Tag Archives conflict

Addressing threats to scholars on the ground demands proactive measures from Academic institutions: Notes from fieldwork in Kashmir

Addressing threats to scholars on the ground demands proactive measures from Academic institutions: Notes from fieldwork in Kashmir

Fieldwork is the most critical, and perhaps, the most demanding component of research, especially in difficult and hazardous contexts such as active conflict zones or nations with authoritarian regimes.I started ...

COVID-19 and Conflict | Between myth and mistrust: the role of interlocutors in managing COVID-19 in Haiti

COVID-19 and Conflict | Between myth and mistrust: the role of interlocutors in managing COVID-19 in Haiti

Mistrust in state-provided information about COVID-19 has characterized citizen responses to the pandemic in Haiti, preventing the effective management of the virus. This article shows that this mistrust is rooted ...

COVID-19 | Ecuador, COVID-19 and the IMF: how austerity exacerbated the crisis by Ana Lucía Badillo Salgado and Andrew M. Fischer

Ecuador is currently (as of 8 April) the South American country worst affected by COVID-19 in terms of the number of confirmed cases and fatalities per capita. While even the universal health systems of Northern European countries are becoming severely frayed by the nature of this pandemic, Ecuador serves as a powerful example of how much worse the situation is for many low- and middle-income countries, particularly those whose public health systems have already been undermined by financial assistance programmes with international financial institutions (IFIs). The IMF and other IFIs such as the World Bank must acknowledge the role they have played and continue to play in undermining public health systems in ways that exacerbate the effects of the pandemic in many developing countries.

The recent IMF Extended Fund Facility (EFF) Arrangement, signed in March 2019 with the Government of Ecuador, was already the subject of massive protests in October 2019 given the austerity and ‘structural reforms’ imposed on the country (aka structural adjustment). It has also directly contributed to the severity of the pandemic in this country given that health and social security systems were among the first casualties of the austerity and reforms. In particular, the government’s COVID-19 response has been severely hindered by dramatic reductions of public health investment and by large layoffs of public health workers preceding the outbreak of the virus.

From this perspective, even though the IMF has recently moved to offer finance and debt relief to developing countries hit by the COVID-19 pandemic, a much more serious change of course is needed. For this, it is vital to understand its own role ­– and that of other IFIs such as the World Bank – in undermining health systems before the emergence of the pandemic in various developing countries, lest similar policy recipes are again repeated.

The baseline

It is clear that the pre-existing national healthcare system in Ecuador has been replete with problems even in ‘normal’ times. As in most of Latin America, the weaknesses of the healthcare system in Ecuador stem from its segmented and stratified character, with a distinct segregation between three main subsectors – the public, social security, and private sectors. The Ecuadorian Ministry of Health has a weak coordinating and regulatory role over these three subsectors, each of which caters to different beneficiary populations and with clearly distinct quality of services. The public system is the lowest quality and the one accessed by most poor people. Despite claims of universal health, the national system is a far cry from anything approaching genuine universalism.

Moreover, there has been a progressive privatization and commodification of healthcare since 2008. For instance, the building of capacity within the social security system has been undermined by the channelling of health funding via contracts to the private sector, where pricing is also mostly unregulated [1]. More generally, Ecuador has consistently exhibited one the highest out-of-pocket (OOP) health expenditure shares in South America, despite a government discourse and constitutional mandate to deliver free, high quality, public healthcare for all citizens. OOP payments – or direct payments by users at the point of service – reached 41.4% per total health spending in 2016 [2]. They include, for instance, payments for medicine or medical supplies by poor people in public hospitals, as well as payments by middle- and upper-class people for consultations and surgeries. The COVID-19 crisis puts pressure on precisely these aspects of healthcare provisioning, rendering the system prone to systemic failure for the majority of the population, especially in times of economic crisis when the ability of users to pay is severely curtailed.

