Intersections: Gender Operationalised? Understanding the NGO Gender Response to Papua New Guinea's Cholera Crisis

Intersections: Gender and Sexuality in Asia and the Pacific
Issue 33, December 2013

Gender Operationalised?
Understanding the NGO Gender Response
to Papua New Guinea's Cholera Crisis

Katherine Smith

Introduction

Humanitarian responses are more effective when they are based on an understanding of the different needs, vulnerabilities, interests, capacities and coping strategies of women and men, girls and boys of all ages and the differing impacts of disaster or conflict upon them. The understanding of these differences, as well as inequalities in women's and men's roles and workloads, access to and control over resources, decision-making power and opportunities for skill development, is achieved through gender analysis. Gender cuts across other cross-cutting themes. The humanitarian aims of proportionality and impartiality mean that attention must be paid to achieving fairness between women and men and ensuring equality of outcome.[1]

The above extract is from the 2011 edition of The Sphere Project's Humanitarian Charter and Minimum Standards in Humanitarian Response (Sphere Handbook). Notwithstanding its critics,[2] the Sphere Handbook is globally recognised as providing 'the de facto standards in humanitarian response in the twenty-first century.'[3] As a collaborative project, the Sphere Handbook enjoys widespread acceptance throughout the humanitarian community from NGOs, the Red Cross and Red Crescent Movement, donors and inter-governmental organisations (IGOs), including the influential humanitarian agencies of the United Nations. Echoing policy movements in the field of development and humanitarian aid over the past thirty to forty years, the Sphere Handbook also recognises the importance of gender analysis and sensitivity for ethical and effective humanitarian response. As a cross-cutting theme, the Sphere Handbook (and by extension, the humanitarian community more broadly) recognises that gender should be considered by all humanitarian actors regardless of emergency phase, type and/or context.
As a policy concept in international aid provision, gender has been the subject of much debate and criticism. Mixed opinions have followed policy changes from the 'women in development' (WID) agenda of the 1970s and 1980s to the current 'gender and development' (GAD) formulation.[4] The turn from women to gender was intended to enable development practice to move past a focus on universalised and essentialised woman to embrace a relational and holistic understanding of gender power relations and identity as they relate to development and later, to humanitarianism.[5] GAD sought to move forward from the strategies of WID which often naïvely added women into masculine-biased social institutions and roles, without considering the potential dangers of doing so or the underlying power dynamics at play. Yet as early as the UN Fourth World Conference on Women in Beijing in 1995, concerns about the utility and success of 'gender' were being raised from several angles. On the one hand, scholars have lamented the depoliticisation of the feminist agenda through the employment of gender, a concept considered to be void of transformative potential. In Cynthia Enloe's words, in aid discourse and practice, gender is used as a 'bureaucratically comfortable synonym for women'[6] and attention to the operation of gendered social power relations ignored. On the other hand, campaigners for a return to a focus on 'women' over 'gender' point to the need for attention to, for example, women's rights, for successful advocacy and social change to be possible.[7] At the same time, conservative voices object to what they perceive to be the potential threat of the concept to traditional religious beliefs and social structures.[8] Similarly, gender is attacked for its complicity in the perceived dangerous practice of deconstructing woman.[9] Yet, despite these objections and others, gender continues to be a dominant policy concept in the international aid arena and, for most aid professionals, is a central ingredient for aid delivery and discourse. At the same time, it continues to be poorly articulated and inconsistently implemented. For the most part, gender-sensitive programming is also markedly altered from the transformative practice originally envisaged by feminist theorists.
Against this background, on-the-ground gender analysis and gender sensitivity in humanitarian policy and programming varies. The ways in which gender policy and practice are implemented and conceptualised in response to particular humanitarian situations is influenced by the diverse realities of relief settings and by those who interpret them (and often have very different understandings from those espoused in global policy frameworks). This paper investigates the impact of these realities and personalities on gender-sensitive policy and programming in one humanitarian response. Within the broader context of the multi-agency response to the 2009–2011 cholera outbreak in Papua New Guinea (PNG),[10] this paper will focus on World Vision's work in Madang province in late 2009 and early 2010. The article will consider the realities of implementing gender-sensitive policy in this relatively small-scale health-focussed emergency relief effort and question what has influenced the way in which gender is understood (both at World Vision headquarters in Port Moresby and in Madang) and put into practice by World Vision staff in the field. In this way, the article will look for and seek to explain divergences between policy and practice, between headquarters' staff and field staff, and between World Vision's work and global standards such as those outlined in the Sphere Handbook.
My analysis proceeds as follows. First, the method and scope of the paper is outlined and some background to the context provided. Second, I provide an overview of the way in which World Vision's gender policy, programming and practice were theorised and implemented in Madang. The subsequent substantive analysis is then structured around three key areas—implementing organisation, response context and emergency type. These three areas of focus have been chosen to frame discussions for two major reasons. Most importantly, they were repeatedly raised by participants as being significant in understanding the approach and outcome of the humanitarian response. Additionally, these three factors demonstrate the variability of the environment under which any given humanitarian response takes place. Examining each underlines the importance of considering case studies to highlight overall trends in the greater humanitarian system. Analysis of the implementing organisation, response context and emergency type in this case unveils a divide between global standards and organisational policy, and practical realities. In short, the case displays difficulty in translating the political concept of gender in a way that is locally and contextually relevant—both in the context of PNG and as part of humanitarian practice more broadly. Sally Engle Merry describes this as presenting difficulty speaking in the vernacular.[11]

