Effective aid after the tsunami

1. Effective aid after the tsunami compiled by Teem Wing Yip

2. As a result of the tsunami... • Many people are need of supplies for daily and long-term living • Many items have been donated for the needy people • More donations are coming in

3. Therefore, how do we ensure that... needs are met and donations are used effectively?

4. How many people are affected? What is the composition of the population? Families? Orphaned children? Elderly? People with long-term illnesses/handicaps? Injured people? What do they need? Temporary shelter? Materials to repair their homes? Food? Clothes? Medical attention? Daily necessities (eg. soap, eating utensils)? First task (should have been done immediately after the disaster): NEEDS ASSESSMENT

5. Here, we will only discuss the distribution of non-food items (we will not be discussing shelter, medical attention, food, etc.).

6. Before any distribution can begin, REGISTRATION must occur Registration... • Establishes an agreed number of beneficiaries • Provides the profile of the refugee population, making it easier to target special groups • Facilitates monitoring and control • Ensures cost-effectiveness and credibility of the distribution operation

7. What is the aim of distribution? Distribution should enable families to function as the basic social unit. Persons outside families must, of course, also be assisted through the distribution system. This group often includes unaccompanied minors, single women, unsupported elderly and young men.

8. Principles of distribution systems Safety. Organised in such a way that the system is free of threat to all who use it, with particular attention to women and the vulnerable.

9. Principles of distribution systems Accessibility. Distribution points are close to where people live and are located in places which do not restrict the access of particular groups. The timing of distributions should suit the intended beneficiaries.

10. Principles of distribution systems Open communication. The recipients must know what they should receive, how much, when and how. The recipients themselves can be the best monitors and controllers of the distribution process; they should be able to see the distribution process for themselves. Involve them directly, don't let information on the distribution process come to them only through their leadership. Ensure the participation of the recipients (women and men) at all levels of the distribution process.

11. Principles of distribution systems The family, as a natural unit, is the target of distribution. This applies to food and non-food items. However this does not mean that you always have to hand the ration to each family directly, in some situations this can also be done more effectively through groups of families or other community structures.

12. Principles of distribution systems Regular distribution cycles increase the confidence of the beneficiaries and decrease their need to circumvent the system.

13. Principles of distribution systems Aim to have at least 1 distribution site per 20,000 recipients.

14. Principles of distribution systems The distribution system should allow beneficiaries to collect rations close to where they live and at regular intervals of about one month. Recipients should not have to travel more than 5 to 10 km to distribution sites.

15. Principles of distribution systems Distribution of dry uncooked rations in bulk is usually the most desirable. Avoid mass cooked food distribution for the general ration.

16. Principles of distribution systems Have a minimum of 2 staff per 1,000 beneficiariesin the distribution system.

17. Principles of distribution systems Avoid payment in kind for distribution workers. It makes monitoring difficult. In times of shortages, vulnerable people may be deprived of the commodities in order to pay staff.

18. Principles of distribution systems In the early stages of a new programme, particularly in large emergencies, effective control over distribution may not be possible. However, from the start, each action you take should contribute to a process whereby stable control is progressively established.

19. The UNHCR has specific guidelines on how to implement a distribution system.

20. What should be given to the needy people? Two types of non-food items... • Routine consumables eg. soap, fuel, sanitary supplies, health supplies, condoms, educational supplies • Non consumables, longer life items eg. mattresses, blankets, kitchen sets, jerry cans

21. What should be given to the needy people? Minimum standards have been established by the international humanitarian community.

22. The Sphere Project " The Sphere Project was launched in 1997 by a group of humanitarian NGOs and the Red Cross and Red Crescent movement. "Sphere is based on two core beliefs: first, that all possible steps should be taken to alleviate human suffering arising out of calamity and conflict, and second, that those affected by disaster have a right to life with dignity and therefore a right to assistance. " The aim of the Project is to improve the quality of assistance provided to people affected by disasters, and to enhance the accountability of the humanitarian system in disaster response."

