What Is the Role of Public Health in a Humanitarian Crisis?

November 8, 2023

A bombed school in Kharkiv, Ukraine, March 16, 2022. Human rights are a set of foundational principles stating that all people deserve a certain level of dignity and respect. These rights include the right to liberty, freedom from persecution and the right to education. Over time, these rights have expanded to include specific mention of and parameters around people with disabilities, children, women and other marginalized groups.

The United Nations (UN) oversees international human rights laws through its Office of the High Commissioner for Human Rights. Some rights were laid out in the Charter of the United Nations of 1945, which currently has 193 signatories, while others were articulated in the Universal Declaration of Human Rights of 1948. While not legally binding, the declaration has inspired or been the basis of more than 70 binding international treaties. Among the rights it establishes as “equal and inalienable rights of all members of the human family” is Article 25, which states that all people have the right to a standard of health that includes medical care and security in the event of sickness, and makes special provisions for mothers and children.

One of the many events that can disrupt human rights is a humanitarian crisis. These crises, whether natural phenomena or interpersonal conflicts, can deteriorate a society’s established human rights and threaten health and safety.

Public health professionals are responsible for treating people in their communities after a crisis, advocating for their human rights and working to mitigate and heal from the damage. Educating public health professionals on human rights is paramount so that all people can retain them, even in the wake of a crisis.

Humanitarian Crisis: Definition and Types

By definition, a humanitarian crisis is an event or a series of events that threatens a community’s safety, well-being, or health to the point that normal supports are overwhelmed. This can be a natural disaster (such as a hurricane or tornado) or a political or human-made event (war, pollution, industrial accidents). Humanitarian crises often disproportionately affect economically depressed regions. The World Bank predicts that by 2030, two-thirds of those in extreme poverty could be in areas experiencing fragility, conflict and violence.

Natural Hazards

While natural disasters typically can’t be fully predicted, communities can still prepare for them. Natural hazards can be divided into six categories, according to the Center for Research on the Epidemiology of Disasters:

Geophysical: Earthquakes, volcanic activity
Meteorological: Storms, extreme temperatures
Hydrological: Floods, landslides
Climatological: Droughts, wildfires
Biological: Epidemics, insect infestations
Extraterrestrial: Impact (comets, asteroids), space weather (shock waves, geomagnetic storms)

The Human Impact on Natural Disasters

Human activity has affected the frequency and severity of natural disasters in recent years, according to the UN. In fact, Oxfam International reports that the number of disasters that are climate-related has tripled in the past three decades, and over 20 million people have been displaced due to climate change.

Human-induced greenhouse gas emissions, deforestation and urban infrastructure are just some of the factors that can contribute to the increase in natural disasters. Climatic events such as heat waves, wildfires, cyclones and droughts have become increasingly common due to human-made pollution.

Recent examples of natural disasters around the world that were intensified by human activity include:

The Texas cold wave of 2020
Cyclone Amphan, which hit the border of India and Bangladesh
Cyclones Idai and Kenneth, which together struck Mozambique, Zimbabwe and Malawi
The 2020 Australian bushfires
Deadly floods in Nepal, India and Bangladesh

Human-Induced Hazards

One of many ways to classify human-induced hazards is to divide them into three classifications offered by the United Nations Office for Disaster Risk Reduction:

Technological: Industrial accidents, structural collapses, radiation leaks, explosions
Transport: Crashes or collisions on land, in the air or in the sea
Social: Wars, riots, stampedes, currency devaluation, mass violence

Human decisions and actions drive human-induced disasters. Hazards such as pollution often occur due to a lack of oversight or regulation. Crises such as armed conflict require those in power to reconcile and compromise.

A third category, known as a complex emergency, occurs when a number of events or factors combine to prevent people from meeting their basic needs.

What Is a Complex Humanitarian Emergency?

A humanitarian crisis is an event or a series of events that threatens the health and security of a large number of people. In a humanitarian emergency, health and security are critically threatened.

A complex humanitarian emergency occurs when multiple factors compound the risk. For example, the human-induced hazard of a train derailing might spark wildfires, or a severe storm might knock out power lines, causing an energy crisis and hampering rescue and repair efforts.

The Center for Disaster Philanthropy lists numerous characteristics that are often part of complex humanitarian emergencies:

Significant human suffering and death
Human-induced environmental destruction
Large numbers of displaced people
Risk of disease outbreaks and public health emergencies
Armed conflict or war
Weakened public institutions (sanitation, health care, education)

These emergencies can also unfold over time. For example, if a hurricane impacts a community that relies heavily on tourism, it would suffer both immediately and in the long term. There would be the initial impact of the storm and then the subsequent lack of economic activity if visitors don’t come to the damaged or recovering region. This could then lead to lasting issues if the economic downturn means residents aren’t able to afford basic necessities or access care, and, in turn, result in social and political upheaval.

Circumstances can conspire to turn a single event into a complex emergency when human-made or natural barriers to providing aid exist. If an earthquake hits a region with armed conflict, it can be harder to get necessary supplies to those in need, for example.

