Feature Disaster management

Appropriate response to humanitarian crises

BMJ 2010; 340 doi: http://dx.doi.org/10.1136/bmj.c562 (Published 03 February 2010) Cite this as: BMJ 2010;340:c562
  1. Charles S Krin, retired family and emergency physician1,
  2. Christos Giannou, former head surgeon, International Committee of the Red Cross2,
  3. Ian M Seppelt, senior specialist3,
  4. Steve Walker, emergency physician4,
  5. Kenneth L Mattox, professor of surgery5,
  6. Richard L Wigle, assistant professor of trauma and critical care6,
  7. David Crippen, associate professor7
  1. 1Salem, Missouri, USA
  2. 2Monemvasia Lakonia, Greece
  3. 3Department of Intensive Care Medicine, Nepean Hospital, Penrith NSW, Australia
  4. 4CareFlight, Sydney NSW, Australia
  5. 5Ben Taub Hospital, Houston, Texas, USA
  6. 6Louisiana State University Medical Center, Shreveport, Louisiana, USA
  7. 7University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
  1. Correspondence to: C S KrinKrin135{at}aol.com

    Pictures of the aftermath of the earthquake in Haiti have led to questions about the relief effort. Charles Krin and colleagues offer some advice for prospective volunteers

    Humanitarian disasters occur with frightening regularity, yet international responses remain fragmented, with organisations and responders being forced to “reinvent the wheel” with every new event. In many of the natural disasters of the last few decades, there has been an outpouring of well intentioned but sometimes misguided help from uncoordinated and untrained people both outside the established channels and sometimes even through those channels. This has led to everything from perishable food and medical supplies rotting on docksides and at airports, trailer loads of ice left to melt in the sun, winter clothing being sent to tropical areas, and even injury and death of volunteers in the affected areas.

    Additionally, these uncoordinated donations and volunteers tend to worsen the situation with confusion and congestion, reducing the effectiveness of relief efforts. Volunteers arriving without their own logistic support also endanger themselves and others who have to look after them and consume scarce resources of shelter, food, and water that might otherwise have gone to some of the victims. It is clearly essential that anyone thinking about volunteering is both informed and prepared and goes through the appropriate channels.

    How relief efforts work

    For international missions, the official government of the affected country must request aid from the United Nations, other governments, or recognised international non-government organisations. An unaffected agency, often the UN Office for the Coordination of Humanitarian Affairs, is designated as the lead agency and coordinates the response by other groups, including governments and military, reservist, civil, educational, church, and hospital groups. Local non-governmental organisations will play a large part, including the national Red Cross or Red Crescent Society in liaison with the International Federation of Red …

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