Background, method and scope
On 11 September 2009, the PNG National Government declared a national health emergency as cholera, a disease hitherto unknown in PNG, began to move across the country. Two months earlier, in July 2009, cholera was reported in Morobe Province on the northeast coast of mainland PNG. The outbreak spread within the province, and then to Madang and East Sepik Provinces in late 2009. By January 2010, cholera had reached the National Capital District, including Port Moresby and nearby Central Province. In the following months, the outbreak spread to Gulf and Western Provinces, finally reaching the Autonomous Region of Bougainville in the early months of 2011. Between 2009 and 2011 more than 15,500 cases of cholera were reported across PNG, with 493 recorded deaths.[13] Within this national context, this research focusses on World Vision's Response to the cholera outbreak in Madang. One of the earliest provinces to be affected, the Madang Provincial Health Department issued a cholera alert for Madang on 28 October 2009, following the admission of the first cholera patient to the local Modilon General Hospital on 24 October 2009. By 28 October, seventy-three patients with cholera symptoms were registered at the hospital, and health authorities had begun conducting awareness campaigns. The worst affected area in Madang Province and the site of World Vision's response was the Humade area of Sisiak—a squatter settlement located approximately two kilometres north of Madang town with a population of more than 5000 people. Water, sanitation and hygiene infrastructure within this area is insufficient and there is limited community knowledge regarding safe hygiene practices.[14]
World Vision's Madang Cholera Response focused on improving access to safe water and was designed to complement the assistance already provided by the Madang Provincial Health Department and other aid organisations working in Madang at the time of the outbreak.[15] Valued at a total cost of $US26,528, the response focussed on three main outputs: establishing Water Sanitation and Hygiene (WASH) management committees, construction and demonstration of Ventilated Improved Pit (VIP) latrines, and the development of a rain water catchment system in combination with the purification of several water points. Prior assistance had focussed on awareness raising, distribution of educational materials and non-food items such as water purification tablets and jerry cans and, of course, on clinical care.[16]
This paper is based on field research that I conducted in February and March 2012 in Port Moresby, Madang town and Sisiak settlement. The empirical core of the research consisted of semi-structured interviews with NGO (including World Vision) and UN staff working on the response to the cholera outbreak both nationally and in Madang, representatives of the Madang Provincial Health Department and residents of the Humade area of Sisiak Settlement. Approximately five community members and ten NGO and UN staff members participated in the study, representing five humanitarian agencies with differing roles and mandates in the national and provincial response. Interviews were semi-structured, lasting up to two hours and were conducted in either English or Tok Pisin (with the assistance of a translator) on the request of the interviewee. Participants were asked to share their experiences and views on how gender affected relief and recovery needs during the cholera outbreak and how it was (or was not) considered relevant to the response framework of their own situation or organisation (if applicable) and others with whom they had contact. Further, participants were invited to discuss their understandings of 'gender,' 'gender equality' and 'feminism' in relation to humanitarian and social justice programming both in the cholera response and more broadly. Here it is important to state clearly that I do not seek to assess the effectiveness or appropriateness of World Vision's response to the cholera outbreak in Madang. Rather, I analyse and suggest reasons for divergences in the understanding of gender in policy and its implementation in programming and practice. This is an important distinction to make and in doing so I recognise the often competing incentives for and values of aid workers, international institutions and donors, and aid recipients in any given humanitarian context. This discordance is especially apparent in discussions of politically and culturally laden concepts such as gender. As such, I do not endeavour to speak for residents of affected areas or represent their views as to the utility of World Vision's program. Interview findings are supported by analysis of primary and secondary written sources. This includes, importantly, analysis of internal policy documents and project designs/evaluations that are not readily available to the public and were provided to the researcher by staff members. These written sources assist in providing a fuller picture of the way gender is understood and implemented across the agency.

