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REVIEWS: Hasan Tahir and Zafar Iqbal Do doctors who volunteer their services in disasters overseas do more harm than good? BMJ 2006; 332: 244 [Full text]

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Harm Avoidance in Voluntary Medical Aid

Ken Millar   (29 January 2006)

Do doctors who volunteer their services in disasters overseas produce more Disasters?

RAJA JAYARAM RAMACHANDRAN   (29 January 2006)

Harm Avoidance in Voluntary Medical Aid 29 January 2006
Ken Millar, Retired SP1 2RE Send response to journal: Re: Harm Avoidance in Voluntary Medical Aid	It is now over ten years since the Diploma in the Medical Care of Catastrophes (DMCC) was established by the Society of Apothecaries of London. As a founder (and current)examiner in this Diploma, I must agree with the authors of this Report that there are many dangers inherent in allowing ungoverned voluntary medical assistance in disaster situations. The syllabus, and associated training, for the DMCC goes a long way towards ensuring that diplomates have the relevant skills and thought processes in place to respond appropriately and safely in such situations. Medical aid in disasters is as specialised an area of our profession as many others, yet this fact remains less well recognised than it should, both within and outside the profession. Competing interests: Examiner in the Diploma in the Medical Care of Catastrophes.
Do doctors who volunteer their services in disasters overseas produce more Disasters? 29 January 2006
RAJA JAYARAM RAMACHANDRAN, SHO in INTENSIVE CARE WHITTINGTON HOSPITAL NHS TRUST,HIGH GATE HILL,LONDON,N19 5NF Send response to journal: Re: Do doctors who volunteer their services in disasters overseas produce more Disasters?	The article by Drs Hasan Tahir and Zafar Iqbal regarding this controversial topic brought back memories of disaster management from the ptsunami and the quake days in India.The number of organisations that extended a helping hand during those troubled times numbered more than 100 according to a study[1].Noble their intention may be,many incidents witnessed by friends and self raises several important questions.Relief work carried out by organisations like WHO led teams,Medicine sans frontieres,UNICEF,Red cross etc are well organised,adequtely staffed by professionals who are well trained and experienced to render such services and work with clear goals and plans.On the other hand,Organisations(Names withheld)who assemble overnight a team from either self registered final year medical students,house officers or doctors who volunteer to improve their surgical skillls or field experience poses greatest threat to public.Their motives are usually to get media exposure(Author has seen the representative of an organisation who brought a team of novices to the coastal ines of south India-Badly hit areas of ptsunami- bragging to a leading TV channel how his team saved hundreds of children and women and rehabilitated them to a nearby camp)or do some basic book keeping to escape taxes or to claim many exemptions.The damage inflicted ranges from inappropriate medications,fluid management to wrong surgical procedures,without adequate anesthetic level or service or delay in appropriate referrals.But in the resource poor areas hit by natural calamities,any helping hand whatever be the motive is received with open arms.Hence any restrictions or efforts to regulate such services is practically impossible.Perhaps in disater management courses,a chapter on how to manage the disasters produced by relief organisations needs to be included. [1] List of NGOs participation in relief and rehabilitation work in A&N Islands. A report by National disaster management division of Ministry of Home affairs,Govt of India. Competing interests: None declared