Recent disasters have shown that we need to review many of the lessons we assumed we had learned in the field of humanitarian assistance, specifically in the health sector. Each emergency sees the emergence of new intervening agencies that focus on providing direct, immediate health services, often for short periods. The various scenarios should be studied to develop models of collaboration that will enable these stakeholders to apply their efforts and resources more effectively, to avert potential problems and avoid repeating the same mistakes.
In the face of devastation, there is an upsurge of solidarity with the victims. The entire world turns its attention to the disaster area and does everything in its power to mitigate the impact through an immediate response. Emergency teams are mobilized urgently and humanitarian donation campaigns are organized, often haphazardly. The eagerness in some quarters for immediate action occasionally results in a surfeit of medical aid and donations that may actually go astray, constituting yet another headache for those responsible for receiving and disposing of them.
Although countries have been building up their emergency response and awareness-raising capacity, the chaos that often follows in the wake of disasters cannot be ignored, throwing into stark relief the limited ability of coordinating agencies to channel efforts appropriately and respond to needs commensurately in order to ensure ongoing attention and the recovery of affected essential services.
The governments of the countries affected, both at national and local level, are sometimes excluded from the early phases of the emergency response, but when assistance tails off (usually after media attention has died down), they have to resume control of the situation under very difficult circumstances.
This lack of coordination in providing humanitarian assistance can be an enormous hurdle. An initial large-scale mobilization creates expectations in the affected communities, but then the area gets less and less attention until, finally, it is forgotten.
It is laudable that countries and/or agencies show interest in providing emergency aid, but if each one acts according to its own protocols, contradictions will result. This lack of coordination will hinder a proper response to the needs of the affected population
Specific guidelines to ensure a coordinated response
The government of a country affected by an emergency is responsible for organizing, coordinating, and providing humanitarian assistance in its territory. This coordination should be spearheaded by the national authorities, which should provide the means and the tools to properly plan and prepare a response based around a health action plan for the affected population. Governments are responsible for maintaining response teams, with organized procedures for receiving and distributing humanitarian assistance, so that they will be able to respond appropriately and effectively in their role as coordinators.
Accordingly, at the end of 2012, the 28th Pan American Sanitary Conference tasked the Pan American Health Organization/World Health Organization (PAHO/WHO) with supporting the coordination of international health assistance in emergencies and encouraging all organizations to harmonize their humanitarian assistance activities. The Conference also requested support for Member States – in the form of training – to strengthen their respective response teams, thus enabling them to provide better emergency assistance within their own territory and to neighboring countries.
During the Conference, after a process involving a number of PAHO/WHO departments, approval was also granted for the Organization’s new Institutional Response to Emergencies and Disasters model, based on the Incident Command System. The model is designed to provide appropriate and timely technical support to Member States affected by disasters, thus enabling them to save lives and protect public health, and to facilitate the deployment of the United Nations health cluster, if required.
The Institutional Response to Emergencies and Disasters policy was prepared on the basis of a number of existing disaster-management models and the recommendations of internal and external evaluations of the experiences of PAHO/WHO in the field of emergency response.