1. Disaster Health Management: Role of NGOs in Disasters
Peter Leggat
Disaster Health Management: Role of NGOs in Disasters
Dr Peter A. Leggat
MD, PhD, DrPH, FAFPHM, FACTM, FACRRM
Associate Professor and Deputy Director
Anton Breinl Centre for Public Health and Tropical Medicine
James Cook University
Townsville, Australia
This lecture is one of a series produced for James Cook University, Australia. This lecture is used as part of their annual postgraduate course in disaster health management.

2. Peter Leggat
About the author
Dr Peter Leggat is co-ordinator of the postgraduate course in disaster and refugee health at James Cook University in Australia. He has also served on the World Safety Organization (WSO) Board of Directors from and from 2003-Present. He was Director General of the WSO from He is currently assisting with their terrorism and counter-disaster initiative. Dr Leggat undertook his studies in disaster health as part of his postgraduate studies in aeromedical evacuation at the University of Otago, New Zealand
Dr Peter Leggat is Associate Professor, Deputy Director and Academic Adviser, Anton Breinl Centre for Public Health and Tropical Medicine, James Cook University, Townsville, Australia, and Visiting Professor in the School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
His qualifications include:
MD (higher doctorate in medicine), University of Queensland, Australia
PhD (in occupational health), University of South Australia
DrPH (in travel medicine), James Cook University, Australia
Dr Leggat is a specialist in public health medicine and holds Fellowship of several professional organisations. He is a former Fulbright Scholar and also the recipient of the Surgeon General’s Medal (Australia) in 2002.
He has been a Board Member for the International Society of Travel Medicine ( ), the World Safety Organization ( , ; incl. Director-General ), and the Australasian College of Tropical Medicine (1991-Present; incl. President , ).

3. Peter Leggat
In this session, we will
Revisit the potpourri of NGOs definitions and acronyms
Examine some of the core values of NGOs and how NGOs operate
Gain some insight into new directions in accountability of NGOs
Examine the civil-military relationship
Appreciate how NGOs may fit into the disaster health management equation
This lecture will endeavour to address these objectives.

4. What are non-governmental organisations (NGOs)?
Peter Leggat
What are non-governmental organisations (NGOs)?
In the current context:
A civic or public advocacy organisation, which generates, transfers, or administers humanitarian and other aid (development / relief)
Generally, NGO's are organised as nonprofit corporations (charities)
Can be local or international (INGOs)
May work with or independent of government
Generally, do not include professional associations, businesses, and foundations
There are many definitions of non-governmental organizations (NGOs). This definition is given in the context of disaster health management. It is important to realize that organizations may relate to definitions other than that prescribed for NGOs, e.g. International Committee of the Red Cross (see

5. Examples of NGOs involved in disaster & humanitarian crisis response
Peter Leggat
Examples of NGOs involved in disaster & humanitarian crisis response
Care
MSF
Oxfam
Red Cross (not ICRC)
Save the Children
St John Ambulance
World Vision
These are some examples of some NGOs.

6. Who are the other players in disaster health management?
Peter Leggat
Who are the other players in disaster health management?
Government
National
State/Provincial
Local
United Nations
Donors
Hybrid organisations with own defined status
International Committee of the Red Cross (ICRC)
Apart from NGOs, there are a number of organizations that contribute to disaster health response. These include government, international organizations (United Nations), donors, and so-called hybrid organizations, such as the ICRC.

7. Related Acronyms CBO: Community-Based Organization
Peter Leggat
CBO: Community-Based Organization
CSO: Civil Society Organisation
DONGO: Donor-Organised Non-Governmental Organisation
GONGO: Government-Organized Non-Governmental Organisation
IO: International Organisation
NGDO: Non-Governmental Development Organisation
PDO: Private Development Organisation
PSO: Public Service Organisation
PVO: Private Voluntary Organisation
QUANGO: QUasi-Autonomous Non-Governmental Organisation
VO: Voluntary Organisation
For reference, these are some acronyms related to NGOs.

