Sunday, January 17, 2010

Learning from Disaster Response

DAY 5 OF THE HAITI QUAKE: CNN and other news media are doing a good job of reporting both good and bad events in Port au Prince. All disaster responses seem desperately slow,at first, given the critical 2 or 3 day time window for saving lives. But response to this mega-disaster is actually proceeding about as fast as can be expected, given the number of victims and the limited harbor, road and airport facilities.

Several issues, however, seem to have got less attention than needed:

Security: Rumors are inevitable, but common sense suggests that a medical team should not abandon its patients for unidentified "security" issues. CNN's Dr. Sanji Gupta should be congratulated for taking the initiative of staying all night with one hospital's patients until the medical team returned. (When this issue arose in the Cambodian refugee crisis of 1979, Thai military had a dusk to dawn curfew for our medical teams in our camp of 25,000 people. But they let one medical team stay each night in the thousand-bed hospital; fears about our safety proved groundless.)

The response now, at the end of day 5, shows that distribution is improving, but slowly. Water tanker trucks, replenished from decontaminated sources outside the city might be more efficient than passing out 100,000 bottles of water (which represents less than a single drink for each of two million people.

Cranes, bulldozers and helicopters are first priority needs after an earthquake. Flying these in on the first day would seem a higher priority than transporting swarms of officials who want to "see for themselves." Haiti has a second harbor and airport at Cap Haitien, well out of the quake zone. Helicopters could shuttle supplies from there to improvised landing pads almost anywhere in Port au Prince, until the harbor is working. But such plans must be set in motion quickly. Spending the first two days merely considering options means thousands die unnecessarily.

Large rescue plans tend to focus operations in the main population center and work outward from there later. That's where the most people are, of course. But people outside the epicenter starve or die of trauma just as quickly, and in some disasters people beyond the city receive no help until weeks later. (The 2005 quake in Kashmir with 75,000 deaths comes to mind.) Even with bad roads, teams could be sent by helicopter or truck out to secondary population centers.

God bless the local citizens who began rescue operations, with their bare hands in many cases, and who translated from Creole to English or French for newly arriving rescue teams. And bless all the competent and caring people who dropped what they were doing back home and showed up in Haiti to help. Many of you will look back on this as the high point of your career.