Statement of
Mr. Rabih Torbay
Vice President for International
Operations
International Medical Corps
Before the House Foreign Affairs
Subcommittee on the Middle East and South Asia and the
Subcommittee on International
Organizations, Human Rights, and Oversight
Thursday, May 1, 2008
No Direction Home: An NGO Perspective on Iraqi
Refugees and IDPs
Chairman
Delahunt, Chairman Ackerman and members of the subcommittees, I am Rabih Torbay, Vice President for International
Operations of International Medical Corps (IMC), a private nonprofit voluntary
organization headquartered in Los Angeles, California that has been working continuously in Iraq since
April 2003. Thank you for this opportunity to appear before you. We appreciate
your leadership in focusing on the needs of over 2.7 million internally
displaced Iraqis. I am
here today to ask you to support a “humanitarian surge” that can
improve the prospects for long-term stability for all of Iraq’s
citizens.
International Medical
Corps was founded in 1984 by volunteer doctors and nurses to train mid-level
health care workers in Afghanistan.
We are now a global humanitarian non-profit organization dedicated to saving
lives and relieving suffering of those affected by war, natural disaster and
disease and to delivering vital health care services that incorporate capacity
building of our counterparts. IMC helps people return to self-reliance by enabling
the development of essential skills for health, livelihoods, rehabilitation and
service delivery. IMC implements major emergency relief and longer term
transitional and development programs that deliver comprehensive health and
nutrition services, rehabilitate infrastructure, train local personnel and
enhance community participation and development in more than 20 countries
including Iraq, Jordan, Syria
and Lebanon.
Today we are focusing on
our work in Iraq.
I had the privilege of establishing our mission there in 2003 and have visited
more than a dozen times since then. I share responsibility for program oversight
and operations with our in-country expatriate director who has been with IMC in Iraq for the past five years, working with
national and local Iraqi government officials; various US entities, including
the US embassy and US Agency for International Development (USAID); the United
Nations; international and Iraqi nongovernmental organizations (NGOs); and
local religious and tribal leaders. International Medical Corps has employed thousands
of local staff over the years, the vast majority coming from the communities
where we work. Currently, we have more than 400 staff members in Iraq,
including 11 expatriates and over 40 visiting technical experts, who live and
work in the “red zone.” Because of the insecurity and tensions in
the country, we depend on building close ties to the communities in the 18
governorates where we work. We vet and hire staff locally and consult and
collaborate with Iraqi institutions, officials, local leaders and groups to
garner support for the relief, development and training efforts that we
implement.
I have just returned from
a ten-day trip to Baghdad and would like to
share with you my observations about the situation of internally displaced persons
(IDPs) in Iraq
and efforts to meet their urgent and growing needs.
Country
Context
At
the start of International Medical Corps’ program activities in 2003, Iraq was
emerging from a 35-year dictatorship that had sapped local initiative, suppressed
opposition or disagreement, imposed highly centralized decision making structures
that controlled every aspect of life and brutally punished rule violators.
Years of war and heavy defense spending, widespread corruption, ruinous
economic policies and the impact of sanctions had crippled the economy and
stripped bare budgets for human services and infrastructure. Because of this
political and economic history, rehabilitating and revitalizing the economy to
one that is more open and democratic will understandably take a substantial
amount of time and resources.
When
the new Iraqi government came to power in 2004, many of its ministries lacked
technical know-how and experience in planning, budgeting and managing or
setting standards needed to operate effectively. Heavy levels of bureaucracy
and fear of possible negative consequences remained and hindered
decision-making. These new ministries were not without serious problems, some of
which have persisted. Various officials have misused ministerial positions at
the local or national level to punish and wage war on their enemies; to permit
and even benefit from corrupt practices; to mistreat vulnerable children and
the sick; and to accept nonperformance, shadow employees and interminable
delays. Other officials who want to move forward have lacked models and
standards. If the US and the international community do not immediately
build the capacity of these ministries and their human capital - insisting on
the need to raise standards, performance and accountability within these ministries
- then Iraq’s problems will
worsen and the situation of displaced and vulnerable Iraqis will continue to
deteriorate.
