Damage v ability to cope shapes need for disaster aid

Editor—Redmond highlights important issues in assessing the needs of populations in humanitarian crises.¹ The article puts into a refreshing and practical perspective the common misconceptions surrounding disasters, some of which have been noted by Noji.²

Coordination and cooperation are the keys to maximising the international effort, and use of appropriate technology and due consideration to the dynamics of the local economy ensure sustainability. However, in discussing the prioritisation of needs in disasters, Redmond seems to have left out an often neglected but important need—information. In such moments of great uncertainty, affected people need to be informed of current and emerging developments as well as how to personally care for their own health. This not only accords them a certain sense of personal responsibility for health, but also promotes trust for and cooperation with relief efforts.

The article also suggests that the threshold for “urgent action” is higher for children under 5 years (“emergency out of control”) than for the general affected population (“serious condition”). If this is not an oversight it is worrying and worthy of further examination.

Finally, Redmond describes the impact of a disaster as the product of the number of people affected minus their ability and capacity to cope. Apart from being simplistic and mathematically flawed, this formula leaves one guessing how exactly to describe the number of people affected—is it mortality, displacements, vulnerability, or consequential morbidity?

The doubtful nature of the formula should, however, not distract from the fact that the need for international aid in disaster should be determined by weighing the extent of damage (however defined) against the local capacity to cope, a fact emphatically presented in this article.