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Do's And Don'ts After Natural Disasters

Washington, Nov. 6, 1998-- The thousands of deaths and heavy damages caused in Central America by Hurricane Mitch are testimony that Latin America and the Caribbean are vulnerable to a wide variety of natural and manmade disasters, according to experts at the Pan American Health Organization. They also highlight a series of do's and don'ts after disasters that can affect the way countries recover.

One little-known effect of these disasters is the generous outpouring of aid, which can greatly help a disaster-stricken country if it meets real needs, according to Dr. Hugo Prado, regional advisor for PAHO's Office of Emergency Preparedness and Disaster Relief. But aid can just as quickly become a burden if it has not been requested or reflects mistaken perceptions of what the real needs are, Dr. Prado said.

Thanks to modern communications, word of these tragedies reaches the international community within minutes, and in some cases in just hours relief is on its way. But, PAHO experts point out, the countries of the Americas have a relatively high level of health disaster preparedness and a sophisticated health infrastructure, enabling them to deal with the immediate medical needs in the aftermath of a disaster.

However, once a disaster strikes, the high cost of relief operations may drain, in a matter of days, the resources normally allotted for a one-year period for primary health care and development programs. This, added to the fact that many countries in this Region have seen their standard of living and level of development decline dramatically, further reduces their capacity to restore normal services and recover from natural disasters.

To avoid past mistakes and make international health relief assistance truly effective, Dr. Claude de Ville, chief of the disaster preparedness program at the Pan American Health Organization, suggests the following:

It is unlikely that medical personnel will be required from abroad, given the capacity of Latin America and the Caribbean to mobilize health resources to respond to the immediate needs of disaster victims. In recent disasters local health personnel treated all injuries within the first days.

The need for search and rescue, life-saving first aid and other immediate medical procedures is short-lived. International assistance usually arrives too late to meet short-term needs. Special caution is necessary when considering international assistance that is useless once the acute emergency phase has passed. This type of assistance includes personnel, specialized rescue equipment, mobile hospitals, and perishable items.

International donors should not compete to meet the most visible needs of an affected country. The quality and appropriateness of the assistance is more important than its size, monetary value or the speed with which it arrives.

Emergency assistance should complement, not duplicate, efforts taken by the affected country. Some duplication is unavoidable as many countries and agencies worldwide hasten to meet the same needs, real or presumed. However, this need not have negative consequences if the assistance can be used later for rehabilitation and reconstruction.

Don't overreact to media reports for urgent immediate international assistance. Despite the tragic images we are shown, get the overall picture and wait until requests for aid have been formally issued.

After a disaster, Dr. Prado says donors should:

• Consult with the countries' health disaster coordinators for information about post-disaster health needs. Each country in Latin America and the Caribbean has a designated health disaster coordinator. After a disaster, this coordinator will conduct an assessment, in cooperation with PAHO/WHO and interested NGOs, to determine health needs. Don't start collecting relief items until you have this information.

• Whenever possible, donate cash or credit directly to the national health authorities, to international agencies, or channel it through well-established private agencies. Most of the relief items needed can be purchased locally or in neighboring countries. Cash also can be used to restore the pre-disaster level of health care conditions and to replace national resources that have been diverted from essential programs and used for the emergency.

• Assist countries during the preparedness, rehabilitation and reconstruction phases. Unfortunately, disasters are rarely newsworthy once the immediate emergency phase is over. Yet, after a disaster, an affected country will deplete much of its financial and material resources. Later, the affected country will need even more international aid for repairs and reconstruction.

• Coordinate the efforts of independent assessment teams or fact-finding missions with those of the affected country and other agencies.

• Do not send used clothing, shoes, etc: in most cases, the local community donates more than enough of these items to meet the demand. It is more economical, convenient and sanitary to purchase items locally than to ship used items. Offers of this type of assistance can be referred to local charities or voluntary agencies.

• Do not send household medicines or prescriptions: these items are sometimes medically and legally inappropriate. Pharmaceutical products take up needed space and divert the attention of medical personnel from other more pressing tasks to sort, classify, and label them.

• Do not send blood and blood derivatives: there is much less need for blood than the public commonly believes. More recently, local blood donors in the affected country will cover the victims' needs. This type of donation is unsuitable because it requires quality and safety controls, such as refrigeration or screening for detection of HIV.

• Do not send medical or paramedical personnel or teams: Local health services are able to handle emergency medical care to disaster victims.

• If international aid is needed, neighboring countries are in the best position to assist during the first 24 hours. Exceptions to this are highly skilled specialists who have been specifically requested by the Ministry of Health. Foreign medical or paramedical personnel who are unfamiliar with local language and conditions should be encouraged to remain at home.

• Do not send field hospitals, modular medical units: considering that this type of equipment is justified only when it meets medium-term needs, it should not be accepted unless it can be permanently donated to the country. Equipment specifications, such as weight, volume, freight and installation costs should be provided to the Ministry of Health so that they can decide on its usefulness.

• Used medical equipment: specifications should be provided. If the value of the equipment justifies it, an on-site inspection may be arranged by a technician in the donor country or an international agency such as PAHO/WHO or the Red Cross.

• New equipment: when considering these donations, take into account the cost of transportation by airfreight, and the continued availability of spare parts. Most manufacturers are willing to wait several days to allow countries to consult with the proper technical Ministry.

• Tents: many countries stock a large quantity of tents that are manufactured locally. The funds that donors are willing to spend to purchase and airlift tents could be put to better use purchasing reconstruction materials locally.

• Vaccines: most often they are neither needed nor approved by the Ministry of Health. Check the presentation, dosage, expiration date, and inform the Ministry of Health, or check with PAHO/WHO.

For further information contact: Daniel Epstein, tel 202-974-3459, fax 202-974-3143, Office of Public Information, PAHO.

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