Vulnerable
Iraqis will be impacted the most if the Government of Iraq (GoI) is
ill-equipped to operate efficiently and effectively, while ordinary Iraqis may
lose hope for any chance of developing a pluralistic, more democratic and
modern Iraq. As reported on April 22, 2008 in The New York Times,
Iraqis tell the US military that “they see their basic needs as being
more than food, clothing, shelter…They include electricity, water and
sewage. And until the Iraqi government provides them with such basic services,
they won’t trust them.” IMC
can confirm that this is a common sentiment heard repeatedly within the Iraqi
communities it serves. The delivery of services to IDP and host communities
is critical to the stability of Iraq.
Forced
Displacement
While
there have been large-scale movements of people within the country’s borders
since the 1980s, the most recent and visible displacement occurred after the
bombing of the Al-Askari Mosque in Samarra
in February 2006. Unlike other population movements that occur en masse over a
short period of time, this most recent displacement in Iraq has been
continuous over many months as individual families’ predicaments
gradually become untenable due to intensified sectarian conflict. As such, the
nature and effects of internal displacement must be considered against a
complex background of strong family support structures, a fledgling government
and fragile and uncertain security levels.
Millions
of Iraqis have been forced to flee their homes and properties in mixed
neighborhoods or conflict areas to safer parts of the country or abroad.
Homeless and jobless, many displaced rely on traditional Iraqi hospitality to
survive – family or friends are expected to welcome guests and provide
for their needs even if it means struggling to provide for their own families. With
personal and family resources exhausted and government services struggling to deliver,
the needy are increasingly turning to non-state actors for assistance.
Few IDPs in Iraq live in camps or on the street,
masking the extent of the displacement. Some two million people were able to
flee to neighboring countries, such as Jordan
and Syria, but as
displacement has continued and neighboring countries have restricted
admissions, and pressure on the U.S.
and Iraqi governments to respond to the needs of the uprooted has increased, the
needs of IDPs and their host families have grown more urgent.
On-going threats of violence have strained families’
resources and their physical and mental well-being. Uncertain access to food
and opportunities for livelihoods has increased vulnerability. Insecurity and
government rules can make it difficult for the displaced to access Iraq’s
Public Distribution System (PDS)
for food and cooking fuel, which, according to the United Nations Development Program,
was supporting 96% of the population in 2004. While the PDS rations are
delivered on a monthly basis, there are regular reports that deliveries do not
always contain all the supplies they are supposed to. Those who work as daily
laborers depend heavily upon the monthly PDS
to provide the majority of their staple food stuffs. Should they be unable to
access work either through imposition of curfews or deteriorating security,
they become wholly dependent upon the stockpiled PDS
rations. Fighting
in certain areas has restricted the government’s ability to deliver the
rations to the communities affected, and now, rising food prices are
threatening to further complicate delivery of the World Food Programme’s (WFP)
food aid to Iraq.
Who Are the IDPs?
While exact numbers of displaced persons are
difficult to obtain, the Ministry of Migration (MoM)
now estimates that total internal displacement has reached 2.7 million. This
includes 1.2 million individuals who were displaced before February 2006 and
1.5 million individuals displaced afterwards. According to the Ministry’s
statistics, 64% of the displaced are originally from Baghdad. Eighty-two percent of that
population comprises women and children, while 58.7% are children under 12
years of age. IDPs face malnutrition, lack of shelter, lack of health services,
inadequate water and sanitation, high unemployment, restricted freedom of
movement and limited access to training or education. Displacement puts families
at grave risk economically, socially, physically and psychologically. The
communities that have hosted large IDP populations have become as destitute as
the displaced. For example, several governorates that have received displaced
persons from Baghdad, such as Karbala,
Najaf and Babel,
among others, are saturated, with their already fragile services and
communities overwhelmed by the large numbers of displaced.