Policy, program and practice: World Vision's (gender) response to cholera in Madang
The three passages above reflect the journey of gender from policy concept, to program consideration, to practical reality. The divergence between conceptualisations/understandings of gender in the website and concept paper and the perceived relevance and applicability of these for staff members implementing the program is apparent. In the section to follow, elaboration of these divergences will be discussed with focus on two issues and their influence on this divergence.
First, throughout discussions with research participants, there was an apparent lack of clarity around the concept of gender and an inconsistent appreciation of its importance at different levels of the organisation. Despite both the concept document and interviewees indicating that gender training was compulsory for all World Vision employees, not all staff had received the training and of those that had in Madang, few could recall more than a very vague and basic definition of gender. None of those interviewed in Madang could express what World Vision's policy on gender was or the process for implementing it and most deferred to either the 'gender specialist' at headquarters in Port Moresby or the World Vision website to explain it. Understandings of the relevance and priority of gender programming both within the Madang office and particularly between the Madang and Port Moresby offices varied significantly—with those at headquarters in Port Moresby having a much more sophisticated theoretical and policy understanding. Particularly interesting was that those who seemed to have a stronger understanding of the concept of gender, at least in terms of accepted discourse, were most distant from implementation on the ground, and by extension—closer the international centre of the organisation. Staff involved in implementation were also among those who considered gender least relevant. When asked, for example, whether they considered the crosscutting issues to have been implemented effectively, one staff member responded:
And when asked why the paragraph on cross-cutting issues was included:
Both statements indicate a distinct lack of appreciation for the contribution a gender lens might make in addition to a lack of ownership of gender work.
Second, linked to this, there was a conspicuous absence of any type of gender analysis prior to commencing programming, despite acknowledgement by staff that the cholera outbreak had gendered effects:
As a result, women were assumed to be automatically vulnerable and weak and that they would be best protected and represented by their (usually male) heads of households. Community consultation on needs, for example, included discussion primarily with male community leaders or in committee settings in which the representation and voice of less dominant groups was low. As one female resident of Sisiak expressed: 'For mothers they cannot stand up and speak up because they will not be listened to.'[23]
Women's vulnerability and weakness was taken as given, even insofar as to argue that their lack of knowledge may be responsible for the transmission of the disease. For example, when asked, why women were considered to be the most vulnerable, one staff member responded:
Significantly, reliance on such pre-established notions of gender and gender relations highlights an inability to understand the characteristics and dynamics of gender relations in specific crisis situations and how these may impact on gendered insecurities. It signifies a divergence from growing appreciations of the intersectionality of gendered identity within the humanitarian sphere and the importance of this for ethical relief provision. Further, it ensures the oft-lamented conflation of 'gender issues' with 'women's issues' in international aid provision. This divergence is particularly striking when compared with the following passage extracted from the Sphere Handbook's Minimum Standards in Health Action (a chapter of the handbook which World Vision had a significant role in developing).
Within World Vision's response to cholera in Madang, the evidence provided above suggests a strong divergence between gender policy ideas, programming commitments and implementation realities. The question then becomes why. I will now turn to discuss three aspects considered to be particularly important influences in this regard.

