The recommendations here are excerpted and adapted from interviews and e-mail exchanges conducted with the three alumni who are the focus of the adjacent feature: Dr. Karen Kramer Hein '68, who volunteered after the tsunami in India; and Drs. William Aldis and Stephen Atwood, both members of the Class of '70, whose jobs involved helping with relief efforts in Thailand and Indonesia.

Prepare for disasters
Hein: It is important to create detection and warning systems for natural disasters. And countries must also consider the spectrum of issues resulting from people-created disasters, such as armed conflict—displaced persons, children affected by conflict, separation, disruption, and displacement of people's livelihoods and lives, and rebuilding and reintegration of people back into their community and civil society.

Aldis: It makes a big difference if the ability to respond immediately and locally is in place. Thailand, for example, had approximately 13,500 acutely injured people who flowed into the public health system within the first 24 to 48 hours. The system was able to absorb them; they were evaluated and triaged—either treated and discharged, admitted, or referred to tertiary hospitals if they had massive injuries. By the time medical teams arrived from Western countries, everything had already been done. So the answer then is to make sure that the capacity for the initial response is already there, prepositioned. Western nations must work with undeveloped countries in a collaborative and equitable way to make sure they can handle the next catastrophe.

Westerners must recognize that the main response in disasters is going to be from communities themselves, points out Aldis. We need to get past this delusion of saying, "Oh, I'm going to rush in and make everything better." That's easy and cheap and worthless. It doesn't work that way.

Mobilize resources
Atwood: It is important to take advantage of opportunities not only to help families affected by a disaster to get their lives back, but also to secure the peace and improve health, nutrition, water, sanitation, education, and protection for other families in these areas, who have often been isolated from the rest of the world because of conflicts or disasters.

Focus on the most vulnerable
Atwood: We have to institute better child protection measures, including registration of separated or orphaned children in the first 24 to 48 hours after a disaster strikes; that's the period when children are most vulnerable.

Hein: We must provide more services for women and children early in relief and recovery work. Disasters enhance the vulnerability of women and children—80% of refugees are women and children.

Rely on local expertise
Aldis: Westerners must recognize that the main response in disasters is going to be from communities themselves. We should support that—the countries themselves—exactly like we would want to be helped if something goes wrong in our country. We need to get past this delusion of saying, "Oh, I'm going to rush in and make

everything better." That's easy and cheap and worthless. It doesn't work that way.

Hein: You have to learn to appreciate the connections that people have with each other and their community. For example, those who helped out after the tsunami didn't see people pulling guns like after Katrina. In the U.S., there is a culture of violence and fear. But in the tsunami region there was an absence of violence by people against each other.

Aldis: Developed nations like the United States need to appreciate what they can learn from other countries. For instance, public-health systems are more sophisticated in Thailand than they are in some Western nations. Conventional assumptions are sometimes turned on their heads if you look closely at other countries. The highest level of competency in terms of emergency response is now often found in the very countries that before we thought we were helping. So the flow of understanding, information, knowledge, and innovation must become increasingly two-way.

Leverage the media
Aldis: It is essential to recognize that the media plays a key role in keeping the public informed of disaster relief efforts. What we need to do is convert the public fascination with disaster into something more relevant—like realizing that preparing people to weather disasters takes a long-term commitment and a lot of advance planning. Sometimes the media publish stories that we don't like because we haven't helped them obtain the information that would permit them to write the right story.