It’s time to rethink emergency medical aid in armed conflict

​​​Michael Walsh​​ argues that only ecosystem disruptors​​​ can realise the full potential of emergency medical teams. A radical reimagining of current structures could save lives and alleviate suffering in armed conflicts and other insecure environments​​

​Core missions compromised​​​​

Medical teams responding to health emergencies in armed conflict face serious context-specific limitations that often undermine their core missions. A recent case in point is the 2023 earthquakes in Northwestern Syria and Türkiye. The Syrian regime under Bashir Al-Assad showed total disrespect for international humanitarian law. This severely limited the acceptance and access of World Health Organization-classified emergency medical teams to disaster-struck communities.

In such highly interdependent worlds, emergency medical teams cannot deliver on the basis of individual effort alone. Other major nodes in the network must be able to bring into existence the conditions necessary for their success.

​​​Instrumentalising medical aid​​​​

The last two decades have seen the re-emergence of great power competition. With it has come a marked increase in ideological, political, and military competition among major power states. This competition has changed profoundly the context for medical teams responding to health emergencies in armed conflict.

The recent re-emergence of great power competition has changed the context for medical teams responding to conflict-zone health crises

When disasters strike at the faultlines, it's not surprising that one or more of these great power competitors and their proxies try to instrumentalise international emergency medical aid in pursuit of competitive advantage.

Creating the right conditions for international medical teams to successfully respond to health emergencies in armed conflict requires consensus. But in hyper-competitive contexts, UN member states are finding it increasingly difficult to reach the consensus needed.

Re-evaluating service models​​​​

Clearly, international humanitarian organisations must do a much better job of sidestepping avoidable failures in this changing reality. This, however, requires a fundamental re-evaluation of the service models for provisioning emergency medical aid in armed conflict.

The dominant models were never designed to achieve their desired outcomes in worlds inhabited by major power competitors which have strategic preferences for inhumane outcomes. The 2023 Türkiye-Syria earthquakes are an appalling demonstration of this.

Major power competitors have strategic preferences for inhumane outcomes. We need new disaster-relief models that fit wildly uncertain worlds like Libya, Iraq, Syria, Ukraine, and Yemen

What we desperately need now are new models that fit worlds like Libya, Iraq, Syria, Ukraine, and Yemen. This will not only require innovation. It will also demand a shift in strategic thinking. In such wildly uncertain worlds, international humanitarian health practitioners must emphasise pattern recognition over formal plans. If they do not, they will be unable to adjust to the constantly changing realities on the ground.

​​​Inflection point​​​​

International emergency medical aid has reached an inflection point. There is a clear and present need to reimagine the structures through which the key stakeholders in the international humanitarian health ecosystem interact. Such radical reimagining could result in the successful emergency medical aid to vulnerable communities damaged by manmade and natural disasters amid armed conflicts.

A radical reimagining of the structures through which key humanitarian stakeholders interact could see the successful delivery of emergency medical aid to war-torn communities

International humanitarian health organisations need to unlock the full potential of emergency medical aid. To do so, they cannot simply default to hiring consultants to design new service models for armed conflict. They will need to deepen collaboration with other key stakeholders to identify, understand, and mitigate the co-innovation and adoption chain risks that undermine such innovations.

Inevitably, these ecosystem disruptors will encounter stakeholders resistant to change out of a desire to protect their equities and maintain their status. Transformational leadership will be required to overcome such self-interested opposition in a fair and deliberative way.

This article presents the views of the author(s) and not necessarily those of the ECPR or the Editors of The Loop.


photograph of Michael Walsh
Michael Walsh
Visiting Researcher, School of Foreign Service, Georgetown University

Michael is a senior subject matter expert who regularly advises governments, humanitarian organisations, and think tanks on democracy, development, and security affairs.

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