Crisis and IFIs

These problems in the healthcare system have been exacerbated by the austerity measures of the current government of Lenín Moreno. The measures were introduced in the context of the protracted economic crisis that started in 2014 and have been endorsed by the IMF and other IFIs. Public health expenditure plateaued at 2.7% of GDP in 2017 and 2018, and then fell slightly to 2.6% in 2019, when GDP also slightly contracted (see figure). This was despite the constitutional goal that established an increase of at least 0.5% of GDP per year until 4% was to be reached, which is still far below the 6% of GDP recommended by the Pan American Health Organization [3].


Source: elaborated from the Fiscal Policy Observatory data (last accessed 7 April 2020 at https://www.observatoriofiscal.org/publicaciones/transparencia-fiscal/file/221-transparencia-fiscal-no-163-marzo-2020.html)
* The main component of this expenditure is on non-contributory social protection (social cash transfers).
** It excludes health expenditure of the social security system.

However, the collapse in public investment in the health sector has been far more dramatic, falling by 64% from 2017 to 2019, or from USD 306 million in 2017 to USD 110 million in 2019 [4]. Such reductions would have been largely borne by the public health system and constitute expenditures that are vital for a COVID-19 response, such as the construction of hospitals and the purchase of medical equipment.

It was in this context that the IMF Extended Fund Facility (EFF) was agreed and signed in March 2019. Within the framework of this programme, the government implemented a large layoff of public healthcare workers (including doctors, nurses, auxiliary nurses, stretcher-bearers, social workers, and other healthcare workers). The layoffs continued throughout 2019, despite protests by the National Syndicate of Healthcare Workers of the Ministry of Health [5], [6], [7]. It is difficult to know the exact number of layoffs because of the fragmented functioning of the health system, although within the Ministry of Public Health alone, 3,680 public health workers were laid off in 2019, representing 4.5% of total employment in this Ministry and 29% of total central government layoffs in that year [calculated from 8]. Similar reductions in the social security sector were announced in 2019 for 2020, although we have not yet been able to find any data on these reductions.

Thus, it is not a surprise that Ecuador is currently doing so poorly in handling the COVID 19 crisis. The retrenchment of the public health system together with an already weak and retrenched social protection system coupled for the perfect storm. But even more worrying is that, in the face of the pandemic, the government paid 324 million USD on the capital and interest of its sovereign ‘2020 bonds’ on 24 March instead of prioritizing the management of the health crisis. This decision was taken despite a petition on 22 March by the Ecuadorean assembly to suspend such payments, along with a chorus of civil society organizations lobbying for the same [9] [10]. The government nonetheless justified the payment as a trigger for further loans from the IMF, World Bank, Inter-American Development Bank, and Andean Financial Corporation [11]. This is especially problematic given that Ecuador has been hard hit by the collapse of oil prices and, as a dollarized economy, its only control over money supply and hence hope for economic stimulus rests on preventing monetary outflows from the economy (and encouraging inflows).

The payment is also paradoxical given that the IMF and the World Bank are currently calling for the prioritization of health expenditure and social protection and for a standstill of debt service, and have announced initiatives for debt relief and emergency financing [12] [13]. Nonetheless, despite such noble rhetoric, it appears that the precondition for such measures continues to be the protection of private creditors over urgent health financing needs.

Atoning for past and present sins on the path to universalism

The COVID-19 pandemic undoubtedly exposes the inadequacies of existing social policy systems in developing countries and the urgent need of moving towards more genuinely universalistic systems. Ecuador is exemplary given that it has until recently been celebrated as a New Left social model even while its national health system has remained deeply segregated and increasingly commodified.

However, while the IMF and other IFIs have emphasised the importance of placing health expenditures in developing countries at the top of the priority list in the context of the COVID-19 pandemic [12], they have not acknowledged their own continuing roles in undermining these priorities. Indeed, their messaging is often contradictory, given that both the IMF and the World Bank have also repeatedly insisted that developing countries must persist with ‘structural reforms’ during and after the pandemic [13] [14]. In other words, there is no evidence that the course has been reset. As one way to induce a reset, it is important that they acknowledge the roles they have played and continue to play in undermining public health systems and universalistic social policy more generally, lest they continue to repeat them despite the switch to more noble rhetoric.

