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Rescue and recovery efforts continue at full-throttle in Haiti, one week after a devastating earthquake struck Port-au-Prince, killing thousands of citizens, and destroying homes, offices, government buildings, roads, bridges and other key facilities throughout the city. Harvard Kennedy School Professor Herman “Dutch” Leonard focuses much of his research on disaster preparedness and crisis response. He offers this analysis of Haiti’s ongoing rescue, recovery and rebuilding efforts.
First stage: Rescue
This is mostly done by the survivors themselves, many of whom manage to extract themselves. The bulk of the rest is done by neighbors, bystanders, other survivors – who extract additional people who cannot free themselves. Third is by the “first responders” (note the irony in the label – they are at best “third responders,” but this implies that we usually ignore or forget the first two) – local police, fire and rescue workers. In Haiti, there was precious little of this third group for two reasons. First, there was relatively little capacity (trained people, equipment, etc.) in Haiti to start with before the event. Second, much of the little capacity they did have was destroyed or disrupted (equipment damaged, people scattered or injured) by the event itself. The United Nations peacekeeping mission seems to have recovered relatively quickly from the devastating losses at its headquarters, and has been able to effect some rescues, which is a good thing indeed and a good performance in incredibly difficult circumstances for them, and I’m sure that has been true of some other local responders as well.
But rescue has now mainly moved to fourth responders – teams from outside the country. This is what we are seeing now. It is heroic and it is wonderful that they are able still to find and save some victims, but the hard and sad reality is that the first hours are the most crucial for saving large numbers of lives, and after the first day there are only a tiny few who can still be rescued – so international teams are, unfortunately, able to do precious little actual lifesaving. But, again, every life saved is a tragedy averted, and this is valuable work even though its direct results will be smaller than we would like to hope (and smaller than the news reports that focus on this part of the work will tend to suggest). In seismic events, rescue is unfortunately for the most part a very short-lived stage and the realities of the time it takes to mobilize from afar dictate the outcome.
Second stage: Stabilizing the humanitarian situation for the injured who can be saved and for the displaced population
This is the stage we are now in, though the news reports still focus a great deal on the tail end of rescue. There are still tens of thousands of lives to be saved through effective action in this stage, and we are well on our way to saving them. This is the big story – absent, rapid and effective mobilization. There could have been tens of thousands of additional lives lost to disease, dehydration and injuries turning septic (a major hazard, especially in tropical events) – and the international mobilization is quickly getting on top of this and saving those lives. Of course, we won’t notice – we see the chaos and incomplete coordination of teams arriving and it all looks very messy.
However, I think – and hope – that we won’t see major losses from epidemic illness or from sepsis. This will be invisible – we won’t see what could have happened, because it won’t happen. But for all its apparent messiness, the humanitarian response that is landing and spreading out and setting up clinics and shelter and nutrition and water and (especially) sanitation is in the process of quietly and largely invisibly preventing tens of thousands of additional deaths.
Third stage: Longer Term Recovery and Rebuilding (and hopefully, Redesigning with more seismic reinforcement)
This stage is only a hope at this point. Unfortunately, we are so used focusing on Stage 2 (which often flies under what is, to me, the false hope flag of Stage 1) that many people tend to lose focus on the situation as Stage 2 ends.
Haiti will be involved in recovery for years and years and while this is not a matter of literally saving lives, it is very much a matter of significantly altering the life circumstances of the survivors and the society as a whole. Recoveries can go well or very badly – one has only to look around New Orleans for examples of both. The difference is driven by the ability of local leadership to learn its way through the problem, catalyze and direct outside assistance – and the ability to maintain flows of assistance from outside.
In Haiti’s case, this is all yet to be seen – and if we aren’t careful and vigilant and focused, the outside assistance part of this will disappear before it begins.
Herman "Dutch" Leonard focuses his research and teaching on pre-event preparedness, crisis response measures and long-term issues of disaster recovery. Photo credit, Kent Dayton.
Rescue: Mostly the first few hours, almost completely over by the end of the first day, inevitably almost completely beyond the reach of the international responders;
Stabilization: Crucially important for the lives of survivors; tens of thousands of lives currently in the balance; now underway and likely to be successful in quietly saving tens of thousands of people; and
Recovery: Crucially important for the quality of life of survivors and the wider affected communities. Won’t begin in any serious way for weeks or months, will go on for years and, at this point, significant international engagement is a fragile hope.