Bakgrund: Sjuksköterskans roll vid humanitära insatser i kris- och katastrofområden har rötter långt bak i tiden. Intresset för internationellt arbete är stort och sjuksköterskan har en viktig och ansvarsfull uppgift. Många olika motiv finns för att delta i ett humanitärt arbete, bland annat viljan att bidra och utföra ett meningsfullt arbete, en professionell utmaning och önskan om personlig utveckling genom att verka i en annan kultur och uppleva något annat. Arbete ställer dock höga krav på kompetens och en rad olika förmågor som t.ex. ledar- och organisationsförmåga, samarbete och flexibilitet. Befintlig litteratur består till stor del av skönlitterära berättelser. Syfte: Syftet var att beskriva sjuksköterskans erfarenheter av humanitärt fältarbete. Metod: Metoden för detta arbete var en litteraturöversikt. Nio vetenskapliga artiklar med kvalitativ ansats har valts ut, granskats och sammanställts utifrån likheter och skillnader enligt Fribergs (2006b) modell. Resultat: Resultatet presenteras utifrån fyra teman; arbetets karaktär, miljö, olika men ändå lika och kompetens. Dessa inkluderar ett antal subteman; bristande resurser, att mötas och samarbeta, professionella utmaningar, levnadsförhållanden i fält, isolering och beroende, kulturella skillnader och likheter mellan människor. Diskussion: Valda delar ur resultatet diskuteras med Madeleine Leiningers teori om transkulturell omvårdnad som teoretisk utgångspunkt. Områden som behandlas är att sjuksköterskorna trots bristande resurser upplevde en tillfredsställelse i att ge omsorg (caring), etiska svårigheter/ dilemman, miljöns olika delar som påverkansfaktorer, viljan att tjäna, medvetenhet om kulturella olikheter och det universella människor emellan och hur man skapar möjlighet till en kulturanpassad vård. Avslutningsvis diskuteras vikten av kompetens med särskilt fokus på pediatrisk omvårdnad med den etiska principen ”att inte skada” belyst. / Background: There is a long tradition of nurses involved in humanitarian work in disaster areas. The commitment for international work is wide- spread among nurses and they have an important role to play. There are many different motives for engaging in humanitarian work. A few central ones are the will to contribute to and do meaningful work, the professional as well as personal challenge attained by working and living in another culture and under different conditions. The work requires high demands on competencies and abilities such as leader- and organizational skills, collaboration and flexibility. The literature presents mostly anecdotal stories. Aim: The aim of the study was to describe nurses´ experiences of humanitarian fieldwork. Methods: The method for this thesis was a literature review. Nine scientific articles with qualitative design have been chosen, analyzed and compiled on the bases of similarities and differences by the Friberg (2006b) model. Results: The result is presented from four themes; the character of the work, environment, different but still similar and competence. These includes a number of subthemes; lack of resources, to meet and collaborate, professional challenges, living conditions in the field, isolation and dependence, cultural differences and similarities between people. Discussions: Based on Madeleine Leininger´s theory about transcultural nursing, chosen parts from the findings are discussed. Areas addressed are the nurses´ experience of satisfaction, despite lack of resources, when being able to give caring, ethical difficulties/ dilemmas, affecting environmental effects, the will to serve, awareness of cultural differences and the universality among human beings and how to create a transcultural care. The importance of competence with special focus on pediatrics related is finally discussed with the ethical princip of  “do no harm” highlighted.

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Although growing scientific evidence has highlighted beneficial effects of religion and spirituality on mental health and psychosocial well-being, the integration of religious and spiritual needs with mental health and psychosocial support in humanitarian contexts has been identified as a gap. Accordingly, this can be linked to a lack of official related guidelines of how to address these concepts in the humanitarian sector. This issue becomes particularly relevant in contexts where religion and spirituality play a crucial role. This study explores this problem in the context of Indonesia which due to commonly occurring natural disaster is targeted by humanitarian responses, while also being a religious and spiritual country. The purpose of this study therefore responds to this background by discovering the integration of religion and spirituality in mental health and psychosocial support provided by humanitarian organisations in Indonesia and formulating recommendations on the same. This was operationalised through a qualitative approach, and more specifically an embedded single-case study design. Further, the material consists of information retrieved through interviews and documents, from humanitarian organisations selected through snowball sampling. Analysed with the support of the ADAPT model, an adapted version, the IASC MHPSS Guideline, and the additional Faith-Sensitive Guideline, this study concludes that humanitarian organisations operating in Indonesia, either mainstreamed or not, work with mental health and psychosocial support, and thereby also include approaches which consider religion and spirituality. However, while well aware of the contextual needs, in particular the latter is not formally integrated. Accordingly, this study suggests organisational capacity building on the integration of religion and spirituality in MHPSS, based on existing guidelines and institutional knowledge and capacity, in order to ensure and improve proper humanitarian responses.

