Making sure we do no harm

In undertaking international development work there is always the possibility of unintentionally causing harm. Through a process of careful self-monitoring and reflection, CBM Australia works hard to minimise the chances of harm occurring. Here are eight situations where we saw there was the potential to cause harm – and how CBM sought to mitigate this possibility, and learn from it.

1. At risk for those at-risk: Staff and the risk of harm during the pandemic

While responding to the COVID-19 crisis and the needs of communities combatting the virus, it is necessary to ensure that CBM staff and staff from partner organisations are not exposed to physical health risks.

Response: CBM’s COVID-19 responses must include education for staff about the risks they might be exposed to, and program plans must ensure that we do not unintentionally place staff at risk of contracting the virus. There must be formal system in place for staff to raise concerns.

2. Using numerical benchmarks to indicate success

We often use numerical targets to demonstrate how many people with disability have benefitted from a program. While this has its benefits, it also puts more vulnerable and marginalised people at risk. It is harder to work with someone with a more severe impairment, and it take more time. Numerical targets alone don’t take account of that. It may mean that programs involve people with milder impairments, at the expense of others, in order to reach their target.

Response: Broad numerical targets are ok – but should be balanced with other qualitative targets. Have a range of benchmarks, including targets for different groups – eg people with different impairments, women, tribal people.

3. Data collection and sensitive questions: what we leave behind

Collecting data from vulnerable groups can have unintended impacts. A program designed to find out about about access to water, was framed as a discussion about men and women’s workloads, and we realised this placed women at risk of violence when men didn’t like what the women were saying.

Response: Data collection plans must consider the repercussions of the issues we explore. We have to think about what might happen once we leave. We need to think about how data is shared, and the impact on those that shared it. Having ways of ensuring follow-up is important, if controversial or upsetting issues have been raised.

4. We are just a little DPO - you’re expecting too much!

While CBM puts a strong emphasis on partnering with DPOs and ensuring their voice is heard, sometimes partnering with a small DPO can pressure them into accepting a workload they might struggle to complete, or may lead them to neglect their own agendas.

Response: It is important to develop specific parameters for how we work with DPOs, so that our interactions strengthens them, rather than drains or overwhelms them. Clarity of expectations, options for payment, and consultation in planning are all key.

5. Where are my drugs? Not having a Plan B.

Supporting health programs in countries with political instability means always having a Plan B. Harm can occur when program do not consider alternative solutions that they can fall back on, leaving people without vital medications and supplies.

Response: Sufficient consideration must be given for securing and ensuring alternative supply models when programs are supporting the supply of medications, and relying on fragile government institutions.

6. The kids are in school, but are they ok?

When aiming to improve education for children with disabilities, there was the potential for these children to fall behind if the school lacked the resources and government support to build an inclusive education framework.

Response: increasing enrolments of children with disability in school must go hand in hand with advocacy to support the upskilling of teachers, and to ensuring teaching, classrooms and facilities can support inclusive education efforts.

7. Undermining social cohesion by introducing jealousy within the community

A program providing families living with disabilities access to vegetable gardens introduced elements of jealousy within the community.

Response: Recognising the risk of community jealousy at the outset is the first step in changing community attitudes through greater education. Programs need to build in community-wide benefits as well.

8. Understanding informed consent and the use of photography

Collecting consent for the use of photos and videos of people with disability, particularly children and adolescents, can become a source of harm. Family pressures to give consent can mean people consent to participate when they would rather not.

Response: Staff need to be well briefed in how to seek consent for photos, as well as how to interact with families and identify when consent is not freely given.