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Humanitarian Disaster Response

McSwain, Norman E nmcswai at tulane.edu
Mon May 16 15:07:40 BST 2011

Perhaps negative but unfortunately it is all too true

Norman McSwain MD, FACS
Professor, Tulane School of Medicine
President, Orleans Parish Medical Society
Trauma Director, Spirit of Charity Trauma Center, ILH/MCLNO 
norman.mcswain at tulane.edu
504 988 5111

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of Gross, Ronald
Sent: Monday, May 16, 2011 8:46 AM
To: 'Trauma-List [TRAUMA.ORG]'
Subject: RE: Humanitarian Disaster Response


As usual, your questions are pointed, and lead one to the following
1.  Like politics, all disasters are local phenomena 2.  Like politics,
universal reactions to disasters are not rational or logical and well
thought out, but visceral, and focus on the individual's desire to help
and not on a well thought out SWOT analysis of the situation at hand.
3.  Like politics, money raised for disaster relief is often spent on
everything BUT the disaster victims - and thus suffering is not
relieved, but often worsened because of all of the "relief" that is
promised and that is never seen.
4.  The 10% rule still rules.
5.  International response to disasters is inherently flawed by a lack
of understanding of the scope of the disaster, the available LOCAL
infrastructure remaining and failure to realistically assess the true
utility of teams that respond.
6.  While we all FEEL GOOD responding to our humanitarian instincts, for
the most part we do NO GOOD in the long term, for the short-lived
availability of the people who respond initially leave those who cannot
leave with a feeling of abandonment as those who can leave return
home.....leaving the misery to those who experienced it in the first

Looks like I got out of bed on the wrong side this morning - so sorry if
I sound so terribly negative.


-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of KMATTOX at aol.com
Sent: Saturday, May 14, 2011 10:30 PM
To: trauma-list at trauma.org
Subject: Humanitarian Disaster Response

I have been having trouble finding some realistic numbers for a project
I am pursuing regarding DISASTERS, and out international responses to
like  Japan, Indonesia, Madrid, New Orleans, Haiti, and many  others.

This is partially an outgrowth of discussions  with some of you on this
server at a Trauma Meeting in New York City last  week.      While some
make the assumption that it  is a HUMANITARIAN thing for any and all
medical care personnel to immediately  want to go to a country like
Haiti after a devastating earthquake, for the  purpose of this inquiry
to this list site, I am making the opposite  assumption:  
Assumed:    Most IMMEDIATE international humanitarian  DISASTER health
responses do NOT achieve favorable short term and long term  outcomes
have secondary motivation factors different from "helping  people."     
So.    I have a series of questions specifically about HAITI  , but the 
principles of the questions and or statements can be made about many
disasters around the world.   
1.     Just how many live bodies were pulled out of the  rubble in HAITI

that required surgical or medical health care?
2.    How many international surgical, orthopedic, nursing,
teams and how many individual doctors went to Haiti during the  first
the first month after the earthquake?     AT  WHAT COST,   
3.    How many patients did these teams actually  treat?    How many 
amputations, at what ages etc. ?
4.   How many of these wound debridments, amputations, etc, ended  up 
infected, and required secondary procedures?     What are  the LONG TERM
of the patients treated during the first 4 weeks?
5.   Of the MONEY that was raised internationally for  Haiti,     How
was actually spent on patients and  health care, and how much ended up
in the pockets of the politicians and  managers?
6.    Did we create more misery than pain relief?
7.    Have we with our international humanitarian health  care
in Haiti altered the well known health care infrastructure in  Haiti?

I have many other questions to this group, but this is a  start.     I
heard dozens of flowery lectures and read  a lot of articles, but the
OUTCOMES are really not addressed and as I  extrapolate between the
lines, it appears that we, in all of our humanitarianism  may have done
more harm than 
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