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Midyear update: Ten humanitarian crises and trends to watch in 2019

Will Swanson/UNHCR
Internally displaced people on the edge of a Protection of Civilians site near Malakal, South Sudan.

Remember those 10 crises and trends to watch in 2019 we presented back in January? The issues are rapidly evolving, but we’ve been keeping watch. 

From new trends in aid policy and climate displacement to political transitions in South Sudan and the Democratic Republic of Congo, our reporting has examined the shifting terrain of humanitarian needs and response.

Here’s what has changed through the year, what we’re paying special attention to, and how it may affect the lives and livelihoods of people on the ground.


Climate displacement

Relocation policies, peace committees, and empty villages

Vulnerable communities around the world have long known what the aid sector is just beginning to articulate: climate change is a humanitarian issue, and its fingerprints are all over today’s emergencies.

What’s new:

Climate shocks and disasters continued to fuel displacement around the globe through the first half of the year, from tropical cyclones to slow-burning droughts. Pacific Island nations were on high alert early in the year as storm after storm swept through the region in quick succession. Conflict is as dangerous as ever in Afghanistan, yet the number of people displaced by drought and floods in recent months is on par with the numbers fleeing war. Drought has left 45 million in need in eastern, southern, and the Horn of Africa. This, along with conflict, has spurred new displacement in countries like Somalia, where at least 49,000 people have fled their homes so far this year, according to UNHCR. The UN’s refugee agency warns of “growing climate-related displacement” – a sign of the continuing shift in the aid sector as humanitarian-focused agencies increasingly underline the links between climate change and crises.


Why we’re watching:

Disaster displacement is nothing new, of course, but what’s rapidly evolving is the ability to trace the roots of these crises to a changing climate. One example: research released late last year found that climate change doubled the likelihood of extreme pre-monsoon rains that struck northeastern Bangladesh in 2017. In March, two years after the resulting floods, our reporting from the epicentre found half-empty villages and rice farmers abandoning their failing crops to move to Dhaka, the congested capital, for good. The World Bank estimates there could be 140 million internal climate migrants by 2050. There are complex economic reasons why people pack up and leave, and quantifying the sheer scale of climate displacement is an inexact science because of this. But Bangladesh’s northeast ricebowl offers a real-time glimpse of how these staggering displacement warnings unfold: one depleted village at a time.


Keep in mind:

Migration experts say the vast majority of climate-fuelled displacement happens within a country’s own borders. So the nuts and bolts of how to adapt fall on vulnerable local communities and governments themselves (albeit with more equitable adaptation funding, they hope, from the wealthy nations most responsible for climate change). Some of these communities are the ones leading the way in preparing for tomorrow’s crises today. Pastoralist groups in northern Kenya, for example, have formed peace committees to negotiate access (and avoid bloodshed) as people migrate in search of water and land. And Pacific governments like Fiji and Vanuatu have recently passed laws governing planned relocations of entire villages – often complicated by ancestral land rights – and national policies on climate displacement.

(PHOTO: Villagers walk along the banks of the Surma River in northeastern Bangladesh.)


‘A humanitarian disaster unfolding before our eyes’

A win by Syrian President Bashar al-Assad now seems even more of a fait accompli, but with a government assault on the rebel-held northwest barrelling on, hundreds of thousands of civilians – and maybe millions – are likely to be stuck in the line of fire before the war’s end.

What’s new:


A Russia-Turkey brokered “buffer zone” that had been keeping a fragile calm in rebel-held Idlib province and its surroundings has now collapsed, forcing an estimated 330,000 people to flee their homes since the beginning of May. Civilians are dying in airstrikes and shelling, and hospitals and other healthcare facilities – even ones that shared their coordinates with the Syrian government in a UN-run “deconfliction” programme – are being bombed. UN relief chief Mark Lowcock recently called the situation “a humanitarian disaster unfolding before our eyes”. Meanwhile, Syrian NGOs are crying foul over a UN plan to shift most of the decision-making for aid operations in the country to Damascus, a move they say will give al-Assad more power over relief work and make it harder to do an already difficult job in places like Idlib.