Child-focused, Christian and transformative: world vision in the international humanitarian system
Each organisation operating within the humanitarian sphere has both a unique history and a specific understanding of the concepts and issues that have gained attention in global discourse. This understanding and history guides the way in which concepts and issues are both presented to staff and implemented. World Vision is no exception. As a Christian and child-focussed organisation, World Vision draws from biblical references and stories of Christ's compassion to demonstrate the value of a gender focus in aid provision.[27] World Vision's Christian identity combined with its foundational work as a child sponsorship agency (an agenda often associated with other social justice issues such as women's rights) has ensured that mainstream conceptualisations of gender policy are highly compatible with its work. As a participant from World Vision based in Port Moresby expressed:
This background suggests that World Vision could be ideally positioned to promote gender awareness and execute gender-sensitive policy and programming in a given humanitarian setting, with one caveat. As a Christian organisation, World Vision embraces gender in a way that remains compatible with its core beliefs. As such, understandings of desired gendered identities and roles remain within a conservative framework and traditional binary. This is seen in such forums as World Vision's stance on family planning support and its ambiguous position on lesbian, gay, bisexual and transsexual (LGBT) rights.[29] Such a framing encourages a liberal understanding of gender justice, focussed on equal rights through the lens of traditional Christian values—of which an unintentional side-effect may be the association of gender with women.
This vision is also strongly affected by the conflicted position humanitarian assistance currently holds in 'aidland.'[30] In addition to its Christian lens and child-focussed history, World Vision explicitly identifies itself as a promoter of human transformation and justice as outlined in their mission statement.[31] To perform this role in the humanitarian space, the organisation (along with many others) must negotiate its place amongst competing understandings of legitimate humanitarianism. As the politicisation of the humanitarian space is increasingly recognised,[32] the sanctity of traditional humanitarian ideals—impartiality, neutrality and independence—is challenged.[33] Relief work focussed on providing, in David Rieff's words, a simple 'bed for the night,'[34] without entering into the politics and power relations of the local context (including with regard to gender) contrasts with humanitarian projects called upon to effect political change. A tension between the demands of new humanitarianism and the narrative of old humanitarianism is evident.
The spectrum of ideals along which humanitarian policy is formulated and delivered still ranges from strict adherence to traditional principles to a firm embrace of an inclusive social justice approach. At one end of the spectrum is the International Red Cross Movement concentrating on traditional ideals, restoration and saving lives, without fundamental political change. At the other end are politically-focused organisations which, like World Vision, embrace a transformative agenda. These organisations include in their policy agendas both disaster response and community transformation.[35] The tension between these two objectives influences the way in which gender policy is both understood (in accordance with transformative ideals) and enacted in humanitarian assistance—still dominated discursively by traditional ideals. For World Vision, the effects of this divergence have been less detrimental than in other comparable aid organisations.[36] Nonetheless, to some extent, World Vision's humanitarian response in this context has fallen victim to a depoliticisation of its own gender ideals—the outcome of a desire to enact transformative ideals in an enduring apolitical discursive space. To enable the humanitarian narrative of 'impartiality,' 'neutrality,' and 'independence' to remain convincing, the theoretically transformative potential of the gender agenda is itself neutralised. Gender analysis is not conducted to understand the power relations within the relief context and when gender is considered, it is reduced to a set of gendered assumptions and homogenised perceptions of women's needs.

