Responding to disasters / by J. Oltio Espinoza

Responding to disasters hether disasters are of natural origin or man- made, their effects in a country's life can be detected for months, and sometimes even years. It is therefore essential that any support operation be designed and implemen- ted with a long-term perspective. This is why all the interventions originating in the Regional Office to meet such situations extend from a preparedness phase (i.e., adoption of ad hoc action plans and development of adequate human resources) to a post-disaster support programme that includes preparing and carrying out- jointly with national and international counterparts-medium- and long-term rehabilitation plans for the health sector. Of course the main thrust of our action takes place immediately after the disaster itself, during the so-called disaster phase. First of all, both the extent of the disaster and its potential consequences on the health of the After a severe earthquake in Turkey, the survivors rapidly installed an emergency water supply, with technical coop- eration from WHO. 28 by J. Oltio Espinoza Where help was needed Earthquakes account for many dis- asters in the relief! of which the Re - gional Office has been involved. Many people will remember Agadir (Morocco) in 1960. Skopje (Yugosla - via) in 1963. Van and Erzurum (Tur- key) in 1975 and 1983. EI -Asnam (Algeria) in 1980. Kalamata (Greece) in 1986. and most recently in the Soviet Republics of Armenia (1988) and Georgia (1991 ) . Among recent man -made disasters in this Region. we can mention the toxic oil syndrome (Spain) in: 1981, and the Chernobyl (USSR) nuclear accident in 1 986, when the Regional Office was put in charge of assessing the immediate health risks connected with the radioactive fallout. National or international crises can also lead to disaster situations. Massive migrations between Bulgaria and Tur- key (1989). the upheaval in Romania (1989- 90). and the crisis in the Middle East. known in the media as the "Gulf War" in early 1991 are typical instances when the Regional Office was reques- ted to help Member States in facing dramatic problems. population have to be assessed. This is usually done by a field mission which is sent within hours. A second step is to provide technical advice to solve the most urgent problems, and avoid stumbling blocks which could originate from a lack of coordination. Only then can we most efficiently mobilize relief assistance, either by relying on our own readily available but limited resources, or by calling upon potential donor countries and/ or relief agencies, whether within the United Nations system or among nongovernmental organizations. It may look like a complex process, but this sequence is essential in order to achieve coordination of effort and ensure efficiency. Working hastily can also lead to slowing down. As soon as the report of a disaster reaches us-and sometimes before the disaster itself when it can be anticipated, for instance in an interna- tional crisis situation-an internal task force is activated within the Regional Office. All relevant specialists from the Regional Office are involved and parti- cipate in both the assessment of the emergency situation and the first steps of assistance. A group of external assessors is also kept on 24-hour notice, and is of priceless support to the task force; its members' competence ranges from seismology to environmental pollution, and includes all the psychosocial aspects involved in emergency situations. Beside the fact that they are invaluable resource persons and can provide technical advice and support, these assessors are ready at any time to accompany a WHO field mission. We also rely on a network of WHO collaborating centres, usually national institutions which have signed an agreement with us to carry out a var- iety of activities at national level for the development of programmes on disas- ter preparedness, relief and rehabili- tation. They also collect and analyse data on disasters, and frequently partici- pate in the training of personnel. • Mr J. 0/tio Espinoza 1s Regional Adviser. Accident Prevention and Disaster Pre - paredness. WHO Regional Office for Europe, Copenhagen. W ORLD HEALTH, November- December 1991