On-field research experience in Emergency war hospital in Cambodia
Emergency is an NGO operating in war and post-war zones implementing high-quality rehabilitative care hospitals, designed to be handled back to local authorities when completely integrated in the territory. The on-field investigation has used a qualitative research methodology (Grounded Theory) and has led to design a model of sustainable integration process.
The two complex systems considered for this research has been the Emergency war hospital and the Cambodian social environment in which it was built.
This organization features suited the research interests. The structure of Emergency has two parallel realities: the organisation head quarter with its two offices in Milan and Rome that coordinate about 172 volunteers groups spread in all Italy and a network of cooperation projects in 13 countries around the world. This research focuses on how Emergency designs and implements its projects.
Emergency interventions have specific characteristics:
- New project often originate in consequence of a bottom-up process. An emblematic case is the Emergency Sri Lanka project that was born in consequence of a significant private funding specifically addressed to the tsunami victims; the intervention resulted from a decision to use the many contributions on a project rather than give it back to the donors as the Emergency policy of intervention address only war and post war territories. This created a new knowhow in the organization of interventions in natural disaster areas
- Each project has specific characteristics due to the fact that the intervention conditions are always peculiar and different even if the intervention is carried out on a territory already known. Each intervention can be considered a wicked problem (Rittel and Webber 1973), always unique and novel in continuous evolution and with more than one resolution. This requires the system to be highly adaptive and reactive to the environment in which it operates.
- The result of each intervention is a self-sufficient and totally integrated structure designed to be given to local health authorities. This implies that each project has to foresee a very subtle handover and withdrawal process.
- A war territory is a highly complex environment, many agents are active and their relationships are often hidden, unpredictable and non-linear.
- The aim is the integration of the structure within the territory from the very first design phase.
The bottom up process, the wicked problem, the handover and withdrawal process, the complexity of a war territory and the value of integration have been one of the main reason to choose Emergency as a case study for this research.
The used methodology springs from the social research techniques framework and combines its methods in the so-called qualitative triangulation. In social research, at least four different meanings of the term triangulation based on a different reading of topographical metaphor coexist. The one this research refers to is the third reflective triangulation of the epistemological field of Hammersley e Atkinson (1995). In this framework the use of different techniques help the research to determine which conclusions can be derived by the empirical documentation delivered by each technique. Triangulation helps to identified and overcome the specific limits of each survey techniques. The use of joint methods allows to approach in a more efficient manner the two parallel reality of Emergency. From on hand both free and structured interviews has been carried out so as to set a research relationship with the Italian head quarter operators, from the other Grounded Theory methods has been used in an on field research period in the Ilaria Alpi Hospital in Battambang, Cambodia.