Outsiders inside and insiders outside: the interactions of global policy frameworks with local realities
Local culture and context play a defining role in the implementation and conceptualisation of international humanitarian policy. This is most dramatically seen where humanitarian organisations form part of a global consortium and operate in crisis settings in partnership with international and local staff. This is certainly the case in Madang, and specifically in Sisiak, where population flow has resulted in the coming together of previously geographically divided and culturally distinct groups. On the backdrop of widespread gender inequality and gender-based violence throughout PNG,[37] the position of World Vision as a global organisation with both local and international staff shapes World Vision's interaction with local societies in distinct ways. Comments by participants in this study suggest multi-layered difficulties in these interactions.
First, some staff display difficulties in engaging meaningfully (with transformative intent) with the local gendered context, culture, politics and power relations. This is particularly true insofar as this requires moving past pre-existing conceptions of gendered relations within the country. On this point, Sally Engle Merry's work is particularly instructive.[38] As Stephanie Lusby explains, ideas must go through a process of, what Merry terms, '"vernacularisation," where transnationally formulated ways of thinking about social justice, or health, are remade to make sense in particular, local socio-cultural contexts.'[39] Merry elaborates that for political concepts to be effectively translated—or vernacularised—three kinds of changes need to take place. Ideas need to be presented in a way that resonates with the local community, whether through narratives, imagery, religious or cultural norms. They must be compatible with social structures—whether these be national, political or familia—and finally a target group must be identified.[40] In this instance, significant attempts at addressing these requisite changes took place—particularly in World Vision's presentation of ideas about gender through Christian narratives. However, comments from participants in this study indicate that ideas about gender programming have not been effectively translated to be compatible with or relevant to existing PNG societal structures or cultural norms.[41] Interviews with participants, particularly Papua New Guinean nationals, suggest discordance between World Vision's ideas and expectations about gender, and what is possible and desirable on the ground.[42]
Second, focusing on those who are charged with adapting global ideas to local contexts—what Sally Engle Merry has called 'translators'—is particularly illuminating in this case. As Merry explains and Jane Ferguson elucidates in her discussion of SWAN women in Burma, translators can be both powerful and vulnerable. They are subject to the demands (and exploitation) of those who, in this case, pay their wages, as well as often being distrusted locally —perceived as agents of a foreign body.[43] At the same time, they are ultimately responsible for the success or failure of the translation of a political concept from the global to the local.[44] In this case, the role of translator is played (although not exclusively) by World Vision and operates at multiple layers through their local and international staff, interacting with the power dynamics of the international system with interesting effects.
As a global consortium with the backing (and funding contributions) of international donors, World Vision exacts significant power and influence over the (less influential) states in which it works —including PNG. As such, for local staff it is difficult to question the suitability of World Vision's global policy frameworks (and those of comparable organisations) for the Papua New Guinean context. Similarly, the legitimacy of an international organisation intervening in issues of social justice is not easily questioned. This is not to say that World Vision's policies are immune to internal debate or that such programs should be eliminated. Rather, the ability of PNG as a sovereign but impoverished nation to question the priorities of international aid agencies is limited. Similarly, on a smaller scale, for locally engaged, usually short-term, staff members, such as those implementing World Vision's cholera response in Madang, to refuse policy directives from headquarters is inherently difficult. This both indicates a power imbalance in the international system and points to a tokenistic engagement with contextual analysis on gender issues by both international and local staff members. On the one hand, there is difficulty in engaging meaningfully with the context and on the other, there is a resistance to consider the gendered impacts of disaster through a framework that has relatively little local ownership. As demonstrated below, gender is perceived as something that requires external training and is often resisted.
Perceiving emergency: disease as a socially indiscriminate disaster
The urgency of curtailing the spread of cholera was a frequently recurring theme in discussions with participants regarding the relevance of gender to World Vision's cholera response—and the national response more broadly. The 'emergency excuse'—where gender analysis and mainstreaming work is delayed until such a time as 'real' emergency needs have been dealt with—has been documented by other authors.[48] Gender may then be deprioritised as a time-consuming optional extra to consider when time or funding allows for such luxuries.[49] Where a relief program's success is framed as dependent on a culture of speed, in-depth contextual analysis (including gender analysis) is not considered appropriate or possible. Aid providers have argued that survival is not dependent on being gender-sensitive, and is sometimes made more difficult by doing so.[50] Programs are often exempt (officially or unofficially) from the same needs assessments, quality, and monitoring and evaluation requirements of other longer-term aid activities due to their emergency status.
This general commentary is consistent with the findings of this research, but with two notable particularities. First, the lack of gender analysis and generally tokenistic attempts to include gender awareness in both program design and implementation reflected the previously mentioned sentiment amongst staff that women were inherently vulnerable to disaster. As noted this allowed for assumptions about the vulnerability of women, a general willingness to act for women and an unaddressed ignorance regarding the way in which gendered power relations may impact the situation. Second, the specificity of a health emergency was utilised to demonstrate the lack of necessity (or possibility) of gender analysis in this humanitarian context. Significantly, and in contradiction with previously expressed sentiments regarding women's inherent vulnerability in disaster, participants emphasised that as there had been no disruption to social order (for example through displacement), women continued to be safe in their communities. This is despite the well-documented high levels of gender-based violence reported throughout PNG.
Concluding comments
The above reflection by a World Vision staff member based in Port Moresby summarises the challenges of understanding and implementing gender policy in humanitarian settings. In a world where humanitarian emergencies present diverse challenges, in disparate geographical settings, international policy frameworks are unlikely to be enacted analogously by the assortment of agencies operating in the global humanitarian space. In this context, the value, credibility and practicality of adhering to global standards is easy to question.
Both my own understandings of gender as a feminist researcher and local understandings of gender in the PNG context diverge strongly from those understandings that are obliged to be implemented by global standards. Indeed, in an area where gender has no direct translation into the local language,[53] the expectation that local understandings will converge with global definitions seems illogical for local aid staff, let alone for their beneficiaries. In my discussions with staff and recipients in Madang, it quickly became clear that there was discomfort with the concept and that, in practice, gender was perceived to refer to differences in needs between men and women with little attention to the negotiation of power relations within or between this duality, or the influence of these relations on the situation. It was considered a foreign concept that was, although useful, not naturally well-suited to work within traditional PNG social structures. In other words, it has not been vernacularised effectively. In contrast with both this understanding and that espoused by the global standards under discussion, my own understanding of gender is as an intersectional identity marker that can be both more or less important to an individual's security than other markers depending on context.[54] I also understand both gendered identity and relationships to be intersubjectively constituted and fluid and reject the duality inherent in the understandings discussed in this paper. Given the divergences in understanding between myself, the participants in this study, and global gender standards, it is difficult to see the relevance of a singular understanding and policy directive on this issue.
In this paper I have argued that three major factors affected the way in which gender was conceptualised and implemented in World Vision's Madang Cholera Response—the implementing organistion, response context and emergency type. Together, they combined to influence a strong divergence between the aspirations of policy and the realities of practice in Madang. With each factor so strongly dependent on the particular circumstances of this context, it becomes clear that the international approach to gender needs to be reframed in a more locally relevant and easily adaptable way. While gender policy and practice is based on pre-conceived understandings and formulations of what 'doing gender' means, it is difficult to see the change referred to above, as being achievable. Here, Sally Engle Merry's idea of 'hybrid vernacularization' may be a useful guide—advocating a process through which 'vernacularization can take a more interactive form, with symbols ideologies, and organization forms generated in one locality merging with those of other localities.'[55]
This finding is consistent with other comparable studies of gender policy and programming in humanitarian assistance.[56] Indeed, in recent years, the policy nuances of particular humanitarian agencies on global gender standards have reflected a growing recognition that aid programming (including its gender components) must be informed by the specificities of the given context and designed in consultation with aid recipients. The work of the United Nations High Commissioner for Refugees (UNHCR) current Age, Gender and Diversity Mainstreaming (AGDM) Policy [57] is one such example of this.[58] At present, such initiatives are imperfectly implemented and have failed to change the shortcomings of gender policy and programming such as those discussed in this paper.[59] Regardless, this type of approach holds promise for the continued relevance of gender as a policy concept in international aid and development. To ensure that international aid is as effective as possible, in Papua New Guinea and elsewhere, it is vital that such initiatives continue to be pursued and improved.

