Aid agencies say they want to save lives or even change the world. But many freely admit they often fail to listen enough to the people they want to help.
Now a new system allows agencies to certify themselves as accountable, but will it make any difference?
"We're establishing a community of organisations who mean what they say," said Nicholas Stockton, executive director of Humanitarian Accountability Partnership (HAP).
HAP has set up a self-certification process whereby participating agencies are committed to meeting a series of measurable benchmarks or risk losing their status. Agencies get certified by HAP for three years, reviewed halfway through. If anything's found wanting, they have 18 months to put it right.
There's a constant tug on aid agencies from donors who want to know where their money's going and from people on the receiving end of disaster relief. Humanitarians say they need to be accountable to both, but these desires don't always seem compatible.
After the December 2004 Indian Ocean tsunami, for example, aid agencies struggled to compete for funds and then spend the unprecedented volume of money that flooded in from corporate, private and international donors.
Aid workers who were there will say - when they're being honest Â? that in many cases agencies put donors' needs first. That meant they often promised to spend money quickly even if it didn't give them time to consult properly with other relief organisations or with the people supposed to benefit from the cash.
Rwandan genocide survivor Esther Mujawayo knows what it's like to need aid and come up against aid agencies that seem to be driven by their own pre-determined goals.
After losing her husband, mother, father and many other relatives in the 1994 massacres, she remembers well-meaning aid agencies sending offers of psychological support. They were a bit shocked, she says, when widows asked for Land Rovers instead.
It was not that the women were heartless - they were suffering acutely from losing everything they loved in the space of a few months - but roadworthy cars would make it possible for them to travel and find out who had survived.
Mujawayo, who established Avega Â? the Association of Widows of the Genocide Â? said survivors had a space to cry and support each other. But, she says: "We also need houses." And aid agencies weren't offering houses, saying it wasn't in their policies.
"Whose policy is it?Â? Mujawayo asks. "When you come to work, whose agenda are you responding to?"
She's angry too that aid agencies were initially unwilling to consider paying for life-saving medical treatment for women who'd contracted HIV through rape during the genocide.
At the time, before anti-retroviral prices dropped to affordable levels, HIV-positive prisoners waiting for trial at the U.N. tribunal in Arusha, Tanzania, were getting funded medication, while women who testified weren't eligible.
Mujawayo worked for Oxfam, so she knows what it's like from both sides.
"The danger is that we end up feeding ourselves, our image (as NGOs). Are we doing the best for our people, or the best for our image?" she asks. "To be able to change requires a big change of mentality."
HAP's founders say these are the kind of contradictions that its self-certification process for aid agencies is meant to counter.
It steps beyond the Red Cross code of conduct in disaster relief, whose principles have become widely accepted since the 1960s. And it goes further than the Sphere Project, which sets out a series of concrete minimum standards for humanitarian relief. Both of these are voluntary codes with no consequences if agencies don't hold to them.
Stockton argues the two-way link between agencies and beneficiaries should be more like a doctor-patient relationship, guided by the principle of the patient giving informed consent to any treatment.
"There has to be consent to what we're doing," he says.
The benchmarks cover a range of commitments to having a humanitarian quality management system, procedures for handling complaints from beneficiaries, and consulting people about assistance that's meant to help them.
The idea, Stockton says, is to follow the ethos of Jean Pictet, a major influence in the International Committee of the Red Cross in the early 20th century.
Pictet's view was that every humanitarian action should be guided by asking what's in the interests of the victims. In moments of difficulty, that question should point the way more surely than the needle of a compass, he said.
Twenty-two aid agencies have now signed up as HAP members, including Save the Children UK, Oxfam GB, Christian Aid, World Vision International and Concern Worldwide.
There are some Scandinavians on board too Â? the Danish Refugee Council and the Norwegian Refugee Council Â? and an international mishmash including Medical Aid for Palestinians, Muslim Aid, the Australian Council for International Development, French organisation Agence d'Aide a la Cooperation Technique et au Developpement (ACTED) and Senegal-based Office Africain pour le Developpement et la Cooperation.
HAP's fans argue that putting accountability first means more lives will be saved, aid workers will be safer, staff will stick with their jobs for longer and institutional knowledge will be improved.
Matthew Frost, chief executive officer of TearFund, a fully signed-up HAP member, says getting certified means agencies end up making changes like moving decision-making authority for spending further down the hierarchy, and shifting from rulings imposed on local teams to giving them guidance.
HAP supporters also say the certification scheme makes it easier for donors Â? both large and small Â? to make well-judged donations.
HAP's Stockton said he wouldn't be in favour of making HAP certification a requirement for donors, but Gareth Thomas from Britain's Department for International Development says he can imagine a time when DfID will make it a prerequisite for funding.
Veronique de Geoffroy of French-based aid agency Groupe URD - which stands for Relief, Rehabilitation and Development - dreads the idea of donors imposing an obligatory international certification system, which they could abuse to fund only their favourites.
"That has enormous risks... It would be extremely dangerous and could easily lead to the politicisation of aid," she says.
In the past, there's been opposition from parts of the aid world Â? particularly from French-based agencies like the Medecins Sans Frontieres family - to imposing universal, across-the-board standards like the Sphere project.
But de Geoffroy - director of operations for URD, which is behind the Quality Compass project set up in 1999 as a method of quality assurance for aid agencies - says those objections don't apply to HAP.
Representatives of Compass, Sphere and HAP, as well as People in Aid, the Active Learning Network for Accountability and Performance in Humanitarian Action (ALNAP) and other complementary projects, are in regular contact and have met to argue out a common shared vision.
De Geoffroy says one risk of a certification process is the possibility that it doesn't guarantee an organisation's actions will be as good as its certification status claims.
But, she says: "HAP could be really useful to agencies, if they continue to be vigilant about the quality of the results of their action for the affected population and not only about their processes."
Further reading:
TALKING POINT- Aid agencies hammer out standards
Critics find fault with Sphere standards for relief work
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