23. The Sphere Handbook " The Minimum Standards and the key indicators have been developedusing broad networks of practitioners in each of the sectors. Most ofthe standards, and the indicators that accompany them, are not new,but consolidate and adapt existing knowledge and practice. Taken as awhole, they represent a remarkable consensus across a broad spectrum,and reflect a continuing determination to ensure that human rights andhumanitarian principles are realised in practice. To date, over 400 organisations in 80 countries, all around the world,have contributed to the development of the Minimum Standards and key indicators." (The handbook is available in over 20 languages. We are now translating some of the most relevant sections into Thai.)

24. Example from the Sphere Handbook: minimum standards in personal hygiene • Each person has access to 250g of bathing soap per month. • Each person has access to 200g of laundry soap per month. • Women and girls have sanitary materials for menstruation. • Infants and children up to two years old have 12 washable nappies or diapers where these are typically used. • Additional items essential for ensuring personal hygiene, dignity and well-being can be accessed. Subject to availability, these items per person per month could include 75ml/100g of toothpaste; one toothbrush; 250ml of shampoo; 250ml of lotion for infants and children up to two years old; one disposable razor. Per household they could also include one hairbrush and/or comb, and nail clippers.

25. We have just discussed WHAT to distribute and HOW to distribute. We will now discuss how to deal with offers of donations.

26. The Pan-American Health Organisation has developed a set of guidelines for effective humanitarian aid in disasters. (South-East Asia could adopt a similar set of guidelines as part of its disaster preparation)

27. From the Pan-American Health Organisation... " Thanks to modern communications, word of these tragedies reached theinternational community within minutes, and in some cases, relief wasmobilized in a matter of hours. This outpouring of assistance can greatlyhelp a disaster-stricken country if it meets real needs. However, it can justas quickly become a burden when the assistance has not been requested ordonor institutions or individuals have misperceptions of what the needs are. "Messages received from both the press and the aid community focusattention on the most visible health effects of natural disasters. ... disaster workers continue to be overwhelmed with donations,the large majority of which are unsolicited medicines, food, clothing, blankets,and other low priority items."

28. Lessons to be learnt from the Americas... " In 1986 countries adopted a regional policy to improve coordination of international humanitarian health assistance. All LatinAmerican and Caribbean nations have Health Disaster Coordinators withintheir Ministries of Health who not only coordinate relief efforts in the eventof a disaster, but continuously update emergency plans and conduct preparednesstraining for health and medical personnel. The Ministries ofForeign Affairs in several countries have established procedures on the roleof diplomatic missions in both donor and recipient countries during theresponse phase of disasters."

29. Member governments of the Pan-American Health Organisation agree to the following (1) • Foreign health relief assistance should be made only in consultation with officials designated by the Ministry of Health to coordinate such assistance. • National health authorities should quickly assess needs for external assistanceand immediately alert the international community to the specifictype of assistance which is, or is not, needed. Priorities should be clearlystated, making a distinction between immediate needs and those forrehabilitation and reconstruction.

30. Member governments of the Pan-American Health Organisation agree to the following (2) • Diplomatic and consular missions should communicate to donor countriesfirm policies on the acceptance of unsolicited or inappropriate supplies. • To avoid duplication of health relief assistance, full use should be madeof the clearinghouse function of PAHO to inform donors of pledgedcontributions and determine genuine health needs.

31. Member governments of the Pan-American Health Organisation agree to the following (3) • Countries should give high priority to the preparation of their ownhealth and medical personnel to respond to the emergency needs of theaffected population. Donor countries and organizations should support such disaster preparedness activities. • All countries must identify their vulnerability to disasters and establish appropriate measures to mitigate the impact on the most vulnerable populations .

32. Has this been done in the region after the tsunami? • Needs assessment must be carried out promptly by national healthauthorities in the affected country. Donors should be informed immediatelyof the specific type of assistance that is or is not needed. Delaysbetween the identification of needs and the actual arrival of assistancefrom the outside are unavoidable and sometimes prolonged, resulting in assistance that arrives after needs have been met.

