November 2025 · Position paper

CASSM's Hurricane Melissa response produced two documented artifacts, developed in the course of CASSM-funded clinical delivery by MobiCare Medical Centre: a resourcing model for a field clinic, and a communications configuration that resolved an unanticipated coordination constraint. Both worked, neither can be evaluated. The deployment generated no measurement against which either could be assessed, and that absence, rather than any particular finding, is where CASSM's research program begins.

The problem is structural, not local

It would be convenient to treat this as an oversight specific to a first large deployment. It is more accurately a condition of the organizational category. Small humanitarian organizations operate under acute time and resource constraints, in which every hour allocated to instrumentation is an hour not allocated to delivery, and the incentive structure consistently favors delivery. Performance measurement in humanitarian relief chains has been shown to differ substantially from commercial supply chain measurement, where established metrics and the organizational capacity to collect them are assumed rather than improvised (Beamon & Balcik, 2008).

The consequence is that field practice accumulates without accumulating evidence. An organization may run twenty deployments and be no better positioned to specify requirements for the twenty-first than it was for the second, because each deployment produces an operational record rather than a dataset.

What this makes unanswerable

Three questions arising directly from the Black River deployment cannot be resolved from available records. How far the delivered site fell short of the commissioned configuration, how a pool of six floating practitioners was distributed across the day, and whether throughput at any station aligned with the model's assumptions. Each is answerable in principle, yet none is answerable now.

The methodological consequence matters more than the individual gaps. Design science research is defined by the development and application of a designed artifact to a problem domain, with evaluation as an integral part of the research process rather than an optional extension (Hevner et al., 2004). CASSM has completed the build. The evaluation stage has no data to operate on.

The nature of what has been produced is therefore constrained. Design science contributions can be positioned according to the maturity of both the problem and the solution, ranging from situated instantiations of a solution to a known problem, through improved solutions to known problems, to genuinely novel contributions (Gregor & Hevner, 2013). Without evaluation data, CASSM's resourcing model can be claimed only at the first of these levels, an instance that was applied once, in one setting, with no established basis for asserting improvement over alternatives. Claiming more would not be supportable.

Where the indicators already exist

The instrumentation problem is not primarily one of definition. Established minimum standards for humanitarian response specify indicators across water provision, sanitation, health service delivery and other domains, together with the thresholds against which adequacy is assessed (Sphere Association, 2018). Several map directly onto quantities CASSM commissioned but did not verify, including sanitation provision relative to population served. The requirement is therefore to adopt and record against existing indicators rather than to develop new ones.

What follows

CASSM's research program begins with instrumentation rather than with research questions, because the questions already generated by field experience cannot be pursued without it. The immediate work is a minimum data specification, what must be recorded during a deployment, by whom, and at what cost to delivery capacity. That specification is itself a design problem, and its constraint is that measurement must not degrade the operation it measures.

Subsequent work will address the substantive questions arising from field experience, including referral continuity, patterns of unmet need identified through screening, and the relationship between deployment configuration and service throughput. Those are reported when there are data to report.

References

Beamon, B. M., & Balcik, B. (2008). Performance measurement in humanitarian relief chains. International Journal of Public Sector Management, 21(1), 4–25. https://doi.org/10.1108/09513550810846087

Gregor, S., & Hevner, A. R. (2013). Positioning and presenting design science research for maximum impact. MIS Quarterly, 37(2), 337–355. https://doi.org/10.25300/MISQ/2013/37.2.01

Hevner, A. R., March, S. T., Park, J., & Ram, S. (2004). Design science in information systems research. MIS Quarterly, 28(1), 75–106. https://doi.org/10.2307/25148625

Sphere Association. (2018). The Sphere handbook: Humanitarian charter and minimum standards in humanitarian response (4th ed.).