Notes

[1] The Sphere Project, Humanitarian Charter and Minimum Standards in Humanitarian Response, Rugby: Practical Action Publishing, 2011, p. 15.

[2] Criticism came from several French humanitarian NGOs, most notably Médecins Sans Frontières. See, for example Jacqui Tong, 'Questionable accountability: MSF and Sphere in 2003,' Disasters, vol. 28, no. 2 (2004): 176–89.

[3] Sphere, Humanitarian Charter, p. iii.

[4] For a detailed discussion see Eva Rathgeber, 'WID, WAD, GAD: trends in research and practice,' in Journal of Developing Areas, vol. 24, no. 4 (July 1990): 489–502.

[5] Jennifer Hyndman and Malathi de Alwis, 'Beyond gender: towards a feminist analysis of humanitarianism and development in Sri Lanka,' Women's Studies Quarterly, vols 3–4 (2003): 212–26, p. 241.

[6] Cynthia Enloe, 'Closing Remarks,' in International Peacekeeping, vol. 8, no. 2 (2001): 111–13, p. 111.

[7] Sally Baden and Anne Marie Goetz, 'Who needs [sex] when you can have [gender]? conflicting discourses on gender at Beijing,' Feminist Review, vol. 56 (1997): 3–25, p. 10.

[8] Baden and Goetz, 'Who needs [sex] when you can have [gender]?' p. 12.

[9] Baden and Goetz, 'Who needs [sex] when you can have [gender]?' p. 13.

[10] Other key agencies in the National Cholera Response include the PNG Government, Médecins Sans Frontières, PNG Red Cross Society, Oxfam Australia, World Health Organisation and AusAID.

[11] Sally Engle Merry, Human Rights and Gender Violence: Translating International Law into Local Justice, Chicago and London: The University of Chicago Press, 2006, pp. 218–19.