Why we’re watching:


While estimates of how many people live in and around Idlib have long hovered around 2.5 million, the truth is that displacement is happening fast, and counting people in a warzone is far from an exact science. We do know that many of the people who have fled the northwest in the past few months have been displaced many times over through more than eight years of war in Syria. They likely have no homes standing to return to and, as they edge towards the closed border with Turkey, many may soon have nowhere else left to go.


Keep in mind:

Idlib is grabbing headlines for good reason, but there are many other unknowns in Syria, including what will become of the tens of thousands of people at al-Hol camp in the northeast: many of them fled so-called Islamic State’s last territory in the country, meaning they’ll likely carry the group’s stigma for years to come, whether they are from Syria or elsewhere. That includes some uneasiness on the part of donors, who worry their aid money could go to people or groups they consider to be terrorists. And while people are still leaving Rukban, the remote camp on the Jordan-Syria border, some 27,000 people remain, and they haven’t seen an aid shipment in more than four months.

(PHOTO: Al-Shaar neighbourhood in eastern Aleppo.)

Outsourcing risk to local responders

Growing pressure and rising fatalities

A local responder educates about Ebola in Congo

When facing limited access and high levels of risk, the humanitarian sector relies on local staff and organisations to deliver life-saving aid. These local aid workers may have better access, but are they also equipped with a fair share of resources to stay safe?


What’s new: 

Local humanitarians continue to shoulder a disproportionate and rising share of the risk when aid workers become targets in humanitarian emergencies. The vast majority of aid workers killed have always been local, but the per capita fatality rates for local staff have risen steeply, according to a new analysis by the Aid Worker Security Database. There’s a growing push for partnerships between international organisations and local ones – fuelled in part by the aid sector’s localisation reforms, which aim to empower grassroots responders. But these partnerships are often far from equal. Local aid groups say they’re hamstrung by short-term funding that may cover the cost of a one-off project, but not the resources to stay safe. The widespread practice of subcontracting donor-funded projects is the norm, and analysts say there’s evidence the model itself can even incentivise risk. A recent study by InterAction, a US-based NGO alliance, found that local NGOs in insecure areas of South Sudan and northeastern Nigeria were competing to lower their costs to win UN and donor projects.


Why we’re watching:

The aid sector’s risk imbalance is as lopsided as ever. Humanitarian organisations have promised to revamp aid and boost direct funding to local NGOs. But, for now, the lion’s share of resources still trickles down through unequal partnerships, local groups say. Nevertheless these local workers and organisations are on the front lines of crises and they’re taking on more responsibilities in humanitarian responses – with or without the funding to manage their growing risk. This is also a factor for local women-led organisations, which may see added gender-based threats in their work. These organisations tend to be newer, smaller, and just as dependent on inadequate subcontracted funding


Keep in mind:

The latest high-profile test for aid worker safety is in the Democratic Republic of Congo, where frontline Ebola responders face distrust and have been attacked in sceptical local communities. There’s now a consensus that a locally led response is crucial to controlling the outbreak. What remains to be seen is how well local health workers will be supported.

(PHOTO: Karungi Shamillah, 27, a Red Cross volunteer in her own community in Majada, Uganda, close to the border of the Democratic Republic of the Congo, educating communities about Ebola.)

South Sudan and Congo

New challenges as political promise fades

Photo of group of people with soldier in background in South Sudan.

2019 was supposed to have been a political year of promise for the Democratic Republic of Congo and South Sudan. Both were undergoing political transitions – in the case of the DRC a potentially seismic election, and in South Sudan a power-sharing government to cement a peace deal. Both events didn’t quite go to plan.

What's new:

In Congo, long-delayed elections to replace President Joseph Kabila – in power since 2001 – finally took place on 30 December. When the results were announced there was domestic and international uproar. Martin Fayulu, the man who all available independent evidence suggested had won, had officially lost. Sworn in instead was Felix Tshisekedi, who is believed to have benefitted from the influence out-going Kabila had with the national election body. Popular disappointment over Fayulu’s defeat is tempered by the fact that at least Tshisekedi is not Kabila. But Tshisekedi will struggle to impose himself against a system that Kabila built, linking powerful politicians and security chiefs to militia leaders in the mineral-rich and troubled east of the country. A government has yet to be sworn in, which complicates the engagement of the humanitarian community. Ebola is one critical issue. The outbreak in North Kivu and Ituri has not abated – despite an expanding vaccination programme – stoking fears of major cross-border epidemics. The Ebola response has been politicised, straining trust between the authorities, health workers, and the community in what is a Fayulu stronghold. Communal violence in the central and eastern regions; mass displacement; severe food insecurity; and cholera and measles epidemics, have left almost 13 million people in need of assistance.


