Report on Public Health Interventions during Complex Crises Situations

This report provides a comprehensive analysis of public health interventions in complex crises, emphasizing the crucial role of Non-Governmental Organizations (NGOs). It explores the qualities that make NGOs effective actors, such as rapid response capabilities, adaptability, and mobility, while also highlighting their ability to generate public awareness. The report examines the provision of health services by NGOs, differentiating between short-term emergency and long-term reconstruction phases, and provides examples from crises in Rwanda, Liberia, Somalia, and South Sudan. It identifies challenges faced by NGOs, including poor coordination, lack of a big picture perspective, and being overlooked by governments. The report concludes by suggesting strategies to improve the efficiency of NGOs, such as fostering better coordination, empowering staff, and recognizing the importance of both short-term and long-term interventions. Furthermore, the report emphasizes the importance of preparedness, including training and inter-sectoral coordination, to enhance the overall effectiveness of public health responses during complex crises.

Running head: PUBLIC HEALTH INTERVENTION IN COMPLEX CRISES 1
PUBLIC HEALTH INTERVENTION IN COMPLEX CRISES
Student’s Name
Institutional Affiliation

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Public Health Intervention in Complex Crises
Complex emergencies are generally connected with extensive devastation of possessions
or potentially gigantic dislodgment of populaces. They are additionally connected with
increments in bleakness, mortality, and the latent for ailment episodes is ordinarily high.
Thus, complex emergencies need fast and composed reaction all together to convey essential
administrations to the influenced populace and decrease the probability of increment in
morbidity, mortality, and flare-ups.
Complex crises tend to attract three vital actors for example bilaterals (legislatures of
individual nations), multilateral (for example UN offices engaged with alleviation work like
UNHCR, OCHA and so on) and Non-Governmental Organizations (NGOs). The army is
additionally being increasingly perceived as a noteworthy actor in crises. NGOs can be
indigenous or on the other hand, universal and they play a pivotal come in conveying
different types of administrations in complex emergencies (Burkle, 2016). They fluctuate
incredibly as far as money related, specialized, and operational limits. Customarily in
multifaceted crises, there has been an improper inclination to put undue unmistakable quality
on universal NGOs (Mills, 2015). This is mostly because of the more considerable assets, both
money related and biological, that these worldwide NGOs have (Mitchell, O’Leary & Gerard,
2015). However, the NGOs with scarce assets but excessive acquaintance of the local
condition have a significant impact in regards to service delivery to the displaced population.
Qualities of NGOs as Actors in Multifaceted Crises
Complex crises will, in general posture fluctuating dimensions of political and security
dangers. Therefore, various actor approach complex crises in multiple ways, contingent upon
their political and security contemplations (Kruke, 2015). Additionally, amid the actors in
multifaceted crises, NGOs have minimal hindrances to the section in the debacle region.

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Furthermore, NGOs have different qualities that make them perfect actors in crises. These
qualities incorporate;
a) Capacity to react quickly
Most significant alleviation NGOs have set up conventions on step by step instructions to
respond to crises, be it artificial or catastrophic events. They moreover have promptly
accessible human, quantifiable and money related assets for utilisation in disasters. Likewise,
they can quickly prepare new assets for usage (Barnett & Walker, 2015). This brands NGOs
ready to react promptly to complex emergencies. In numerous circumstances, NGOs have
been the leading to arrive and begin conveying administrations even earlier than the bilateral
and multilateral accomplices come, also, at times even earlier than the host governments.
b) Adaptability
Utmost NGOs, both great and little, have the ability to adjust quickly to evolving
situations. Several multilateral and bilateral accomplices have standards and guidelines that
occasionally prevent their activities. For instance, numerous multilaterals and bilateral have
stringent safety precautionary measures which in a few occurrences may block administration
conveyance to populaces in extraordinary need. In expansion, multilateral and bilateral
entertainers need to think about host administration concerns which in certain occurrences
may hinder conveyance of administrations in multifaceted crises (Dailey & Starbird, 2015),
c) Mobility
NGOs can achieve numerous challenging to achieve regions and populaces. Some
plentifully supplied NGOs have their air or ocean conveyance abilities, and this makes them
be able to go everywhere.

