This paper uses a case-study approach to describe how organizational characteristics may influence program outcomes in humanitarian aid situations. Organizational structure and human resource management are discussed as organizational factors that influence the vulnerabilities of clients and employees. Interview and archival data from a program on reintegrating refugee and internally displaced women and girl survivors of sexual violence in Sierra Leone and observations based on the author’s experience with the organization provides a relevant basis for isolating the firm as an important context within which refugee programs are embedded.