[1] http://cdes.org.ec/web/wp-content/uploads/2016/01/privatizaci%C3%B3n-salud.pdf
[2] https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)30841-4/fulltext
[3] https://www.cepal.org/es/publicaciones/45337-america-latina-caribe-la-pandemia-covid-19-efectos-economicos-sociales
[4] https://coyunturaisip.wordpress.com/2020/03/28/los-recortes-cobran-factura-al-ecuador-la-inversion-en-salud-se-redujo-un-36-en-2019/
[5] https://www.eluniverso.com/noticias/2019/03/06/nota/7219694/trabajadores-publicos-salud-denuncian-despidos-masivos
[6] https://www.elcomercio.com/actualidad/recorte-personal-contratos-ocasionales-ecuador.html
[7] https://www.elcomercio.com/actualidad/despidos-trabajadores-ministerio-salud-evaluacion.html
[8] https://www.observatoriofiscal.org/publicaciones/estudios-y-an%C3%A1lisis/file/220-n%C3%BAmero-de-servidores-p%C3%BAblicos-del-presupuesto-2018-2019.html
[9] https://www.elcomercio.com/actualidad/asamblea-suspender-pago-deuda-coronavirus.html
[10] https://ww2.elmercurio.com.ec/2020/03/24/la-conaie-pide-al-gobierno-suspender-el-pago-de-la-deuda-externa/
[11] https://www.bourse.lu/issuer/Ecuador/34619 (first link under the notices section)
[12] https://www.imf.org/en/News/Articles/2020/04/03/vs-some-say-there-is-a-trade-off-save-lives-or-save-jobs-this-is-a-false-dilemma
[13] https://www.worldbank.org/en/news/speech/2020/03/04/joint-press-conference-on-covid-19-by-imf-managing-director-and-world-bank-group-president
[14] https://www.worldbank.org/en/news/speech/2020/03/23/remarks-by-world-bank-group-president-david-malpass-on-g20-finance-ministers-conference-call-on-covid-19

This article is part of a series about the coronavirus crisis. Read all articles of this series here.

About the authors:

Ana LucíaAna Lucía Badillo Salgado is a PhD researcher at the ISS focusing on the political economy of social protection reforms in Ecuador and Paraguay, in particular the role of external actors in influencing social policymaking. She is also a Lecturer at Leiden University College. mug shot 2

Andrew M. Fischer is Associate Professor of Social Policy and Development Studies at the ISS and the Scientific Director of CERES, The Dutch Research School for International Development. His latest book, Poverty as Ideology (Zed, 2018), was awarded the International Studies in Poverty Prize by the Comparative Research Programme on Poverty (CROP) and Zed Books and, as part of the award, is now fully open access (http://bora.uib.no/handle/1956/20614). Since 2015, he has been leading a European Research Council Starting Grant on the political economy of externally financing social policy in developing countries. He has been known to tweet @AndrewM_Fischer

COVID-19 | Rethinking how to respond to COVID-19 in places where humanitarian crises intersect by Rodrigo Mena

COVID-19 | Rethinking how to respond to COVID-19 in places where humanitarian crises intersect by Rodrigo Mena

It is widely known that COVID-19 will disproportionately affect developing countries and impoverished peoples. Many of these countries are already affected by conflict and disasters including humanitarian crises, making the ...

“Whose responsibility is it anyway”? Questioning the role of UN peacekeeping mission MONUSCO in stabilizing the eastern DRC by Delphin Ntanyoma

“Whose responsibility is it anyway”? Questioning the role of UN peacekeeping mission MONUSCO in stabilizing the eastern DRC by Delphin Ntanyoma

In the highly volatile eastern DRC, where over the past decades violent conflict and political instability have claimed the lives of thousands of civilians, UN peacekeeping mission MONUSCO has intervened ...

Complexity of Micro-level Violent Conflict: An ‘Urban Bias’ lenses of a Native Researcher? by Delphin Ntanyoma

Micro-level violent conflict is complex, and the triggers of violence are unpredictable. Building on long-seated unresolved grievances coupled with the presence of foreign armed groups in Eastern Congo, the South-Kivu province is facing a barely noticed humanitarian crisis whose understanding can even puzzle a native researcher. In such a context, can a ‘native researcher’ with lenses affected with ‘urban bias’ understand complex contours of micro-level violent conflict? 