8. Peter Leggat
Every NGO is different and is governed largely by their own individual charter
It is important to realize that every NGO is different and are governed by their own charter.

9. How do they operate? NGOs vary greatly
Peter Leggat
How do they operate?
NGOs vary greatly
Organizational structure is similar to businesses
Usually non-rigid hierarchy; significant flexibility and authority at the field level
International NGOs often team up with local NGOs or have regional or local branches
NGO structure is often similar to that of a business and usually retain considerable flexibility in responding to disasters. NGOs may have international structures as well as local or regional structures, which can assist in their timely response.

10. Core values Neutrality Impartiality Independence
Peter Leggat
Neutrality
Aid will not be used to further a particular political or religious standpoint
Impartiality
Aid is given regardless of race, creed, or nationality
Aid is based on need alone
Independence
Aid agencies shall not act as instruments of government foreign policy
NGOs providing aid in disasters usually have the core values of neutrality, impartiality and independence.

11. Peter Leggat
Core values
Core values may impact on NGO’s willingness to work with other agencies
Even perception of value violation will be avoided
Such core values may contrast or conflict with core values of other groups involved with disaster health response.

12. What do they do? Operational verses Advocacy
Peter Leggat
What do they do?
Operational verses Advocacy
Grassroots, long-term projects, development work
Willing to work in high risk areas; not constrained by sovereignty
In theory, emphasis on sustainability
Full integration with local population
Good positioning for disaster response
NGOs are usually proficient in both advocacy and operational capability.

13. Peter Leggat
What do they do well?
Usually have excellent advocacy or lobbying capacity
Can fill gaps-specialised skills/capacity
Usually mobilise quickly
Often well connected at local level
Advocacy is important for fundraising and working with various groups and organizations involved in disaster health response. Those NGOs with local branches are usually well connected at the local level, which can assist greatly with timely response.

14. What don’t they do well? Can duplicate services Turf wars can erupt
Peter Leggat
What don’t they do well?
Can duplicate services
Turf wars can erupt
May step outside their areas of specialty
Often overcommit/overextend capacities
May not be so good at sustainability
NGOs can work beyond their means and capability, which is sometimes expected in times of disasters but may not lead to an optimal response.

15. Peter Leggat
The extent to which an NGO can contribute to any disaster relief operation is often dictated by context
The extent to which an NGO can contribute to any disaster relief operation is often dictated by context.

16. What is the context? How robust or resilient is the community?
Peter Leggat
How robust or resilient is the community?
Are there plans in place?
Are the roles clarified?
What voice does the NGO have? Are they recognised by other NGOs?
How are they funded?
What is the situation?
Who is there? What is their capacity?
Are their tensions between players?
How well are they recognised there?
What frameworks are in place on the ground?
These factors may contribute to the context, which may enhance or inhibit optimal and timely response in times of disasters.

17. Who pays them? Funding sources Perceptions are important
Peter Leggat
Funding sources
Private Donations (citizens, businesses and foundations)
International Organizations (UN)
National Governments
Perceptions are important
Importance of public relations and the Media
NGOs need funding. Some funding may be provided by government, but often funding comes from the private sector, particularly through specialized foundations and fund-raising arms of the NGO.

18. Where international assistance required in disasters
Peter Leggat
Where international assistance required in disasters
Donors also rely on NGOs, because of their access to the populations in need
And again, their access is dependent on their neutrality
NGOs, as implementing partners of donor organisations, are the legs on which disaster response stands
Likewise, donors require NGOs in order to provide the operational response to disasters.

19. Accountability How do we know that NGOs are doing the right thing?
Peter Leggat
Accountability
How do we know that NGOs are doing the right thing?
Who monitors NGOs?
As NGOs, especially international NGOs, tend to be outside of many government controls and official scrutiny, accountability can be issue.

