Risk Wise

increase milk powder supplies for emergency situations to avoid

malnutrition in affected children. To dispel the misconception,

health talks were conducted to educate the mothers on the bene-

fits of breast milk. The programme was expanded to promote

appropriate child feeding and caring practices, including diversi-

fying diets and improving hygiene, as even with adequate nutrition,

poor hygiene could still aggravate the spread of diarrhoeal diseases.

In response to this MR conducted a bathing exercise to educate

parents on the need to keep their children safe from diseases.

Lessons learned

There is a need to establish cooperative networks with partner agencies

and local authorities

– No single agency can be fully self-sufficient in

its operations and work independently from other NGOs. NGOs

must be open to collaborations with more experienced or bigger part-

ners to tap into their resources, network and expertize to supplement

their deficiencies. For example, in order to provide efficient and

effective medical aid, relief agencies must be well equipped in other

resource areas like logistics, manpower and telecommunication

amenities. These resources facilitate proper planning and coordina-

tion in the midst of operational chaos. The goodwill established with

trusted networks during peacetime will pave the way for successful

cooperation when disasters occur.

There is a need for a holistic approach

– Basic needs for survival

required and expected by the affected communities are intercon-

nected. Effective aid cannot be extended in a piecemeal manner.

Local cultural sensitivities need to be understood

– In making recom-

mendations for the prevention or management of diseases, relief

workers need to be sensitive to customary practices and social beliefs

that may create psychological barriers to the local community’s accep-

tance of proposed treatments. Within a relief team, able and

knowledgeable leaders should be appointed in the field to take charge

of operations and be accountable for decisions.

Operations in ground situations need to be adaptable

– Relief workers

must be adoptable and adaptable to ground situations. Medical aid

workers cannot expect to duplicate the same working conditions

that exist in an urban peacetime setting or impose their own standard

practices on their local partners and co-workers.

MR believes that healthcare is but one of the five key components

for effective and sustainable development in disaster-stricken and

impoverished rural communities, the other four being shelter; water

and sanitation; education; and livelihood opportunities. The five

components are intimately connected, hence the need to address

them in a holistic fashion. Immediate and tangible benefits appeal

more to these communities.

Immediate subjective wants versus gradual objective needs

Having worked in 19 countries over the last six years in disaster-

stricken and impoverished rural areas, the common thread that runs

through these communities is that the targeted communities’ chief

motivation stems out of immediate subjective simple personal wants,

which prevail over gradual objective comprehensive communal needs.

Livelihood opportunities and their sustainability are paramount

to any household. Water is quintessential to the immediate survival

and sustainable development to these affected and disadvantaged

communities. A development project, which provides immediate and

sustainable sources of food and income – for example potable water

and water for farming – is virtually certain of winning over the wills

and minds of the targeted communities.

Macro issues such as the threat and spread of avian

flu and HIV, or environmental degradation, are least

proximate to these communities in terms of conscious-

ness and conscience.

Parallel to developed communities, people become

interested in insurance only after they have reached a

certain level of comfortable income and lifestyle. This

psychological block is motivated by the limited social

bandwidth and the anxiety of immediate personal

survival. Such phenomena accurately explain the rural

or affected communities’ disinterest towards immu-

nization. For disaster-stricken communities in rural

areas, given the trauma and devastation around them,

the survivors will not be motivated to adopt any revo-

lutionary health procedures that would not

compensate them for the loss of their families and

properties.

In addition, culture and religion are known to influence

the ways people define health, express pain, select treat-

ment options and deal with grief. These characteristics of

the affected communities represent yet another challenge

to the international aid community. Relief workers cannot

underestimate the influence such beliefs bring in shaping

rural communities’ understanding of medical treatment

and the myths created surrounding the spread of modern

medical theories.

Conclusion

Poverty increases vulnerability and, as such, immu-

nization programmes should be implemented in

impoverished and developing communities during

peacetime. However, it must also be taken into consid-

eration that efforts to eradicate an epidemic after a major

disaster require extensive resources, thus causing signif-

icant financial strain on the affected country. To avoid

this, a holistic preventive strategy to combat diseases

needs to be implemented proactively before an epidemic

occurs. In addition, the need for education to encourage

practice cannot be overemphasized and this needs to be

done during peacetime.

Essentially, any aid agency that wishes to embark on

the formulation of a pandemic contingency plan must be

able to appreciate the concerns, outlook and culture of

the targeted communities. Only then can the commu-

nities be won over effectively.

A general increase in the number of large-scale

natural disasters requires an international response –

hence the need for an effective network of NGOs (of

diverse capabilities) for better coordination, maxi-

mizing on each other’s strengths and avoiding

duplication of efforts. This would allow for greater

efficiency in the allocation of resources and better

services to the targeted communities. Regional capac-

ities to respond to disasters should be developed and

relevant institutional relationships strengthened. This

would include existing regional organizations, the UN

regional offices, and the national disaster management

agencies and health agencies of countries prone to

natural disasters.

[

] 35