Groundbreaking Approach to Disaster Relief: The Humanitarian Response to Cyclone Nargis, Which Struck Myanmar on 2 and 3 May, Heralds a Fundamentally New Approach to Relief Coordination. as a Result, a Unique Survey Showed What Really Happened to the Survivors

By Cumberland, Sarah | Bulletin of the World Health Organization, September 2008 | Go to article overview

Groundbreaking Approach to Disaster Relief: The Humanitarian Response to Cyclone Nargis, Which Struck Myanmar on 2 and 3 May, Heralds a Fundamentally New Approach to Relief Coordination. as a Result, a Unique Survey Showed What Really Happened to the Survivors


Cumberland, Sarah, Bulletin of the World Health Organization


Dr Rudi Coninx had just finished training on coordinating emergency relief efforts when he was summoned by WHO Director-General Dr Margaret Chan to join her at a teleconference. A devastating cyclone had just struck Myanmar. More than two million people were believed to be affected across the Ayeyarwady delta and Yangon regions.

"I was the only one from WHO headquarters in Geneva who could go because I happened to have a current visa," says Coninx, who was despatched to Myanmar the following day to coordinate health relief in the stricken region.

"Technical and administrative units in the south-east Asia office of WHO worked almost round the clock, drawing experience from the tsunami," says Dr Poonam Khetrapal Singh, deputy regional director for WHO Regional Office for South-East Asia (SEARO).

Meanwhile, staff from the World Health Organization (WHO) Country Office in Myanmar were already putting a new system into action with other United Nations (UN) agencies and nongovernmental organizations (NGOs) that were present. First, WHO convened the agencies providing health relief--known as the "health cluster"--to assess the situation and decide which health interventions were needed to prevent death and disease.

The "cluster" approach--the idea that a group of relevant UN agencies and others coordinate specific areas in an emergency response--is the result of recent UN reforms. "The tsunami of 2004 made clear the need for a coordinated approach that is predictable, accountable to donors and doesn't duplicate the efforts of different organizations," says Coninx.

WHO co-chaired the Myanmar health cluster with United Kingdom-based charity Merlin. "This relationship was extremely beneficial as it allowed for the sharing of staff, technical and strategic expertise and the administrative burden," says Yves-Kim Creac'h, head of Merlin's Emergency Response Team.

Unlike previous humanitarian responses by multiple agencies, the cluster approach meant that all UN agencies and partners, such as Save the Children and World Vision, worked together to share information and resources with agreed common goals.

"When I visited Aceh after the tsunami, there were about 300 NGOs but coordination was an issue," says Poonam Singh. "A lot of supplies were delivered that weren't needed and there was a huge logistics overlap. This time there was a platform to bring everyone together as a combined effort."

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Coninx adds: "In Myanmar, when an aeroplane landed with medical supplies, we could make it known among the [members of the health] cluster what was available and allocate resources to underserved areas." As the extent of the disaster and the health needs of the people in the stricken region became clear, the collaborative effort gathered momentum. Each week more organizations joined the cluster voluntarily, until more than 40 partners were meeting twice a week to pursue a single plan of action.

When responding to disasters, it is vital to have reliable information on the health needs of the survivors. "The first thing that needs to be done to provide relief is to find out what is really happening," says Coninx. As with many disasters, an early warning system for epidemics was needed in Myanmar. This involved a daily exchange of information between these agencies to compare reports of outbreaks and verify those reports. For example, they confirmed that there was no cholera epidemic, but that the number of cases was only slightly higher than it was before the disaster.

Poonam Singh who visited Myanmar after the cyclone says that, despite negative media reports, the government was actually doing quite a lot to meet the health needs of the people. "Because of WHO's long relationship with the Ministry of Health, we were looked upon a little differently by the government. Right from the beginning, the WHO representative to Myanmar [Professor Adik Wibowo] met every morning with the health ministry and we managed to get around the visa restrictions by recruiting locals, including retired WHO staff. …

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