By Alison Hayward
In the wake of Hurricane Sandy earlier this month, I saw a familiar sight by the side of the road: a radio station was emceeing an aid event for disaster relief. The event organizers were overseeing donations that were pouring into the parking lot they were commandeering for the task, as evidenced by a veritable mountain range forming in the parking lot, made up mainly of piles of donated clothing and blankets. Donating things like blankets and food items surely helps budding humanitarians to conjure images in their heads of how their concrete donations will be used. Yet most who donate such goods to disaster relief efforts are unaware that they are likely to be hindering the ability to provide efficient aid to victims, rather than helping.
The perceived need for donated clothing, blankets, food items, or medical supplies is often listed by major relief groups such as World Vision and the Red Cross as one of the top disaster myths. It seems to be only common sense that disaster victims would need such things, because disasters not only destroy local resources, they also disrupt supply chains by devastating transportation systems, storage facilities, and utilities that may be needed to store or transport items. In both domestic and international disasters, we are bombarded by media images of victims desperately trying to stock up on such goods, or seeking them in the wreckage. Noting our own abundance of such material items, a sense of guilt or of duty to serve those in need is a common reaction, and thus, donation drives are organized, and mountains of blankets begin to grow.
In many ways, this influx of goods creates a challenge for aid agencies. Such agencies, when well-run, have strategic plans designed to mobilize necessary supplies to victims in need. They may have organized caches of supplies in disaster areas which are maintained during the relevant seasons, or the ability to purchase items wholesale locally that they have matched to specific identified needs. In contrast, donated goods sent via grassroots efforts from various domestic or international sources are sent in a jumble, without knowledge of the specific needs on the ground to be filled, and may undermine those local supply chains and services that are still active after a disaster – which further damages the area’s economy. Because large-scale disasters, for many reasons, tend to strike harder in the “global South” and humanitarian aid comes to these sites from the “global North”, another common occurrence is the sending of inappropriate items for the climate. Large shipments of blankets and winter gear thus arrive in tropical or subtropical areas, and relief workers must spend time arranging for organization, storage, and transport of these items to other locations, costing them time and money that could have been used more effectively elsewhere.
Similar ethical logic is applicable to the volunteer medical assistance that comes from non-local sources during disasters. Although these situations can arise domestically, the best recent example would be the Haiti earthquake of 2010. The catastrophic damage of the earthquake was featured prominently in the news media, and Haiti’s location makes it a more affordable and quick flight from the United States than most earthquake or tsunami targets. Innumerable medical and non-medical volunteers thus streamed into Haiti to “help” with disaster relief.
Even though many of these volunteers had been in contact with local organizations prior to arrival, they still found that they were ill-prepared to provide meaningful assistance to Haitians affected by the earthquake. These volunteers had knowledge and skill sets that were useful in the global North, where electricity, running and potable water, medical referral networks, and follow-up care are widely available. When taken out of these contexts, even teams of volunteers who had come heavily laden with supplies found that their equipment could not function in the makeshift Haitian clinics or damaged hospitals. Surgeons who were used to being able to focus on their surgical procedures realized that their post-operative patients were developing bloodstream infections. And as volunteers became victims, both of injuries in aftershocks and of epidemic illnesses such as cholera, resources were diverted from Haitians in efforts to help them.
The frustrated feeling that “no one’s in charge here” was common. There was little recognition of the fact that untold numbers of volunteer groups showing up and conducting semi-autonomous relief projects was part of the reason that proper organization and monitoring of efforts was so difficult. How many of these volunteers would have been willing to donate the amount that they spent to travel to and stay in Haiti towards disaster aid, so that organizations and agencies could mount a more effective, coordinated effort? This question is an important one. Unless we are willing to accept that there are personal, non-altruistic reasons for wanting to provide medical care or supplies directly to disaster victims, i.e. the desire to be perceived as heroic, or to learn how to provide care in a resource-limited situation, or to gain experiences that may help advance our careers – then it should be clear that helping disaster victims through established channels of aid, rather than assembling autonomous teams and efforts, is likely to be the best solution.
This means that if an individual wishes to use his or her medical skills to provide humanitarian aid, that individual should strongly consider doing so through a path that may be less easy or convenient, such as signing on for a term of service with Medicins Sans Frontieres, or training with and joining a Disaster Medical Assistance Team (DMAT).
In a disaster situation, aid is generally distributed in a utilitarian fashion – an attempt to maximize the effectiveness and the efficiency of the aid that is being provided. Thus, it follows that a person who is trying to fulfill a moral obligation to help disaster victims who are in need should also strive to the best of their ability to do the greatest amount of good for the largest number of victims. It is more compelling to provide care to a known person or family in need than it is to have the knowledge that you are aiding a larger, more abstract group of persons, but this motivation needs to be balanced against the wish to provide truly meaningful and effective aid to disaster victims. It is more compelling to think about a specific, though nameless person being warmed by your blanket than it is to think about the unknown needs being fulfilled by your donation to the Red Cross. But next time a disaster strikes in a location remote to your own, try to harness your desire to provide care to those in need and rise above the wish to help a specific person with a specific concrete item or service. Consider how much you’d be willing to spend to personally travel to the disaster area to aid those victims.
Keep the blankets in your closet. And send money, send money, send money.