Bakgrund: Internationellt humanitärt arbete är ett område där sjuksköterskor är aktiva. Att delta i internationella humanitära insatser innebär emellertid att arbeta i miljöer annorlunda från de normala med andra förutsättningar. Miljön där sjuksköterskan arbetar påverkar också omvårdnaden och det ingår tillika i sjuksköterskans yrkeskunskap att ha kunskap om den miljön där arbetet äger rum. Tidigare forskning visar att sjuksköterskor inte känner sig tillräckligt förberedda inför arbetet i dessa sammanhang. Syfte: Studiens syfte var att undersöka hur sjuksköterskors erfarenheter av miljön i internationella humanitära insatser samt hur upplevelser av arbetet i denna miljö, kommer till uttryck i egna berättelser. Metod: Kvalitativ textanalys, enligt Holme och Solvang, av 18 narrativa artiklar skrivna av sjuksköterskor, eller i enstaka fall intervjuer med sjuksköterskor, som deltagit i internationella humanitära insatser. Resultat: Genom analys av de narrativa artiklarna framkom fyra huvudteman: Bristande resurser, Utsatthet, Emotionella möten, samt Coping. I temat Bristande resurser beskrivs miljön. Miljön präglades av resurssvaghet, något som påverkade sjuksköterskornas arbete. Utsatthet skildrar hur sjuksköterskorna utsattes för risker och faror under uppdragen. Under temat Emotionella möten återfinns sjuksköterskornas beskrivningar av betydelsefulla möten med lokalbefolkningen. Coping berör sjuksköterskornas beskrivningar av strategier för att hantera svårigheter, teamets betydelse samt hur uppdragen upplevdes som givande. Slutsats: Resursbristen i arbetet upplevdes som svår. Arbetet i de internationella uppdragen hade stora variationer. Kreativitet, flexibilitet och förståelse var viktiga för att hantera svårigheter i arbetet under uppdragen. Genom att sätta in resultatet av studien i en klassificeringsmodell av omvårdnadsvetenskapens områden kan internationellt humanitärt arbete konceptualiseras utifrån ett omvårdnadsvetenskapligt perspektiv. Klinisk betydelse: Resultatet från denna studie kan användas för att förbättra utbildningen för sjuksköterskor i internationella humanitära insatser. / Background: International humanitarian aid work is a field where nurses are active. Yet, to participate in international humanitarian action is to work in an environment different from what is normal with unlike circumstances. The environment where nurses work also has an effect on the nursing care and it is a part of the nurses’ professional knowledge to have insight of the environment in which the work takes place. Earlier research suggests that nurses feel inadequately prepared for the work in this context. Aim: The aim of the study was to explore in which way nurses’ experiences of the environment in international humanitarian aid work and how experiences of the work in such environment, are expressed in their own narrated texts. Methodology: Qualitative textual analysis, according to the way of Holme and Solvang, of 18 narrated articles written by nurses, or in a few cases interviews with nurses, whom have all participated in international humanitarian aid work. Result: Four main themes emerged from the analysis of the material: Lack of resources, Vulnerability, Emotional meetings, and Coping. The theme Lack of resources describes the environment. The environment was characterized by resource weakness, which affected the nurses' work. Exposure depicts how nurses were exposed to hazards and dangers during the missions. In the theme Emotional meeting the nurses descriptions of meaningful encounters with the locals is to be found. Coping relates to the nurses descriptions of strategies to address difficulties, the importance of the team and how the missions were experienced as meaningful. Conclusions: Lack of resources was perceived as difficult. The work of the international commissions had wide variations. Creativity, flexibility and understanding were important to address difficulties during the missions. By inserting the results of the study in a classification model of nursing science areas, international humanitarian aid work can be conceptualized from a nursing science perspective. Clinical impact: The results of this study can be used to improve education for nurses in international humanitarian aid work.

Afghanistan has been in armed conflict for over 30 years. The many wars have severely affected the environment negatively. Sweden has between 2010-2015 been allocating 4,7 billion SEK in foreign aid to Afghanistan. This is a qualitative study with the purpose to critically analyse how this foreign aid has contributed to a sustainable environmental development in Afghanistan. To be able to answer this question a review of projects documents and Sida assessment was conducted. This was then supplemented by interviews with 14 people who in different ways had been working with these issues. In the analysis theories connecting to environment, poverty and conflict have been used. Sida is supporting two types of foreign aid in Afghanistan; humanitarian aid and development aid. The study found that the Sida’s humanitarian work in Afghanistan has a clear focus on environmental issues, whereas the development aid overall where lacking a focus on environmental issues. The larger focus within the humanitarian aid was explained by that environmental consideration is a part of the Sida’s strategy for the humanitarian aid in Afghanistan and humanitarian aid’s natural connection to environment, in for instance natural disasters. The lack of environmental focus within the development aid was found to have three explanations; the strategy did not have an environmental focus, the staff lacked the necessary environmental knowledge and environmental issues was not believed to be prioritized in Afghanistan. It was however believed to be possible to have more focus on the environment in Sida’s work in Afghanistan. The study shows that environmental issues are not believed to be a necessary component for creating a sustainable development or peace in Afghanistan. The study is arguing that one way to create more focus on environmental issues within the development aid would be to work closer with the humanitarian aid. The thesis was finally presenting an alternative way to look at environment and sustainable development; to focus on the environmental problems of the current generation and by doing so preserving the nature for the future generations.

