Humanitarian Advisor, Analysis and Advocacy Unit, Médecins Sans Frontières, Brussels, Belgium.
Disasters. 2014 Oct;38(4):673-89. doi: 10.1111/disa.12078.
In recent years, protracted crises and fragile post-conflict settings have challenged the co-existence, and even the linear continuum, of relief and development aid. Forced migration has tested humanitarian and development paradigms where sudden-onset emergencies, violence and displacement arise alongside ongoing development work. Drawing on Médecins Sans Frontières interventions in the region from December 2010 to May 2011, this paper examines aid and healthcare responses to displacement in Côte d'Ivoire and Liberia; it focuses on challenges to the maintenance of preparedness for such foreseeable emergencies and to adaptation in response to changing situations of displacement and insecurity. This 'backsliding' from development to emergency remains a substantial challenge to aid; yet, in exactly such cases, it also presents the opportunity to ensure access to medical care that is much more urgently needed in times of crisis, including the suspension of user fees for medical care.
近年来,旷日持久的危机和脆弱的冲突后环境给救济和发展援助的共存甚至是线性连续提出了挑战。被迫迁移对人道主义和发展模式提出了挑战,因为突发紧急情况、暴力和流离失所与正在进行的发展工作同时出现。本文借鉴无国界医生组织 2010 年 12 月至 2011 年 5 月在该地区的干预措施,考察了在科特迪瓦和利比里亚应对流离失所问题的援助和医疗保健反应;它侧重于在可预见的紧急情况方面保持准备的挑战,以及在流离失所和不安全局势不断变化的情况下的适应。从发展到紧急情况的这种“倒退”仍然是援助面临的一个重大挑战;然而,在这种情况下,它也提供了一个机会,以确保在危机时期获得更迫切需要的医疗服务,包括暂停医疗服务的用户费用。