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Two key challenges exist in monitoring and assessing the humanitarian impact of sanctions. The first is in determining the current status of humanitarian conditions in the sanctioned country or region, in the midst of a complex and often rapidly changing political and security environment. The second is in distinguishing between the effects of sanctions and the effects of other factors that influence the humanitarian situation in the targeted country.29
Situations of humanitarian crisis exhibit a complex interdependence of economic, political and social conditions. Identifying humanitarian outcomes and the chain of causation that leads to them is challenging and controversial. However, some problems with measurement of relevant variables are particular to situations with sanctions.
- First, in some instances sanctions may cause an increase in the risk of changes in humanitarian conditions among a large group of people. This increased risk, and the actual changes that may result, may be obscured by concurrent events that independently contribute to negative humanitarian outcomes, such as war, mass migration or economic crisis. In fact, most sanctions are accompanied by some of these other concurrent factors, as well as problems of governance.
- Second, in sanctioned countries or regions, reduced access to data on key indicators may obscure trends and their causes, leading to further lack of clarity in the assessment. For example, in many wartorn societies or failed States, basic demographic statistics (such as a population census) and core UN data (percentage of children immunized) may not have been updated for several years or more.30
- Third, there is the potential for oversimplification of the influence of sanctions, which is especially likely if investigators make only brief trips to affected areas and live detached from the feel of everyday life experienced by the local population.
In situations of sanctions, cause and effect associated with humanitarian conditions may be difficult to separate. The fluidity of the situation means that the effects of sanctions may feed back into the chain of causation to further influence outcomes, indicating a spiral, rather than a linear, sequence of events (see figure 4). The sanctioned government or group may, for example, ration essential imported goods, putting further pressure on systems for domestic production and modifying normal market mechanisms for distribution.
Sanctions, as political and economic events, may be many steps removed from the humanitarian outcomes of interest in the chain of causation. The longer the chain of events, the greater the chance that identification and specification of steps and their interrelationships are misunderstood. Moreover, the kind of effects on economic systems that may be caused by sanctions can be the same as those caused by other events occurring at the same time, such as war and mismanagement of the economy. Therefore, it is important that the context in which sanctions are imposed be taken into account (socalled context analysis) to assist in identifying the unique consequences of sanctions. Context analysis in Liberia in 2001, for example, highlighted that the dollar value of humanitarian assistance cuts was already greater than the income that would be lost from sanctions.
Accounting for mediating factors
The task of identifying the unique contribution of sanctions to humanitarian conditions is further complicated by the fact that the impact of a sanction on a population can be mediated by a countrys underlying economic and social systems. Coping mechanisms that may help to mitigate or shift the impact of sanctions emerge in times of humanitarian crisis. Governments, industries and citizens each have ways of shifting resources and activities to circumvent the restrictions that sanctions at first impose.
There are thus multiple intermediate paths to harm or protection that complicate identification of a straightforward causal model. For example, changes in the distribution of essential goods within the family and the mobilization of underutilized resources due to political/social stimuli modify the impact of resource changes that may result from sanctions.
The experience of Cuba and Serbia, where infant mortality declined (a good outcome) during sanctions, is a more relevant and dramatic example of this phenomenon. These modifying influences are difficult to isolate and often go unrecognized or unmeasured unless qualitative research is carried out to supplement numerical indicators (see section 4.6). Even a dramatic decline in important resources does not always or immediately lead to increases in morbidity or mortality due to the resilience of such humanitarian assets as public education, healthy behaviours, trained health workers and infrastructure. Assets like these may deteriorate only gradually and can even be improved despite sanctionsrelated constraints. Similarly, a rally round the flag response to sanctions can mediate how people feel about their living conditions and may result in more effective mobilization of local resources in reaction to threatsactual or perceivedrelated to sanctions.
Time lags in humanitarian implications becoming apparent
Resource mobilization at various levels within the sanctioned country/region also contributes to another challenge in assessing the unique impacts of sanctions, namely: that there may be a time lag between the imposition of sanctions and the humanitarian consequences becoming apparent.
Delays in implementation of sanctions by States or intergovernmental organizations, the level of commodity reserves and resource stocks available in country, and possible indirect effects of sanctions on economic activity and humanitarian assistance may all contribute to a time lag.
For example, the imposition of sanctions may result in additional selfimposed restrictions by thirdparty States that may reduce legitimate trade because they are unclear about the scope of sanctions (what is and what is not covered). Also, depending on the type of sanctions, they may result in brain drain in particular targeted sectors, or among public sector employees, over time. This drain on professional expertise and knowledge will have a delayed impact on humanitarian conditions.
Being open to seeing unexpected and indirect impacts
A further difficulty is presented in attempting to identify causes of indirect impacts of sanctions, and possible relationships between sanctions and less tangible impacts. Examples of these indirect and less tangible impacts include:
- The threat of imposition of sanctions may cause international donors to reconsider their support for funding humanitarian operations in the sanctioned State;
- Foreign corporations, unsure of their national legislation on sanctions and on the scope of the measures imposed, may curtail legitimate trade for fear of acting in breach of national laws;
- Local currency exchange rates and food commodity prices may react speculatively to possible or actual imposition of sanctions.
Though not related to sanctions, an example worth noting is the famine in Bengal, India, during 1941-1943, a time of severe economic and financial realignments around the world because of the ongoing global conflict. During 1941 and 1942 there were fears that the Japanese army would invade and occupy India, beginning in the eastern area of Bengal. As a result, commodity markets overreacted and the cost of food tripled, even though there was no actual physical decline in food availability (in fact, the rice harvest was better than average). Because food consumption dominated household budgets, this led to a contraction in all other purchases, leading to a sharp recession during which time millions of people lost their jobs, particularly urban workers. The combination of higher food prices and dramatic collapse in income streams resulted in an estimated two million deaths due to starvation. Japan did not invade and the food remained plentiful, but the humanitarian impact of the selfperpetuating dynamic of overreaction was enormous.31
Two examples of direct and indirect effects of sanctions that may occur in some instances are shown in figure 6.

Investigators undertaking humanitarian assessments under sanctions must be cognizant of these challenges to identifying the unique impact of sanctions, and must take particular care to gather and utilize qualitative information, which will assist in identifying how resources are mobilized, substituted or modified under sanctions.
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