20. Who monitors NGOs? Self-Regulation: NGO Standards
Peter Leggat
Who monitors NGOs?
Little External Monitoring
Self-Regulation: NGO Standards
Red Cross Code of Conduct
InterAction PVO Standards
Sphere Minimum Standards in Disaster Response
As there is little formal external monitoring of NGOs, several NGOs and related organizations, involved in disaster health response, have developed their own standards and codes of practice.

21. Sphere Project www.sphereproject.org Launched in 1997
Peter Leggat
Sphere Project
Launched in 1997
Humanitarian NGOs and related organizations, including Red Cross and Red Crescent movements
Three elements
Handbook
Collaboration
Expression of commitment to quality and accountability
The Sphere Project is one of these standards. Further information is available at URL:

22. Sphere Project www.sphereproject.org Includes
Peter Leggat
Sphere Project
Includes
Humanitarian Charter
Minimum standards in disaster response
One example of a standard to aspire to/be measured against
The Sphere project includes a Humanitarian Charter and minimum standards in disaster response.

23. NGO Culture Independent: need to cooperate Decentralised authority
Peter Leggat
NGO Culture
Independent: need to cooperate
Decentralised authority
On-the-job training (changing however)
Often develop a range of field guidelines, e.g. MSF, Red Cross
Hopefully develop long-term perspective
In addition, NGOs involved in disaster response develop their own doctrine, including a range of field guidelines to assist with maintaining a consistent and evidence-based response in the field.

24. How do NGOs coordinate? Australian Embassy team
Peter Leggat
Australian Embassy team
Other Government Agencies
UN Coordination Entities [UNHCR, WFP, UNDP, UNICEF, OCHA, Special Humanitarian Coordinator]
NGO-Only Coordination Bodies/Field-level coordination meetings
Host Government Ministries / Authorities
Civil-Military Cooperation or Operation Centres
It is important that NGOs co-ordinate with other agencies in the field so that they do not duplicate services in the field.

25. Zone of Collaboration/Coordination
Peter Leggat
Government
Military
UN/IOs
Host
Countries
NGOs
Religion
Business
NGOs must establish a zone of collaboration and co-ordination with all agencies involves with disaster response. It is very important to establish collaboration and co-ordination with local agencies of host nations.
Zone of Collaboration/Coordination

26. Civil-military cooperation
Peter Leggat
Most disasters and humanitarian emergencies do NOT involve the military
The need for civil-military cooperation may be the exception rather than the rule
However the logistic support provided by larger NGOs or the military in support of smaller NGOs can be invaluable
Although most disasters and humanitarian emergencies do not involve the military, some do, often because of the logistical support that the military can offer, particularly to NGOs that do not have significant logistical support.

27. Civil-Military Co-operation Services typically requested by NGOs
Peter Leggat
Civil-Military Co-operation Services typically requested by NGOs
Security Services
Landmine Locations
Security Briefings
Convoy Support
Guidance on Local Security
Technical Assistance
Access to Remote Areas, Ports, and Airfields
The military can provide a range of services to NGOs in the field, which would be otherwise quite difficult to source privately.

28. How effective are NGOs? What have they chosen to do?
Peter Leggat
How effective are NGOs?
What have they chosen to do?
What is their mandate
Do they add value?
What will the other players allow them to do?
How do you measure these? Are they accountable?
Although the effectiveness of NGOs response to disasters in the field is largely in their own hands, it is also determined in part to the extent to which they can collaborate and co-ordinate with other agencies.

29. Peter Leggat
The capacity of an NGO to contribute to disaster response depends on their own ability to
Define their role within the broad context of disaster health management,
Effectively communicate that role (are other players aware?), and
Ensure that they add value
The capacity of an NGO to contribute to disaster response depends on their own ability to define their role within the broad context of disaster health management; effectively communicate that role; and ensure that they add value.