Edited Version April 5, 2000 Transcript
EIIP Virtual Online Library Presentation
"Disaster Myths"
Dr. Jean Luc Poncelet
Pan American Health Organization (PAHO)
EIIP Moderator: Avagene Moore
The original unedited transcript of the April 5, 2000 online Virtual Library presentation is available in the EIIP Virtual Forum Archives (http://www.emforum.org). The following version of the transcript has been edited for easier reading and comprehension. Typos were corrected, date/time/names attributed by the software to each input were deleted but the content of questions and responses are as stated by each participant. Answers to participants’ questions are grouped beneath the appropriate question to facilitate meaning.
[Opening]
Avagene Moore: Welcome to the EIIP Virtual Library!
Before we introduce our guest speakers today, we want to remind you of a couple of the features of the EIIP Virtual Forum.
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[Introduction]
And now to introduce our program today --- As explained in our first promo on Monday, we had server problems last week and our scheduled speakers were unable to give us details on the SALEMDUG Emergency Management Technology Certificate Program.
They are here along with Dr. Jean Luc Poncelet and will give us a very brief overview after our full discussion of "Disaster Myths." We will hear from our guest from the Pan American Health Organization (PAHO) first and then Walter Green and Preston Cook will be introduced to overview their new certificate program. We will run over our usual hour but ask you to please stay for the overview. Several of you may be interested in getting your Technology Certificate and there is an opportunity later this month at the SALEMDUG Conference.
[Note: Please access separate transcript for SALEMDUG certification portion.]
Jean Luc Poncelet currently serves as Regional Advisor, Disaster Preparedness Program for Latin America and the Caribbean, PAHO/WHO in Washington, D.C. Since 1986 he has served in Quito, Ecuador as Disaster Preparedness Program Coordinator for South America, Bridgetown, Barbados and St. John's Antigua as Caribbean Sub-regional Advisor, and in San Jose, Costa Rica as Program Officer for Disaster Preparedness for Central America.
Dr. Poncelet has participated in humanitarian operations after several major disasters in this hemisphere. He holds a Masters degree in Public Health from the Universite Libre de Bruxelles, Belgium. He will present some facts about a couple of disaster myths and will allow you to ask questions after each one. I will remind you of our protocol for Q&A when we are ready for your questions.
Jean Luc, we are very pleased to have you here today. Jean Luc is coming to us from Miami where he is involved in a conference. Thanks for taking time for the Virtual Forum. I turn the floor to you at this time.
[Presentation]
Jean Luc Poncelet: Hi to everybody. Here comes the presentation.
Humanitarian Assistance Myths are still Very Much Alive
Myths surrounding humanitarian assistance following disasters have been catalogued for years. Some of them figure on the web site: <http://www.paho.org/english/ped/myths.htm>.
The objective of this presentation is to stimulate a discussion of potential solutions to one of these myths. This is the position of the author and not of the organization.
The myth exists that it is useful to send any kind of assistance to the disaster-affected population such as following Hurricane Mitch in Honduras, the earthquake in Turkey or more recently, the flood in Venezuela. In disaster situations, as in any situation, priorities have to be established.
In that case, the first one is survival of the victims and the earliest recovery of essential services, such as hospitals and water systems. The victims do not need unsorted or soon-to-expire medicines, used clothes, unknown food, etc. They are thinking about saving their lives and livelihood, safer houses and returning as quickly as possible to their normal lives. Any actions that delay these priorities will not be looked upon with favor by the affected population, if not in the short term, at least in the long. Useless supplies will compete with good ones to be transported and handled by scarce human resources and shipments.
The reality is that the affected populations need specific items. Even with today's sophisticated means of communications, we have to accept that these needs will not be known immediately. Inherent to this, the public in donor countries as well as the international community must recognize that, given the distance, differences in culture, sovereignty, etc., their role is to complement local capacity, not send supplies based on their beliefs. Sometimes, one has the impression that the donor public's need to satisfy their feelings of generosity is what drives the decision process and not what the affected population most urgently needs.
A first alternative to this myth is to invite cash rather than in-kind donation. This allows professional organizations, individuals, specialized NGOs, etc. to adapt to the quickly changing needs. Another good way to direct spontaneous and much-needed generosity is to inform the public about what makes for good international donations. For instance, that assistance usually reaches the affected countries days and weeks after it is sent; that in-kind donations often present difficulties and should be left only to specialized NGOs or international institutions, etc.
A dimension of professionalism must be added to humanitarian assistance operations and a kind of code of conduct proposed, adopted and broadcast. To achieve this, a serious campaign to educate the public and politicians will need to be launched. Also, personnel working in the field of humanitarian assistance have to be better trained. This will take years.
Comments or questions from those in the chat room are most welcome at this time.
Avagene Moore: Please input ? if you have questions or comments about this disaster myth. Compose your remarks and hold them until you are recognized by name. It sometimes takes a moment to get the first question.
[Audience Questions]
Question:
Rick Tobin: Many times people are unsure of giving money to relief organizations due to past misuse or "myth" of abuses. Any ideas on countering those concerns?