Displacement
rates leveled off at the end of 2007, due in part to the ceasefire announced by
Al Sadr and the U.S.
military surge. Although levels of violence have decreased, the possibility of a
return to normal life has been negatively affected by the continuous threat of
insecurity and terrorist attacks, which are still prevalent in parts of Iraq, as evidenced by the recent violence in Basra and Baghdad’s
Al Sadr district.
The
massive movement of IDPs to and from the governorates of Baghdad,
Karbala, Najaf, Babel,
Al-Anbar, Basra
and Ninewa since February 2006 has had a significant impact on the country.
This displacement has created a major shift in sectarian demographics. It is
clear that the main drivers to return are some confidence in adequate levels of
security and access to services in the place of origin.
Last
fall, International Medical Corps conducted an IDP survey, “The
Socio-Economic Crisis Among IDPs in Iraq,” to gain a better
understanding of the socioeconomic status of IDPs in their new locations. IMC found that while 95.7% of IDP families surveyed
were dependent on a breadwinner for income, 85% of IDPs were unemployed at the
time of the survey. For 75% of respondents, finding employment was their primary
concern, but was complicated by a lack of knowledge of job opportunities in
their areas of displacement. Some 28.5% of respondents were illiterate, and 57%
had only a primary education, making it difficult for them to find work except
as unskilled laborers, which put them in competition with host community
laborers in an oversaturated market. Most IDPs suggested that they wanted to
remain in their current secure locations if they could find long-term work.
This
study found that families, which averaged six persons per family, were hard-
pressed financially to find and afford adequate shelter. At the time of the
survey, 59% were renting houses, 18% lived with host families, 22% were in
collective settlements and 1% resided in tent camps. In addition, 40% of the
IDPs lacked access to safe drinking water, and 14% had no access to medical
care, while one-third were unable to obtain needed medications. While the
relatively better-off were able to rent flats or houses, dwindling resources
were coupled with rising rents – particularly in areas with an influx of
IDPs or refugee returnees. Almost all (83%) the displaced men and women surveyed
wanted livelihood opportunities and/or vocational training to help them meet
basic needs and to lessen confrontations and social tensions with their host communities.
Returnees
At
the end of March 2008, the Ministry of Migration reported a total of 13,030
returnee families (approximately six persons per family). Of this total, 83%
returned from internal displacement and 17% from abroad; 4,300 of the 13,030
families returned to Baghdad. The
government was offering registered returnees a $1,000 payment in Baghdad, and the MoM’s
implementing partners were providing ad hoc food and nonfood items. While it is
believed that some IDPs and refugees returned because of perceived security
improvements, others returned because they lacked any other options. Mass
returns organized by provincial councils or government ministries have been
deficient in long-term planning, sufficient reintegration assistance and
services needed to have a durable impact. Currently, returnee families who have
registered with the government upon their return are offered a six-month
stipend of $150; however, the registration process is complicated and difficult
to access.
MoM
survey teams interviewed 300 returnee families in five different locations and
found that 98% reported they were returning from internal displacement. Only
45% found that their “non-moveable property” was accessible and in
good condition. Some returnees are trying to reintegrate into the social and
economic fabric of their original areas or into new communities if their community
of origin is insecure or has become a single ethnic or sectarian enclave.
Returnees suggest that after security, their major concerns are shelter,
employment, education and access to utilities including water, electricity and sewage.
Heads
of family tend to return “under the radar” to assess their home
communities or new ones, before deciding whether to bring their families back.
Some returnees do not register, preferring anonymity to the $1,000
compensation.
Large-scale
returns of IDPs are unlikely; instead, returns will probably continue to occur
over an extended period of time and in small numbers. Regardless of the number,
there is a possibility that many of those displaced are unlikely to ever return
to their place of origin due to the nature of their displacement and the permanently
severed community ties. Furthermore, both the government and the
international community agree that Iraq is not yet ready for large-scale
return of the displaced.
Iraq Requires a Humanitarian Surge
The recent improvement in security in parts of the
country provides a window of opportunity for addressing the needs of Iraq’s
displaced populations. International Medical Corps has been advocating since
November 2007 for a “humanitarian surge” to improve prospects for
long-term stability in Iraq.
