Address to the Tsunami Health Conference
Margareta Wahlstrom, Deputy Emergency Relief Coordinator of the United Nations and Special Coordinator for the Response to the tsunami affected communities
Your Excellency Minister Public Health of Thailand, Professor Suchai,
Dr Lee, Director -General of the World Health Organization,
Esteemed Representatives of the Local Government, National and International health expert communities.
Dear Colleagues, Ladies and Gentlemen,
It is an honor and a pleasure to be with you here today when you meet in Phuket to review your contributions and accomplishments in the tsunami response operation. All aspects of our human health is at the center of any emergency response. We have all been favorably impressed by the action of WHO and its many national and international health partners in this operation. By placing itself at the center of action and engaging with the response actors you do influence the course of action and lead initiatives on for example the global assessments. As we can see, just by glancing over the panels in which you are working during this conference, the broad range of health aspects required to engage in an emergency already demonstrates the integration of the health experts in the larger context.
While we need you to uphold standards, set norms and lead in developing best practice, we also need your practical leadership and engagement with all health actors in an emergency of this nature- only then can we ensure that we also act to bring your expertise to bear on the total health of the individual - and the society. The outcome of this lessons learnt exercise which will be a significant contribution to the overall learning for future action that the national and international disaster response actors are now carrying out in a variety of for a in the region and at HQ and capitals levels
A few words about the very recent past that many of you have experienced so painfully.
We are today four months and nine days after the tsunami disaster struck on December 26, 2004. The impact immediately killed hundreds of thousands of people and also immediately changed forever the lives of many hundreds of thousands who lived but lost so much -families and friends, homes, property, jobs and incomes and with that some of their confidence in life, and perhaps their identify and dignity as breadwinners of families and members of a community. While we were trying to understand that the frightening reality of so much human devastation as the loss of up to 230,000 human lives, and the local communities and governments under chock were assisting their members, the international disaster relief system was fast to respond. Today we have many sums made up, we know that up to 230,000 individuals were killed, two million people have been affected. We know that 65 governments have contributed to the UN 977 million usd Flash appeal, and that one billion dollar has been given to the UN alone so far. That two billion dollars have been given to the Red Cross Red Crescent movement and hundreds of millions of dollars to the NGOs, largely by individuals and private donors. That 35 nations contributed military assets in one form or the other. That more women than men died in the tsunami disaster. That tens of thousands of fishermen have lost their boats and nets. That children have been immunized and that schools have reopened. We know that the total of the reconstruction master plans of the four most affected countries amounts to 10-12 billion USD. But we still continue to have difficulties comprehending the human impact of the devastation. It will take a long time to fully understand the social consequences of the destruction as communities have been destroyed, displaced without possibly being able to ever return to their original homes.
What have we collectively achieved since the 26 of December? As is very well known to all of us in this room, the first relief is provided by the local communities, who, in spite of being so severely affected indeed assisted the even more affected. Neighboring countries and the international emergency response system - in spite of Christmas lull around the world – reacted fast and massively. It has delivered relief, medical and health assistance, food, material assistance to hundred of thousands ( two million) of people in spite of serious obstacles. The amounts of resources made available have been massive, the coordination challenges equally massive.The national help by neighbors, military and local police, by private corporations and others surely outstrip what the international aid provides, but it is not accounted for in the same way as the international assistance -which we regret as this would help to put the international action into perspective.
Now while we think ahead about the longe term recovery and reconstruction, we are also in a period of lessons learnt, and see a number of evaluations being produced very soon about our response to this disaster. If we are perceived as having been successful in delivering relief in the final conclusion there are some key factors I would like to highlight as crucial for the success, that are specific for this region and this emergency:
- strength of the national governments and the existence of established national frameworks of legal and regulatory nature,
- very fast mobilization of international early response teams and assets in support of the national action
- immediate local and international military transport assets and material supplies
- early availability of large financial resources . So far 6,8 billion USD recorded in our FTS. Of this amount which is a conservative figure, 14% have been given to the UN through the Flash Appeal.
- finally, the human element; people, show their very best sides when faced with a natural disaster and even more so one of such chocking magnitude as this one.
It has become a frequently repeated statement that this disaster was unprecedented”.
