This editorial continues the discussion on post-disaster needs assessment, which began in the last issue of this Newsletter. Assessments are an important first step to determining immediate humanitarian needs. How governments manage these assessments and coordinate with other agencies that are conducting their own evaluations have an impact on the end result as well as the level and quality of humanitarian assistance received.

Managing fact-finding missions and improving the flow of information

For a variety of reasons, many international actors feel compelled to send their own fact-finding mission or assessment team to a disaster-stricken country. National disaster coordinators must accept that these teams will compete for their time and attention, even though they are hard pressed to provide information to their own constituency.

External assessment teams often have a broad range of technical skills and experience that are not easily found in any one single country. Countries can turn this expertise into an asset by working together in a coordinated fashion. The following suggestions are offered to governments to make the most of this potentially valuable expertise.

  • Be transparent and build confidence: When estimating damage and needs, err on the safe side. National authorities should not blindly accept figures from an affected community. International teams cannot simply rubberstamp a diagnosis offered by local authorities; they will spot check the validity of the estimates. Governments can employ this approach to improve their own estimates.
  • Focus on gaps (unmet needs) that the outside world can realistically meet. For instance, there is no point in requesting first aid supplies (except to replenish stocks), as this phase will be over long before the supplies are available on site! Consider if search and rescue teams or trauma hospitals are cost effective and timely before requesting them. Ignore yesterday’s needs and anticipate tomorrow’s needs!
  • View bilateral or UN teams not as a time consuming problem, but as an additional source of expertise. Governments know local conditions better, but international donors often have much broader exposure to and experience in large disasters.
  • Integrate UN experts, particularly the United Nations Disaster Assessment and Coordination (UNDAC) team, into the national assessment system. For example, negotiate with the UN Representative to assign UNDAC team members to work within the national Emergency Committee, rather than on the UN premises. Joint collaboration will avoid issuing conflicting statistics or different conclusions in assessment reports, which in the end, only weaken national institutions.
  • Facilitate the work of country or NGO teams, but be firm in requiring that they share their detailed findings with everyone. The lack of shared assessment results in the aftermath of the tsunami was shocking and ultimately inefficient.
  • With the assistance of UNDAC, attempt to coordinate and assign specific responsibilities to external teams (either geographically or by sector). National authorities should focus on compiling and providing a big-picture assessment.
  • Accept that the mass media has enormous influence over what happens with external assistance. Invite the media to participate in field assessments as “embedded” journalists. They can provide a very useful perspective. If you don’t involve them, they will, on their own, disseminate their own diagnosis of gaps and needs, which may be neither objective nor comprehensive.
  • Finally, don’t wait to have all the data to provide guidance on what is needed, what is counterproductive and particularly what is not needed. Disaster scenarios are usually very similar. Once national authorities have a sense of the magnitude of the disaster (within hours at most), preliminary and conservative  requests or appeals must be issued. Later, they can be amended or adjusted upwards as data comes in.

Implications for health  needs assessments

Under WHO’s definition of health, many short-term humanitarian needs are health-related. Putting into practice the above recommendations will have a direct bearing on the health assessments carried out by the Ministry of Health and PAHO/WHO. Some have already become commonplace.

  • Transparency and confidence building is achieved when PAHO/WHO and Ministry of Health make joint field visits to disaster-affected areas. It is not in anyone’s best interest for PAHO to simply forward to the international community reports received from local health services. Similarly, estimates of the risk of an outbreak should be evidence-based, avoiding statements that are unnecessarily alarmist and that inevitably damage long-term credibility. The strategy of establishing a joint national/international health information center in the Ministry of Health could be replicated by other sectors.
  • PAHO/WHO’s extensive experience with disasters, both within and outside the Americas, has helped Ministries of Health to anticipate future humanitarian needs. Issuing an early and realistic PAHO/WHO appeal within days of a disaster reflects the cooperative relationship between PAHO and Ministries of Health. PAHO’s guidelines on effective donations and field hospitals also have helped to highlight less effective areas of disaster assistance.

Some Areas for Improvement

  • Helping to facilitate the assessments conducted by international health NGOs still remains a challenge. More needs to be done to fully transform these NGOs into valuable and competent partners of the Ministries of Health.
  • Inviting the international mass media to participate in actual field visits is not yet a common practice. Press conferences are too infrequent and are no substitute for embedding selected news sources into PAHO/Ministry of Health operations.
  • PAHO is in a unique position, as part of the UN (and UNDAC) and as a close collaborator with the Ministry of Health (and Civil Protection), to serve as a bridge between national and international assessment efforts.

Increasingly, international humanitarian assistance has become more generous. However, this has generated legitimate and specific requirements for first-hand information on the nature of humanitarian needs. National coordinators should strive to accommodate these requirements. In the past, bilateral and particularly multilateral assessment teams have inadvertently constituted a burden for the national counterparts. With their superior access to the latest in communications and logistics, these external teams may unwittingly undermine national teams by rushing to issue statistics and assessments without attempting to reconcile different perspectives or conflicting data. For this reason, national disaster authorities should ensure that the UNDAC strengthens, not replaces, the country capacity to coordinate the overall assessment. Above all, data must be shared openly by NGOs and donors alike to reveal the big picture of what exactly will most benefit the disaster victims.