By research and interpretation of official documents published by the Swedish Ministery for Foreign Affairs and the Swedish International Development Cooperation Agency (Sida), this thesis aims to understand and shine a light on the symbols that shape the Swedish public aid culture and how these symbols function in a narrative of what Swedish aid to the Democratic Republic of Congo is and is not. The theoretic framework leans on both the symbolic/interpretative anthropology of Edward Bruner, Clifford Geertz and Sherry Ortner; Omar Lizardo's more contemporary writing on the power of symbols; and Jerome Bruner's psychological perspective on symbols. The conclusion is that Swedish public aid appears to use a set of symbols and a narrative anchored in arbitrary parts of Sweden's and Congo's mutual history to conjure up the image of a dark and dangerous Congo in contrast to the knowledgable and good Sweden.

While aiming to reach results (such as improved health status) humanitarian workers in aid organizations such as Red Cross and Red Crescent Movement (RCRCM)[1], make use of outcomes in related global forums, standards and networks. Common concepts discussed related to humanitarian action are the following ones: effectiveness, local ownership and mutual accountability. In addition, concepts such as Results Based Management (RBM), highlighting the importance of delivering and accounting for results influences humanitarian organizations. Donors such as governments are pushing for RBM. The RBM reform impacts Swedish aid policy and RCRCM in Sweden, represented by Swedish Red Cross. However researchers and civil society actors find that RBM is not a silver bullet to facilitate results.   Dialogue with beneficiaries goes back to the beginnings of humanitarian action, but dialogue using social media to capture beneficiaries’ views started only around a decade back.   In this case study, I investigate RCRCM and focus on Swedish Red Cross. In particular I explore the following research problem: how does beneficiary communication and accountability using social media contribute to reaching and measuring results?   My data includes individual and focus group interviews and RCRCM guiding documents. Conclusions include that: indeed beneficiary communication and accountability contributes to reaching results and have potential to better capture results. Direct RCRCM organizational benefits are potentially huge given RCRCMs extensive worldwide community level network. The benefits include better access, more relevant activities and funding opportunities. However challenges include perceived lack of expertize, management commitment and generally slow change of mind set with regards to downward accountability. [1] A) The International Committee of the Red Cross (ICRC), B) the International Federation of Red Cross and Red Crescent Societies (IFRC) and C) national societies in 189 countries around the world (see section 2.1) / När biståndsarbetare i hjälporganisationer som rödakorsrörelsen (RCRCM)[1], arbetar för att nå resultat (såsom bättre hälsa för utsatta människor) använder de sig ofta av de ambitioner som vuxit fram i biståndsrelaterade globala fora, nätverk och standards såsom: effektivitet, lokalt ägarskap samt ömsesidigt ansvarsskyldighet och ansvarsutkrävande. Samtidigt har begrepp som ”result based management” (RBM) fått stort inflytande på humanitära organisationer när det gäller vikten av att nå och visa på konkreta resultat. Finansiärer, såsom regeringar, ställer allt tuffare krav på RBM metodik används genom ett starkt inflytande på svenskt bistånd och därmed på RCRCM i Sverige, företrätt av Svenska Röda Korset. Dock finns både forskare och humanitära organisationer civila som hävdar att RBM knappast är någon patentlösning vare sig för att nå eller visa på resultat. Medan dialog med biståndsmottagare funnits så länge bistånd funnits har systematisk dialog med hjälp av sociala medier för att få förmånstagarnas synpunkter bara skett ett tiotal år. I denna fallstudie undersöker jag RCRCM med fokus på Svenska Röda Korset. I synnerhet studerar jag följande forskningsproblem: hur bidrar dialog med och ansvarighet gentemot förmånstagare som sker med sociala medier till att nå och mäta resultat?Mitt material inkluderar individuella- och fokusgruppsintervjuer samt studier av RCRCMs styrdokument. Slutsatser inkluderar att: direkta organisatoriska fördelar för RCRCM av dialog med mottagare är potentiellt enorma givet RCRCM världsomspännande lokala nätverk. Fördelarna inkluderar ökad möjlighet att nå de mest utsatta, mer relevanta insatser och bättre finansiering. Bland utmaningarna som lyfts är brist på expertis och ägarskap hos organisatio-nens ledning och svårighet till byte av ’mind set’ vad gäller nedåtgående ansvarighet. [1] A) Internationella rödakorskommittén (ICRC), B) Internationella rödakors-och rödahalvmånefederationen (IFRC) och C) nationella föreningar in 189 länder i världen (se sektion 2.1)