International relief efforts remain fragmented, warn doctors

Despite the frightening regularity of humanitarian disasters like the earthquake in Haiti, international responses remain fragmented and must be improved, argue a group of trauma surgeons on bmj.com today. They warn that an uncoordinated push to get people and equipment into the affected zone as soon as possible can worsen the situation and reduce the effectiveness of relief efforts.

They also advise anyone thinking about volunteering to join an established group and obtain appropriate training to enable them to function in a disaster zone.

Many healthcare professionals from developed countries do not know what to do when faced with the horrors of a major humanitarian disaster, so proper preparation is key to providing prompt relief, write Dr Charles Krin and colleagues.

In the US, volunteers are required to undertake a National Incident Management System (NIMS) course so that they are aware of the likely systems and where they will fit in to the system. Other countries run similar programmes. Passports and immunisations also need to be kept up to date.

Medical volunteers should have a basic understanding of field and trauma medicine, be able to treat wounds and fractures with limited equipment and in non-sterile conditions, and know basic field sanitation and water purification techniques.

These measures will help avoid well intentioned but sometimes misguided help from uncoordinated and untrained people that can hamper relief efforts, say the authors.

Surely, we have learnt enough from the natural disasters of the last few decades to allow us to set priorities and offer a reasonably coordinated international relief effort the next time this happens, say the authors.

They call for international dialogue to explore ways to improve the response to these events.

"We have a perfect opportunity in Haiti to work towards true international cooperation, they conclude. "The Haitians will benefit from a long-term commitment to rebuilding, and the world medical community will benefit from the lessons learned when next we are called upon to provide disaster relief."

Source: BMJ-British Medical Journal