Humanitarianism: An End to Suffering or the Destruction of Dignified Humanity?

Humanitarianism has traditionally endeavored to minimize the suffering of individuals through neutral, immediate care in crisis situations in an attempt to reconstruct human dignity (Redfield 328). Medical humanitarian organizations such as Doctors Without Borders, or MSF, whose foundations are based on the alleviation of immediate suffering, however, prioritize mere physical existence, or “bare life”, at the expense of a dignified and satisfying life that extends beyond minimal survival through a refusal to combat the structural violence that is often responsible for the suffering it attempts to treat (Redfield 329-330, 340). Such a “minimal existence” is far from dignified, as there is a sharp distinction between simply living and living well (Redfield 340). One may argue that humanity is defined by recognition of one’s individual capabilities and emotions as well as the needs and desires that are not connected to one’s basic survival; our existence as social, cultivated beings is what fundamentally separates the human race from other living species. MSF’s emphasis on immediate medical treatment thus diminishes the perceived humanity of these individuals, as alleviation of their suffering is evaluated only on the basis of physical necessity and not on their personal experience with poverty, social inequality or other forms of structural violence (Redfield 342).

Individual choice is also vastly limited within MSF’s interventions, as patients are not really given the option of deciding whether to accept treatment (Redfield 337). This raises the question of whether patients are even willing to receive treatment that will essentially prolong the misery and suffering engendered by their social conditions; to what extent can immediate medical aid satisfy victims of structural violence who feel as if they have already lost everything? Humanitarianism may therefore have an extremely limited effect on broken societies in which “temporary relief cannot repair the damage” (Mackreath). Sick individuals will continue to be sick even after momentarily recovering if the underlying social and political factors exacerbating this sickness are ignored; in this sense humanitarianism does little to truly mitigate suffering (Redfield 346; Mackreath).

In France, undocumented immigrants may acquire the legal right to live in France if they possess a life-threatening illness that cannot be treated in their countries of origin (Ticktin 1-2). These immigrants consequently become defined by their illness, as their existence in France is perpetually determined by disease (Ticktin 7). As I mentioned earlier, I believe that humanity extends beyond bare life; how can these individuals therefore be publicly perceived or accepted as part of humanity when their identities are restricted to that of the “apolitical, suffering body” (Ticktin 7)? A disregard for dignified humanity may thus exacerbate the mistreatment of immigrants, who may consequently be perceived as ‘inferior’ within French society and thus undeserving of humane treatment or the maintenance of their basic human rights. These immigrants are not even provided with the foundations of a decent or fulfilling life, as they are prohibited from working and are thus denied any economic, social or political participation in France that is essential for the preservation of a dignified human existence, forced to live “with nothing to wake up to each morning except one’s illness” (Ticktin 9).

The failures of humanitarianism are further exemplified through the experiences of Syrian refugees relocated to the United States to escape the suffering engendered by structural violence and civil war. Although they are relocated on the basis of immediate need, Syrian refugees are provided with virtually no resources to sustain themselves or maintain a sense of dignity amidst their suffering (Davis and Hemish).

One may argue that suffering can only truly be ameliorated by self-determination, meaning an individual’s ability to control his or her own life; self-determination may be perceived as essential for the preservation of dignity (Mackreath). Yet humanitarianism does not bring victims closer to self-determination, as it does not grant them the ability to truly improve their lives or even decide the fundamental conditions of their existence; self-determination is virtually impossible when one’s social status as a dignified human being is compromised. As a consequence of their inability to legally work in France, for example, many immigrants are forced to obtain the means for their survival through degrading and exploitative work in the black market that exacerbates their suffering while simultaneously diminishing recognition of their humanity (Ticktin 7).

Humanitarianism cannot fully alleviate suffering or reaffirm human dignity through a narrow emphasis on immediate care without attention to the maintenance and improvement of patients’ “elaborated human experience” that is essential for a satisfying and happy life (Redfield 330). Who will address structural violence, if not those who have volunteered to help suffering individuals? Humanitarian organizations must strive to promote a dignified existence by actively challenging structural violence and political inequality to enable aid recipients to be publicly perceived and rightfully treated as human beings.

Discussion Questions:

  1. How may humanitarian organizations successfully challenge and potentially change conditions of structural violence and political inequality? Do they have the authority or power to do so, or is this far too idealistic?
  2. To what extent does humanitarianism compromise individuality? Can individuality be perceived as essential for human dignity?

Bibliography

Davis, Charles and Mohamed Hemish. “A Refugee’s Story: From War in Syria to Poverty in the US.” teleSUR 4 November 2015. Web. 5 November 2015.

http://www.telesurtv.net/english/analysis/A-Refugees-Story-From-War-in-Syria-to-Poverty-in-the-US-20151104-0036.html

Mackreath, Helen. “The Early Plight of Humanitarianism.” Jadaliyya 26 October 2015. Web. 4 November 2015.

http://www.jadaliyya.com/pages/index/23005/the-early-plight-of-humanitarianismn

Redfield, Peter. “Doctors, Borders and Life in Crisis.” Cultural Anthropology 20.3 (2008): 328-361.

