BMJ  2005;330 (8 January), doi:10.1136/bmj.330.7482.0-f

Editor's choice

Death by tsunami and poverty

Fishermen in the Indian Ocean were unaware of the wave that swept past them and devastated their homes and families. How many of us are unaware that over a million people died in the 1970s after a cyclone struck Bangladesh and an earthquake shook China? What, then, makes this tsunami disaster so potent—beyond unprecedented television and newspaper coverage—that the United Nations will have launched a flash appeal by the time you read this week's BMJ?

A wave that killed on two continents is a stark reminder that the many divisions within and between nations are insignificant when compared with the challenge posed by nature. Increasingly, too, we live in an interconnected and interdependent world. Strengthening infrastructure and the potential for medical response in poorer countries garners moral support among people in rich countries and also helps all citizens of our world. Among the dead or missing after this Asian catastrophe are more than 5000 Europeans—a small number in global terms, but a major disaster for Europe.

Kofi Annan has described this tsunami as the worst natural disaster his organisation has faced. The death toll is 150 000 and rising. The World Health Organization believes the grieving of millions will be compounded by waterborne diseases related to unsafe drinking water and inadequate sanitation (p 59). How much of the billion or so pounds of aid already pledged will materialise? How much will be rendered ineffectual by the threadbare infrastructures of many of the affected countries? How do we conjure clean water, roads, and health services from empathy?

As charities and rock stars join forces in a campaign to make poverty history (www.makepovertyhistory.com), the British government has a pivotal role to play in its presidency of the G8—a policy group of the world's eight most powerful nations—and through its presidency of the European Union (p 59). "We must now all accept the utter futility of trying to shut up our borders to problems abroad," says Prime Minister Tony Blair in last week's Economist, where he states his two priorities as alleviating poverty in Africa and combating climate change. The challenge for him, though, is to magic real change from these admirable intentions.

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