The continued lack of basic services in Iraq, particularly for IDPs, their host
communities and the returnees,
should be addressed by “scaling up” NGO direct assistance efforts while
concurrently building the capacity of GoI ministries to enable IDPs to more
quickly reintegrate into their old communities or join new ones.
More donors and humanitarian actors are needed to
fill the relief to development “gap” that prevents so many Iraqis,
but particularly IDPs and host communities, from living normal lives with jobs,
adequate housing, health care, education, water and electricity. The US,
and other donors, should fund their NGO partners to intensify efforts to train
Iraqi ministry counterparts at the national and governorate levels so that the
GoI’s ability to govern responsibly and provide essential services is
increased. While the GoI’s capacity is being enhanced, donors should
continue and increase support to NGOs responding to emergencies and meeting the
basic human needs of Iraq’s
most vulnerable populations.
Security through Community Involvement and
Support
International Medical Corps has worked in all 18
governorates in Iraq,
operating from 11 offices in Baghdad, Erbil,
Nassiriya, Amara, Najaf, Karbala, Babel, Baquba, Anbar, Muthana and Mosul. Having worked in Iraq
continuously for over five years and being based outside the Green Zone, IMC operates without the protection of the Iraqi or
US military or private contractors. Working and living among the community, IMC has developed a skilled, knowledgeable staff
and a support network throughout the country. Operating under a strict model of
acceptance, IMC is able to simultaneously
respond rapidly to emergency situations and implement sustainable community
support programs. With the support and acceptance of local leaders and
government institutions that are familiar with our work and recognize the
benefits, we operate on a basis of mutual trust and understanding in the most
difficult areas. As in any service industry, failure to deliver quality work
would reduce IMC’s access to
communities in the future. In a society that is skeptical of any external
intervention, a failure to deliver could have terrible consequences. Continuity
and consistency have been a major factor in our acceptance.
International
Medical Corps maintains a level of discretion in implementing activities so as
not to compromise program staff or beneficiaries. Although we have worked in all 18
governorates, we strive to localize the nature of each intervention so that its
work in the community is well respected, integrated and appreciated by local
political, religious and tribal leaders, as well as governorate and ministry
officials. Community acceptance and ownership play a major role in the
protection of our staff and assets, as well as the safety of the projects.
Effective travel management procedures—from extensive route planning through route reconnaissance and surveys, to
convoy integration and low profile movement—have proven to be successful
in protecting staff as they travel extensively throughout Iraq. IMC also makes extensive use
of photography, video and GPS mapping data and weekly reporting to monitor
projects. Recently,
in Sadr City, fighting made it impossible to
bring civilian vehicles into the area, so we consulted locally and improvised. Wheelbarrows
were used to deliver a month’s supply of food, water and medical supplies
to vulnerable families and institutions affected by an extended curfew and
heavy fighting.
IMC Monitoring and Evaluation
International Medical Corps holds its Iraq programs
to the same high monitoring standards as programs in other countries.
Monitoring and evaluation teams are used for tracking progress, monitoring
quality and assuring that programs are delivered to international standards.
For all projects, there is ongoing monitoring on several levels: institutional
monitoring (financial, physical and organizational issues that affect the
program), context monitoring (tracking the context in which the project is
operating, such as changes in critical assumptions and/or risks, policy changes
or other areas that may affect the capacity of the project to respond) and objectives
and results monitoring (assessing whether objectives and strategies developed
are relevant to the changing situation on the ground and if the results are on
track).
International Medical Corps faces many challenges
in the monitoring and evaluation of its activities due to the unstable and
insecure operating environment. Security restrictions on travel prohibit many
senior staff, and certainly expatriate staff, from accessing many of our
project sites. To address this challenge, IMC utilizes staff capacity building
for assessment/implementation teams to develop alternative approaches, such as
extensive use of photography, video and GIS data mapping to overcome the lack
of access to program sites. Additionally, IMC employs a large network of national
staff with varied backgrounds, allowing them to reach every corner of Iraq.