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d) Generating public Alertness
This is being a fragment of the civil community; NGOs generally have great media
connections. NGOs have utilized their association with the mass media to make public
alertness and keep up the spotlight on issues they contemplate significant. This association
with mass media can be amazingly valuable in complex crises as it makes consciousness of
the circumstance as well as urges donors to offer help (Einarsdóttir & Gunnlaugsson, 2016).
This association of NGOs and the media was especially vital in the underlying phases after
the torrent when the complete effect and demolition had not been entirely fathomed by
numerous individuals, counting political pioneers in the influenced nations.
Health Service and NGOs Provision in Complex Crises
NGOs play a vital role in the production of health services in complex emergencies areas.
There is tusk can be categorized as both long terms during the reconstruction stages and short
term in the emergency stages of a disaster (Iizuka, 2018). A typical example is evident during
the Rwanda and Liberia crisis where the NGOs were not the first response unity on the
ground, but at a certain point, they become accountable and supported an approximate of
95% of health care deliveries (Balboa, 2015). On that note, the NGOs have been seen to be
beneficial during the eruption of complex emergencies. Therefore, a significant amount of
health services are being provided in both the nations up to date by the NGOs despite the
crises happening more than ten years in the past. Scheming of national medication decorum
such as malaria has been rendered by the NGOs in Liberia. On the other hand, nations such as
Somali and South Sudan, NGOs have assumed a significant tusk in the provision of quality
health care services to the affected people.
The essential public health amenities that are being provided by the NGOs during complex
emergencies situations constitute of vector control, therapeutic services, water and sanitation,
aid in disease surveillance, training, and health education (Ramesh, Blanchet, Ensink &

PUBLIC HEALTH INTERVENTION IN COMPLEX CRISES 5
Roberts, 2015). During the early phases of emergencies, the NGOs can provide a significant
portion of therapeutic services. Additionally, they were the vital source of infection
reconnaissance data. The militant groups and the NGOs initially provided dengue fever
outbreak and vector control activities in the prevention of malaria. Emphasis needs to be put
on the benefits that have been retrieved from the NGOs services in the management of the
complex emergencies.
A significant portion of the complex emergencies is categorised by population
displacement, widespread violence, and loss of life, extensive damage to the economies and
societies. In addition, there are significant safety risks in for the humanitarian respite workers
in some of the regions, need for multi-faceted, great humanitarian scale assistance and
mitigation of the humanitarian aid by army and political constraints (Deloffre, 2016).
Challenges Tackled by the NGOs
The consequences of complex emergencies are often long-lasting and can take a long
duration for it to be resolved entirely, such as the aftermath of a flood. It is essential that the
humanitarian specialist in providing an actual response to the situation the ground since
altered information will lead to inadequate evaluation of service delivery (Blanchet et al.
2017). The experts that are working on the long -term challenges need to be available at the
early stages of a complex emergency.
Nonetheless, NGOs being significant in disaster response management, it also faces some
of the difficulties during service delivery. The significant problems that the NGOs faces
comprise of poor coordination, lack of big picture, and being ignored.
a) Poor Coordination
Partaking a solid coordinating frame is crucial for the prosperous delivery of services to
the affected population during complex emergencies. Thus poor coordination will lead to the
NGOs to eventually have duplicate projects and in a similar locality and hence it may lead to

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unequal distribution of services and resources. The NGOs seem to be chaotic as a result of
insufficient dominant coordinating system
b) Lack of Big Picture
This is often a considerable challenge to the minor NGOs that have lack stable attachment
with the multilateral and the government (Foghamma et al., 2016). This situation leads to the
small NGOs to lack awareness of what is taking place on the ground in terms of location and
number of people that have been displaced, the scale of destruction and the prioritized
services that need to be offered. As a result, NGOs may get involved in some of the projects
that are not justifiable after their departure.
c) Being Ignored
The native government where a complex emergency has to erupt often tend to ignore the
NGOs services and majorly deal with the multilateral and the bilateral. On that note, the
NGOs are not seriously taken, and their concerns are considered to be non- technical. This is
because of their existence and interaction with the affected people; particularly the local ones
are in a restored position to recognize and correct the requirements of the affected people.
The local NGOs that are being looked down upon by the government are the ones that are
significant in determining and creating awareness during complex emergencies. Hence they
can make concerns in the situation where there is a lack of water and sanitation services amid
the communities in the remote regions that can be accessed or identified with ease.
Refining the Efficiency of NGOs
To improve the service delivery of various emergency services, it is essential to enhance
the manner that Improving the effectiveness of NGOs works in complex emergencies. It is
high time that the native multilateral, bilateral, and governments need to appreciate and
understand that NGOs play fundamental tusk in catastrophe response (Conrad, 2015). The