[12] Sisiak Resident 1, Personal Communication with Author [in person], Madang, 6 March 2012.

[13] Paul Horwood, Deirdre Collins, Marinjho Jonduo, Alexander Rosewell, Samir Dutta, Rosheila Dagina, Berry Ropa, Peter Siba and Andrew Greenhill, 'Clonal origins of Vibrio choleras O1 El Tor Strains, Papua New Guinea, 2009–2011,' Emerging Infectious Diseases, vol. 14, no. 11 (2011): 2063–65.

[14] World Vision, Project Concept Paper: Madang Cholera Response, unpublished, 2009, p. 1.

[15] World Vision, End of Project Report, p. 6.

[16] World Vision staff members were involved in the provision of some of these programs but were not the funding body.

[17] World Vision, 'World Vision's approach: gender integration,' Gender, n.d., online: http://strongwomenstrongworld.org/wp-content/uploads/2012/10/gender-redesign.pdf, accessed 17 December 2013.

[18] World Vision, Project Concept Paper, p. 4.

[19] World Vision staff member 1, Personal Communication with Author [in person], Madang, 8 March 2012.

[20] World Vision staff member 2, Personal Communication with Author [in person], Madang, 8 March 2012.

[21] World Vision staff member 2, Personal Communication with Author [in person], Madang, 8 March 2012.

[22] World Vision staff member 3, Personal Communication with Author [in person], Port Moresby, 14 March 2012.

[23] Sisiak Resident 1, Personal Communication with Author [in person], Madang, 6 March 2012.

[24] World Vision staff member 2, Personal Communication with Author [in person], Madang, 8 March 2012.

[25] Sphere, Humanitarian Charter, pp. 294–95.

[26] World Vision, 'World Vision Australia – Our Christian Identity Statement 2 – Exercising the compassion of Christ,' World Vision, n.d., online: https://www.worldvision.com.au/Libraries/OurChristianIdentity/WVA_OCI_Compassion_of_Christ.sflb.ashx, accessed 20 November 2012

[27] Linda Tripp, 'Gender and development from a Christian perspective: experience from World Vision,' Gender and Development, vol. 7, no. 1 (March 1999): 62–68, p. 65.

[28] World Vision staff member 3, Personal Communication with Author [in person], Port Moresby, 14 March 2012.

[29] Nigel Marsh, 'A, B + C puts World Vision at the front of the prevention discussion,' World Vision, n.d., online: http://www.worldvision.org/worldvision/pr.nsf/stable/barcelona_6, accessed 30 November 2012

[30] David Mosse (ed.), Adventures in Aidland: The Anthropology of Professionals in International Development, New York: Berghahn Books, 2011.

[31] World Vision, 'Our Mission,' World Vision, 2013, online: http://www.worldvision.org/content.nsf/about/our-mission, accessed 30 November 2012.

[32] For example Michael Barnett, 'Humanitarianism transformed,' Perspectives on Politics, vol. 3, no. 4 (December 2005): 723–40; Daniel Warner, 'The politics of the political/humanitarian divide,' International Review of the Red Cross, vol. 833 (1999), online: http://www.icrc.org/eng/resources/documents/misc/57jpt3.htm, accessed 18 December 2013.

[33] These ideals form part of the fundamental principles of the Red Cross Movement (often described as the founding organisation of modern international humanitarianism).

[34] David Rieff, A Bed for the Night: Humanitarianism in Crisis, New York: Simon & Schuster, 2002.

[35] World Vision, 'FAQs about World Vision Australia,' World Vision Australia, 2013, online: http://www.worldvision.com.au/AboutUs/FAQsAboutWorldVisionAustralia.aspx#6d73e671-96ef-4446-bea7-9d5a93a957b3, accessed 17 December 2013.

[36] For example, in the work of the International Committee of the Red Cross and Red Crescent Societies.

[37] Andrew Egan and Amy Haddad, Violence against Women in Melanesia and East Timor: A Review of International Lessons, Canberra: AusAID Office of Development Effectiveness, 2007.

[38] Sally Engle Merry, Human Rights and Gender Violence: Translating International Law into Local Justice, Chicago and London: The University of Chicago Press, 2006, pp. 218–19.

