Humanitarians in the Frontline: The protection sector in the COVID-19 humanitarian response

It’s no longer business as usual for protection officers on the frontline of humanitarian responses. Protection officers work across the humanitarian system to enhance the human rights, safety and dignity of displaced people and other populations of concern. Responses to the COVID-19 crisis will affect the many projects they lead – from refugee protection, to gender-based violence, to housing, land and property issues, to child protection. There will be impacts for the many organisations supporting the world’s most vulnerable communities, including UNHCR, UNICEF, the International Committee of the Red Cross (ICRC), other UN agencies and non-government organisations (NGOs).

International aid workers in crisis zones will stay and deliver wherever possible, despite potential risks. In current circumstances movement is restricted, so UN agencies or international NGOs (INGOs) will rely more heavily on national staff, who in turn will rely more heavily on local NGOs, area governments and communities themselves. 

Protection officers working in remote camps with refugees, returnees and internally displaced persons (IDPs), as well as in settlements in densely populated urban settings, all face major challenges in dealing with COVID-19. From UN and INGO headquarters, a plethora of guidance and commentary on COVID-19 is arising. But it’s imperative that agencies do not hide behind obscure, ambiguous or conflicting guidance: they must instead articulate clearly what protection actors can do to assist communities hit by this crisis. This means working together, managing camp conditions, clarifying ethics, engaging in contact tracing, collecting data, and not letting formal legal status (refugee, asylum seeker, IDP) get in the way of protection and assistance.

The protection sector working with the health sector

Colleagues in the health sector will become increasingly overwhelmed. Two recent examples show why. In Burkina Faso, quarantine and curfew resulted in the closure of some health centres and left more than 1.6 million people in conflict-affected areas with little to no access to medical care. A crowd in Ivory Coast recently destroyed an under-construction coronavirus testing centre, in part because of poor communication and a lack of community ownership. 

Where possible, protection teams will need to find ways to activate their networks – using their experience in communicating with communities – to help fill some of the obvious gaps. In Geneva, the Global Protection Cluster (led by UNHCR) and Health Cluster (led by WHO) have worked for nearly a year drafting a Joint Operational Framework that, if well implemented, could save lives in coming months. Experienced protection officers placed in the health sector could assist with the development of stronger relationships between the clusters and ensure protection supports the eight pillars identified by WHO  in February as crucial to the COVID-19 response.  Their work together could ensure that data and experiences are shared, and that gender and age analysis is strengthened so that, for example, the needs young women and girls who suffer most in emergencies are identified and dealt with in the early stages.

IDPs, asylum seeker or refugee status is not relevant in this crisis

A focus on status will not allow us to effectively deal with COVID-19; if we exclude IDPs, asylum seekers and refugees, no one will be safe.  It is counter-intuitive for a humanitarian committed to the principle of humanity to pick and choose which ‘persons of concern’ should be prioritised for treatment; our principles direct us to the most vulnerable civilians. 

Our mandates sometimes lead us down a narrower path, supporting only those with the ‘status’ of IDP, asylum seeker or refugee. The circumstances of the COVID-19 pandemic demand that humanitarian responders consider migrants, prisoners, slum and shantytown dwellers, street children, stateless persons, individuals with health or domestic violence issues, daily labourers, people with mental health issues, land mine victims – and the list goes on. Status cannot be the only guide in current circumstances; rather an individual’s heightened protection risk needs to be the driving force for humanitarian responders, who need to ensure that IDPs, refugees, returnees and migrants are treated in the same way as those in the community in which they live, because COVID-19 affects all people regardless of their status. 

Protection, shelter and camp coordination

Colleagues with camp and shelter responsibilities are key protection actors. With the community, they will need to find creative ways to isolate and quarantine to ensure that patients with suspected COVID-19 don’t mix with others. These colleagues will also need to take responsibility for stabilisation centres when hospitals or medical centres discharge patients to make way for more serious cases. 

Patients moved from the ICU must not be abandoned, so palliative care might also become a bigger factor, even in camp settings. Grief counselling will become a larger part of protection officers’ normal psycho-social counselling work, and they will need to enhance their skills.  

Protection teams need access, yet it is important to establish priorities to ensure they are not competing with refugees, IDPs and medics for access to personal protective equipment (PPE) or testing kits. 

Tightening crowd management, ensuring temperatures are checked, and promoting regular hand washing are vital, as is increasing the number of distribution points to ensure social distancing. All these tasks will work best if all clusters are involved. For instance, when it comes to IDP operations, UNHCR leads three humanitarian clusters – Shelter, Camp Management and Protection – so it is well positioned to strengthen the humanitarian response by ensuring that these clusters work more closely together than they have before.

