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Health-Related Relief in the Former Yugoslavia: Needs, Demands, and Supplies

Published online by Cambridge University Press:  28 June 2012

Margareta Rubin ,
J. Hans A. Heuvelmans ,
Anja Tomic-Cica  and
Marvin L. Birnbaum
Margareta Rubin*
Affiliation:
Socialstyrelsen, The Swedish Board of Health and Welfare, Department of Emergency Planning, Stockholm Sweden and Consultant to the World Health Organization
J. Hans A. Heuvelmans
Affiliation:
Médians sans Frontieres, Amsterdam, The Netherlands Currently, Health Inspectorate of The Netherlands Department of Pharmacy and Medical Technology, The Hague, The Netherlands
Anja Tomic-Cica
Affiliation:
Médians sans Frontieres, Sarajevo, Bosnia-Herzegovina
Marvin L. Birnbaum
Affiliation:
Departments of Medicine and Physiology, University of Wisconsin-Madison
*
*Socialstyrelsen, The Swedish Board of Health and Welfare, Department of Emergency and Disaster Planning, Stockholm, Sweden, E-mail: margareta.rubin@chello.se
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Abstract

Introduction:

Many organizations rally to areas to provide assistance to a population during a disaster. Little is known about the ability of the materials and services provided to meet the actual needs and demands of the affected population. This study sought to identify the perceptions of representatives of the international organizations providing this aid, the international workers involved with the delivery of this aid, the workers who were employed locally by the international organizations, the recipients, and the local authorities. This study sought to identify the perceptions of these personnel relative to the adequacies of the supplies in meeting the needs and demands of the population during and following the war in Bosnia-Herzegovina.

Methods:

Structured interviews were conducted with representatives of international organizations and workers providing aid and with locally employed workers, recipients of the assistance, and the authorities of the areas involved. Descriptive and inferential statistics were used to assist in the analysis of the data.

Results:

Eighty-eight interviews were conducted. A total of 246 organizations were identified as providing assistance within the area, and 54% were involved with health-related activities including: 1) the provision of medications; 2) public health measures; and 3) medical equipment or parts for the same. Internationals believed that a higher proportion of the needs were being met by the assistance (73.4 ±16.4%) than did the nationals (52.1 ±23.3%; p <0.001). All groups believed that approximately 50% of the demands of the affected population were being addressed. However, 87% of the international interviewees believed that the affected population was requesting more than it actually needed.

While 27% of the international participants believed that ≥25% of what was provided was unusable, 80% of the recipients felt that ≥25% of the provisions were not usable. Whereas two-thirds of the international participants believed that ≥25% of the demands for assistance by the affected community could not be justified, only 20% of the recipients and authorities believed ≥25% of the demands were unjustified.

Conclusions::

Many organizations are involved in the provision of medical assistance during a disaster. However, international organizations and workers believe their efforts are more effective than do the recipients.

Keywords

aidassessmentassistancedemandsdisastermaterielsneedsnon-governmental organizationspersonnelsuppliesworkers
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 15 , Issue 1 , March 2000 , pp. 9 - 19
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2000