Ticktin, Miriam. “Where Ethics and Politics Meet: The Violence of Humanitarianism in France.” American Ethnologist 33.1 (2006): 33-49.

 

14 thoughts on “Humanitarianism: An End to Suffering or the Destruction of Dignified Humanity?”

  1. Hi Alexandra,
    Thank you for this thorough discussion. I confess I felt slightly ‘uncomfortable’ while reading your article because, like Professor Mason mentioned in class, it is somewhat difficult to criticize a morally-guided objective like saving lives. However, I think you did a great job dissecting the complexities and shortcomings of humanitarians. And like you, I also believe that humanitarians should integrate more horizontal initiatives in their current work. As you concluded in your last paragraph, “who will address structural violence, if not those who have volunteered to help suffering individuals?” However, I also want to emphasize the responsibility of governments in (developing) countries that are undergoing turmoil. When we put too much focus on the work of humanitarian groups, we risk undermining the accountability of the administrative bodies that should be implementing structure and distributing resources for its citizens. It is these administrative bodies that are causing/exacerbating much of the inequality (though I know I am somewhat simplifying the complexities of inequality), and I’d argue that humanitarianism – even by attempting to combat structural violence – is not enough to fix underlying inequalities without the collaboration of governments/concrete legislation.

    Regarding your first question, I don’t think it’s idealistic to expect humanitarian organizations to challenge conditions of structural violence. I do think that it is much more difficult, though, and it requires much more resources (not only in the form of money, but also in the form of skilled volunteers). In order to create long-lasting infrastructural and structural re-working, global health initiatives cannot rely on mobility and temporary action; they, instead, have to be on the ground for long periods of time and thus require several trained individuals. They also have to focus more on collaborating with governments (as I somewhat explained in my first paragraph); because humanitarian organizations are seen as “apolitical,” they are allowed access into several different countries. An objective of restructuring societies politicizes humanitarian bodies; this may potentially become an issue in terms of entering contexts of high political tension.

    I’d like to play Devil’s advocate regarding a point you made in your second paragraph: “…patients are not really given the option of deciding whether to accept treatment. This raises the question of whether patients are even willing to receive treatment that will essentially prolong the misery and suffering engendered by their social conditions…” If humanitarianism isn’t focusing on fixing structural violence, do you think it would be better for physicians and professionals not to intervene in such situations at all? Do they not “bear a particular ethical responsibility for offering treatment”? (Redfield 337). Is it not worth saving a life if the quality of that life in the future is dubious?

    But I think you made a great point: perhaps humanitarian organizations risk becoming complicit in structural violence. Humanitarian work often takes place in contexts where people do not have many choices (these contexts include those of social/economic/political turmoil), and humanitarian work, in some cases, can further decrease these choices/options. However, I don’t want to discount that humanitarianism provides perhaps one of the most powerful ‘choices’ of all: the choice to be alive.

    1. I also want to add that I enjoyed your discussion of how immigrants can become defined by their illness. Thank you for making this point.

    2. Hi Nini,
      I completely agree with your point that we cannot free governments from their responsibility to ensure the welfare of their citizens by placing a heavy emphasis on the role of humanitarian organizations. Governments should, of course, bear the brunt of such responsibility. However, I also believe that the apolitical nature of humanitarian organizations detracts from the sense of urgency necessary to combat structural violence, as it conveys the message that the alleviation of immediate suffering is enough.
      I do believe that if there is an option to save a life, doctors must make all efforts to do so. Yet what if patients would rather die than continue to live a life plagued by misery, where the alleviation of one illness will only serve as temporary relief until another illness surfaces? I am not suggesting that humanitarian organizations possess the responsibility to determine who lives and who dies based on moral and ethical grounds, yet I believe it is important to recognize that not every patient may wish to receive treatment if that entails future endurance of the same crippling conditions of structural violence.

  2. Alexandra,

    While reading your post I thought about the nurse in the Ticktin reading who claimed the Humanitarianism in France only provided “false hope”. Initially, humanitarian efforts give hope because they seem to help. However, it soon becomes clear that this help “false” because it is only provided in a limited sense. The underlying problem is not being addressed. Once services are no longer provided, individuals in these unfortunate situations will likely revert to a state similar to the one they were in before receiving aid.

