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Nearly one in three Iraqis is in urgent need of humanitarian assistance such as food, shelter, water or health care. That finding comes from a report released this week by the NGO Coordination Committee of Iraq and Oxfam International. This crisis is occurring in what is arguably the most dangerous environment for relief organizations in the world.

NPR's John Burnett reports on how aid groups manage to survive in Iraq.

JOHN BURNETT: In 2003, after the regime fell, there were some 300 international humanitarian agencies working in Iraq. Today, there are 80. Most have moved their headquarters to quiet Kurdish areas in the north or to neighboring Jordan.

Western managers never or rarely show their faces in the rest of the country. They hire entirely Iraqi staffs, who then downplay the United States affiliation. This question was put to Yarub Al-Shiraida, Iraq country director for Relief International.

Do you drive around Baghdad in a vehicle that says Relief International?

Dr. YARUB AL-SHIRAIDA (Iraq Country Director, Relief International): No, no, no.

BURNETT: Why not?

Dr. AL-SHIRAIDA: There's no way to (unintelligible) whenever.

BURNETT: Relief International is a Los Angeles-based agency that receives partial funding from the U.S. State Department to work in Iraq building schools and water treatment systems and helping internally displaced persons. Al-Shiraida says his organization depends on community acceptance. And he feels comfortable working even in sensitive areas with sectarian violence.

Dr. AL-SHIRAIDA: The problem when you move from one case to another, then you have to hide your identity as a relief worker, especially for American organizations.

BURNETT: In the past four years, CARE, Save the Children, Oxfam International and Catholic Relief Services have all pulled out of Iraq because of the worsening security situation. Among the most chilling incidents, when a truck bomb exploded outside the U.N. Headquarters in Baghdad, killing 22, and the kidnapping and murder of longtime aid worker Margaret Hassan.

Iraqis who choose to continue working for foreign aid agencies do so with extreme caution. A Baghdadi who gives her name as Zena(ph) is deputy director for the congressionally funded U.S. Institute of Peace, headquartered in the Green Zone, which works to reduce interethnic violence.

ZENA (Deputy director, U.S. Institute of Peace): But usually, we work for - on a very low profile, I mean, we don't go with security and we don't go on certain times and...

BURNETT: Do your friends and family know that you work for the Institute of Peace?

ZENA: No, except for my family. None of them, of my friends and not even my community or the place I live in, they have no idea where I work.

BURNETT: One of the largest relief groups still working in Iraq is Mercy Corps. The Portland, Oregon-based organization has 150 Iraqi employees working throughout the country doing things like setting up computer training centers and promoting women's literacy.

Like Relief International, Mercy Corps depends on the goodwill of local communities, says country director Paul Butler, who is himself based in northern Iraq. Employees travel without security, unlike heavily protected U.S. contractors. He says they write Mercy Corps on the sides of their vehicles in Arabic, not English. Their work is partially funded by the U.S. Agency for International Development - USAID.

Mr. PAUL BUTLER (Country Director, Mercy Corps, Iraq): We don't advertise the name of USAID and the U.S. government unlike, you know, normal USA programs around the world. It's called branding where you have to advertise where the source of funding comes from.

BURNETT: And that's just fine, says Bambi Arellano, USAID director in Iraq.

Mr. BAMBI ARELLANO (Director, USAID, Iraq): Whether it has a specific agency or label attached to it, I think I'm less concerned about that because at the end of the day, it really is about giving people something to have faith in for the future for themselves, for their children.

BURNETT: It didn't used to be like this. Relief workers, like journalists, used to be able to depend on a degree of built-in neutrality. But since the U.S. military interventions in Afghanistan and Iraq, western humanitarian groups are no longer seen as neutrals, says Mercy Corps's Paul Butler.

Mr. BUTLER: In Afghanistan, the coalition forces started to initiate their own relief operations. So the line was blurred between what humanitarian organizations do and what the military is supposed to do and Iraq carry that even one step forward.

BURNETT: In Iraq, the situation is complicated by the new hearts and minds approach of the U.S. military where armed, uniformed soldiers regularly deliver large amounts of humanitarian aid to war-torn communities. It's more important than ever, Paul Butler says, for relief agencies to stress their independence from armed forces.

John Burnett, NPR News, Baghdad.

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