Contact tracing – adjusting to a new role 

The contact tracing that is required to respond to COVID-19 will test the capacity of protection teams. The ICRC and others in the protection sector have experience tracing families in conflict and other humanitarian crises, where family separation often occurs. Contact tracing is a very different, yet vital, task that the health sector cannot do alone. Protection colleagues often have community and referral networks in place for engaging with women, men, boys and girls and various minority groups in communities, which they may need to activate here. 

Even so, they will be challenged to adjust quickly to support health colleagues. Medical authorities need to know whether people are visitors or residents, as this can impact the understanding of how the virus is moving, growth rates of infection, or recovery times. Protection officers may have some of this information, and providing observational data and advice on safely collecting it will be important, yet not without implications.

Ethical dilemmas can’t remain unresolved

Protection officers in field positions have substantial knowledge of local socio-cultural and political contexts and basic training in humanitarian ethics, yet not specific to a COVID-19 setting. In crowded camps and settlements, and in the absence of operational medical centres and of medics, protection officers may be called upon to guide their protection teams and communities on delicate ethical issues. Presenting the dilemmas is not enough. 

Studies confirm the high risks for older people from COVID-19. Where does the protection sector stand on how much weight should be given to age, which is easy to determine, as compared to life expectancy, which is nearly always an estimate? In some countries, medics have already established an age limit for access to ICUs. 

Help Age International (HAI) implores UN bodies to provide greater leadership and guidance to ensure that countries around the world stop unacceptable ageism and age discrimination in the pandemic. Yet, we are likely to want discrimination in favour of older working people when it comes to recommending that they stay home from a workplace where they are more at risk. HAI wants the allocation of scarce medical resources to be based on medical need, scientific evidence and ethical principles. Protection teams in the field need help to work out a position with communities that will avoid the case-by-case decision-making that may do harm in crowded camps and settlements.

It’s not just about age. Where hospitals beds and ventilators are not readily or easily accessible, who should be prioritised? Protection teams might benefit from familiarising themselves with the framework of the Stanford Humanitarian Surgical Response in Conflict Working Group and the related mathematical models that help medics decide whom they treat in conflict. Egalitarianism (treating patients without discrimination based on age or level of illness), utilitarianism (maximising total benefit, generally assessing expected remaining high-quality years while ignoring urgency), and priority (treating the sickest people first, even though it could result in refusing treatment to many patients who are less sick but more likely to live if treated) are the general options. Each model is inevitably unsatisfactory. Yet a standardised approach consistent with that of health colleagues might minimise preventable deaths and reduce potential difficulties that could otherwise reoccur in camps or settlements if this is left unresolved. Protection officers will benefit by articulating and using their own consensus framework that enables decisions to be communicated to the communities in which they work.

Data collection

Protection teams collect numbers and data to analyse everything from recruitment of children into armed forces to incidents of gender-based violence and other human rights abuses. Some data is shared, yet much remains confidential. A data-collection system is foundational for understanding the evolving epidemiology of the pandemic and for improving the quality of the response. Distinguishing the needs of men, women, boys and girls is crucial for a solid protection response, for instance. What is collected and coordinated among all actors will need to change to meet the needs of a new collaboration led by health professionals, so that epidemiologists gain a better understanding. Communication between data systems, so far not achieved even among protection teams, is also essential for fast analysis.

Leadership, not more coordination

The loose consensus that usually makes up humanitarian command structures will make decision-making impossible unless the Humanitarian Coordinators who lead the Humanitarian Country Teams set clear parameters in support of WHO in each country. Aldrich convincingly argues that ‘failures in coordination and communication during disaster response have become so common that they are expected’, while Konyndyk suggests that ‘[h]umanitarian reform efforts in recent decades have underperformed because they have focused on enhancing coordination without realigning funding incentives.’ 

Challenges in military–civilian coordination, where militaries are responsible for the evacuation of civilians, will also arise. Unarmed humanitarians in insecure environments need to be sure others adhere to the principles of humanity, neutrality, impartiality and independence. Médecins Sans Frontières, Samaritan’s Purse and the ICRC, who are key providers of both medical and protection services in many difficult operations, may need to use their influence to guide the humanitarian response in support of the World Health Organization (WHO). Protection teams need to prepare advocacy messaging and related activities based on the advice of the WHO to ‘test, test, test’ every suspected case.

Stringent restrictions on international movement introduced because of the pandemic have reduced our capacity and threaten the lives of people already in humanitarian emergencies. The protection sector’s response to this rolling apex needs to be measured by the number of lives saved, not the number of webinars, seminars, guidance and strategies. What will save lives is putting well-resourced local staff capable of communicating with broader communities as close to the problem as possible.  

Author

Paul White is an Australian lawyer and Senior Protection Adviser with ProCap (the UN Interagency Protection Project), who has been deployed in Africa, Asia and the Middle East including to operations in Iraq, Syria and Somalia. He has recently completed an assignment with the Global Protection Cluster at UNHCR in Geneva.