of resources. This leads to dire mismatch between supply of health services and real-time needs of refugees. As a result, there are massive redundancies, futile efforts, and inefficient spending that leave the true needs of this population unidentified and exacerbates the ongoing humanitarian and public health crisis in the region.
Although there are numerous barriers to conducting research on the health of the refugee population, including barriers related to funding, logistics, and ethical considerations, one of the primary limitations continues to be the disconnection between the academic institutions and the humanitarian organizations. But this division is not restricted to the refugee crises; it plagues all kinds of health interventions in humanitarian crises, impairing the efficacy of humanitarian aid.
How can we mend the disconnect between evidence and action in the humanitarian sector? What we need is a linking institution that can fill in the void between the experience of field workers and the technical expertise of academia. A proper partnership would provide the opportunity for aid workers to propose research priorities and questions from the field, and link these workers to experts and researchers at universities. The organization would facilitate a strong collaboration between aid workers and university experts to design and implement research programs on the field questions. Interventions working on the ground would allow researchers to access field sites in order to conduct the research, while university review boards would lend ethics oversight of the research.
For academic institutions, the gain would come in the embodiment of high-impact research and academic publications, as well as the creation of new training opportunities for graduate students. For aid workers, academic-humanitarian collaborations would help progress best practices in the field, allowing their agencies to better fulfill their commitment to safeguarding the health and well-being of people afflicted by crises. The partnership must also be supported by other stakeholders. For instance, in the case of the Syrian refugee crisis, the Arab League should invest in such an organization. The United Nations could contribute by making an agency completely devoted to addressing this disjunction. Donors must acknowledge the importance of such a partnership and encourage its making.
Why does such a partnership not exist yet? Collaboration is not easy in practice. Humanitarian and academic communities operate along different timelines; the academic drive for robust methodologies and rigor in gathering and analyzing evidence can be slow, which can frustrate humanitarian organizations wanting clear operational recommendations to implement in their current humanitarian programs. Additionally, humanitarian and academic communities not only have different ethical codes, but also are assessed against different criteria.
Initiatives such as the Enhancing Learning and Research for Humanitarian Assistance(ELRHA) in the UK have emerged in recent years to overcome such challenges [3]. ELRHA is a collaborative network dedicated to supporting partnerships between higher education institutions and humanitarian organizations and partners around the world. One way ELRHA helps support collaboration is through their research matching process in which users can send in a request through the system for a humanitarian research partner; the request will be sent to the 300 academic members through e-alerts and will also be posted on the website. ELRHA then carries out a brokering process to help bring the right partners together.
Very few organizations like EHLRA exist. This type of work is just emerging, however, and there is a lot of potential to amplify activity and impact in this time of overwhelming global crisis. Productive partnerships between humanitarian organizations and academic research institutions are not only possible, but necessary.We all have a responsibility in supporting humanitarian crises.By strengthening such a collaboration, we can bring together great minds and efforts to improve the lives of the world’s most vulnerable populations.
- Diggle, E., et al., The role of public health information in assistance to populations living in opposition and contested areas of Syria, 2012–2014.Conflict and Health, 2017. 11(1): p. 33.
- Syria Complex Emergency – Fact Sheet #4 FY19 | March 15, 2019 | U.S. Agency for International Development [Internet]. 2019 [cited 2019 Nov 30]. Available from: https://www.usaid.gov/crisis/syria/fy19/fs4
- https://www.elrha.org/programme/humanitarian-innovation-fund/