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References

1.Gunn, SWA: Multilingual Dictionary of Disaster Medicine and International Relief. Boston: Kluwer Academic Publishers. 1990. p23.CrossRefGoogle Scholar
2.Al-Madhari, AF, Keller, AZ: Review of disaster definitions. Prehospital and Disaster Medicine 1997;12(1):17–21.CrossRefGoogle ScholarPubMed
3.Sundnes, KO, Task Force on Quality Control of Disaster Management: Health disaster management: Guidelines for evaluation and research in the Utstein style. Prehospital and Disaster Medicine 1999;14(2):43–52.CrossRefGoogle ScholarPubMed
4.Pan American Health Organization: San José Declaration. Prehospital and Disaster Medicine 1999;14(3):153–154.Google Scholar
5.Pan American Health Organization/World Health Organization: Evaluation of the preparedness and response to Hurricanes Georges and Mitch: Conclusions and recommendations. Prehospital and Disaster Medicine 1999; 14(2):53–65.Google Scholar
6.Johnson, WP, Lanza, CV: After Hurricane Andrew: An EMS perspective. Prehospital and Disaster Medicine 1993;8(2):169–171.CrossRefGoogle Scholar
7.Burkle, FM Jr: Complex humanitarian emergencies: I. Concept and participants. Prehospital and Disaster Medicine 1995;10(1):36–42.CrossRefGoogle ScholarPubMed
8.Burkle, FM Jr: Complex humanitarian emergencies: II. Medical liaison and training. Prehospital and Disaster Medicine 1995;10(1):43–47.CrossRefGoogle ScholarPubMed
9.Burkle, FM Jr: Complex humanitarian emergencies: III. Measures of effectiveness. Prehospital and Disaster Medicine 1995;10(1):48–56.CrossRefGoogle ScholarPubMed
10.Maningas, PA, Robison, M, Mallonee, S: The EMS response to the Oklahoma City bombing. Prehospital and Disaster Medicine 1997;12(2):80–85.CrossRefGoogle Scholar
11.Tyron, JR: Medical relief mission to Bosnia/Herzegovina: A case report. Prehospital and Disaster Medicine 1997;12(2): 96–102.CrossRefGoogle Scholar
12.Leonard, RB, Spangler, HM, Stringer, LW: Medical outreach after Hurricane Marilyn. Prehospital and Disaster Medicine 1997;12(3):189–194.CrossRefGoogle ScholarPubMed
13.Binder, S, Sanderson, L: The role of the epidemiologist in natural disasters. Ann Emerg Med 1987;16:1081–1084.CrossRefGoogle ScholarPubMed
14.Lillibridge, S, Noji, E, Burkle, F: Disaster assessment: The emergency health evaluation of a population affected by a disaster. Ann Emerg Med 1993;22:1715–1720.CrossRefGoogle ScholarPubMed
15.Alexander, D: The health effects of earthquakes in the mid 1990s. Disasters 1996;20:231–247.CrossRefGoogle ScholarPubMed
16.Noji, E, Kelen, G, Armenian, H, et al: The 1988 earthquake in Soviet Armenia: A case study. Ann Emerg Med 1990;19: 891–897.CrossRefGoogle ScholarPubMed
17.De Bruycker, M, Greco, M, Lechat, M: The 1980 earthquake in Southern Italy: Morbidity and mortality. Intl J Epidemiol 1985;14:113–117.CrossRefGoogle ScholarPubMed
18.Ebergardt-Phillips, J, Saunders, T, Robinson, A, et al: Profile of mortality from the 1989 Loma Prieta Earthquake using coroner and medical examiner reports. Disasters 1994;18:160–170.CrossRefGoogle Scholar
19.Klain, M, Ricci, E, Safar, P, et al: Disaster reanimatology potentials: A structured interview study in Armenia: I. Methodology and preliminary results. Prehospital and Disaster Medicine 1989;4:135–154.CrossRefGoogle Scholar
20.Ricci, EM, Pretto, EA, Safar, P, et al: Disaster reanimatology potentials: A structured interview study in Armenia. II. Methods for evaluation and response to major disasters. Prehospital and Disaster Medicine 1991;6:159–166.CrossRefGoogle Scholar
21.Pretto, EA, Ricci, E, Klain, M, et al: Disaster reanimatology potentials: A structured interview study in Armenia. III. Results, conclusions, recommendations. Prehospital and Disaster Medicine 1992;7:327–338.CrossRefGoogle Scholar
22.Pretto, EA, Angus, DC, Abrams, JI, et al: An analysis of prehospital mortality in an earthquake. Prehospital and Disaster Medicine 1994;9:107–124.CrossRefGoogle Scholar
23.Sáenz, R, Bissell, RA, Paniagua, F: Post-disaster malaria in Costa Rica. Prehospital and Disaster Medicine 1994;10:154–160.CrossRefGoogle Scholar
24.Angus, DC, Pretto, AE, Abrams, JI, et al: Epidemiologic assessment of mortality, building collapse pattern, and medical response after the 1992 earthquake in Turkey. Prehospital and Disaster Medicine 1997;12(3): 222–231.CrossRefGoogle ScholarPubMed
25.Schultz, CH, Koenig, KI, Noji, EK: A medical disaster response to reduce immediate mortality after an earthquake. N Engl J Med 1996;334:438–444.CrossRefGoogle ScholarPubMed
26.Berckmans, P, Dawans, V, Schmets, G, Vandenbergh, D: Inappropriate drug-donation practices in Bosnia and Herzegovina, 1992–1996. N Engl J Med 1997;337:1842–1845.CrossRefGoogle Scholar
27.Autier, P, Ferir, MC, Hairapetien, A, et al: Drug supply in the aftermath of the 1988 Armenian earthquake. Lancet 1990;335:1388–1390.Google ScholarPubMed
28.Ali, HM, Homeida, MM, Abdeen, MA: “Drug dumping” in donations to the Sudan. Lancet 1988;335:538–539.CrossRefGoogle Scholar
29.Offerhaus, L: Russia: Emergency drug aid goes awry. Lancet 1990;336:745.Google Scholar
30.World Health Organization, Regional Office for Europe, Zagreb Area Office: Medical supplies donor guidelines: WHO humanitarian assistance for former Yugoslavia. Version 3:01.04.94. Zagreb, Croatia: World Health Organization, January, 1994.Google Scholar