This blog post tries to raise awareness on complexity of micro-level layers of recurring violent conflict. It builds on Kalyvas’s (2006) understanding of ‘urban bias’[1].  He states that urban bias refers to lack of information on countryside violence but also the tendency to paint gunmen involved in violence as primitive and criminals. Though Kalyvas stresses on reporting and accounting on civil-war violence, this blog post considers that ‘urban bias’ is widely embedded in understanding the local context while little attention is paid to those painted as ‘criminals’.

In March 2019, I visited Minembwe in the South-Kivu province, the Eastern Democratic Republic of Congo (DRC). It was amid tense violent confrontation between opposing local armed groups largely affiliated to ethnic communities in the region. The MaiMai groups are affiliated to Babembe, Banyindu and Bafuliro communities against Gumino, while Twirwaneho are linked to Banyamulenge community. However, local armed groups are currently being supported by foreign groups from Rwanda and Burundi, the two DRC’s neighboring countries. The reasons for my visit to this region were twofold. One, I had to use this opportunity to teach two courses at undergraduate level within Eben-Ezer University of Minembwe. Two, this is a region I had to visit as part of my fieldwork. Although I am a native of this region, however, this time, I came back as a researcher in conflict economics studies.

The background of Eastern Congo violent conflict is complex with different layers. The region I visited has been under regular clashes between communities – due to mutual contestation, confrontation around ‘autochthony’ versus ‘immigrants’, misunderstanding between farmers and cattle herders as well as other dynamic motives. Community clashes have been going on for decades. Recently, Burundian and Rwandan rebels have been involved in clashes that are supported by local groups. Burundian and Rwandan groups are respectively supported by Kigali and Bujumbura with aims of overthrowing regimes in their countries. They are meddling into local problems with an intent of creating an unoccupied space for further military plans.

Subsequent to recent clashes, roughly 150 villages (including my parents’ village) were burnt down between 2018-2019. It has led to approximately 200,000 internally displaced people. Most of these have been concentrated in Minembwe facing high risks of hunger and diseases. Hundreds are estimated to have died during this period. Existing schools and health facilities have been destroyed. Moreover, due to limited access to transport infrastructures and media, the tragedy happening in this region remains unnoticed to a large extent.

Despite efforts deployed by the local opinion leaders, the neighborhood of my village named Kidasi, part of Minembwe region, was attacked on 13th June 2019 due to a shooting of one person; and a revenge that killed tens. Local population have fled towards Minembwe due to an incident that could have been prevented, if there have been a presence of committed security services. Such incidents build on collective sense of victimization and popular prejudice. Nevertheless, a ‘mundane incident’ can spread widely to hundreds of kilometers. Guns are used to settle family issues as was done in my village’s neighborhood wherein driven by hatred and jealousy, one sibling killed another.

However, when visiting my own village during the fieldwork, I appreciated regular dialogue between ethnic communities. For example, the local opinion leaders managed to save the life of a local chief who was arrested by a group of gunmen. The local chief was released following their interventions. During this visit, I managed to learn also from some members of a committee in charge of reconciliation and dialogue. It was impressive to hear testimonies and efforts of ethnic communities regarding their cohabitation.  One could hope that this would be a local model of trust among communities.

My impression was that these local initiatives aiming to sustain peace needed some support. I thought my intervention could be oriented in exchanging ideas with primary and secondary school teachers. We discussed possibilities of re-constructing my primary school made up of woods and straws. Due to poverty and inaccessibility in terms of transport infrastructure, the local population cannot afford costs of a decent building. Moreover, parents are also burdened by remunerating schools’ teachers. Children from these schools drop out due to their inability to pay school fees. My discussion with teachers focused mainly on these features of having a school reconstructed and possibilities to support vulnerable parents.

We had a fruitful exchange and looked forward to support the education of the vulnerable. Together, we introduced a request within a local NGO to see their possibility to help building a school. We shared information about channels through which we can involve state authorities. Beyond that, we discussed negative effects of violent confrontation. We had many old and recent references about how violence can hardly spare any of these ethnic communities. Their role as members of the ‘literate’ class was touched.

