Risk, Resilience, and Response

HHI's research on Risk, Resilience and Response examines the impact of complex humanitarian emergencies and aims to find ways to improve resilience and response. Explore the individual programs below to learn more about this work. 

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Risk, Resilience, and Response

Gender, Rights and Resilience

Investigates and addresses issues relating to gender, peace, and security in fragile states

Non Communicable Diseases

Seeks to address the heavy burden of chronic disease in humanitarian settings

Emergency Health Systems

Emergency Health Systems

Works to bridge the gap between system development and humanitarian response and improve the quality and access of emergency care for those who need it most

Peace and Human Rights Data

Conducts research and builds capacity in countries experiencing complex emergencies and serious violations of human rights and international humanitarian law

Infectious Diseases and Epidemics Program

Aims to reduce the impact of infectious disease on vulnerable populations

Urbanization and Resilience

Investigates urban environments and crises to allow individuals, households, communities and cities to thrive

Program on Resilient Communities

Evidence and advocacy to bolster community resilience to disasters and climate change

Children in Crisis

Addresses the critical needs of crisis-affected children and youth in humanitarian context

Related Publications

Sylvia Kehlenbrink, James Smith, Eimhin Ansbro, Daniela C Fuhr, Anson Cheung, and Ruwan Ratnayake. 8/1/2019. “The burden of diabetes and use of diabetes care in humanitarian crises in low-income and middle-income countries.” The Lancet, 7, 8, Pp. 638-647.Abstract
Human suffering as a result of natural disasters or conflict includes death and disability from non-communicable diseases, including diabetes, which have largely been neglected in humanitarian crises. The objectives of this Series paper were to examine the evidence on the burden of diabetes, use of health services, and access to care for people with diabetes among populations affected by humanitarian crises in low-income and middle-income countries, and to identify research gaps for future studies. We reviewed the scientific literature on this topic published between 1992 and 2018. The results emphasise that the burden of diabetes in humanitarian settings is not being captured, clinical guidance is insufficient, and diabetes is not being adequately addressed. Crisis-affected populations with diabetes face enormous constraints accessing care, mainly because of high medical costs. Further research is needed to characterise the epidemiology of diabetes in humanitarian settings and to develop simplified, cost-effective models of care to improve the delivery of diabetes care during humanitarian crises.
Philippa Boulle, Sylvia Kehlenbrink, James Smith, David Beran, and Kiran Jobanputra. 3/13/2019. “Challenges associated with providing diabetes care in humanitarian settings.” The Lancet, 7, 8, Pp. 648-656. Publisher's VersionAbstract
The humanitarian health landscape is gradually changing, partly as a result of the shift in global epidemiological trends and the rise of non-communicable diseases, including diabetes. Humanitarian actors are progressively incorporating care for diabetes into emergency medical response, but challenges abound. This Series paper discusses contemporary practical challenges associated with diabetes care in humanitarian contexts in low-income and middle-income countries, using the six building blocks of health systems described by WHO (information and research, service delivery, health workforce, medical products and technologies, governance, and financing) as a framework. Challenges include the scarcity of evidence on the management of diabetes and clinical guidelines adapted to humanitarian contexts; unavailability of core indicators for surveillance and monitoring systems; and restricted access to the medicines and diagnostics necessary for adequate clinical care. Policy and system frameworks do not routinely include diabetes and little funding is allocated for diabetes care in humanitarian crises. Humanitarian organisations are increasingly gaining experience delivering diabetes care, and interagency collaboration to coordinate, improve data collection, and analyse available programmes is in progress. However, the needs around all six WHO health system building blocks are immense, and much work needs to be done to improve diabetes care for crisis-affected populations.
Sylvia Kehlenbrink and Lindsay M Jaacks. 6/6/2019. “Diabetes in humanitarian crises: the Boston Declaration.” The Lancet, 7, 8. Publisher's VersionAbstract
Nearly three out of every four deaths worldwide in 2017 were caused by non-communicable diseases (NCDs). Many countries have made progress reducing risk factors for NCDs such as tobacco use, hyperlipidaemia, and hypertension, but no countries have successfully reversed the increasing trends in diabetes prevalence and mortality from diabetes. This situation represents a massive global health failure, since type 2 diabetes is largely preventable with lifestyle modification and cost-effective treatments exist for both type 2 and type 1 diabetes.  Type 1 diabetes is of particular concern, since it is fatal in the absence of insulin treatment.
Ronak B. Patel and Jay Chadhuri. 3/2019. “Revisiting the Sphere standards: comparing the revised Sphere standards to living standards in three urban informal settlements in Nairobi, Kenya.” Journal of International Humanitarian Action, 4, 6. Read PublicationAbstract
Humanitarian actors have long used the Sphere Handbook and its minimum standards to guide operational practice. The new revision attempts to update these standards partly to address urban crises that have challenged the humanitarian system. Yet, these indicators have never been based on a substantial body of evidence or data from the varied living standards found in cities or specifically informal settlements. This study aims to contextualize the Sphere standards for urban populations by comparing a sample of the revised key indicators to living standards in three urban informal settlements of Nairobi, Kenya, during a non-crisis period to examine their relevance and applicability, and discuss the implications.
Mihir Bhatt, Kelsey Gleason, and Ronak B. Patel. 1/2019. “Natural Hazards Governance in South Asia.” Oxford Research Encyclopedia of Natural Hazard Science. Read PublicationAbstract
South Asia is faced with a range of natural hazards, including floods, droughts, cyclones, earthquakes, landslides, and tsunamis. Rapid and unplanned urbanization, environmental degradation, climate change, and socioeconomic conditions are increasing citizens’ exposure to and risk from natural hazards and resulting in more frequent, intense, and costly disasters. Although governments and the international community are investing in disaster risk reduction, natural hazard governance in South Asian countries remain weak and often warrants a review when a major natural disaster strikes. Natural hazards governance is an emerging concept, and many countries in South Asia have a challenging hazard governance context.
Patrick Vinck, Phuong Pham, Kenedy Bungu, Juliet Bedford, and Eric Nilles. 3/2019. “Institutional trust and misinformation in the response to the 2018–19 Ebola outbreak in North Kivu, DR Congo: a population-based survey.” The Lancet Infectious Diseases, 19, 5, Pp. 529-536. Read PublicationAbstract
The current outbreak of Ebola in eastern DR Congo, beginning in 2018, emerged in a complex and violent political and security environment. Community-level prevention and outbreak control measures appear to be dependent on public trust in relevant authorities and information, but little scholarship has explored these issues. We aimed to investigate the role of trust and misinformation on individual preventive behaviours during an outbreak of Ebola virus disease (EVD).

Recent Posts

More reciprocal, cohesive local collaborations needed for disaster risk reduction in the Philippines

Massachusetts, USA — For the Philippine disaster risk reduction (DRR) system to further strengthen and be sustainable, local humanitarian actors need to conduct more cohesive and reciprocal collaborations with each other, researchers from the Harvard Humanitarian Initiative (HHI) have recommended based on their recent study.

“Local organizations are best placed to prepare for and respond disasters. Our research suggests that international aid agencies continue to play a large role in the network of Philippines disaster agencies, pointing to the need to build greater ties...

Read more about More reciprocal, cohesive local collaborations needed for disaster risk reduction in the Philippines