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A severely malnourished displaced Somali child is admitted at southern Mogadishu's Banadir hospital for treatment on August 2, 2011. Warnings grow that famine could spread across all southern Somalia, but the urgent action needed to avert that is being hampered as conflict escalates and rebels maintain a stranglehold on aid.Famine was declared in two Somali regions last month, but UN humanitarian relief chief Valerie Amos has warned it could extend across the majority of the south. (MUSTAFA ABDI/AFP/Getty Images)
A severely malnourished displaced Somali child is admitted at southern Mogadishu's Banadir hospital for treatment on August 2, 2011. Warnings grow that famine could spread across all southern Somalia, but the urgent action needed to avert that is being hampered as conflict escalates and rebels maintain a stranglehold on aid.Famine was declared in two Somali regions last month, but UN humanitarian relief chief Valerie Amos has warned it could extend across the majority of the south. (MUSTAFA ABDI/AFP/Getty Images)

MARILYN McHARG

Shocking images aren't enough Add to ...

Since the media renewed their interest in the decades-old crisis in and around Somalia, we’ve seen a surge of advertisements from aid groups, featuring starving children with visible ribs and staring eyes. The subtext to these ads is that, if you don’t donate, you’re abandoning these children and they’ll die. It’s that simple.

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Médecins sans frontières is one of the international aid agencies struggling to respond in Somalia and refugee camps in Ethiopia and Kenya. We’re also struggling to define responsible fundraising within a discourse that relies on guilt and superficial messages. Fundraising experts warn us that offering a more complex picture of the difficulties of delivering aid will lead to cynicism and donor fatigue: It’s shock value that works.

At the risk of losing some donations, MSF believes we must realistically represent what Somalis are facing, and our limits in assisting them. Simplifying the message may boost revenue, but if it comes at the expense of presenting a realistic picture, then the cost is too high.

Aid is difficult. Things go wrong all the time. In war zones particularly, non-governmental organizations continually fall short as we face massive challenges in accessing people who need us most. We’re always overwhelmed, always facing painful choices that involve doing the best we can with what we have. It’s never enough, even in the most straightforward emergencies.

Of all the places I’ve seen, Somalia is among the most complex emergencies. Working there requires an understanding of local political players, a capacity to constantly negotiate with warlords, and the drive to keep projects running despite security threats. Movement across front lines is almost impossible, preventing aid organizations from getting staff and supplies to those suffering the most. Somalis who can make the journey come to aid delivery points inside the country, or across the border in neighbouring countries. Those who can’t make it perish. Families are forced to leave loved ones behind when they lack the strength to go on.

The current crisis is the product of 20 years of war. Even before the recent drought, it was estimated there were only four doctors for every 100,000 people. Most health workers were based in cities. One in 10 women died in childbirth, and as many as 25 per cent of children under 5 never saw their fifth birthday. The average lifespan was 47 years. Drought, of course, has exacerbated the crisis: Harvests have failed, livestock have died. But this is on top of war, and some of the worst health indicators in the world, as well as high food prices and transportation costs.

Ads and headlines that label this crisis Famine in the Horn of Africa or East Africa Drought reduce the plight of people struggling to survive decades of the harshest circumstances on Earth, brought on by political chaos and military agendas, to something that can be solved with food and water.

Giving to save the life of the starving child in the photo, to alleviate your guilt, won’t take Somalia very far. That’s not to say that donations are not important; rather, that there’s more to the story. Your generosity will save lives; there’s nothing more important. At the same time, let’s be honest in admitting that humanitarian aid won’t solve Somalia’s problems, beyond keeping people alive for better times in the distant future. Aid is a temporary measure until more permanent solutions can address root causes, and the downward spiral can be reversed.

Donors can handle this complexity. Aid organizations, all of us, need to confront the story behind the tragic, if successful, fundraising images. If we can share our pain and disappointment more, we can break through the illusion we have inadvertently created that we are here to cure what ails the world. Yes, we will lose some donors. But I’m convinced that most will continue to support aid, and will do so from a much stronger foundation, one that makes room for error. If aid organizations were bolder about the realism of our communications, we could foster groundbreaking levels of transparency and accountability.

Despite all the shortcomings of aid organizations, they offer the best hope for millions of people in crisis. This is about a duty to respond, and doing all we can. And this duty must outweigh cynicism – people’s lives depend on it.

The current crisis isn’t affecting the entire Horn of Africa, and it isn’t simply caused by drought. What differentiates the people affected by the crisis? Years of suffering through war and violence, and limited access to health care and other essential services, compounded by drought.

With an expectation that we’ll alleviate our guilt and solve the crisis by feeding the starving children in the photos, the subsequent and inevitable rounds of suffering will only be met with a stomach-churning “not again,” and perhaps a cynicism that was intended to be avoided in the first place.

Some of our colleagues from other NGOs have chafed against our criticism, going so far as to call it “not helpful.” We in the aid industry seldom openly criticize one another’s practices out of concern that it merely denigrates the entire sector in the public’s mind. But there are times when lifting the cone of silence will help influence our philanthropic culture so Canadians can make informed choices.

Marilyn McHarg is executive director of Médecins sans frontières/Doctors Without Borders Canada.

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