Preventing a Humanitarian Catastrophe in Taiwan

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Preventing a Humanitarian Catastrophe in Taiwan

A cross-strait conflict would involve tremendous human suffering – and major difficulties in providing humanitarian aid.

Preventing a Humanitarian Catastrophe in Taiwan

People rehearse a rescue operation in a damaged building during a civil raid drill in Taipei, Taiwan, May 4, 2023.

Credit: AP Photo/Chiang Ying-ying

Prepare for the “worst case” scenario: that’s an alarm bell as loud as any other. Military confrontation over Taiwan would bring colossal destruction, massive suffering and significant loss of life. Yet little has been said about this potential humanitarian disaster, with most analysis focusing instead on the geopolitical ramifications. 

Focusing not just the political and military concerns but the consequences for people leads to different conclusions. Recent diplomatic overtures may yet stem the tide of war, but given the potentially catastrophic impact, it’s well worth considering potential scenarios and the humanitarian outcomes. 

Three Possible Scenarios

At least three scenarios are possible should violence escalate. To simplify analysis here, the likelihood or probability of one or more of these scenarios actually taking place is not discussed because the number of variables and permutations makes assigning meaningful probabilities impossible. 

Scenario 1: China undertakes limited military action to seize control of the outer Taiwanese islands, which would lead to accelerated process of reunification. The humanitarian impact of this action would be limited largely because of the relatively low population of the islands involved. However, this would be both a highly symbolic victory for China and have a profound psychological impact on Taiwan as well as regional dynamics, particularly the economy’s current status quo. It would cast a dark pallor of uncertainty that could not be sustained. 

Scenario 2: China carries out limited military action to soften Taiwanese resolve in order to sue for a Hong Kong-style settlement. The humanitarian impact of this scenario would be grave. While the civilian casualty ratio would be limited because of the tactics used, the level of suffering would be significant, with thousands of deaths and tens of thousands or more forcibly displaced within the country as people attempt to find areas they perceive to be of no military interest. The sizable group of foreign laborers in Taiwan would try to flee in haste. Consequently, the economic situation would take a dramatic turn for the worse. Together, this situation would cause psychological trauma and give rise to serious protection concerns, made worse by a limited ability to address such concerns. 

Scenario 3: China carries out major military action against Taiwan in an all-out assault in the hope that a swift blow leads to forcible annexation. The humanitarian impact of this third scenario would be catastrophic. With the civilian population concentrated in the cities on Taiwan’s west coast, a direct military attack on these cities would result in a very high civilian casualty ratio and be a major driver of humanitarian concern.

The swiftness of any kinetic operation and the need to show dominance would also likely result in significant collateral damage. Civilian deaths and injuries would intensify psychological trauma and the destruction of the economy would significantly affect all Taiwanese (not just those directly impacted by violence). The impact on children and older persons would be extensive. 

A mass exodus may be attempted but a huge percentage of the population will be prevented from doing so by military operations, logistics, and simple geography. 

Frustrations over a lack of military progress, because of heavily organized resistance, may lead to a deviation of proportionality and restraint by the People’s Liberation Army and result in extensive human rights abuses. If a process of dehumanization begins, the consequences will match other places where genocide has occurred. 

Important Assumptions

These worst-case scenarios would result in reworked political dynamics, a drop in development indicators, and devastating economic impacts. But it would also severely affect how humanitarian relief can be delivered. 

First, a conflict would necessarily mean severely restricted humanitarian access even as the need becomes urgent. Relief agencies would scramble to establish operations. In the event of hostilities, the “cluster system” and other coordination mechanisms would have to be set up overnight and there would be a heavy reliance on remote and virtual work. Despite advances in recent years, management from a distance is far from adequate for the difficulties of actual relief work. 

Common indicators of a humanitarian emergency include high mortality rates (e.g., greater than four per 10,000 people per day), reduced availability of potable water (less than 15 liters of water per person per day), and disease outbreaks such as measles. All of these would likely occur in the event of large-scale conflict in Taiwan. Given the modern and urbanized population of Taiwan, additional concerns stemming from forced displacement and restricted access will make response that much more difficult. Working on major urban infrastructure and sophisticated populations is not beyond the capabilities of the humanitarian community, but it will certainly stretch it in ways that are only matched in a limited number of circumstances over the last several decades. The now standard expectations of real-time data collection and dissemination, including monitoring, analysis, and use of social media would, most likely, not be possible. 

The possibility for grave human rights abuses during a cross-strait conflict also looms large. While China is a signatory to the Geneva Conventions, the government in Beijing recognizes state rights over individual rights and downplays issues like civil liberties. It is also unclear if China would acquiesce to initiatives commonly led by the United Nations or regional groups such as observer missions, localized ceasefires, and the creation of humanitarian corridors. At a minimum, there would be heightened stress factors such as anxieties from close proximity to fighting, including air strikes and artillery bombardment. In times of war, people are forced to resort to negative coping mechanisms – everything from substance abuse and prostitution to physical harm – that lead to increased protection concerns such as direct harm to children and gender-based violence. 

Finally, the war may distort humanitarian principles. The ethical stance of aid workers, backed up by international humanitarian law, is the bedrock of any humanitarian response. Under these scenarios, however, these principles will likely be challenged like almost never before. 

In order to achieve the humanitarian imperative (the principle of humanity), neutrality may not be broadly achievable because of the dynamics of the military operations discussed above, including restricted access and humanitarian space. This space is understood to mean the ability to reach populations in need without government, military, or other types of interference or restriction. This has been an ongoing struggle for humanitarians in recent decades, and the prospects for success may be entirely non-existent in an island-based military confrontation. Reliance on government and military resources to access affected populations will limit the principle of independence as well. Many organizations may adopt the principle of solidarity – taking sides with the Taiwanese cause – and, in a not unprecedented move, jettison the principle of neutrality as a result. 


With the world looking at such a dire set of potential scenarios, urgent attention is needed. While there are many diplomatic and military conclusions that can be drawn out of this analysis, three main recommendations are put forth here from a humanitarian perspective. 

First, elevate humanitarian diplomacy. In the nexus between defense, diplomacy, and “development,” the latter is almost always the junior player. Its set of interests are often secondary or even tertiary. Collectively, as the weakest actor, it has the smallest budgets and least say. Further, humanitarian assistance is the attempt to deal with the failures of development and the messes left by military operations. 

In the scenario of a cross-strait conflict, the consequences are potentially so catastrophic, that those in influential positions need to be more outspoken. Humanitarian diplomacy typically involves ground-level practices such as negotiating access, raising awareness, and promoting principles. This way of working can be brought to a strategic level to prevent the worsening situation from developing into war.   

Second, prepare. The humanitarian community is ill prepared for any of the scenarios described here. Contingency plans, networking, coordination, resource mobilization, stockpiling, training, and simulations are called for. Implementing organizations have a lot to do, but donors play a crucial outsized role in enabling preparedness to happen. 

Finally, localize. The particular characteristics of a humanitarian crisis in Taiwan would encounter severely restricted access. This points to one main solution: localization of aid. This involves an approach that centers on affected communities and local stakeholders, empowers their decision-making, and relies on talents and resources that already exist. By increasing investment there, it is possible to be more effective and accountable at the same time increasing reach and efficiency. 

Fortunately, this approach has gained recognition (the NGO Field Ready has pioneered the approach for local manufacturing in disaster contexts), but it is far from mainstream. Work over the last decade, accelerated by the COVID-19 pandemic, has shown that this “innovation” is ready to be effective at scale. Unfortunately, Taiwan may provide that opportunity unless action is taken now.