In my last week in Liberia, I half-jokingly asked to return to Medicine Sans Frontieres (MSF) as a logistician instead of a medic:
Logisticians provide support to MSF's medical programs. They co-ordinate the purchase and transportation of supplies, both locally and internationally; oversee transportation and communications equipment use and maintenance; and supervise local non-medical staff. They are also responsible for security protocols. Their duties include frequent interaction with local authorities and organizations.
They're pretty bad-ass people...security, construction, transportation, etc. And even in a medical NGO like MSF, they matter just as much as the medics - mainly, because if there are no meds or supplies...um, the medics can't do much.
Which brings us to one of the continued problems of emergency/relief care: logistical limitations. Unless a disaster can be anticipated (e.g. hurricanes), it's nearly impossible to organize relief efforts within the first 48 hours - when a significant amount of the morbidity and mortality occur.
For example, in the recent Peru earthquake which occurred on August 15th...MSF (an organization which has superb logistical capabilities) couldn't get the assessment team or the first batch of supplies onto the scene until August 18th:
August 16, 2007 – In the evening of Wednesday, August 15, the Peruvian coast was hit by a powerful earthquake (8.0-magnitude on the Richter scale). According to local sources, more than 500 people were killed and 1,000 were injured. The most affected cities are Chincha, Pisco, and Ica, located around 200 km south of the capital, Lima.
Doctors Without Borders/Médecins Sans Frontières (MSF) is organizing a team to assess the heavily hit areas in the south. A cargo charter is scheduled to leave Saturday, August 18, from Bogota, Colombia, with five tons of medical and non-medical supplies, including tents to set up dispensaries, and water-and-sanitation material.
Even with pre-packaged emergency supplies and ready-response teams, disasters which happen in remote locations cannot be accessed easily. Relief workers need airports with large enough runways, either accessible roads + vehicles or teams of helicopters, an understanding of local conditions/languages/customs, local contacts AND enough security. I daresay these requirements cannot be met within the first 24 hours...limiting the ability of relief workers to impact dire conditions in the early hours.
Combined with the unlikely ability of poorer countries (or richer countries - see here) to have adequate domestic emergency responses, this situation, simply, blows for disaster victems.
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