In South Sudan a transitional power-sharing government to end a five-year war was meant to have been installed in May, but instead has been delayed to November. There were a number of unimplemented sticking points to the peace deal between President Salva Kiir and rebel leader Riek Machar that it is hoped the delay will resolve. The conflict has killed almost 400,000 people, displaced millions, and plunged pockets of the country into famine. Although the truce is largely holding, the country remains divided between government and rebel-held areas, which complicates humanitarian access. And while security has improved in the capital, Juba, there are still plenty of local conflicts dismissed as “cattle raiding” or “revenge killings” that clearly have a political root. A unified national army and agreement on state boundaries are key issues to be implemented in the coming months, but the fact that both sides have continued to recruit does not augur well for the November deadline. That fuels some scepticism over whether this power-sharing government will work when two others – based on the same formula of dividing up national resources between the warlords – did not. In the meantime, South Sudan’s acute suffering continues. Almost seven million people – more than 60 percent of the population – are facing a critical lack of food, with famine once more forecast in some of the most isolated areas.

Why we’re watching:

South Sudan and the DRC are two of the world's largest humanitarian crises, displacing more than 10 million people between them. Political change could yield more peaceful conditions on the ground.

Keep in mind:

The extent of displacement and food insecurity in South Sudan and the large number of conflicts in Congo amount to a scale of humanitarian crisis only matched by Syria and Yemen. In dollars and cents, South Sudan’s $1.51 billion donor appeal is only 38.2 percent funded and Congo’s $1.65 billion appeal (excluding Ebola) is so far only 21.5 percent funded.

(PHOTO: Internally displaced people in Kuda, a village 45 kilometres west of Juba, South Sudan.)


A fledgling deal but little real progress

Photo of a young girl in Yemen with a watering can at a dry camp for displaced people.

It has been six months since Yemen’s main warring sides hammered out a ceasefire deal for the northern port city of Hodeidah, but implementation has been sluggish at best. Elsewhere in Yemen, the violence is getting worse, and the UN says there are “famine-like conditions in dozens of places” across the country. 

What’s new:

The negotiations on how to carry out what has become known as the Stockholm Agreement have been slow and contentious, and a recent unilateral Houthi withdrawal from the Hodeidah ports was heavily criticised by the rebels’ opponents, namely the Saudi Arabia-led coalition and the internationally recognised (but mostly exiled) government of President Abd Rabbu Mansour Hadi. Still, it’s a small bit of progress in a conflict that is intensifying on multiple other front lines. We said it in January and it’s still true: there are more than two sides to this war, and as fractures inside the main alliances grow, so do local grievances. Southern separatists still want more of a voice in Yemen’s future, and there has been little respite for Taiz, a city and province that, despite talk of de-escalation in Sweden last December, has had little respite from violence in more than four years of war.

Why we’re watching

In the midst of Yemen’s complicated chaos are 24 million people who the UN says need some kind of aid – that’s 80 percent of the country’s population. A wave of cholera in the first part of this year now seems to be on the wane, but many of the hardest-hit areas were places with heavy fighting or displacement. That’s no coincidence: a decimated healthcare system and a destroyed economy plus conflict make for a deadly combination. Malnutrition makes a person more susceptible to cholera and other diseases.

Keep in mind 

Yemen is more than just Hodeidah. The city is key to imports in the north (and to averting famine), but needs in the country as a whole are so great it garnered the UN’s biggest ever ask ($4.2 billion) for one country in January, followed the next month by a record-breaking pledge from Saudi Arabia and the United Arab Emirates ($1 billion) that has still not been fulfilled.