Through this team, IMC is able to monitor projects through frequent visits and
beneficiary interviews, as well as the alternative approaches mentioned above.
Additionally, our main donor, the Office of U.S. Foreign Disaster
Assistance of USAID, has contracted a monitoring and evaluation organization,
International Business and Technical Consultants, Inc., that independently
verifies the delivery, quality and success of IMC’s and other NGOs’
programs.
Coordination
International
Medical Corps works in coordination with Iraqi government authorities and local
community leaders and other national and international organizations to ensure
project sustainability and effectiveness and to help build government capacity.
Coordination helps complement and expand, rather than duplicate, existing or
proposed relief and development interventions. Coordination with other OFDA NGO
partners has helped IMC to achieve program objectives in a timely manner while
optimizing the use of available resources. IMC also maintains almost daily
contact with USAID, OFDA and the US embassy, updating them on achievements,
constraints, issues and plans and coordinates very closely with the different
UN agencies.
International
Medical Corps has strategic and operational partnerships with three of Iraq’s key
service delivery ministries: Ministry of Health, Ministry of Labor and Social
Affairs and Ministry of Migration. We also consult with the Ministry of
Education, Ministry of Higher Education, Ministry of Youth and Sport and the
Ministry of Women’s Affairs to ensure a gender-balanced approach. IMC
staff serves on a number of key government advisory committees dealing with
health, displacement and community economic development.
Will and Capacity of the Iraqi Government
While
the Government of Iraq should do more to assist Iraqis, both the internally
displaced and those living as refugees in the region, most of the ministries
are not yet equipped to do so. After 35 years of Baath party rule, full
centralization of authority, and a reluctance and fear of decision making, many
ministries are almost paralyzed by the traditional bureaucracy and a lack of
modern know-how. However, through IMC’s
recent work with the Ministry of Health (MoH), the Ministry of Migration (MoM)
and the Ministry of Labor and Social Affairs (MoLSA), we have noticed a will to
move forward, paired with their frustration over their lack of capacity.
International Medical Corps and the MoH are engaged in designing and
implementing a new Iraq health care strategy
reform and a new continuing medical education and continuing professional
development initiative for the country’s physicians that will update
national standards for the practice of medicine. This effort involves
around 45 physicians from the US
and the UK from a variety of
medical specialties who travel to Iraq to train their counterparts. For
the first time, the MoH is co-funding this training program, with the Iraqi
government providing $6 for every dollar invested by the donor. IMC and the
MoH have also recently launched a national emergency medicine training
initiative.
As
part of its efforts to build MoLSA’s capacity to provide better services
to the most vulnerable populations in Iraq, IMC
and MoLSA conducted an in-depth assessment earlier this year of all government
residential child care institutions. IMC,
with MoLSA involvement, renovated and equipped 11 of these residences, and
developed and conducted training for the manager and social worker at each
facility on modern standards of care, child psychology and case management. MoLSA
staff proved not only interested, but also willing to raise their standards of child
care to international standards, including the consideration of alternate
community child care arrangements, while recognizing their need for additional
training and resources for these activities.
International
Medical Corps’ primary partner in the GoI is the Ministry of Migration. IMC has a team of 17, including an expatriate staff
member, co-located at the ministry and working on professional managerial,
budgetary and business skills development to enable ministry staff to track IDP
movements, develop assessments of IDP needs and gaps in services and create
coordination mechanisms that would allow for Iraqi service ministries to aid
the displaced, although the ministry lacks the authority to require such
coordination.
The
same level of cooperation between government officials and IMC occurs at the
governorate level. For example, with the support of the governor of Najaf, IMC
conducted emergency preparedness trainings for different departments within the
local government, with many of the costs covered by the government. A similar
training is being planned for the governorate of Karbala.