- It was truly an international disaster because so many countries around the world were directly affected by its people being killed or affected by the tsunami.
- It was also unprecedented in the expressions of compassion, –helped by the media exposure of the suffering of so many people - and the very large amounts of money that the public and private sector immediately made to provide relief. Regretfully there has been disasters where more people have been killed but not with such international reaction.
- The number of actors in the response to the disaster was significant and posed some serious operational and coordination challenges for the affected Governments and for the UN.
The immediate conclusion is the consequences of the realization of a truly interdependent world. We can contribute to shape the future of the devastated areas. The second conclusion is that, if the public and private sector is directly providing very large amounts of financial resources to the UN and NGO humanitarian system, we have to design an accountability system that is appropriate to report back to these stakeholders, in a pro active and coherent way so that they also understand how the resources are used. It also means that governments as traditional donors to NGOs in relief work, are less influential than before if more money is now being provided through individual and public donations. This means, that we have to learn how to coordinate better in this new environment. And our accountability and stakeholder group increases in numbers!
Thirdly the number of actors is an opportunity but also a threat. The opportunity is there to strengthen the disaster relief international system and also to reach many people. The threat is that the need to provide strong coordination and leadership to such a numerous and diverse community puts immense pressure on the affected governments and communities in a time when they have least resources and often little experience in doing this. The oft repeated word 'accountability' has a very real meaning in that we must accept the responsibility to deliver concrete results and be able to describe these results. The people that are expecting their homes, health clinics and schools to be rebuilt are well informed about the generosity of the international community and ask for concrete evidence of that the resources are being used for the intended purpose.
And in all this now rests some of the real challenges for the governments, the international community and the affected communities themselves, at the same time we know, once the peak of intensity of the relief period is behind us and the long and often too slow work of recovery and rebuilding will create impatience and the perceptions of loss of momentum of efforts.
The risk of the loss of momentum. Keep up the momentum of the ongoing relief while engaging in the planning and implementation of reconstruction work. The reconstruction might take longer than what wish to gain pace and people's situation might deteriorate instead of improving.
Ensure there is no gap. Through our programs and management ensure that we do not contribute to create a gap between the relief/recovery and rehabilitation and reconstruction phase. The gap risks throwing people back into crisis, there is loss of confidence which can fuels social dissatisfaction. The onus is on us to ensure that we understand our part in the total effort, that we engage in coordination and cooperation and ensure we contribute to sustainable efforts that will not undercut effort to reduce risks and vulnerabilities.
Ensure that already marginalized communities do not become forgotten or even more marginalized. The affected areas are mostly marginal to the countries economy. The human beings are not, and cannot be marginal. We must commit to long term engagement to support the viability of the recovery programs and ensure that this tie into the reconstruction programs and that these do seamlessly support each other.
Support and expect national leadership from the outset. We must have a clear understanding about what reconstruction means and what it requires in particular of a/ the coordination mechanisms that are in place and how these need to be adjusted for the reconstruction phase b/ the national government’s need to establish policy direction, frameworks and in certain cases new legislation ( it will take time) c/ need for a sustained international assistance and engagement.
Engage in the cooperation and monitoring to ensure equity in assistance both humanitarian relief and recovery assistance.
Commit to coordination. The cost of fragmentation and lack of coordination is high. And above all it risks undermining accomplishments for lack of linkages. While the national lead and expertise is the basis for the response, there is a body of standards, expertise and agreed best practices agreed in the international cooperation that should form the basis on which the cooperation in such situations take place.
And among these, two major challenges stand out today. The issue of provision of transitional shelter is one. The Government of Sri Lanka committed to ensure the building of 30,000 units of housing before the 10 of May before the start of the rainy season. In a normal year less than 8,000 units are built. In Aceh there is a need for 130,000 new homes to be built. These are massive undertakings. In the Maldives, the Government is seeking to improve people's safety in the vulnerable islands as they rebuild. In addition, for the permanent new housing to be built, we know that there are major land tenure and land rights issues that will take long time to settle. I noted for example that in Aceh on 5% of land was registered as 'owned' pre tsunami. If then there is a condition put on rebuilding that tenure is proved through registration of land rights, it is obvious that a lot of pragmatism and flexibility will be required to ensure that people can stabilize their lives. This represents by any standards a major displacement crisis. With long term displacement comes special health risks.