(PHOTO: A young girl fetches water at an informal camp for displaced people in the Abs district of Yemen's Hajjah province.)

Militancy in Africa

An increased tempo of attacks brings surging needs

Photo of armed police on patrol in Niger near Burkina Faso

Violent jihadism continues to gain ground in Africa, representing a serious trial for weak and neglectful governments and driving up humanitarian needs for civilians. Extremist groups operate in Egypt and Libya, and across a belt of Sahelian countries. They are also newly active further south in the Democratic Republic of Congo and in Mozambique, and have a historical hold in Somalia.

What’s new:

There has been an increased tempo of attacks by jihadist groups under the banner of Islamic State in the Greater Sahara (ISGS) along the joint borders of Mali, Niger, and Burkina Faso. Nigeria’s Islamic State West Africa Province is known to be cooperating with ISGS. Around 4.2 million people are displaced in the Sahel – a million more than in 2018 – as a result of the violence. In the DRC, so-called Islamic State is also supporting factions within the Allied Democratic Forces, a shadowy Islamist rebel group that has been fighting the Congolese and Ugandan governments for decades. 

Why we’re watching:

In Nigeria, ISWAP (a “Boko Haram” splinter group) is building a proto-state on the islands in Lake Chad. It offers some basic public services to citizens in a long-neglected region. It has built a formidable military capability against a demoralised Nigerian army that has generally failed to win the trust of civilians. There is a popular distinction in northeastern Nigeria between ISWAP and the indiscriminately murderous original Boko Haram group. Meanwhile, the jihadist coalition, ISGS, has proved particularly deadly this year, exploiting ethnic and anti-government grievances. From central Mali it has spread to northeastern Burkina Faso and western Niger – developments we have extensively reported. There are concerns a southwards push could see ISGS launch attacks against communities and perceived Western interests in coastal Benin, Togo, and Ghana. In the DRC, Islamic State in the Central African Province, linked to the long-existing Allied Democratic Forces, has claimed responsibility for attacks on villages and military posts in the east of the country – a region of substantial rebel activity and ground zero for the Ebola outbreak. In Mozambique the more perplexing insurgency of Ahlu Sunnah Wa-Jama – is it a largely criminal enterprise? – also has links to ISCAP. But ascribing the growth of any of these groups simply to transnational links would be a mistake. As we have noted, they are home-grown movements rooted in local conditions, with the ideology of jihad often a radical response to the governance failures of the state.


Keep in mind:

African armies have proven unprepared to deal with these guerrilla forces. Governments continue to reach for military solutions, backed by their Western partners. At the same time, an over-militarised response risks fuelling support for the extremist cause as a consequence of human rights abuses committed by the security forces and measures that restrict people’s livelihoods.

(PHOTO: A national police unit is on security patrol on the road from the Nigerien capital, Niamey, to the border with Burkina Faso.)

Anti-terror compliance

Tweaked US laws and a UK flip-flop

Taxpayers, governments and aid agencies all agree that keeping aid out of the hands of extremists like so-called Islamic State, Boko Haram, or al-Shabab is a big priority. But will donors’ impossible demands on diversion actually stop aid from reaching innocents in need?


What’s new:


US lawmakers tweaked counter-terrorism laws and promptly made most US aid to Palestine open to legal challenge. The fear of cash aid leaking into terrorist pockets also caused a policy flip-flop by the UK in northeastern Syria


Why we’re watching:


NGOs argue that donors are not taking their fair share of the risks of delivering aid to warzones like Yemen, Syria, or Somalia. Donors, NGO advocates say, are trying to wash their hands of liability under the guise of “zero-tolerance”. 


Some cases are clear-cut: in Syria, staff of an American aid group were caught systematically passing millions of dollars worth of food packages to militants, according to USAID investigators. But how detailed should NGOs’ due diligence be? Who is legally to blame if small amounts go astray? In May, the issue marred the re-launch of NGO alliance Start Network. Former member Norwegian Refugee Council stepped aside, saying it couldn’t agree a counter-terrorism clause open to vague interpretation.