Jean Luc Poncelet: Cash is the best way. There were indeed abuses in the past, but there are enough reliable agencies to make those donations.
Question:
Jeremy Pickens: How do you plan on getting material on location quicker? I understand the delay of getting things in timely manner, but if you build stockpiles then the question becomes who will allocate materials?
Jean Luc Poncelet: The needs during the first few days are real specific to the place. Specially when donations are made from out of the country, they will always arrive late.
Question:
Robert Tabler: As a newcomer to this field I was wondering if there were any standards developed for the type of training needed to perform certain tasks?
Jean Luc Poncelet: If you are referring to donations for the public, there is no such training that I know of. What exists though are guidelines for good donations. Some are available on the PAHO site.
[Note: see <http://www.paho.org/english/ped/technical/donations.html>]
Jean Luc Poncelet: Those guidelines were prepared since 1986.
Question:
Avagene Moore: Robert, is that the training you are referring to?
Robert Tabler: I was responding to the comment that workers needed more training.
Question:
Avagene Moore: Jean Luc, do you wish to add something more?
Jean Luc Poncelet: Correct. Humanitarian professionals need be better trained. It is not enough just to send supplies. Up to now the public in general is happy by knowing that their country or themselves are sending supplies, but are not frequently interested in knowing if it reached the people.
Question:
Ray Pena: To follow up on Rick's question - donors need to believe that agencies are reliable. How can individual/corporate donors be made to believe this? Can PAHO identify reliable agencies? Why should donors trust PAHO's judgement?
Jean Luc Poncelet: You are correct. It is not only PAHO's judgement. The receiver comments are the important ones. What PAHO is doing is to try to reflect the comments that people provide us after each disaster. PAHO cannot identify agencies one by one. What is needed is to agree on general guidelines and pass to the public in general that sometimes it is better not to send anything.
Question:
Virgilio Escutia Jr: Are local church groups utilized?
Jean Luc Poncelet: Churches, Red Cross etc, can be very useful for that.
Comment:
Sheena Vivian: I guess I'm wondering how difficult it would really be, if local Emergency Managers took the initiative to assist their churches and service organizations with understanding the hurdles of donations and moving them gently to cash donations. I do believe that organizations making these donations wish to know that they were useful, not just contributing to the problem.
Avagene Moore: Good point, Sheena. Jean Luc, anything to add?
Jean Luc Poncelet: This is the point to make people understand the hassle it represents to have useless donations
Question:
LindaUnderwood: Have you looked at the CERT (Community Emergency Response Team) program model?
Jean Luc Poncelet: Unfortunately, I do not know that model. Can you explain?
Avagene Moore: Perhaps you can give Jean Luc a Web site reference, Linda.
That is a bit lengthy to explain here.
LindaUnderwood: It certainly is lengthy. You can get information at
<http://www.cert-la.com> and <http://www.fema.gov/emi/cert/>.
Question:
Rick Tobin: Here's a possible solution for reliability of donation use. Forbes Magazine recently rated the best and worst non-profits in the US. Why not having an open rating system that shows how much an NGO actually spent of their donations on problems, versus admin costs? Wouldn't that be fair?
Jean Luc Poncelet: The rating of NGO's is one way but very limited. What do you do with agencies that just provide technical assistance?
Comment:
Ann Thomas: Further to the issue of donations management, PAHO developed a Supply Management System, SUMA, to provide information on the flow of supplies after a disaster. SUMA inventories incoming supplies (not cash donations).
Comment:
David Crews: There are a number of church consortiums for donations. Two come to mind: InterAction and Church World Services (CWS). They are very active in Eastern Europe, South America and Africa.
Jean Luc Poncelet: There are a lot of examples of good agencies. The issue is to pass the message to the public. The in-kind donation of the community in a foreign country is usually the worst. Let' s go to the another of those myths.
Myth 2 -- Foreign medical volunteers with any kind of medical background are needed
Jean Luc Poncelet: As soon as a major disaster, such as an earthquake, strikes any part of the world and receives wide coverage of the mainstream media, institutions, especially from the developed countries, send their medical and rescue teams, giving the impression that the immediate arrival of such a team will save enormous number of lives.
In reality, most survivors owe their lives to neighbors or a rescue team of the immediate surrounding area. However, the few lives saved by foreign teams are highly publicized, displacing from the front page the more successful, but less sensational, rescue work of the local population.
That myth of the much-needed foreign medical volunteer rushing to the affected area is one of the most difficult to erase from the minds of the population and institutions. For example: the Honduran and the Japanese government were criticized when they politely declined the offer of foreign medical assistance, as they believed that the burden of foreign doctors would outweigh their positive contribution.
It is true though that especially in poor areas, a number of lives could have been saved if the rescue teams were better trained and local resources better oriented. However, the solution to the large number of victims is not to rush in any medical team (which will, in any case, arrive hours and more frequently days after the physically-accessible injured have received some medical attention), but to accompany local authorities in strengthening their local capacity.
The huge budget spent in sending complex field hospitals and western-trained medical teams should be directed to more efficient activities such as training of local teams, preparing local communities to respond, or sending medical volunteers only after having a better idea of the real needs.
