Humanitarian Health Action

Proceedings from the WHO Conference on the Health Aspects of the Tsunami Disaster in Asia

Phuket, Thailand, 4-6 May 2005

Management and coordination of disaster responses

32. In-country management capacities were overwhelmed by the scope and suddenness of the tsunami. . The subsequent global response resulted in confusion, congestion, and competition for scarce logistic and transport resources. Within the health sector, some of these operational difficulties could have been prevented through more effective coordination.

33. Participants heard that effective supply systems and logistics were key to efficient disaster responses. Logistic systems are needed to underpin health sector disaster response assistance and facilitate national or international relief efforts. It is unacceptable for relief efforts at the time of an acute disaster to be impeded by administrative burdens that relief workers impose on affected communities (or on personnel in the front line who are trying to provide assistance). Excessive supervisory visits should also be discouraged.

34. However, coordination requires consent and cooperation of all stakeholders, which is not always forthcoming. Governments of disaster-prone countries have indicated that they seek the UN system's authoritative support in responding to (and, at times, directing and controlling) offers of people, equipment and materials made available through external assistance - with WHO serving as the health arm of the UN system. This is vital in situations where the sheer number of external groups offering assistance poses major challenges for the planning and phasing of relief efforts. External assistance to a disaster-affected country should be managed by governments through a participatory structure involving representatives from both recipient and donor communities. This is particularly relevant for actions in the health sector where needs can change quickly over time, and the cost of handling inappropriate assistance (people, equipment and materials) is very great indeed. Several countries are reviewing or revamping their national and local coordination structures, to reflect the Tsunami experience, for example, 'disaster management authorities or centres'. WHO can advise on how these overall coordination structures could adequately and specifically reflect health sector concerns.