Clinical Review ABC of conflict and disaster

Needs assessment of humanitarian crises

BMJ 2005; 330 doi: (Published 02 June 2005) Cite this as: BMJ 2005;330:1320
  1. Anthony D Redmond, emeritus professor of emergency medicine
  1. Keele University, North Staffordshire


    As many as two billion people are at risk of or exposed to crisis conditions, and some 20 million people live in such conditions. Communities are exposed to crisis conditions when local and national systems are overwhelmedand are unable to meet their basic needs. This may be because of a sudden increase in demand (when food and water are in short supply) or because the institutions that support communities are weak (when government and local services collapse because of staff shortages or lack of funds).

    Embedded Image

    Triage of patients in a refugee camp on the Iran-Iraq border

    Crises can be triggered by:

    • Sudden, catastrophic events—such as earthquakes, hurricanes, flooding, or industrial incidents

    • Complex, continuing emergencies—including the 100 or so conflicts currently under way, and the many millions of people displaced as a result

    • Slow onset disasters—such as widespread arsenic poisoning in the Ganges delta, the increasing prevalence of HIV infection and AIDS, or economic collapse.

    Importance of needs assessment

    The immediate global reporting of crises can and often does provoke cries of “Something must be done.” Laudable as such sentiments might be, if that something is not what is needed, its uninvited dispatch can only divert already stretched human and physical resources away from the task in hand.

    Embedded Image

    Homeless survivors of earthquake

    If aid is to do the most good for the most people it must be targeted. To do this, a rapid needs assessment should be carried out as soon as possible and in direct consultation with local authorities. The resuscitation of a population is similar to the resuscitation of a severely injured patient,with needs assessment as the all important primary survey.

    Those making the assessments should be experienced and recognised as acting on behalf of international agencies. However, too many assessments can waste time, unnecessarily duplicate effort, and frustrate the host community. Sharing …

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