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Humanitarian Missions

What is a humanitarian mission?

The traditional roles of a nation’s military are to defend the nation’s borders against enemies, and to prepare to wage war when necessary.  The U.S. military has seen a dramatic increase in the number of missions that service members have participated in, and in the number of nations to which they have been deployed.  

While the use of the U.S. military is increasing, the traditional roles of fighting wars and protecting the nation’s borders have been augmented by what are broadly known as humanitarian missions. Such missions are also known as Operations Other Than War (OOTW) or Strategic and Sustainment Operations (SASO).  Each mission is likely to have unique features, based on factors such as geography, climate, the population being served,  and the local infrastructure.  

However, there are features that are common to many humanitarian missions:

  1. Most humanitarian missions are undertaken in response to a humanitarian emergency.  

  2. A humanitarian emergency is defined as a crisis involving a large population for whom the local government is unable to meet basic needs, either due to disruption or displacement.  

  3. Humanitarian emergencies are generally brought on by one or more specific events, such as war, famine or natural disaster.

  • Natural disasters: These are unpredictable, sudden climatic or geologic events.  Some populations have greater vulnerability to such events due to overpopulation and weak infrastructure.  Examples include earthquakes or hurricanes.

  • Technological Disasters: These include release of nuclear, chemical, or biological toxins. This may be accidental (e.g., Chernobyl nuclear reactor, Bhopal India chemical plant), or intentional, as a terrorist act (e.g., Tokyo subway release of Sarin nerve gas, Federal building bombing in Oklahoma City).  

  • Complex Emergencies: These are the result of war or civil strife, typically involving displacement of many people from their homes, heavy damage to infrastructure, and continuing risks to personal safety. In recent years, more civilians have been killed and injured in war than have soldiers. Some are refugees, who leave their own country as a result of war, violence, or fear of persecution. Others are classified as displaced persons, since they stay within their own nation’s borders, but leave their homes. An example of a complex emergency is the continuing violence in the Balkans.

What effects do disasters have?

Effects can be expected to vary according to the type of disaster as well as unique local factors such as infrastructural features. Among the effects that should be anticipated and assessed in preparing a response are:

  • Inadequate water supply: most likely to be contaminated by floods. This is also a problem with large numbers of displaced persons in complex emergencies.

  • Inadequate shelter: likely to be particularly effected by earthquakes and hurricanes.

  • Inadequate sanitation: a leading contributor to the spread of disease. This is common to complex disasters with displaced persons, as well as many natural disasters such as hurricanes and floods.

  • Inadequate health care: This is often a problem even before a disaster in the developing world, making efforts to respond to a disaster that much more difficult.

  • Trauma: a superimposed problem in sudden, catastrophic natural events such as earthquakes or tornadoes. It may complicate complex emergencies if military or paramilitary forces terrorize a population.

  • Mortality: the unfortunate end result of many of the above factors.  Most often measured through calculation of crude mortality rates (CMRs), which can be compared with baseline CMRs for the region to give an estimate of the severity of the disaster as well as the success of one’s response efforts.

What are the most common causes of mortality in humanitarian emergencies?

These are also the most common causes of mortality in the developing world, especially in children, even in the absence of humanitarian emergencies: 


You have been deployed to a refugee camp on the Mozambique-Kenya border where 10,000 Mozambique natives have been displaced from their homes as a result of prolonged floods, punctuated by cyclones.  You are inundated by hundreds upon hundreds of individuals with diarrhea.  Most are children, and many appear markedly dehydrated. 

What approach should you take in treating individual cases?  Back at home, you would have started an IV and given liters of saline to many of the children you see.  However, you have limited resources—two physicians and six corpsmen make up your team, and your available IV supplies wouldn’t even treat 1% of the patients you see.

  • The treatment of choice is oral rehydration therapy (ORT), which is safe, effective, and cheap—and most important of all, it can be given by mothers or other relatives, enabling your personnel to evaluate and institute therapy for far greater numbers.  Diarrhea can cause more than half the deaths early in a humanitarian emergency, but dramatic reductions in mortality have been made possible by ORT.  Several alternative formulations have been found to be effective, using local components such as corn or rice in place of sugar.

What should you think about on a population level?

  • In this setting, overcrowding, inadequate sanitation, inadequate nutrition, and inadequate water supply all contribute to the problem.  Enlist your preventive medicine team in improving sanitation by establishing a latrine area separate from any water supply, attempt to establish a safe water supply, attempt to establish more sufficient shelter with greater space between families.  In addition, particularly if dysentery (bloody diarrhea) is present, consider whether there are differences between different areas of the camp, which may give you epidemiologic clues regarding factors in the outbreak (e.g., effected individuals are getting their drinking water downstream from where others are defecating).

Authored by Major Michael Roy, USAF, MC

For more detailed information, read: 

CDC: Famine-Affected, Refugee, and Displaced Populations: Recommendations for Public Health Issues, MMWR - Vol. 41, No. RR-13

HA Multiservice Procedures for Humanitarian Assistance Operations: FM 100-23-1



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Bureau of Medicine and Surgery
Department of the Navy
2300 E Street NW
Washington, D.C

Operational Medicine
 Health Care in Military Settings
CAPT Michael John Hughey, MC, USNR
  January 1, 2001

United States Special Operations Command
7701 Tampa Point Blvd.
MacDill AFB, Florida

*This web version is provided by The Brookside Associates Medical Education Division.  It contains original contents from the official US Navy NAVMED P-5139, but has been reformatted for web access and includes advertising and links that were not present in the original version. This web version has not been approved by the Department of the Navy or the Department of Defense. The presence of any advertising on these pages does not constitute an endorsement of that product or service by either the US Department of Defense or the Brookside Associates. The Brookside Associates is a private organization, not affiliated with the United States Department of Defense.

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