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NGOs need not to be viewed as contestants by the constitutional government thus should be
seen as the actors who if appropriate engaged can enhance the humanitarian response during
the complex emergencies (Nickerson, Hatcher-Roberts, Adams, Attaran & Tugwell, 2015).
Creation of excellent links amid the multilateral, bilateral, NGOs and the government can
reinforce on the manner the actors work in the crises.
It is essential for the NGOs to be involved in the process of policy formulation and
decision making. Hence incorporating the views of the NGOs will aid in coming up with the
appropriate remedies during the emergence of a disaster (Banks, Hulme & Edwards, 2015).
Empowering the NGOs stuff members by offering practical training to them in both the field
level and the headquarters to improve their technical abilities. This type of association will
standardize the techniques that have been utilized by different partners and also enhance the
transfer of skills and knowledge to strengthen the relationship between various NGOs. There
is a need to motivate the small local NGOs services because they are the fundamental players
in response to humanitarian (Visoka, 2015). However, they may not be at the capacity to
contest the vital global interventions in term of financial and human assets, but on the other
hand, they have background understanding and knowledge on the affected population (Melin &
Olander, 2019).
It is essential to portion the requirements of the people that are suffering as a result of the
complex emergencies into two. The categories comprise of the long term and the short term
requirements. The short terms requirements can be termed as the immediate aid that is
offered by the humanitarian professionals (Spiegel, 2017). The humanitarian experts are
trained to address the needs that are mostly agents such as water, shelter, food, sanitation,
logistics, epidemiological surveillance, and medication (Downes, 2015). On the other hand,
the experts that are dealing with the long term impacts are from varying proficient
backgrounds.

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A vivid example is a situation that was witnessed in Angola after several years of civil war
that led to the placement of scheme that will deal with the situation which cannot be handled
by the humanitarian experts (Ventevogel, Ommeren, Schilperoord & Saxena, 2015). This
type of situation is majorly dealt with by long term experts such as the planners and
developers. The specialists can deal with the critical issues in complex circumstances like the
enactment of the operational health care programs with native resources. Setting up a crisis
response in the task of the humanitarian specialist and dealing with the extended crisis can be
handled by developer expert.
Preparedness
NGOs perceive preparation to be the most appropriate investment. These processes
include activities such as training of the health sector personnel, supporting the
implementation and the progressively reinforce the national disaster programs, inter-sectoral
coordination, and inter-institutional mechanism. The NGOs majorly depend on the local
responses to a disaster to evaluate the magnitude that it has and if there is a need for global
interventions. The professional association amid the international and the local officials can
lead to the mobilization of the international resources in complementing the national and
local response.
The key aspects in regards to complex disasters comprise of the protection of the public
health service need for quality information and availability of the timely and appropriate
specialist (Seu, & Orgad, 2017). On the other hand, in the majority of the complex
emergencies, the available data is fragmented, and thus, the information needs to be assessed
with care to avoid the risk bias during reporting.

PUBLIC HEALTH INTERVENTION IN COMPLEX CRISES 9
Prevention of Public Health Effects of Complex Disasters
The consequences of prevention of public health on complex disaster is categorized into
tertiary, secondary, and primary.
a) Primary Intervention
Primary health is regarded as the primary strategy of public health, and epidemiology is its
crucial tool. In the circumstances of armed conflict, epidemiology can be practiced reliably
and safely in certain areas. Monitoring, traditional documentation, and assessment elements
of the infection can be ineffective in this situation (Davies & Bennett, 2016). In the countries
that have been affected by war, provision of necessities like adequate shelter, food, sanitation,
potable water, and immunization has been challenging. The major focus of primary
prevention is by ending the violence.
b) Secondary prevention
It involves early identification by evolving conflict affiliated food scarcity and population
movements and development of the proper public health skill to facilitate the effective
working of the works. Moreover, it prepares the framework that mitigates public health
impact. The crucial stages in the secondary prevention comprise of early detection,
contingency planning, and personnel training.
c) Tertiary prevention
It incorporates the prevention of excessive morbidity and mortality in the situation that a
disaster happened. Health complications have been identified that lead to critical morbidity
and cause the majority of the death.
In conclusion, the NGOs play a major role in resolving the complex emergency. It is
therefore essential for all actors to work together, by formulating a typical response to
increase the strengths and hasten the process of solving complex emergencies. The key to a