These events have often become longer and more complicated due to compounding issues such as climate change, which can all be exacerbated by a lack of preparedness and action. Humanitarian crises are more likely to become complex humanitarian emergencies, and communities are less prepared to deal with them.

Examples of Complex Humanitarian Emergencies

Recent and ongoing conflicts have produced large-scale complex humanitarian emergencies. These incidents destroy the infrastructure and safety that people rely on to provide for themselves and their families. This may cause them to flee their homes and seek out places where they can get the resources they need.

Syria

Syria’s ongoing civil war has created a complex humanitarian emergency that’s nearly completely human-induced. The drawn-out, complicated armed conflict has severely eroded the country’s economy and created a massive refugee crisis. With no end in sight, these issues will likely persist long after the fighting ends.

Yemen

A similar complex humanitarian emergency is occurring in Yemen. In a civil war since 2014, the people of Yemen have suffered due to a lack of basic goods caused by blockades and constant armed conflict. A 2021 report by the United Nations Development Program predicted that more than 377,000 people would die in Yemen by the end of that year as a result of the conflict — 60% from preventable disease and hunger and 70% being children under the age of 5.

COVID-19 Pandemic

Another unique example of a complex humanitarian emergency was the rapid spread of the global COVID-19 pandemic. In a matter of weeks, the world shut down and enforced varying levels of mandates that required massive shifts in daily life. The impact of the pandemic in the early months was widespread, with around 10 million people being out of work and stock markets crashing by 20% to 30%. Communities had to immediately adjust to make sure that people had their basic needs met and that the spread of the disease was kept in check until vaccines were available.

As of November 2022, almost 6.6 million people have died of the virus, and the International Monetary Fund reports that the global economic impact of the lockdown was the worst downturn since the Great Depression.

Impact of History on Haiti

History can also play an important role in the onset of complex humanitarian emergencies, such as in Haiti. The island nation suffers from frequent storms, the impact of these being exacerbated by its complicated past as a French colony. While Haiti was able to achieve its independence in the early 1800s, France forced those in Haiti to pay reparations, which disrupted the Haitian economy for generations. This makes it more vulnerable to potential complex humanitarian emergencies, due to the shortage of necessary resources to prevent or recover from humanitarian crises.

Haiti experienced a coup in 2004, severe earthquakes in both 2010 and 2021, a cholera outbreak linked to UN peacekeepers and a 2021 presidential assassination. The country’s also currently undergoing a period of civil unrest, armed gang conflict, shortages of drinking water and fuel and widespread hunger. These crises have compounded to create a deeply entrenched, complex humanitarian emergency requiring a response on multiple fronts.

War in Ukraine

A complex humanitarian emergency has quickly unfolded in Ukraine over the course of the past several months due to Russian forces invading the country. More than 7.2 million refugees have fled the country, 6.9 million are displaced within the country and fighting has devastated local infrastructure. The United Nations High Commissioner for Refugees has declared Ukraine a Level 3 emergency, the agency’s highest level of classification.

Public Health’s Role in Humanitarian Crises

The role that public health professionals play in a humanitarian crisis is an important part of the prevention and recovery process. Their efforts can also mitigate the scope of the disaster by focusing on providing the basic necessities of all humans: water, sanitation and hygiene (WASH). Without these necessities, people can suffer further due to dehydration or infection. To meet WASH needs, public health professionals may have to repair infrastructure or create ways to get people the things they need quickly.

Needs vary for different crises. In Ukraine, for example, the Red Cross has provided food for more than 800,000 people, essential supplies to more than 300,000 internally displaced people and health services to more than 700,000 people. In Yemen, UN agencies and nongovernmental organizations worked with the World Health Organization to form the National Health Cluster: a humanitarian response to coordinate outreach and services among multiple organizations.

Advocating for Communities

Public health professionals can be critical to triage issues and leverage resources to help communities recover. This can happen on a local community basis as well as at the governmental level, such as through health department officials. This ensures that emergency response and preparedness efforts align with any existing preparedness plans that may be in place. It may also mean collaborating with local government or community officials to create new preparedness plans to maximize resources. They can also help local groups and governments evaluate their efforts to determine the impact of what is being done.

In addition to helping communities impacted by humanitarian crises meet their basic health needs, public health professionals can assist in recovery by being advocates for lasting positive change. Their unique knowledge and understanding of the systems that facilitate wellness for communities, such as proper handwashing, water filtration and waste disposal, can assist in equipping people with the resources to prevent and mitigate crises in the future.

Public health professionals can work toward creating sustainable solutions to help build resilience for the next crisis and assist in preventing future complex humanitarian emergencies.

Make an Important Difference in the World

Humanitarian crises will continue to unfold all over the world. Complex human emergencies require dedicated, trained public health professionals to work to minimize the impact of these events when they occur. USC’s online Master of Public Health and its five concentrations, which focus on areas such as global health, health promotion and biostatistics, can help prepare individuals for this challenging but crucial work. Find out how USC can help you embark on a rewarding career in public health.