Thursday, January 21, 2010

Why we didn't all just go to Haiti

I think it's reasonable to say that many of us, when we hear of a crisis, would much rather do something tangible than sit around and weep, pray, or part with our money. And yet, praying and giving money are often some of the best things you can do. This article does a good job of explaining exactly why.

Interestingly enough, much of my work this last year has hinged around this kind of a problem - specifically with medical equipment. So often, wealthy nations or hospitals want to help "the poor starving children" and think that by donating items, they can really be of help. A common idea is that "something is better than nothing." In all reality, that couldn't be farther from the truth.

In disaster situations and even extreme poverty, the infrastructure isn't present to keep even human waste from getting into the water system, much less dispose of expired drugs, medical waste, and unusable food/clothing items. A rule of thumb we often repeat in guidelines for effective medical equipment donations is "if it's not acceptable in the donor country, it's not appropriate for the recipients."

Seems to me we just keep coming back to that simple 'do unto others...' advice.


Disaster do-gooders can actually hinder help
Uninvited volunteers, useless donations can cost money, time — and lives
By JoNel Aleccia
Health writer
updated 7:13 a.m. ET, Thurs., Jan. 21, 2010


No question, the two church-goers from New Jersey had the best intentions in the world when they arrived in Port-au-Prince this week to help victims of Haiti’s killer earthquake.

Trouble was, that was all they had in a land where food, water, shelter and transportation are at a desperate premium, said Laura Blank, a disaster communications manager on the ground for World Vision, a Christian humanitarian aid group with long ties to the country.

“They seemed very eager and very passionate about helping the people of Haiti, but they didn’t have a ride to get out of the airport,” said Blank, who had to direct the pair to assistance.

More than a week after a magnitude-7 earthquake devastated the country, disaster organizers say they’re seeing the first signs of a problem that can hinder even the most ambitious recovery efforts: good intentions gone wrong.

From volunteer medical teams who show up uninvited, to stateside donors who ship boxes of unusable household goods, misdirected compassion can actually tax scarce resources, costing time, money, energy — and lives, experts say.

“Everyone wants to be a hero. Everyone wants to help,” said Dr. Thomas Kirsch, co-director of the Johns Hopkins Center for Refugee and Disaster Response. “It’s not the way to do it.”

Even a medical crew from his own school — Kirsch declined to identify them — arrived in Haiti so ill-prepared they had to seek sustenance from non-governmental organizations.

“They had no bedding, supplies or food,” he said. “They ended up glomming onto some of the NGOs.”

Volunteers simply show up
What to do with well-meaning volunteers is not a new problem. In every disaster, large numbers of people simply show up to help. A handbook published by California disaster officials estimates organizers can count on 50,000 “convergent” volunteers after any severe earthquake. After the Sept. 11 terror attacks, more than 40,000 unsolicited volunteers arrived at Ground Zero in New York.

In the U.S. and around the world, aid organizations are walking a fine line, trying to encourage skilled professionals who can provide indispensable assistance — and waving off those who might not be up to the task. At the federal Center for International Disaster Information, a stern note warns the well-intentioned:

“Volunteers without prior disaster relief experience are generally not selected for relief assignments,” it reads. “Most offers of another body to drive trucks, set up tents, and feed children are not accepted.”

It’s an effort to help would-be Samaritans recognize the reality of the situation, said CIDI director Suzanne H. Brooks.

“It’s very romantic in the TV and movies,” she said. “They think it’s flying in for a weekend. They need to think of it in terms of months.”

Those best suited to help are probably already there, experts said. They’re trained crews who not only have experience working in disasters, but also in developing nations, Kirsch said. The best teams also have a command of Haitian Creole and French, if possible.

When teams arrive without those skills and without their own supplies, they drain resources that could better be used for actual victims, said Dr. Kristi L. Koenig, an emergency physician at the University of California, Irvine, who specializes in disaster response.

“Unless you’re part of a team before the disaster happens with a formal mission, you’re going to be part of the problem,” she said.

Even worse, certain volunteers have required emergency intervention themselves, Kirsch noted.

