To Adapt or Not to Adapt? Accommodating Change in Humanitarian Response (abstract)

What conditions facilitate or frustrate opportunities for adaptation during on-the-ground responses by non-governmental organizations (NGOs)? I seek to explain variation in the outcomes of adaptations by Doctors Without Borders (MSF)* during three crises: Ebola in West Africa in 2014, middle-income diseases after the Syrian Crisis, and HIV/AIDs and mental health in the late 1990s and early 2000s. This research shows that humanitarian organizations can be uniquely accommodating of uncertainty and change. In these cases political entrepreneurship by those in the field is filtered through an internal structure that deliberately accommodates debate and creative recombination of resources. Actors do not simply exploit ambiguous power relationships, networks, or informational resources for recombination (Sheingate, 2003). Rather, a decentralized organizational structure offers resources and deliberately facilitates the creation of novel ideas and solutions.Interestingly, humanitarian action is facilitated by organizational structures that differ significantly from the centralized structures that best support human rights advocacy (Wong 2012). However, accommodation can be disrupted by the institutional constraints of the humanitarian mandate. Adaptation near this boundary sparks significant*I use the French abbreviation for the organization because this is common to the movement. MSF stands for Médecins Sans Frontières.