Though these were likely minor efforts on my side, I was more oriented on normative ideas to find urgent solutions to the challenges presented in these schools. I seem to have concentrated on ‘literate’ class alone and missed to talk to someone who could just shoot (un) intentionally in the air; and will kill all efforts. As a matter of fact, the shooting by unknown assailants of a member of Babembe ethnic community, has drawn wide retaliation by (counter) attacking and ‘revenge’ on Banyamulenge ethnic community. After leaving my village, I was told that I should have met Mutamba[2]. Why? Was the view I had of the local context be interpreted as an ‘urban bias’?

Regardless of Mutamba’s literacy level, his influence relies on manipulating young people to express themselves by ‘shooting bullets in the air’. I am not yet sure if meeting Mutamba (whom I called later on phone) could have prevented my neighborhood to fall into clashes. However, I argue that in such volatile context coupled with collective victimization guns have more power than anything else. As I question Kalyvas (2006), I felt that, meeting teachers was sufficient. However, I certainly had no clue and clear information on Mutamba. I wish that I could have met many of such people if this would have spared this region.

[1] This is a given name of the guy whom I was indicated he could, by shooting in the air or target someone for his own interests, pull the neighborhood into intractable clashes.
[2] See Kalyvas, Stathis N. (2006:38-48) in “The Logic of Violence in Civil War”. Cambridge University Press, Cambridge.

About the author:


Delphin Ntanyoma is a PhD candidate at the ISS. His research falls within Conflict Economics and is part of the Economics of Development & Emerging Markets (EDEM) Program. With a background of Economics and Masters’ of Art in Economics of Development from ISS, the researcher runs an online blog that shares personal views on socio-economic and political landscape of the Democratic Republic of Congo but also that of the African Great Lakes Region. The Eastern Congo Tribune Blog can be found on the following link: www.easterncongotribune.com.






IHSA Conference 2018 | The instrumentalisation of disasters by David Keen

IHSA Conference 2018 | The instrumentalisation of disasters by David Keen

Today, not just disaster but the functions—and instrumentalisation—of disaster have been brought right into the heart of Europe. If widespread official violence and the instrumentalisation of disaster can happen right ...

(How) should scholars say what humanitarians can’t? by Roanne van Voorst and Isabelle Desportes

In January this year, a long day of interviewing aid workers involved in the Myanmar Rohingya crisis revealed that these aid workers often refrain from talking about the human rights ...

The Hague Peace Projects: practicing peace and justice by Helen Hintjens

How can peace and justice be embodied? How can we move from thinking about societal problems to taking concrete action to bring about change? The Hague Peace Projects, a program bringing together diaspora communities in The Hague to think and act together to build peace, shows us how these principles can be brought to life.

Art assumes many roles beyond acting as a canvas for self-expression, from creating greater consciousness of societal problems to serving as a platform for activism. It is a central element of The Hague Peace Projects (THPP), a program that promotes dialogue and campaigns for change through a variety of means. The project, which engages diaspora communities to advocate for peace, can inspire others to become involved in this or similar local initiatives to embody the change they aspire to.

On a (peace) mission

Located in The Hague, known as the City of Peace and Justice, THPP is one of several programs working with diaspora communities to involve them in contributing to positive change in their home countries and across Europe. The project’s main goals are to work toward a world in which conflict between humans, groups of people and countries are not solved by violence, but “through dialogue, respect for human rights, and honest cooperation between equals” (THPP).

THPP was established in 2015 by Jakob de Jonge, himself an artist. The project seeks to help find peaceful solutions to (armed) conflicts. It brings together diaspora from conflict zones that live in The Netherlands, facilitating their collaboration toward finding realistic solutions to local conflicts. The project is based on the belief that diaspora communities know best what causes conflict in their home regions and how such conflicts can be addressed in a non-violent manner. Through dialogue, social media, blogs and public events of all kinds, THPP contributes to diasporic dialogues. THPP also views art as a medium of communication for peace.