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10
prosperous reaction to calamities is by enhancing donor response and supporting public
awareness (Veenema, Rains, Casey-Lockyer, Springer & Kowal, 2015). For the NGOs to
effectively perform their tusk in service delivery to the affected population, they have to
support and encouraged by the government.

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References
Balboa, C. M. (2015). The accountability and legitimacy of international NGOs. In The NGO
challenge for international relations theory (pp. 179-206). Routledge.
Banks, N., Hulme, D., & Edwards, M. (2015). NGOs, states, and donors revisited: Still too
close for comfort?. World Development, 66, 707-718.
Barnett, M., & Walker, P. (2015). Regime Change for Humanitarian Aid: How to make relief
more accountable. Foreign Affairs, 94(4), 130-141.
Blanchet, K., Ramesh, A., Frison, S., Warren, E., Hossain, M., Smith, J., ... & Dahab, M.
(2017). Evidence on public health interventions in humanitarian crises. The
Lancet, 390(10109), 2287-2296.
Burkle Jr, F. M. (2016). Complex public health emergencies. Koenig and Schultz's Disaster
Medicine: Comprehensive Principles and Practices, 433.
Conrad, D. (2015). The Freelancer–NGO alliance: What a story of Kenyan waste reveals
about contemporary foreign news production. Journalism Studies, 16(2), 275-288.
Dailey, D., & Starbird, K. (2015, February). It's Raining Dispersants: Collective
Sensemaking of Complex Information in Crisis Contexts. In Proceedings of the 18th ACM
Conference Companion on Computer Supported Cooperative Work & Social
Computing (pp. 155-158). ACM.
Davies, S. E., & Bennett, B. (2016). A gendered human rights analysis of Ebola and Zika:
locating gender in global health emergencies. International Affairs, 92(5), 1041-1060.
Deloffre, M. Z. (2016). Global accountability communities: NGO self-regulation in the
humanitarian sector. Review of International Studies, 42(4), 724-747.
Downes, E. (2015). Nursing and complex humanitarian emergencies: Ebola is more than a
disease. Nursing outlook, 63(1), 12-15.

PUBLIC HEALTH INTERVENTION IN COMPLEX CRISES
12
Einarsdóttir, J., & Gunnlaugsson, G. (2016). Applied ethics and allocation of foreign aid:
disparity in pretensions and practice. Development Policy Review, 34(3), 345-363.
Foghammar, L., Jang, S., Kyzy, G. A., Weiss, N., Sullivan, K. A., Gibson-Fall, F., & Irwin,
R. (2016). Challenges in researching violence affecting health service delivery in complex
security environments. Social Science & Medicine, 162, 219-226.
Iizuka, A. (2018). The nature and characteristics of Japanese NGOs in international disaster
response. Disaster Prevention and Management: An International Journal, 27(3), 306-
320.
Kruke, B. I. (2015). Planning for crisis response: The case of the population
contribution. Safety and reliability of complex engineered systems. CRC Press, Boca
Raton, 177-186.
Melin, M. M., & Olander, P. (2019). Supply-side incentives for mediation: which actors
mediate international crises and why?. In Research Handbook on Mediating International
Crises. Edward Elgar Publishing.
Mills, K. (2015). What Responsibilities Does the International Community Have in Complex
Humanitarian Crises and Mass Atrocity Situations?. In Human Rights Protection in
Global Politics (pp. 223-244). Palgrave Macmillan, London.
Mitchell, G. E., O’Leary, R., & Gerard, C. (2015). Collaboration and performance:
Perspectives from public managers and NGO leaders. Public Performance & Management
Review, 38(4), 684-716.
Nickerson, J. W., Hatcher-Roberts, J., Adams, O., Attaran, A., & Tugwell, P. (2015).
Assessments of health services availability in humanitarian emergencies: a review of
assessments in Haiti and Sudan using a health systems approach. Conflict and health, 9(1),
20.