SPARKED BY OUTSIDERS 1. Sometimes I am struck by artists and other creators who seemingly grasp humanitarian action better than I. This realization comes with a modicum of envy. They seem to breathe the human condition rather than analyze it. Humanitarian action is a silo, a sectoral silo that shapes and also stunts our perspectives as we engage with the external world. It thus resembles other fields of action with the critical difference that humanitarianism relates to just about everything because its purpose is humanity, the whole enchilada. This blog is the first in a series where I hope to pass on some of that envy.
The Prosthetic Breast of Humanitarian Action
In 1999 I entered MSF as part of the “bearing witness” industrial complex, translating my civil rights and rural development experience into support of témoignage by MSF project teams. Twenty-five years later, tired of work-related reading, I picked Audre Lorde’s The Cancer Journals from the teetering pile on my wife’s desk. Lorde’s experience with breast cancer in 1970s America, woven into her experience as a black lesbian feminist, accentuated the gap between bearing witness to the struggles of others and bearing witness to one’s own struggles; and how with a patient’s insight and a poet’s words she was able to produce a piece transcendent enough to offer this humanitarian a lesson or two or ten. Proof, if we needed more of it, of the value of lived experience.
Choices and options
I’m going to have the mastectomy, knowing there are alternatives, some of which sound very possible in the sense of right thinking, but none of which that satisfy me enough. … Since it is my life that I am gambling with…[1]
There are choices, even if humanitarians feel that so much of their work is driven by a singularity of options, an imperative to move with urgence and exceptionalism’s license to do so. Erasing the choices open to Other societies and Other individuals – a reductionist view of crisis – from our internal narratives helps us to justify these decisions to ourselves. And as our explanations move upwards and outwards towards home society – misinformation in the form of fundraising campaigns[2] – we push responsibility away by foregrounding the necessity of our action, the unique effectiveness of our capacities, and the Other’sdependence upon us.
Lorde’s daring exemplifies how selecting among choices may often be calculated, but a quantitative reckoning replies to an institutional logic while defeating a human one. You can neither remove a breast nor identify the most urgent cases of distress via a process of counting, even if the sector dreams of a joint intersectoral global tool. Worse still, these quantitative reckonings come rooted in the biased mathematics of our capacities and their deficiencies. This is the culture of “needs assessment”, our scrutiny of the stuff that people do not have while remaining unaware of or undervaluing what they do have (their assets, capacities, and well-honed powers of survival). Even there, INGOs often assess the stuff that people don’t have based on the stuff which they possess – so the shelter agency with a warehouse full of tarpaulin, employing staff with heavy financial and emotional stakes in delivering tarpaulin to people in crisis, making an assessment of people’s need for shelter, which it and the institutional funders then redefine as people’s need for this shelter agency to deliver tarps, and completely ignoring the fact that people themselves might see their need differently, not for a tarp but for a job so that they could buy a tarp or rent a home, or for security so that they could return to the home that they own. Lorde is clear: the mastectomy responds to her need.
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The articulation of the alibi
For as we open ourselves more and more to the genuine conditions of our lives, women become less and less willing to tolerate those conditions unaltered, or to passively accept external and destructive controls over our lives and our identities. Any short-circuiting of this quest for self-definition and power, however well-meaning and under whatever guise, must been seen as damaging, for it keeps the post-mastectomy woman in a position of perpetual and secret insufficiency, infantilized and dependent for her identity upon an external definition by appearance. (Lorde, p. 50).
Lorde lowers the Boom! That paragraph should hang as a reminder in the room of every strategic plan workshop, every project team weekly meeting, every community outreach worker morning briefing, and every government and UN office. As Global Truth Solutions summarizes this travesty: it “is indisputable that people should be ‘at the centre’ of humanitarian assistance. It is equally indisputable that they are not.”
Frequently critical in her thinking, Lorde seemingly saves a particular disdain for the ‘saviors’. Not the authors and friends in whom she found wisdom and solace, but in the energetic champion of a prosthetic breast that was so realistic Lorde would “never know the difference”. Lorde’s rebuke thus fell upon a well-meaning woman from Reach for Recovery, who dispensed useful advice and the idea that through prosthesis, Lorde could be “just as good as [she] was before because [she could] look exactly the same.” (Lorde, p. 34). This injurious comparison to the accepted standard, the unattainable perfection, pokes a particular spear in the ribs of international aid.
