Humanitarian Aid Work: A Critical Approach - Softcover

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Carlos Martin Beristain is a physician and specialist in psychology.

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Foreword
M. Brinton Lykes

Globalization has brought those from the Northern Hemisphere's economically more advantaged communities into ever more immediate contact with extreme poverty, natural disasters, pandemics, wars and catastrophes. Recent catastrophes, most notably the multiple earthquakes and hurricanes that have devastated communities around the world in the first decade of this new millennium, evidence the vulnerabilities of all the world's people as well as the catastrophic consequences of political decision-making that fails to protect those most vulnerable to the effects of humanitarian disasters.

One policy-level response to these structural disparities and their consequences for the poorest and most vulnerable members of disaster affected populations has been a series of international treaties, conventions and agreements. For example, the eight United Nations Millennium Development Goals—which range from halving extreme poverty to halting the spread of HIV/AIDS and providing universal primary education by 2015 -were agreed to by all the world's countries and its leading development institutions in one effort to redress these dramatic social inequities. Yet, despite these ideals, two thirds of the world's population today live in extreme poverty and experience the threats and the realities of violence and catastrophe as daily routine. UNICEF's 2005 State of the World's Children reports that one of every two children in the world suffers some form of severe deprivation with most living in poverty. Fifteen million children under the age of 18 had been orphaned by HIV/AIDS by 2003. Moreover, international monitors have identified thirty-two armed conflicts in 26 different states in 2004. Recent comparative research links poverty and war, confirming that the more undernourished the population of a region of the world is, the more likely there is to be a war. For example, during the past decade 61% of states with more than 35% of the population malnourished also experienced armed conflict whereas only 15% of those states with 4% or less of the population living in extreme poverty had an armed conflict within their borders.

Individuals are increasingly challenged to respond to these global inequalities. Medical personnel have longstanding experiences accompanying soldiers into war and responding to humanitarian crises. In recent years growing numbers of psychologists, social workers, and other human service workers have joined their ranks in contexts as disparate as the aftermaths of the genocide in Rwanda, Hurricane Katrina in the United States, and the earthquake in Kashmir. As they enter these emergency situations these workers frequently confront not only immediate disasters but the longstanding structural and institutional inequities described above as well as patriarchal power structures, bureaucratic inefficiencies sometimes marked by corruption, and more needs than could possibly be addressed by the resources at hand. In the best of cases, internationalists and local professionals, paraprofessionals, and indigenous leaders and healers work collaboratively to render care to the most marginalized and least powerful in situations that are frequently chaotic and often perilous. In less ideal circumstances they compete for resources, undermine each others confidence, and risk doing more harm than good.

Carlos Martín Beristain has devoted his life to working in these situations—contexts that the Salvadoran Jesuit and social psychologist, Ignacio Martín-Baró called "limit situations." Trained as a medical doctor, he journeyed to El Salvador and Guatemala early in his professional life and responded to the voices of victims triply oppressed by extreme poverty, an ongoing civil war, and patriarchal cultural and political systems and structures of marginalization.

Drawing on over a decade of field experiences in Latin America as well as a burgeoning literature about the psychological and social effects of war and disasters, Beristain developed this volume at the interface of theory and practice as one response to these complex social and political realities. Written in a language accessible to the wide range of helping professionals and volunteers who work in disasters, Beristain describes the psychosocial effects of catastrophes and the community's capacities to integrate resources and creatively respond towards reweaving the social fabric of their lives.

Humanitarian Aid Work: A Critical Approach offers an excellent introduction to those seeking to respond to the complex social, political, cultural, and linguistic diversities within any humanitarian crisis. These workers, often professionals from a variety of social scientific, legal, human service, and health fields, are often challenged by world views, meaning systems and customary practices different from their own. They seek to respond to the immediate demands and complex realities within crisis situations while balancing theoretically sound approaches, sensitivities to cultural and linguistic differences, and a quest for comparability between and across these and other diversities. Rigorously trained social scientists wanting to help but also seeking to control, predict, or prevent greater distress and damage in the context of humanitarian crises face immense challenges. They also encounter moral, political, and economic ambiguities in situations that simultaneously demand immediate action, challenging workers to respond to individual, family, community and society.

Beristain confronts these complexities theoretically and practically—and in a deeply human voice. Reframing existing individualistic psychological theories about the individual, familial, and societal effects of war and humanitarian crises, he develops a mosaic, crafted from deep observations, a bond of commitment to those who have suffered, and solidarity with them as they seek to reconstruct their worlds and rethread the social fabric of their lives. As significantly he demonstrates how this deeply interpersonal bond is situated within and nurtured by a commitment to international human rights and extended to seeking truth with justice. His collaboration in various Latin American truth commissions, as well as his expert testimonies at the Inter-American Court and within various agencies of the United Nations further informs the work presented here.

Beristain educates without being didactic. He transforms the ambiguous language of "psychosocial humanitarian care" into concrete practice informed by theory. He persuades through example, complementing thick descriptions of field work with theoretical arguments supported by empirical evidence. "Psychosocial work" has multiple referents and the phrase or its corollary, psychosocial trauma, is frequently thought to be ambiguous, signifying everything and therefore nothing. Perhaps because this interdisciplinary work is at the interface of economic, anthropological, environmental, physical, cultural and biosocial processes and outcomes, practitioners and theoreticians writing about it are blamed for not being clear or for using circular thinking to characterize endeavors that are either not well conceptualized or lack a clear objective. Beristain embraces this challenge, discussing the complex situations, mixed emotions, ethical dilemmas and concern for their own personal wellbeing that challenge psychosocial workers each day. He describes the common challenges they face when working within and across educational, economic, cultural differences in local communities where he or she is seeking to insert him or herself in the midst of often complex and contradictory relations among donors, local and foreign NGOs, and the survivors.

The victims are always visible in Beristain's work and their voices puncture an all too frequent official silence wherein impunity and a lack of justice...