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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.

國際社會目前面臨如何減少全世界難民數量的問題，同時也面臨許多難民帶來的問題。為了要使國際社會的難民問題得到緩解，越來越多的國際人道救援機構在難民問題相當嚴重的區域，進行著人道救援行動，期望能改善大多數難民的生活狀況，並在許多方面給予難民支援，最終目標希望能根本減少全世界的難民數目，或是讓難民也能正常生活。 剛果民主共和國正是目前國際人道救援行動的主要目標之一，因為剛果民主共和國的鄰國多為長期內戰衝突的國家，因此有大量的難民逃至剛果民主共和國境內。再加上剛果民主共和國內部的種族衝突也在大國因為自身國家利益考量，未能及時阻止衝突蔓延的情況下，剛果民主共和國內戰也延續了十年，造成剛果民主共和國政府自身難保，而境內的難民問題亦日趨嚴重。 為協助剛果民主共和國政府處理相關的難民問題，國際人道救援行動投入大量人力與物力安頓難民的生活，並協助逃往國外的難民回到剛果民主共和國境內。在聯合國安理會的維和部隊，以及國際人道救援機構，如聯合國難民署與人權觀察等組織的協助之下，受到剛果民主共和國內戰衝突的難民，皆逐漸在剛果民主共和國境內衝突趨緩之際，重新回到家園或原居住地生活。而藉著國際人道機構對於剛果民主共和國難民的救援行動，也發現國際人道救援救援網絡漸形完整，因而一方面讓許多原本隱而不顯的人道危機，得到更多外界的關心與幫助，使國際人道救援行動能更加順利，快速改善當地的難民處境，另外一方面則也顯現出國際人道救援機構在難民問題上的重要地位。 / International society now is facing the difficulties of how to reduce the number of refugees and also the problems that caused by refugees. To help the refugees, more and more international humanitarian aid agencies conducting the humanitarian aid operations in the conflict zones. Their operations are to ameliorate the conditions of refugee’s life and the most important thing is help them repatriated to their homeland. The bloody conflict in Democratic Republic of Congo (DRC) made the international humanitarian aid agencies aware that the government of DRC had no ability to manage the influx of the refugees from neighbors. So the humanitarian aid agencies spend lots of energy to help the refugees from DRC or in DRC to be repatriated or to help them integrate with locals. On the aid operations that international humanitarian aid agencies did to the refugees in DRC, we found that the network of international humanitarian aid becomes more and more complete. Those operations helped gather more attention from publics, so we can avoid the humanitarian crisis in the future or make the refugee’s situations better. And the importance of international humanitarian aid agencies is also evident in the case of refugee problem in DRC.

Practitioners of Forecast-based Action (FbA) argue that a humanitarian response able to utilize forecasts to accurately predict disaster, secure funding, and take action before the onset of a crisis will benefit donors and beneficiaries alike. In search of effective and efficient early-action regimes, a number of major humanitarian actors are developing FbA projects of various designs, predominantly in response to natural disaster and famine. While numerous organizations and institutions have expressed interest in developing FbA mechanisms, the tool has only been applied in a limited capacity to the humanitarian needs generated by armed conflict. This research seeks to understand whether a scalable FbA approach can be developed to stage principled, anticipatory humanitarian action in response to situations in which rigorous evaluations predict the likelihood of imminent armed conflict. The hypothesis is that the application of FbA to armed conflict is possible, but due to the complex political nature of conflict, implementing organizations should try to focus on creating mechanisms managed by humanitarian actors and, in so far as possible, be insulated from outside influence. This research is the first academic work to specifically investigate the application of FbA to armed conflict. Following an extensive review of current FbA mechanisms and conflict early warning practices, this research concludes that a conflict-centered FbA system akin to the automated FbA systems in use today to respond to natural disaster and famine is possible, but that the endeavor presents many practical and conceptual barriers to implementation. In particular, diffuse models such as the Start Fund offer a hopeful glimpse at a type of horizontal, member-driven FbA mechanism that is both highly context-sensitive and relatively insulated from outside influence. Such a design, however, features notable and inherent limitations in its ability to reliably and accurately predict the outbreak of conflict and respond in a manner that minimizes regretful actions.