In the same way it is accepted in the Western Hemisphere that an injured person cannot be treated until qualified medical personnel arrives, so too will we have to accept that humanitarian assistance is not only a question of good will. Just as we can harm a patient more by moving him/her improperly, we can similarly do more harm by sending foreign medical teams or inappropriate humanitarian supplies to disaster-stricken countries when these compete with an already overburdened system.
Your questions and comments are most welcome.
Avagene Moore: We will take a few questions. Input your ? now. Sacha, you are first. We are limited in time so need to move quickly.
Question:
Sacha Bootsma: How do you explain the success of MSF?
Jean Luc Poncelet: They are professionals and do not always intervene in the first few hours. The success is based also on the knowledge that they have of the country before the disaster strikes.
Question:
Avagene Moore: What does MSF stand for?
Sacha Bootsma: Medicos Sin Fronteras, I do not know the name in English
Lynn Orstad: Doctors without Borders.
Comment:
Ray Pena: A comment rather than a question - Right on, Jean Luc! This is a variation of the first myth. The best thing is always to enable people to manage hazards as effectively as possible themselves.
Jean Luc Poncelet: Correct we have to work with people at local level before the event. That is the most effective way.
Comment:
Lynn Orstad: We also should look at the aspect of working with Traditional Healers.
Comment:
Pat Bittner: As Ray said, it's especially important to prepare the local population. International interest wanes very quickly and it's the local community left to their own devices. That's why it's preferable to invest in local preparedness rather than sending foreign teams.
Jean Luc Poncelet: Demonstrated for many years.
Lynn Orstad: Here in British Columbia there was a huge outcry that "our" search & rescue teams were not in Turkey to assist. However, by the time they would have arrived, the benefit of their skills would have not been used. People have a tendency to react on the emotional rather than what needs to be done.
Jean Luc Poncelet: The problem is to guide the emotion. The generosity is essential to keeping the world together.
Pat Bittner: It's a difficult balancing act -- convincing your home country that help in the form of rescue teams is not needed when they are witnessing the tragic images on the TV! This would be one good aspect of a public donations campaign.
Jean Luc Poncelet: The problem is that you need more rescue people in a disaster but by better preparing local resources.
Question:
Amy Sebring: One of the articles makes a statement to the effect that preparedness efforts in Latin/South America have paid off in comparison with other parts of the world. Can you comment? I think Jean Luc has just referred to this.
Jean Luc Poncelet: It is difficult to compare regions. But indeed you can compare the same region at different periods. The difference is big. You start to have a culture of preparedness in the Americas that does not exist anywhere else, at least to that extent.
Amy Sebring: Pat, Jean Luc, the CERT program that Linda referred to earlier is a model for training local communities to respond and would probably fit in well in other areas.
Comment:
LindaUnderwood: The Los Angeles Fire Dept. recently trained people in Turkey about CERT.
Jean Luc Poncelet: Excellent.
Question:
Avagene Moore: Is the emphasis of PAHO and other global organizations training local resources?
Jean Luc Poncelet: It is the emphasis of PAHO and other very professional organization such as OFDA.
Question:
Pat Bittner: That's one aspect of PAHO's Emergency Preparedness Program -- developing health sector human resources. There is also a great deal of interaction with and among global organizations.
Comment:
Bob Tabler: Here at the USF Center for Disaster Management we have several people taking the CERT course with the idea of retooling it for the groups served by PAHO.
Sheena Vivian: I think the retooling is imperative and must be done with a cultural understanding. Emergency preparedness IS NOT one size fits all cultures.
Jean Luc Poncelet: The issue is to replace everything in the country's context.
Lynn Orstad: Actually, even in North America, one size does not fit all.
Bob Tabler: Yes, and we understand that the CERT training will be somewhat different for each country in order to meet their needs.
Jean Luc Poncelet: Sometimes agencies are providing more to the community after the disaster than they ever received before.
Final Question:
Clarke Guzzi: In rural areas that may have many separate, isolated communities for several days, has staging of basic first aid supplies that do not outdate at strategic locations (hospitals, churches, schools, community gathering points, etc.) been proven effective and utilized successfully? If so, is an austere medical care list of basic first aid supplies available?
Pat Bittner: WHO has a list of Emergency Medical Supplies on their web site: <http://www.who.ch> Do a search for Emergency Medical Kit.
[Note: see also <http://www.who.int/dsa/cat98/emerg8.htm#The New Emergency Health Kit 1998> for info regarding a relatively recent publication on this topic.]
Avagene Moore: Thank you, Pat. Our time is up for this portion of our program. Jean Luc, thank you for clarifying some of the myths about disasters. If you have the time, please stay with us for a few more minutes. If you need to get back to your conference, we certainly understand the demands on you today.
Audience, thank you for your participation in the first part of our discussion. If you wish to learn more about disaster myths, see the following page on the PAHO Web site <http://www.paho.org/english/ped/myths.htm> and read the articles referenced on today's background page <http://www.emforum.org/vlibrary/000405.htm>.