    While reading the Ticktin article, I could not help but wonder why the immigrants were not just given a work visa as well as an illness visa. Couldn’t the additional work provided by the immigrants be beneficial for France’s economy? I suppose one could claim that the reason why is because French system is partially rooted in discrimination and that the government does not really want to give these individuals rights. But then I wonder, why would the French government even provide humanitarian aid in the first place? Or even offer the opportunity, albeit difficult, to obtain papers at all? (This still confuses me, so if anyone has an idea why, I would more than happy to you’re your opinion!)

    In the end I wonder if we can even blame these initiatives. As far as I understand, by definition, humanitarians provide physical aid but are not obligated to do anything more. Maybe we need to redefine humanitarianism or reevaluate our roles in global health as developed nations. Until then I do not think we can specifically accuse humanitarian efforts without criticizing ourselves and all other countries in power.

    1. Hi Derana,
      Thank you for your comment. I completely agree with your point on the necessity of distributing work visas, as immigrants are provided with virtually no means of sustaining themselves or living a dignified existence. This is consistent with my assertion that the illness clause constitutes a degeneration of humanity, the sacrifice of a meaningful life for the preservation of bare existence.

  3. The concept of “suffering” is an interesting one and one in which you mentioned frequently in your response. Although I am not trying to undermine the suffering felt by those in other countries without access to basic resources, nutrition, health, etc. I do question at what point suffering is ‘over,’ or when humanitarian organizations have ‘sufficiently’ done their job? Many people have access to many of these basic resources in the U.S. yet are still plagued by mental and physical suffering, just as there is still structural violence. You’ve mentioned some plausible answers to these questions though, namely the point of self-determination and being able to control one’s life as necessary to alleviate suffering, yet to what extent can one really exercise control over an ever-changing, ever unstable world? Taking too much of the ownness, too much individual responsibility over one’s own life can even promote suffering when perceived outcomes do not match expectations.

    I agree, though, that self dignity is important in ameliorating suffering, yet I don’t think humanitarian organizations should be fully responsible for trying to make this happen in other ways than what their specific work calls for. They should help to the best of their abilities at challenging the structural violence that perpetuates suffering, but by putting the ownness on humanitarian groups to act, it can make other groups/boards/governments actually responsible for addressing these issues, complicit.

    1. Hi Jeanette,
      I do agree with your claim that individual responsibility may promote suffering through failed achievement of expectations. However, this goes for anything in life and does not only encompass autonomy with regard to healthcare and political life. Does the possibility of failed expectations suggest that we should not still try to regulate our lives to the best of our ability? I believe that autonomy is essential for a dignified and meaningful existence. Without such autonomy, we cannot make the fundamental choices that govern our life; we would have virtually no power over our wellbeing or our happiness. In spite of the existence of a world that is constantly changing, I believe that an individual may still maintain autonomy through basic legislation and societal recognition of one’s individual rights. Independence and self-determination is, perhaps, even more necessary in a changing word; these factors are the only way an individual may continue to regulate the world around him. The ability for an individual to make his own decisions is essential to his wellbeing; people are guided primarily by self-interest. We must each be able to help ourselves, or we run the risk of receiving no help at all.

  4. I appreciate your discussion of the “bare life” model of many humanitarian groups, but am cautious of your choice of “dignified” as a life that extends “beyond minimal survival.” For me at least, “dignified” has classist connotations of a narrowed, exclusionary propriety. That said, I acknowledge and appreciate your discussion of how unaddressed structural violence is in traditional models of humanitarian aid, and am especially drawn to your discussion of how this structural violence compounds on the suffering body: what happens when sick bodies are forced to work on the black market and have their humanity further exploited? How do we navigate the responsibility of a state to it’s noncitizen constituents? How is this the task of an apolitical humanitarianism?

    Your discussion of the rights gained by the ill in claiming citizenship in France is compelling, and I would like to echo your sentiment that “their existence in France is perpetually determined by disease.” Overall, I am left wondering how humanitarianism could be modified to attend to both the biological and social body. What are your thoughts?

  5. Hi Alexandra,
    Thank you for your insightful point of view on this matter. It is a terrible truth that humanitarian organizations must balance efficiency with deliverance of humanity to those whom they are trying to help. I also commend you on raising the point that many MSF patients are not given an option of deciding if they desire treatment, which is a sobering point to consider when paired with the concept that self-determination is a major key to happiness.
    In response to your first question, unfortunately, I don’t think many humanitarian organizations, especially MSF, can successfully challenge structural violence and political inequality. Let us recall that MSF is granted permission to set up sites in many of its locations solely because it is an apolitical entity. If it were to advocate for any political stance that puts pressure on that country’s government or status quo, they would be barred from ever working there again. It is the nature of humanitarian organizations like these to deliver emergence aid at the cost of remaining silent about political and social injustices.
    However, there is still hope. While these are not the organizations to combat structural violence, those like Partners in Health are willing to initiate horizontal tactics and attempt to reverse the global structural imbalance that still exists today.