Keep in mind:


Some 70,000 civilian wives and children of IS fighters are now encamped at al-Hol, Syria and present a test case of humanitarian principles and of donor risk appetite. Looking ahead, a creeping advance of counter-terrorism conditions attached to aid grants will become a battle between security and humanitarian agendas.

(PHOTO: Aid distribution on the Syrian Turkish border.)

Infectious diseases

Ebola and measles strain responses

Infectious diseases are adding to humanitarian operations already under strain. An Ebola outbreak in the Democratic Republic of Congo has crept across the border to Uganda. Pakistan is seeing a spike in HIV cases amongst children. And measles has risen in countries such as Ukraine and Yemen, already mired in conflict. Worse – attacks against medical workers, growing conflict, and climate change are making it even harder to contain outbreaks.


What’s new:


Healthcare workers have scrambled to contain waves of infectious diseases sweeping across nations – rich and poor. In the first three months of the year alone, the number of measles cases worldwide quadrupled compared to the same period last year. Africa saw the most dramatic rise with an increase of some 700 percent on the continent, while countries such as Madagascar, Ukraine, and Yemen – already struggling to meet humanitarian needs – also saw a surge. The Ebola outbreak in Congo grew to be the second deadliest since 1976 with cases spreading across the Ugandan border and containment efforts thwarted due to more than 170 attacks against health workers. Misinformation surrounding vaccination efforts also contributed to spikes in violence and the suspension of operations. In Pakistan, meanwhile, more than 800 people – some 80 percent of them children – tested positive for HIV in an outbreak that spotlights the country’s healthcare and treatment practices. Outbreaks of diphtheria in Venezuela and Haiti have also continued, with new cases reported this year. 


Why we’re watching:


Antibiotic resistance is on the rise and could have far-reaching effects on humanitarian workers trying to treat simple illnesses and injuries in conflict situations and beyond. By 2050, as many as 10 million people could die from an infection resistant to antibiotics, experts say. Climate change is also expected to further the spread of more diseases this year. Hurricane season is underway, and already this year rare back-to-back cyclones in Mozambique and southern Africa caused spikes in malaria and cholera cases. Warming temperatures are also expected to increase dengue fever cases, with southern Africa and the Sahel particularly at risk due to weakened healthcare systems and growing populations. Unless halted, attacks against healthcare workers may allow the Ebola outbreak in Congo to spread to the populous city of Goma and regionally to Rwanda or South Sudan. There have already been cases in Uganda. Equally, continuing attacks against medical workers in Sudan, Libya, Syria and Yemen are expected to limit humanitarian efforts to treat diseases and injuries. 


Keep in mind:

Epidemics and outbreaks are costly to manage and contain – especially at a time when some donor nations are curtailing spending. The Ebola response is still short of more than $10 million that it was promised, and now the World Health Organisation is pleading with partners to help fill the shortfall. If the outbreak isn’t stopped, there’s also the chance that countries could run out of vaccines to guard against the virus.

(PHOTO: Health workers put their gloves on before checking patients at the hospital in Beni, Democratic Republic of Congo.)

Returning refugees

Pressure grows in a pivotal year

Photo of a classroom in Uganda for South Sudanese refugees

The pressure remains high on millions of vulnerable people to return to dangerous homelands, with 2019 showing itself to be a pivotal year for the four largest refugee crises: Syrians, Afghans, South Sudanese, and Myanmar’s Rohingya account for around half the world’s registered refugees, not to mention millions more internally displaced people.

What’s new:

More and more Syrian refugees are heading home, in some cases under pressure from host governments, but given how widely the figures vary, we can’t be sure exactly how many: While the UN’s refugee agency, UNHCR, was able to verify 21,000 returns from January through early April, Turkey said in late May that 329,000 people had returned to Afrin alone since the country’s forces took control of the Syrian-Kurdish enclave last year.  

Afghans continue to face pressure to return on multiple fronts. The UN recorded more than 220,000 returns this year from neighbouring Iran and Pakistan; UN agencies are planning for at least 680,000 by the end of 2019. The threat of deportation has eased in Pakistan but heightened in Iran, the source of the vast majority of recent returnees. In Europe, Afghan asylum seekers are increasingly seeing their claims rejected, and thousands each year are returned.

