A group of trauma surgeons on bmj.com today argue that despite the frightening regularity of humanitarian disasters like the earthquake in Haiti, international responses remain fragmented and must be improved.

They caution that getting people and equipment into the affected zone as soon as possible in an uncoordinated attempt can worsen the situation. It can also reduce the effectiveness of relief efforts.

In addition, they recommend joining an established group to anyone thinking about volunteering. It will allow them to obtain appropriate training and enable them to function in a disaster zone.

Dr Charles Krin and colleagues explain that “many healthcare professionals from developed countries do not know what to do when faced with the horrors of a major humanitarian disaster, so proper preparation is key to providing prompt relief.”

In the United States, volunteers are required to undertake a National Incident Management System (NIMS) course. This prepares them to be aware of the possible schemes and where they will fit into the system. There are similar programs in other countries. Passports and immunizations also need to be kept up to date.

Medical volunteers should:

• have a basic understanding of field and trauma medicine
• be able to treat wounds and fractures with limited equipment and in non-sterile conditions
• know basic field sanitation and water purification techniques

The authors explain that these measures will help avoid well intentioned but sometimes misguided help from uncoordinated and untrained people that can obstruct relief efforts.

The experts continue by saying “Surely, we have learnt enough from the natural disasters of the last few decades to allow us to set priorities and offer a reasonably coordinated international relief effort the next time this happens.”

They add that there is a need for international dialogue in order to investigate ways to improve the response to these events.

They write in conclusion: “We have a perfect opportunity in Haiti to work towards true international cooperation. The Haitians will benefit from a long-term commitment to rebuilding, and the world medical community will benefit from the lessons learned when next we are called upon to provide disaster relief.”

“Appropriate response to humanitarian crises”
Charles S Krin, retired family and emergency physician, Christos Giannou, former head surgeon, International Committee of the Red Cross, Ian M Seppelt, senior specialist, Steve Walker, emergency physician, Kenneth L Mattox professor of surgery, Richard L Wigle, assistant professor of trauma and critical care, David Crippen, associate professor
BMJ 2010; 340:c562
bmj.com

Written by Stephanie Brunner (B.A.)