  6. You are completely right, humanitarian organizations are failing at addressing the structural violence that exists in the areas they intervene in. However I’m not sure if it’s necessarily the job of these groups to implement horizontal interventions. While in theory, humanitarianism is about reliving suffering caused by social forces, in practice it doesn’t go beyond saving lives. Groups like MSF are successful at addressing the immediate needs of an area, but to try and change the structural violence that are so prevalent in these places would require too much time and resources. Also making structural changes would require humanitarian organizations to be more intertwined with politics and legalities of the region which could lead to many unintentional consequences. I agree with the comment above, NGO’s like Partners in Health are more equipped to handle attacking structural violence than humanitarian groups like MSF.

  7. Thanks Alexandra, for a well-formulated and critical post. One issue, which was mentioned by another commentator, that I’d like to bring up is the complicated nature of criticizing something based on good intentions. That is, I think it is easy to criticize the policy in France which forbids refugees from working while they are there to receive care – this clearly restricts their freedoms and forces them to choose between a rock and a hard place. However, your first point in that paragraph (which I do not on the whole disagree with), that allowing refugees to enter the country if they have a life-threatening illness which they cannot treat in their home country forces those individuals to be defined by disease and creates a devalued space for them to fill in French society, comes at the cost of attacking a program which started with a really good idea: letting people who are unable to care for a life-threatening illness seek refuge and care in another country.

    Again, I think your criticisms are all valid. It is just that we have come to a point in our curriculum where again and again we see a good idea met with unintended consequences, or an okay idea being met with terrible consequences, etc. It is a bit frustrating and paints a bit of a bleak picture on humanitarian organizations (or global health initiatives with different focuses). As you asked yourself – is it too idealistic for these types of groups to work on short-term interventions as well as challenging systemic problems?

    As for the second question – I think the idea that individualism is central component of humanity is a bit of a Western concept, albeit one that I feel strongly affiliated to. Certainly something which robs people of autonomy/self-determinism prevents them from achieving means of reflecting their values, and this is a dehumanizing choice. Anything which sets people on an uneven playing field leads to certain people seeming to be given “more” humanity than others, so perhaps equality is a more crucial metric than individuality.

  8. Alexandra,

    I thought your post was very thought-provoking and you delved deeply into the complexities surrounding humanitarianism. I certainly agree with your belief that “humanity extends beyond bare life” and that humanitarianism cannot alleviate suffering caused by structural violence or social suffering. At the risk of sounding too hopeless (!), I have to wonder then, what’s the alternative? I think it would be more detrimental to not have any humanitarian intervention at all, even if they merely create a ‘bare’ existence.

  9. Hi Alexandra,

    Thank you for your post – I found it to be very interesting and thought-provoking. By definition, humanitarianism regards a moral incentive to help those suffering, especially in the context of a crisis or emergency. You highlight many of the failures cause by humanitarian aid, as the aid is short-term and does not combat structural and political violence. I agree with you in that to combat these emergencies that humanitarian organizations often tend to in developing countries, the most effective treatment would be to challenge structural violence.
    However, the goal and focus of humanitarian organizations is to provide emergency relief to those suffering. While the relief they bring is only temporary, it is relief nonetheless. I don’t think these organizations have the funding and leaders to combat the specifics of structural violence. I wonder how much of combatting structural violence falls upon these organizations if their resources are focused on treating injuries, diseases, and illnesses?

  10. Hello Alexandra,

    Thank you for putting together such a stimulating post. Like the comments above, I find it difficult to criticize actions of organizations like MSF that provide emergency care in war zones, epidemic afflicted areas and such. While I realize that they operate on the basis of ‘zoe’ and look after physical needs of diseased or injured bodies and often vacate a region once the emergency is over leaving a vacuum, I think they serve an important function in the hour of need and provide, as Nini puts it, a choice to live. I feel that the nature of the contexts in which they function necessitates that they work in the manner they do. Perhaps they ought to do more once the emergency is over but that role can also be played by other organizations and the governments. PIH, for instance, is one such organization. They address not only the health issues in a community, but also tackle poverty and other structural inequalities as a part of their initiative to achieve better health for all. I don’t know about authority, but I definitely feel that organizations like NGOs are capable of addressing conditions of structural violence albeit on a small scale.

    As for your second question, I think that can be seen as a matter of perspective. Yes, in some ways when you’re another patient in line at a refugee camp to see the doctor, your individuality is affected. However, I’ve been to the national public hospital in New Delhi and there too one could argue, people lose their individuality. I’m not saying that this is the way it should be, far from it. But I think certain things may have to be compromised if lives are to be saved. Say, in a war zone, if MSF volunteers started taking a different approach to their work and focused on preserving ‘bios’ instead, they would have to turn away a lot of the people because of resource constraints and in that case one could say that humanitarian aid doesn’t value all lives equally.

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