Deficiencies in quality

European disasters

Common failures are:

· delay in assessing the severity of the situation;
· poor co-ordination and planning
· delay in providing first aid
· ignorance of the principle of triage
· poor logistics of supply and referral
· inappropriate relief arriving too late
· personal difficulties of relief workers
· failure to understand the relationship of disaster
· relief to primary health care.

Some of these issues were discussed at the WHO workshop on natural disasters held on 22-25 November at Rabbat (see Appendix IV).

Disasters in the third world

As stated earlier large numbers of European personnel are sent overseas having been recruited by mainly nongovernmental agencies. While there has been some improvement, these workers are often poorly prepared for those tasks which are asked of them. Often too, they are young, inexperienced and poorly briefed.

Common failures are:

· Overemphasis on disease

· Overemphasis on working in clinics as against in the community

· Using inappropriate high technology

· Cultural insensitivity

· Ignoring local resources especially manpower and equipment

· Providing a level of health care which cannot be maintained after the emergency.

· Ignorance of community health including epidemiology, water, sanitation, nutrition and tropical diseases

· Lack of emphasis on training.