Clinical Review ABC of conflict and disaster

Conflict recovery and intervening in hospitals

BMJ 2005; 331 doi: https://doi.org/10.1136/bmj.331.7511.278 (Published 28 July 2005) Cite this as: BMJ 2005;331:278
  1. James M Ryan,
  2. Peter F Mahoney,
  3. Cara Macnab

    Conflict recovery

    The essence of conflict is the actual or implied use of violence. Recovery implies a return to a previous state. Recovery may be rapid (measured in months) or may take many years. The timing of recovery varies: it may start during the acute phase of a crisis (provision of humanitarian assistance in the midst of conflict can be the earliest manifestation of recovery) but usually begins in the post-emergency phase, when a degree of stability and safety allows a more comprehensive approach.

    Time line and phases

    Recovery from disaster or conflict can be considered as having a series of phases—emergency response and transition, early recovery, medium term recovery, and long term development.

    Emergency response and transition—The emergency humanitarian response in the crisis phase is the aspect of humanitarian work most widely observed by the media and best understood by the general public. Aid agencies deploy and work in the full glare of publicity. This phase passes, and a transitional phase begins, often characterised by the departure of many of the immediate response agencies and the media. The tragedy slips from public consciousness.

    Early recovery—This phase starts with the ending of hostilities. It is a period of relative safety, but money, staff, and equipment often become scarce—despite earlier promises of aid, the tap is turned down, if not off. There then starts a period of uncertainty, which is open ended, difficult, and unglamorous.

    Medium term recovery—By now, the affected region should have some form of government, even if this is externally imposed. The process of rebuilding infrastructure has begun, and recognisable instruments of a functioning state become evident, such as health and education ministries, the emergence of a civil service, and police. This period requires specialised aid.

    Long term development—Long term recovery should have as its end point not just a …

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