[39] Stephanie Lusby, 'Refracted "awareness": gendered interpretations of hiv and violence against women prevention in Papua New Guinea,' issue 33, Intersections: Gender and Sexuality in Asia and the Pacific (2013), online: intersections.anu.edu.au/issue33/lusby.htm (this volume), para 7.

[40] Merry, Human Rights and Gender Violence, p. 219.

[41] Importantly and in addition, some incompatibility also remains between the politically transformative concept of gender equality and the structures and narratives of humanitarian assistance as a practice, particularly around the idea of neutrality discussed in this article. In this way, the concept has not only failed to be successfully vernacularised in the PNG context, but also in the discourse and practice of humanitarian assistance itself.

[42] Drawing on Sally Engle Merry's work, Christina Kenny (this volume) provides a helpful account of the way in which local conceptions of female bodies and identities can often differ from transnational discourse. Her analysis is also relevant here. See Christina Kenny, '"She grows to be just a woman, not a leader." Gendered citizenship and the 2007 general election in Kenya,' Intersections: Gender and Sexuality in Asia and the Pacific, issue 33 (2013), online: intersections.anu.edu.au/issue33/kenny.htm (this volume), para 5.

[43] See Jane Ferguson, 'Is the pen mightier than the AK-47? Tracking Shan women's militancy within and beyond the ongoing internal conflict in Burma,' issue 33, Intersections: Gender and Sexuality in Asia and the Pacific (2013), online: intersections.anu.edu.au/issue33/ferguson.htm (this volume), para 7.

[44] Sally Engle Merry, 'Transnational human rights and local activism: mapping the middle,' in American Anthropologist, vol. 108, no. 1 (2006): 38–51, p. 40.

[45] World Vision staff member 2, Personal Communication with Author [in person], Madang, 8 March 2012.

[46] World Vision staff member 3, Personal Communication with Author [in person], Port Moresby, 14 March 2012.

[47] UN Office for the Coordination of Humanitarian Affairs PNG staff member, Personal Communication with Author (in person), Port Moresby, 2 March 2012.

[48] See Hyndman and de Alwis, 'Beyond gender,' pp. 212 –26.

[49] Eli Stamnes, 'The responsibility to protect: integrating gender perspectives into policies and practices,' Responsibility to Protect 8, Oslo: Norwegian Institute of International Affairs, 2010, p. 18.

[50] Hyndman and de Alwis, 'Beyond gender,' p. 214.

[51] World Vision staff member 2, Personal Communication with Author [in person], Madang, 8 March 2012.

[52] World Vision staff member 3, Personal Communication with Author [in person], Port Moresby, 14 March 2012.

[53] Although PNG has three official languages—English, Tok Pisin and Hiri Motu—Tok Pisin is the most widely spoken and understood. English is spoken by 1—2 per cent of the population.

[54] For example, race, class, age, education level, ethnicity, disability.

[55] Merry, 'Transnational human rights and local activism,' pp. 46–48.

[56] See, for example Fenella Porter and Caroline Sweetman, 'Editorial,' in Mainstreaming Gender in Development: A Critical Review, ed. Fenella Porter and Caroline Sweetman, Oxford: Oxfam GB, 2005, pp. 2–10.

[57] UNHCR, 'Age, gender and diversity policy: working with people and communities for equality and protection,' refworld, 2011, online: http://www.unhcr.org/refworld/docid/4def34f6887.html, site accessed 25 September 2012.

[58] The AGDM policy is implemented primarily through UNHCR's ground-breaking participatory assessment (PA) tool. The policy takes into account both how different identity factors affect needs in humanitarian settings and how existing gendered power relations impact on access and decision-making ability. The PA methodology supports this policy by 'building partnerships with refugee women and men of all ages and backgrounds by promoting meaningful participation through structured dialogue.' UNHCR, 'The UNHCR tool for participatory assessment in operations,' UNHCR. The UN Refugee Agency, 2006, online: http://www.unhcr.org/450e963f2.html, accessed 20 February 2013.

[59] Virginia Thomas and Tony Beck, Changing the Way UNHCR Does Business? An Evaluation of the Age, Gender and Diversity Mainstreaming Strategy, 2004–2009, Geneva: Policy Development and Evaluation Service, UNCHR, 2010.

Published with the support of Gender and Cultural Studies, School of Culture, History and Language, College of Asia and the Pacific, The Australian National University.
URL: http://intersections.anu.edu.au/issue33/smith.htm
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