Minorities
Religious
Minorities
It is currently estimated that 3% of Iraq’s population is composed
of religious minorities, including Chaldeans (an eastern rite Catholic Church),
Assyrians (Church of the East), Syriacs (Eastern Orthodox), Armenians (Roman
Catholic and Eastern Orthodox), Protestant Christians, as well as Yezidi,
Sabean-Mandaeans, Baha'is, Shabaks and Kaka’is (Religious Freedom: Iraq
2007).
In January 2007, the MoM reported that approximately half of the
country’s minority communities had fled abroad. Many Christians, once
numbering 1.35 million of the country’s 27.5 million, were forced to flee
Baghdad, some
seeking refuge in Ninewa and the Ninewa Plains, an area known to harbor many
religious minority groups. Like other internally displaced, they have not
received proper attention or substantial support, although recently Congress
earmarked $10 million to aid Christians and other minority groups in Ninewa Plains
via a FY08 appropriation.
International Medical Corps, given its historical presence and
ongoing humanitarian interventions in Ninewa plains, as well as its partnership
with the Assyrian Aid Society (AAS), believes that much more support is
required. There are an estimated 9-15,000 displaced families in the Plains, 80%
of whom are Assyrian/Chaldean/Syriacs. Although this is a relatively small
number when compared to other IDP populations, they are more vulnerable
given that they are targeted minorities. An AAS survey in 2007 found 70% of the
displaced from these minority groups expressing an interest in going abroad,
although over 50% would remain in the area if jobs and housing were available.
These groups now suggest that to preserve Iraq’s pluralistic society,
$100 million in relief and development funds should be invested to provide food
and nonfood items, shelter, higher education, water and sanitation,
agricultural and economic development initiatives to encourage these religious
minorities to settle and effectively integrate into the Ninewa Plains area.
With funding from OFDA, we have continuously provided relief
assistance, including non-food items and medical supplies, to those most
affected in Ninewa and Ninewa Plains and are currently rehabilitating schools,
establishing child friendly spaces and providing activities aimed at
revitalizing communities, all of which prioritize social integration and
conflict mitigation.
In Southern Baghdad, Sabean Mandeans had to leave their homes and
travel to Eastern Iraq for safety, only to find themselves once again close to
conflict due to efforts to expel al Qaeda from Iraq. Last August Al Qaeda
killed 300 Yezidis in bombing attacks on their villages in northern Ninewa
province. IMC, again, with funding from OFDA, responded immediately with
emergency relief assistance and supplies.
Palestinians
According to the UN High Commissioner for Refugees (UNHCR), the
Palestinians are the most vulnerable minority in Iraq. Under Saddam Hussein’s
regime, there were 34,000 Palestinian refugees who were denied Iraqi citizenship,
but were treated as a privileged minority and provided with essential
subsidies. With the fall of Hussein’s regime, many Palestinian
communities were attacked and driven from their homes, pursued by Shi’a
militias and other militant groups. Many fled to neighboring countries;
approximately 4,000 used forged passports to enter Syria, a country that is no longer
willing to harbor them and has forcefully pushed them to join Palestinians at
Al Tanf camp on the Syrian-Iraq border. They now live in tents and are subject
to extreme temperatures and brutal isolation, unwanted in either country.
UNHCR is now seeking resettlement opportunities for these and
other Palestinian refugees. The Palestinian population in Iraq has fallen to some 15-23,000
persons. They are still eligible for government rental subsidies, legal
representation and some assistance; however, IMC confirms that Palestinians are
still often targeted by insurgents, militants and other criminal groups.
Limitations and Constraints
Certainly, security is the main challenge for NGOs working in Iraq. NGOs
there must adapt to operating through limited humanitarian space and gain
acceptance and trust from communities.
Bureaucracy and lack of capacity of the Iraqi government is
another challenging issue, especially when work is coordinated with and
governed by different line ministries with varying levels of capacity, minimal
communication between them and with often times competing agendas.
Nevertheless, working closely with these ministries is an important means of
building their capacity and encouraging them to take ownership for their
citizens’ needs.
Adequate and timely funding is another limiting factor to
effective, timely and comprehensive responses to the ongoing crisis. OFDA is to
be commended for its continuous support and flexibility, but the lack of
funding limits what the international community can do to address some of the
most urgent and pressing needs. In addition, the lack of commitment from other
external donors creates great dependence on the US government as a main source of
funding.