“Most people do quite well, but about 10 percent don't,” he said. “They end up totally freaking out and having to be evacuated.”

Winter coats and high-heeled shoes?
A different but equally pressing problem is the flood of ill-advised donations that aid agencies already are facing, organizers said. A handful of “Help Haiti” food and clothing drives across the country are inspiring cringes among some workers, said Diana Rothe-Smith, executive director of the National Voluntary Organizations Active in Disaster, a coalition of agencies.

“I would strongly recommend that no donation drives be conducted unless there’s an existing organization on the ground, in Haiti, that has asked for the help,” Rothe-Smith said. “It does pile up very quickly.”

Donations of old clothes, canned goods, water and outdated prescriptions are accumulating, said Brooks. While such items sound useful, they’re actually expensive to sort, to transport and to distribute, she said. Cast-off drugs can be dangerous.

Oftentimes, the household items donated are simply not useful to the disaster victims they’re intended to help.

“I guarantee you someone is going to send a winter coat or high-heeled shoes,” Brooks said.

In fact, after the tsunami in Indonesia in 2004, aid organizers in Sri Lanka were forced to deal with donations of stiletto shoes, expired cans of salmon, evening gowns and even thong panties, according to news reports. In Florida, a truckload of mink coats showed up during the 2004 hurricane season, Rothe-Smith said, a likely tax write-off for a retailer having trouble pushing furs.

The compassion behind some donations is understandable — and laudable, she added. People see dire images on television or in news reports and they want to help.

“It seems to make logical sense to go through your own cupboard and gather those items,” Rothe-Smith said.

The reality, however, is that inappropriate donations actually do more harm than good.

“If you buy a can of peas and it costs 59 cents, it’ll cost about $80 to get it where it needs to go,” Rothe-Smith said.

Mathematics of donation favor cash
Many agencies try to motivate donors with the mathematics of the situation. Jeff Nene, a spokesman for Convoy of Hope, a Springfield, Mo., agency that feeds 11,000 children a day in Haiti, urges cash donations that allow his group to buy in bulk from large suppliers and retailers.

“When people give $1, it translates into $7 in the field,” he said. “If they spend $5 for bottled water, that’s nice and it makes them feel good, but probably it costs us more than $5 to send it. If they give us $5, we can get $35 worth of water.”

That’s a sentiment echoed by virtually every aid agency.

“I would really say at this point, honestly, right now, money is the best thing to give,” Rothe-Smith said.

Donors can find vetted agencies helping in Haiti on sites such as Charity Navigator.

Still, trying to direct the flood of compassion can be tricky, Nene acknowledged.

“Some people get a little miffed by it. They think they’re trying to help and when you don’t receive it in that attitude and spirit, they get upset,” he said.

“You just have to tread lightly. You don’t want to crush people when they’re so willing to help.”
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URL: http://www.msnbc.msn.com/id/34958965/ns/world_news-haiti_earthquake/

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Sunday, January 17, 2010

Haiti: Pre-earthquake

In light of the catastrophe in Port-au-Prince, Haiti, I figure I should probably write a little bit about my experience there. Fortunately, the hospitals we were working with are farther inland and all their locations are still standing. This puts them in the position of providing care to many of the wounded. Having worked with the people at Partners in Health (PIH), I would highly recommend sending any support through them if you want to help with the disaster relief. PIH isn't just an outside aid organization, their whole strategy is to train and employ Haitian nationals, from the cleaning staff and community health workers all the way up to the doctors and nurses - and everyone in between.

While in Haiti, we worked with Youdy, their head biomedical technician. I was so impressed with his knowledge and desire for learning. Youdy has completed multiple courses in specific types of equipment, both in the US and via distance-learning. He is training at least 8 young men to work at the different site hospitals and as assistants for him. While we were in Haiti, Billy and I worked with Youdy to repair 3 tabletop sterilizers and help set up an x-ray machine. Once we arrived at home, we were also able to send back the parts for a 4th sterilizer which is likely in service now.

More to come later. For now, here are the pictures from my time there:

Zanmi Lasante Hospital in Haiti



Stand With Haiti