Change through action

Jakob explains that he was inspired by his friend Sylvestre Bwira, a Congolese human rights defender, to start this project. Jakob defines THPP as “both a think-tank and a do-tank” spreading “creativity and hope”. THPP’s approach echoes the goals of ISS, which increasingly places emphasis on the importance of scholar activism in bringing about change. Both organisations wish to be “critical but constructive”, grounded in “grassroots communities”, and reaching out to influence “platforms of power”.

THPP is reliant on volunteers, who in turn feel themselves part of a movement for social justice and peace. Having worked with THPP on several projects related to the African Great Lakes region, I put a few questions to Jakob:

Can you tell BLISS readers how art connects with advocacy through The Hague Peace Projects?

As a ‘socially engaged’ artist, it felt weird working alone in a studio. I wanted to connect with people as much as possible, so I decided to engage people through my art. Through visual art I try to present the disturbing mix of horror and beauty that we see in the world. What inspires me is the hope that things can be different if you genuinely desire it to be. Art is also a way to uncover a glimpse of optimism, in the belief that ideas come to life through visualisation, as with THPP’s exhibition The Survivors, in 2016, inspired by a Syrian boy’s drawings. Idealistic as it may seem, THPP is all about transforming reality, however slowly.

What THPP activities have touched you most deeply?

What moves me and keeps me going are the everyday life stories of colleagues I work with. THPP is based on working groups of diaspora members (mostly refugees) from different conflict regions around the world. Each working group establishes its own space for ongoing dialogue between conflicting communities. This creates basic trust between those who might otherwise fear to connect with others in daily life. This trust becomes fertile ground for all sorts of relevant peacebuilding activities.

Two things have especially moved me: First, many colleagues in the THPP working groups have a history of severe suffering. Team members have personally paid a high price for being seen as a member of a certain social group, or for speaking out for the rights of others. They have been tortured, detained, lost their families, witnessed unspeakable crimes and finally, have had to flee abroad. They often lost everything.

Coming from Sudan, the DRC, Bangladesh, Uganda, Syria, Burundi, Turkey, Sri Lanka and elsewhere, it strikes me how resilient, hopeful and committed to change they remain. The people I work with strive for positive outcomes, even when these are hard to imagine. It moves me very much when you see a person’s attitude change over time, from fearful, emotional and easily triggered, to more relaxed, open and creative.

Similarly, publicly commemorating the murder of Bangladeshi writer and free thinker Avijit Roy, as we have done annually since 2016 remains a very special moment. It is a powerful reminder you can never really silence someone through violence. Seeing friendships develop between Turks and Kurds, seeing Dutch Somalis getting together for something positive like Somali poetry, rather than the usual stigmatising divisions, or just dancing together at THPP office with people of every background, including Hutu, Tutsi and Twa. There have just been too many beautiful moments!

After three years, how do you reflect on working in the City of Peace and Justice?

I collaborate well and on many levels with The Hague Municipality. We fully support their mission of striving to be a City of Peace and Justice. In fact, that is how we chose our name. “The Hague” gives many people around the world hope that their tormentors may eventually end up in prison in Scheveningen!

At the same time I believe much more can be done to make the City of Peace and Justice more than a mission statement. The idea is very powerful and creates a kind of responsibility to be different from other cities. The challenge is to show what peace and justice look like in reality, not only internationally, but for all the city’s inhabitants, and across all layers of policy.

How can interested parties become involved?

We are a 99% volunteer organisation and rely heavily on volunteers for goodwill and to take initiative. We always need qualified and motivated people to join our network, so if you are interested, please send an email and your CV to info@thehaguepeace.org.

Main Photo: The Hague Peace Projects

20160917_190837Dr Helen Hintjens is Assistant Professor in Development and Social Justice at the ISS, working in the field of migration. Like Jakob, she graduated with a BA in Fine Art from the Royal Academy of Art (KABK) in The Hague. From 2015 to 2017, she collaborated with THPP to organise three African Great Lakes Diaspora conferences that were held at the ISS. The first conference report is on the THPP’s website; the second conference produced the Declaration and Plan of Action on the role of diaspora media in peacebuilding in the Great Lakes Region. The third conference on women, men and peacebuilding, will be reported on soon. Watch this space!