Experience teaches that the basic tenets of responding to specific needs and involving the local people are essential, particularly in an emergency setting.
Search-and-rescue and emergency medical services come first. The immediate priority after a natural disaster is providing emergency first aid and medical services to injured persons. Local residents, health professionals, emergency workers, and public-safety officers are the first responders.
Widespread injuries occur simultaneously, overwhelming medical systems. The overwhelming number of injuries occurs in the initial moments of an emergency, creating an acute need for health personnel, medical supplies, blood, and medicines. Medical facilities and physical infrastructure also typically suffer, exacerbating the strain on medical systems.
The urgent need for shelter, food, water, medicine for displaced persons takes precedence. The top priority during the first 72 hours is search-and-rescue and lifesaving medical triage. Arrangements for shelter, food, water, and medicines, including the establishment of new supply lines, must be developed simultaneously.
The type of disaster affects the types of health services required. Earthquakes, for example, typically cause various blunt-trauma and orthopedic injuries, such as broken bones, lacerations, and crush syndrome from being trapped under heavy debris. Floods tend to cause water-borne diseases, skin infections, acute respiratory infections, dysentery, cholera, and amoeba, and diseases related to close living quarters of displaced communities. Consequently, different disasters require different medical assistance.
Attention must be given to displaced communities and their needs. In addition to the acute medical needs caused by specific types of disasters, people can become ill due to their lack of shelter, compromised water and sanitation systems, lack of refrigeration, and untreated minor injuries. These circumstances can lead to bacterial infections and disease outbreaks among people who are forced into temporary shelters.
Logistical flexibility must be employed as unique challenges present themselves. Bottlenecks in emergency response often occur when efforts to bring in personnel and material assistance converge in an area with damaged infrastructure. Warehousing, transport, communications, and needs assessments are difficult in such circumstances. In recent years, there have been several reports showing how the introduction of non-essential or unneeded items can actually impede relief efforts by clogging in-country logistics and distribution channels.