The UN’s envoy for South Sudan has said that half a million refugees and displaced people have gone home since last year’s fragile peace deal, and in Bangladesh nearly one million Rohingya refugees are still in limbo. The cramped refugee settlements have the population of a city, but Rohingya can’t attend formal schooling or legally work. Bangladesh has not announced new repatriation plans following two aborted attempts last year, but the government says the Rohingya must one day return home. 

Why we’re watching:

Even as some Syrians come back from internal displacement or exile, more than 330,000 people have just fled a government assault in the rebel-held northwest. Some returning refugees have reportedly met with arrest and interrogation, and others have found their homes destroyed and difficulty making a living. 

Afghans are coming home to a country wracked by war and disaster. Civilian deaths from conflict are at a 10-year high, 132,000 people are newly displaced by fighting this year, and drought and floods have displaced even more.

Not all south Sudanese are interested in going home: some have said that they are concerned about interrupting their children’s education.

In Myanmar, UN investigators say the government has done little to ensure that Rohingya will be safe should they choose to return. At the same time, conflicts new and old continue to trap civilians while humanitarian access shrinks: the UN says 30,000 civilians have been displaced this year in Rakhine State as the military clashes with the Arakan Army, an ethnic Rakhine rebel group.

Keep in mind:

Kenya is set to begin closing the Dadaab refugee camp, home to 211,000 mainly Somali refugees, at the end of August. The government flagged its intention to shutter the camp in 2016, claiming – without evidence – that it was a terrorist training ground. It has already stopped the registration of new arrivals, and current residents will be relocated to other camps in Kenya or encouraged to return to war-torn Somalia.

(PHOTO: South Sudanese refugees learn in Uganda.)


The honeymoon period of Abiy Ahmed is over

Ethiopia is a giant emerging from an era of tight political control while struggling to improve productivity and economic growth to keep pace with population growth. Chronic poverty and climatic shocks combine with an array of explosive political hotspots to form a complex picture of humanitarian risk. 


What’s new: 

Ethiopia says it has thwarted a coup attempt, in the most serious challenge to Prime Minister Abiy Ahmed so far. Hundreds have been arrested in a sweep following the 22 June incident, allegedly engineered by a former general from the Amhara region. Away from the high stakes assassinations and politicking, Ethiopia’s low-intensity conflict multiverse continues to expand, with millions suffering humanitarian consequences from clashes and displacement. Added to that are severe power shortages, politicised census planning, a poor rainy season in the southeast, and heavy-handed treatment of the internally displaced population.


Why we’re watching:

Abiy’s honeymoon period is over. Despite his political reforms, heightened identity-based violence, huge internal displacement, and youth unemployment remain worrying problems. The June coup attempt demonstrates the risks of relaxing previously draconian political controls: the ringleader had been released under Abiy’s government after serving years in prison on earlier charges of coup-plotting. Peacemaking with Eritrea has stalled, with borders apparently sealing up after a period of euphoria. Reporting on forced displacement of people in the Gedeo region appeared for a while to have triggered a change of heart by local authorities on humanitarian access and a greater respect for the principle of voluntary movements. Nevertheless, 2-3 million people are estimated to be displaced due to violence or drought, while the government has embarked on a systematic attempt to send IDPs home, often to an uncertain future. “Active hostilities” hampered humanitarian work on over 70 occasions in May alone.


Keep in mind:

While Abiy is called upon to make peace in Sudan, he has to steady the ship at home, quell multiple siummering conflicts, and deal with a foreign currency crunch. Ethiopia’s economic reforms include a rich prize: opening up of its phone and data market, which has captured the attention of the communications industry. Other developments to watch: relations with Somalia and Somaliland, and new legislation that may liberalise the licensing and administration of NGOs, whose activities had been tightly restricted in a 2009 law. Ethiopia is pushing a massive return programme of displaced people, the outcomes are as yet unclear. 


(PHOTO: Eritrea President Isaias Afwerki, centre, is welcomed by Ethiopia Prime Minister of Abiy Ahmed, right, in Addis Ababa. LEAD PHOTO: Internally displaced people on the edge of a Protection of Civilians site near Malakal, South Sudan.)

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