In 1859 a young Swiss traveller called Henri Dunant found himself caught up in the humanitarian tragedy that followed one of the most terrible battles of the nineteenth century. While Dunant witnessed many extraordinary acts of kindness amidst the harrowing scenes he so vividly described, the founder of modern humanitarianism also made two profound observations. First, the ever-present risk that ill-directed compassion can do more harm than good. Second, that traumatic events are inherently disempowering, exposing all those affected to opportunistic and sometimes extreme forms of exploitation.

While Dunant recorded these observations nearly 150 years ago, he might equally have been describing a contemporary disaster relief operation. The joint evaluations of the international responses to the 1994 genocide in Rwanda and the 2004 Indian Ocean tsunami both drew attention to the harmful and wasteful consequences of humanitarian action launched without adequate consultation with the people affected by the disaster. So why, after 150 years of institutionalised humanitarian assistance, should there be so many emergency relief programmes that fail to live up to Jean Pictet's 'golden rule'?

In every humanitarian transaction there is an imbalance of circumstantial power between those able to give help and those in urgent need of assistance. This inequality between provider and receiver means that the act of giving is often exercised without the consent of the person in need.