Another limiting factor is remote management. Most
international organizations, donors and NGOs are present only in Amman or in smaller
numbers in the Green Zone. This has created heavy dependence on
secondary sources for information related to the on-going crisis, limits their
ability to adequately respond to real-time needs and presents a substantial
barrier to interacting with and developing trust among Iraqi counterparts.
International and National NGOs
With the exception of the Kurdish north, there are
very few international NGOs working in Iraq. Compared with similar
humanitarian crises around the world, the number of organizations providing
direct assistance in Iraq
is small. IMC and the other NGOs
in Iraq, however, have
proven that it is possible to operate in all regions of Iraq, working
with local communities and delivering vital services. A humanitarian surge,
one that brings greater operational presence inside Iraq, could greatly enhance
the delivery of immediate and tangible benefits to the displaced and increasingly
disillusioned Iraqis.
Iraqi NGOs are for the most part localized and have
limited capacity and access to funds. Despite this, they have strong contextual
knowledge of the communities where they work and can be valuable partners.
Given the fact that these national NGOs will remain with the burden of
supporting their communities long after international players have left the
scene, it is incumbent upon the international community to build the capacity
of national and local NGOs to be self-sufficient. In doing so, however, it
is critical that the principles of impartiality and non-discrimination be
adhered to by all humanitarian actors, and that sectarian agendas or allegiances
to one or another political or religious group do not play a role in assistance
programs. Such affiliated national organizations have been growing in
number as the plight of the ordinary Iraqi continues. Due diligence is required
to ensure that any local partners are unaffiliated and impartial in their
membership and mission.
US Government Assistance
US funding for services for IDPs has remained
relatively modest over the course of the past five years. It has also often
been slow in its allocation due to the reliance on supplementals. USAID/OFDA’s
total expenditure for humanitarian assistance since 2003 should have been far
greater than the $254 million allocated, given the level of need and the
importance of reconnecting Iraq’s
citizens to essential services.
Earlier this year, International Medical Corps
joined other NGOs in requesting the President to not only increase US humanitarian
assistance, but to also urge the Government of Iraq and its neighboring states
to increase their humanitarian aid. In an earlier hearing before your
subcommittees in March 2008, USAID testified that it was hoping to assist
500,000 IDPs in FY08 by providing $63 million to five NGO partners, including IMC, to provide emergency water, sanitation,
livelihoods, food, commodities and shelter, as well as slating $36 million to
WFP before enactment of a FY08 Iraq supplemental—a supplemental that many
hope the Congress will use to increase urgently needed humanitarian aid.
Since 2003, International Medical Corps has received
funding from the US
government for its work in Iraq:
approximately $51 million from OFDA, $10 million from Bureau of Population,
Refugees, and Migration, $2.9 million from the Department of State (DoS) and $1
million from USAID. With these funding levels—modest relative to the
other US funds dedicated to Iraq—IMC
has reached millions of people by rehabilitating over 300 clinics and hospitals;
operating 60 mobile medical units; completing over 230 sustainable water and
sanitation projects; providing economic opportunities to IDPs to increase their
self-reliance and promote social cohesion; and addressing the needs of
vulnerable populations, including IDPs, women, and children. Our experience
illustrates that by working with and through communities, assistance can and
does reach the people. The tremendous need, however, far outweighs the limited
resources currently available.
Conclusion
and Recommendations
In
closing, let me touch on a few recommendations International Medical Corps
would offer to better address the current situation and to prepare for the
return of the displaced in the future.
Improve coordination mechanisms.
A recent conference hosted by OFDA in Amman highlighted the
absence of effective coordinating mechanisms for identifying and addressing the
needs of displaced Iraqis. Donor agencies, international NGOs, UN agencies, US
government actors, and the MoM all recognized the lack of proper coordination
as one of the greatest impediments to providing for the immediate needs of the
internally displaced populations. IMC
enjoys excellent access to the US Embassy, USAID and OFDA – but notes
frustration over the lack of coordination between the different
“donor” arms of the US
government, including DoS, USAID, OFDA, the Commander’s Emergency
Response Program and the various contractors implementing programs in-country.