33. Has this been done in the region after the tsunami? • Inform donors of what is not wanted or needed. This is as critical as givingspecifications for requirements. Guidelines should be circulated to allpotential suppliers of assistance and diplomatic and consular representativesabroad to prevent ineffective contributions.

34. Has this been done in the region after the tsunami? • Information must be circulated openly and subjected to review to ensureaccountability in the management of humanitarian supplies. Donorsand national authorities must be provided accurate reports on the statusof shipments and distribution of supplies. Supply management systems [such a system is used by the PAHO]assist in maintaining inventories, categorize,and sort incoming supplies, and provide donors and national authoritieswith accurate reports on the status of shipments and deliveries.

35. Has this been done in the region after the tsunami? • Don’t overreact to media reports for urgent international assistance. Despite the tragic images we are shown, get the complete picture andwait until pleas for aid have been formally issued.

36. Things to discourage sending after a disaster... • Used clothing, shoes, etc. In most cases, the local community donates more than enough of these items to meet the demand. It is more economical, convenient and sanitary to purchase items locally than to ship used items. Refer offers of this type of assistance to local charities or voluntary agencies.

37. Things to discourage sending after a disaster... • Food. Although the international media may highlight local distribution problems, food should not be sent. If food is requested, it must be non-perishable, clearly labelled, and appropriate to the local culture.

38. Things to discourage sending after a disaster... • Household medicines or prescriptions. These items are medically and legally inappropriate. Pharmaceutical products take up needed space and divert the attention of medical personnel from other more pressing tasks to sort, classify, and label them.

39. If offers are received, consider them carefully before accepting... • Used medical equipment. Specifications must be provided. If the value of the equipment justifies it, an on-site inspection may be arranged by a technician in the donor country or an international agency.

40. If offers are received, consider them carefully before accepting... • New equipment. When considering these donations, take into account the cost of air freight, the continued availability of spare parts, and local availability of personnel who are trained in operation and maintenance of the equipment. Most manufacturers are willing to wait several days to allow technical consultation with the appropriate Ministry.

41. If offers are received, consider them carefully before accepting... • Tents. The funds that donors are willing to spend to purchase and air-lift tents could be put to better use by purchasing reconstruction materials locally.

42. If offers are received, consider them carefully before accepting... • Vaccines. They are most often neither needed nor approved by the Ministry of Health. Check the presentation, dose, and expiration date and inform the Ministry of Health.

43. Myths and realities of disasters, as identified by the PAHO... (Do we still believe in these myths and are we perpetuating them by what we are doing and saying?)

44. Myth: Foreign medical volunteers with any kind of medical backgroundare needed. Reality: The local population almost always covers immediate lifesavingneeds. Only medical personnel with skills that are not availablein the affected country may be needed.

45. Myth: Any kind of international assistance is needed, and it’s needed now ! Reality: A hasty response that is not based on an impartial evaluationonly contributes to the chaos. It is better to wait until genuineneeds have been assessed.

46. Myth: Epidemics and plagues are inevitable after every disaster. Reality: Epidemics do not spontaneously occur after a disaster and deadbodies will not lead to catastrophic outbreaks of exotic diseases. The key to preventing disease is to improve sanitary conditionsand educate the public.

47. Myth: The affected population is too shocked and helpless to take responsibility for their own survival. Reality: On the contrary, many find new strength during an emergency.

48. Myth: Disasters are random killers. Reality: Disasters strike hardest at the most vulnerable group, thepoor—especially women, children and the elderly.

49. Myth: Locating disaster victims in temporary settlements is the best alternative. Reality: It should be the last alternative. Many agencies use funds normallyspent for tents to purchase building materials, tools, andother construction-related support in the affected country.

50. Myth: Things are back to normal within a few weeks. Reality: The effects of a disaster last a long time. Disaster-affected countries deplete much of their financial and material resourcesin the immediate post-impact phase. Successful relief programsgear their operations to the fact that international interestwanes as needs and shortages become more pressing.