Dartmouth Medicine HomeCurrent IssueAbout UsContact UsSearchPodcasts

PDF Version   Printer-Friendly Version

Page: 1 2 3 4 5 6 7 8 9

Seismic Effects

In the long run: The experts' recommendations for long-term aid

The recommendations here are excerpted and adapted from interviews and e-mail exchanges conducted with the three DMS alumni who are the focus of the adjacent feature: Dr. Karen Hein '68, Dr. William Aldis '70, and Dr. Stephen Atwood '70.

Set up systems
Aldis: We need to professionalize the way the response to disasters is handled. For example, volunteers should be trained appropriately and preferably should work through organizations that are experienced at providing relief and recovery services.

Atwood: It would be best to regionalize emergency response teams so they can respond rapidly. Teams should be cross-sectoral and crossagency, with the roles of the different agencies clearly defined. And any agency that responds must have some knowledge of the culture, geography, and political systems of the countries affected. There also needs to be better coordination among agencies of the United Nations, national and international nongovernmental organizations, and donors.

Forge local relationships
Aldis: We should aim to build consortiums where countries partner with international nongovernmental organizations. There shouldn't be mass coordination—it has to be some sort of consensus, a loose consortium. The days when the World Health Organization could tell countries what to do are long past. These countries are far ahead of that. We must move toward building working relationships with people in other countries before something goes wrong. You should know them, they should know you, know that

In order to really help after a disaster, says Aldis, you're going to have to engage. You're not going to [be able to do that] by blowing in on Tuesday on a Thai Airlines flight and going out on Friday. It takes a consistent, long-term involvement to engage the deeper social issues that affect, collectively, everybody in the world.

you have some kind of competency. Then you will have a presence on the ground through them.

Keep a global focus
Hein: It is one world. What is happening elsewhere affects us all. The tsunami represents a pattern of what will continue to happen—complex disasters, not just natural disasters, but manmade, too. Conflict in Africa, for instance, is exacerbated by drought. There's an increasing degree of global warming. There's no distinction between what's required to respond to natural versus manmade disasters. The tsunami helped make that clear. And we've come to realize that national boundaries are not important to diseases—viruses, HIV, hanta virus, bird flu. So our response should not be confined. We should do what makes sense globally.

Look at the long term
Hein: We need to widen our scope and think about what it takes to help children thrive, not just survive. If we focus exclusively on the moment of destruction or the immediate aftermath, it makes our vision too narrow. We need to think about prevention, amelioration, and long-range improvement in the lives of children and young people.

Atwood: Remember that the game isn't over until it's over. Organizations and the public have to realize that even though the emergency phase has passed, the full reconstruction of these societies will take years and will require sustained support.

Hein: Large organizations [like WHO, UNICEF, the International Red Cross, the International Rescue Committee, the Christian Children's Fund, Doctors Without Borders, CARE, Save the Children, and so on] have sufficient resources and infrastructure to be involved in unstable situations or "hot spots" around the world for years or decades, not weeks or months. They also have the expertise to base activities on evidenced-based approaches, not fashionable ideas of the moment, and the desire to bridge the worlds of policy, research, service, and politics to do what's necessary to bring thoughtful, effective support and intervention to complex situations.

Aldis: In order to really help after a disaster, you're going to have to engage. You're going to have to care. A disaster superimposed on poverty presents challenges for any relief effort. You're not going to answer those questions by blowing in on Tuesday on a Thai Airlines flight and going out on Friday. It takes a consistent, long-term involvement to engage the deeper social issues that affect, collectively, everybody in the world.

Build back better
Atwood: Rebuilt structures should meet standards shown to withstand earthquakes. "Building back better"—the motto of this recovery effort—also means building back safer to protect children from any further harm.

Page: 1 2 3 4 5 6 7 8 9

Back to Table of Contents

Dartmouth Medical SchoolDartmouth-Hitchcock Medical CenterWhite River Junction VAMCNorris Cotton Cancer CenterDartmouth College