Compounding this is the limited presence of the UN humanitarian
agencies inside Iraq
and the inherent weaknesses in trying to coordinate operations from a location
outside of the country. A coordination mechanism needs to be established in Baghdad, one that includes
all relevant operational and donor agencies and that engages the appropriate
government ministries.
Humanitarian and development actors must enhance
the role of the Government of Iraq
in meeting the needs of the displaced through consultation and capacity
building.
What is critical now is a demonstration of
political will and a building of practical know-how within the Iraqi government
to meet the needs of its displaced populations. The relevant government
ministries should be apprised of and consulted on relief and development policy
and program work. IMC’s
experience is that many of the ministries are willing, but may require help in
designing, planning and budgeting, setting standards and training for current
and future activities. To effectively
build the human resource capacity of Iraq’s ministries and governorate
staff requires the will and agreement of the government, as well as utilizing
partners with cultural sensitivity, the necessary expertise, collaborative
styles and a willingness to invest the time and energy needed to develop solid
relationships, gain acceptance of a project and win ministry support. Failing to involve the
ministries will retard the institutionalization of good government services and
inhibit the sustainability of much of the good work that is currently on-going.
OFDA funding should be increased.
While efforts to improve the capacity of the
government of Iraq
are essential for long-term sustainability, immediate needs among the
vulnerable Iraqi populations must be addressed if a renewed downward spiral of
violence is to be avoided. It is critical that the international community respond
to meeting basic needs and bridge the service delivery gap until the government
bodies are capable of delivering sufficient assistance to their citizens. To
date, OFDA has been the most effective donor agency in addressing the urgent
needs of displaced and vulnerable Iraqis. It has also been one of the most
effective coordinating bodies. Despite its proven track record in Iraq,
OFDA remains largely under-funded with respect to the needs on the ground and
the capacity of its partners to deliver effective projects.
Donor agencies need to adopt a broader mandate for
funding in Iraq.
Donor agencies typically apply a strict mandate for
the type of activities and interventions they will support. However, Iraq
is a case that requires simultaneous support in a wide range of sectors that
span the continuum from relief to development. Given the relatively small
number of donors in Iraq,
it is important that current donor agencies allow considerable flexibility in
the programs they fund. This will give implementing partners the ability to
provide comprehensive assistance to Iraqi communities that not only address
immediate needs but also build toward long-term solutions.
Invest in human capacity.
There has been a substantial focus and investment
on rehabilitating physical infrastructure in Iraq; however, it’s time we
focus on strengthening human capital. One of the major problems facing IDPs in
particular and Iraqis in general is unemployment. There will be no stability in
Iraq
unless the high levels of unemployment are addressed. It also is essential that
key service delivery ministries of the Iraqi government are provided with
support and backstopping so that they can assist these vulnerable citizens. While government capacity is developed, it is critical
that work conducted by NGOs, contractors and others address the needs on all levels,
from the community to the governorate and national level.
We hope this hearing will demonstrate that
cost-effective NGO programs can be “scaled up” to provide effective
aid to displaced families and their host communities while concurrently
building the capacities of Iraq’s
ministries. We need you and your colleagues to support a new surge, a
humanitarian and development surge that will demonstrate US commitment to
alleviating suffering, fostering self-reliance and strengthening Iraq’s
will and capabilities to meet the needs of all of its citizens. This is the
time for the international community to focus on increasing human capital in Iraq
and on challenging the responsible government ministries to enhance their partnerships
with communities and with local and international NGOs to improve access to
vital services – shelter, employment, education, health, water,
electricity and sanitation. Over the past five years, the Congress has
supported a substantial investment in rebuilding the physical infrastructure in
Iraq.
Now we need a humanitarian surge.
Thank you, Mr. Chairmen, for this opportunity to
present our views.