Finally, accountability. UN, NGOs, Governments must hold ourselves accountable for results and use of resources to the affected people and to donors of resources.
Our common concern now is: the reconstruction planning in the tsunami affected countries; how indeed does the international and national system cooperate and how do we define roles that build on our strengths and resources. We are also in need to build a better shared understanding and description of the situations and what the needs are. We should continue to develop mechanisms for joint and shared assessments, instead of having many assessment, with differing measurements, differing target groups and timelines. We should aim at have a higher degree of senior and strategic consultations so that when we determine operational strategies we can mutually reinforce each others objectives, even if we are very specific organizations. We cannot but ensure that we reinforce the impact of our action to the benefit of the population in need. For the tsunami operation, there are some specific issues – in addition to those I have already mentioned above; the financial resources that we have received exceed what can be responsibly utilized during the emergency phase. All of us must think how the long term use of the large amounts of financial means can benefit capacity and institution building and in particular for the early warning and preparedness systems now very high on the agenda for implementation. Without doubt, we will all benefit if we have the same message in our communications: we have received very large resources, we are grateful and we shall ensure that these are use for the benefit of the populations in the region affected by the tsunami. These resources cannot but also help stabilize the livelihoods of people for years – avoiding the risk of the gap, I mentioned before, and help build the preparedness and early warning we know has been so successful in other countries, in this region. This will take years.
The UN World Conference on Disaster Risk reduction held in Kobe/Hyogo in January 2005 provided us with an Action Plan for disaster risk reduction. Only such a direction s and an understanding that ultimately, disaster impact is reduced, by reducing poverty and ensure adequate preparedness and disaster response systems as well as national investments in legislation, institutional strengthening and development of national mechanisms for maintenance of all such systems. The international system for response as important as it is to provide relief and support, will always be a second line response to the national mechanisms. We must work alongside national institutions to better protect people’s lives, livelihoods and physical property, as well as national development investments. We hope that this will all be at the center of this years ECOSOC and General Assembly debate as the member states consider their progress on the millennium development goals. Regretfully, we already know that the progress is not good enough. And certainly not to the targets set. We have a role also to contribute to more progress on the Millenium Development Goals.
USG for the UN humanitarian affairs Mr Egeland has a strong vision for the international humanitarian response system. To this end the Secretary General of the UN and Jan Egeland took the initiative for >the Humanitarian Response Review. It aims to review why we were so ineffective in meeting the needs in for example Darfur, Sudan and DR of Congo and what to do to improve the performance of the international system. We have been responsive in the tsunami and hence it is of significance for the international humanitarian response system to see what were the success factors, how situation specific these were and what we require to make sure the system is always responsive, also to orphaned, forgotten and slow moving disasters. Your conference will be a significant contribution to this Review.
The better we harmonize our action, the more we can achieve. We must be able to respond to the small disasters that also have very large consequences on individuals’ lives, as well as to those large disasters that spread their impact across borders and regions and are constant reminders about the vulnerability of human society.
A few words to the colleagues in the military forces participating in the operation. In this part of the world it is a well known fact that armed forces along with police and civil defense are the primary and crucial actors to respond in a national disaster or emergency. The Indian army did not only respond to its domestic catastrophe but also immediately came to the help of Sri Lanka and Maldives. The Pakistan navy helped Maldives, that Malaysia and Singapore performed crucial and central tasks in Aceh. The USA, Australia, UK and many, many others contributed.
Some of us humanitarian partners were not clear on how to relate to this resource, to start with. Being used to work with and share space with militaries in mostly conflict affected environments ,this was something new and a bit unknown about this operation where we all responded to assist in the tsunami disaster. We have now seen the immense value of this. This understanding will enable us to fully draw on the combined resources for the best results. The unpredictable nature of this resources needs to be explore though. Can we assume these will be available ‘next time’.
I thank you for your contribution to the tsunami response and count on your continued engagement to provide a better life for the communities on the stricken regions in the Indian Ocean region but also for your cooperation always improving the centrality and quality of the international humanitarian system and strengthening of peoples’ resilience. Thank you.