Today, Lorde’s declaration of empowerment – Every woman has a militant responsibility to involve herself actively with her own health (Lorde, p. 65) – seems ever more distant in humanitarian contexts (and more globally?). Despite increased awareness of the sector’s inequitable power dynamics vis-à-vis people in crisis, the distance to a humanitarian emancipation grows because the root of this humanitarian power lies in its capacity to transform.
First, humanitarian action resembles a response to people’s problems yet more accurately constitutes an alleviation of symptoms (of deeper crisis), a shallowness that manages to elicit both hand-wringing and acceptance for decades on end, along with considerable financial backing. In Lorde’s cancer experience, this humanitarian power is mirrored in the sleight of hand effected by mastectomy as a cosmetic experience: “…the concentration upon breast cancer as a cosmetic problem, one which can be solved by a prosthetic pretense.” (Lorde, p. 47). I have often talked about this in terms of the humanitarian alibi. Like a prosthetic breast, humanitarian action forges a humanitarian pause, healing enough global anxiety and stopping enough bleeding for the world to look elsewhere. No breast cancer to see here.
Second, and far less visible in our self-criticism, much can be learned by a community sharing the experience of struggling to overcome the destruction and pain of crisis. The alternative, to which we’ve born witness over the past five decades of humanitarian action, has helped instill reliance and dependency as a degradation that, once internalized, too often becomes self-perpetuating. Speaking at the individual level, to these geo-political effects (e.g., the causes and politics of breast cancer) Lorde adds personal politics.
The emphasis upon wearing a prosthesis is a way of avoiding having women come to terms with their own pain and loss, and thereby, with their own strength. (Lorde, p. 41).
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Little or no choice
I think now what was most important was not what I chose to do so much as that I was conscious of being able to choose, and having chosen, was empowered from having made a decision, done a strike for myself, moved. (Lorde, p. 25).
Even in a state of crisis and facing complexity beyond her training, Lorde insisted upon and exercised her agency. Of course, aid is often critical to the survival of people. In practice, we decision-makers, we in the agencies, we often decide for and gamble with the lives of others. We inherited such power, but who gives it to us today? And how is such a hierarchy maintained for years and then decades? We know the answers and yet we resist the solutions. The real task is to think hard about that resistance. How can we resist our institutional and personal resistance? Can ethics help?
Medical ethical principles, for example, accord a remarkable value to autonomy, creating stringent safeguards that require consent except in very limited circumstances. Even if acting in the best interest of their patients, doctors cannot act without the various options being explained to the patient, who owns and takes the decision. The exception is when the patient is incapacitated (e.g., unconscious), and even there, ethical guidance requires scrutiny to be placed upon the necessity of immediate action and the potential for alternative courses of action. Stripped bare, the logic of charity pales in comparison: the choice – mastectomy or chemotherapy – is taken to be ours (and our donors).
In spite of high-level perennial commitments and policies for accountability to affected people (AAP), the sector remains “stuck in the weeds.” The way out of the weeds is not to create and impose more policies or launch new guidance and conferences. Our path out of the weeds is to recognize and operationalize our existing lodestar principle of humanity. We are stuck not in weeds but in a modern age transgression of that principle. That benefits are delivered does not elude this conclusion. When necessary, accountable compromises to humanity – properly deliberated and reviewed – may be required in some situations. But pasting the excuse of “emergency” onto years of protracted crisis flunks the humanity test.
There is a progressive cost to ignoring this basic ethic of respect, our own principles, and the consequences of treating communities as societal equivalent to unconscious. A cost to ourselves, as we increasingly become accustomed to unnecessarily harmful ways of working, and they solidify in our processes and our norms. A cost to people, as stunting takes place when this disregard carries on for decades, sequentially divesting people of the opportunity to do “strikes” for themselves. Perhaps one answer to “how much divestment?” lies in the near absence of resistance. The lack of significant resistance from communities themselves suggests prolonged disempowerment; and the lack of resistance from local governments seems self-interested (a discharging or responsibilities).
The alternative is to operationalize faith in people having alternatives. We have alternatives. This returns us to Lorde, who in the period after the surgery worried about the possibility of a recurrence and how she might deal with her life being shorter than she had expected. “Would I be able to maintain the control over my life that I had always taken for granted.” (Lorde, p. 48). This control is part of the human experience, and should be part of the humanitarian principle of humanity.
[1] Audre Lorde, The Cancer Journals (1980) London: Sheba Feminist Publishers; p. 27.
[2] Or is it an acceptable form of disinformation, given the good intentions? I worry that future societies will view it as a form of organized fraud — telling a false story in return for cash!