Quakes and disasters: How to help

BOSTON — To find out about the emergency response to the earthquake in Chile and how the world responds to disasters and longer-term health problems, GlobalPost talked to Marie-Noelle Rodrique, the deputy director of operations for Doctors Without Borders/Medecins Sans Frontieres (MSF).

How is Medecins Sans Frontieres responding to the earthquake in Chile?

We have sent a team of five to six people to Chile and they are busy assessing the situation. Chile is a different challenge for us. It is quite a rich, well-organized country with generally good health care where the population generally has good access to health care. This is not a country where we usually work.

Slideshow: Day three of the Chile Quake

The Chile government and authorities are responding well to the emergency. They need money. They need equipment and supplies. But they are getting help to the people in need. They are getting supplies and health care to the many people who are homeless.

There are not so many gaps in the health care as a result of the Chile earthquake. We at MSF are looking for those gaps. We have gone to Santiago and to Concepcion and the various smaller cities of southern Chile. We find they are quite well equipped medically. We are trying to find the pockets of people outside of the main epicenter, places that may have been overlooked, where people are in emergency need.

In the wake of the back-to-back earthquakes in Haiti and now Chile – how do you respond to donor fatigue?

People give money when they can identify with the victims. So for instance with the tsunami of 2004 many people had visited the areas as tourists so they were engaged with the areas that were devastated. MSF found that people responded with generosity and they maintained their donations throughout the year to help in that emergency. If people can indentify with a situation then you see a huge outpouring.

Slideshow: scenes of destruction

In the case of the earthquake in Haiti, the United States and Canada have a very close proximity to the island. People know about Haiti because they have big immigrant populations. The news media went to Haiti and gave it very big coverage on the television and radio and in the newspapers. That resulted in a big generous response.

But when you look at Pakistan, which had a devastating earthquake in 2005, it did not get the same kind of response. Pakistan is very far away and not many people had visited there. The media coverage was limited. There were not so many journalists who reported on the disaster and the suffering in Pakistan. So there was not a big a response in donations.

Identification, proximity and the media agenda, the way the media highlights the disaster, the way media coverage can bring the disaster right home to the people — these all contribute to the way people donate.


Are too many of the emergency responses just band-aids that patch up the most immediate problems but do not address the long-term problems?

Haiti is a good example. MSF has been working in Haiti for 19 years because there are structural problems in providing health care. Not many other organizations have been in Haiti and people did not pay very much attention to Haiti. But now with the earthquake there has been a great deal of media attention, for a long time. It is easier to get people interested and to get donations for Haiti.

But still the emergency response that you see is short term. In the next few months several organizations are going to be leaving the country. Right now there are 396 NGOs in the health sector working in Haiti. In the weeks to come, only 15 of them will stay for more than six months. By the end of this year the majority of the groups will be gone. Haiti had long-term issues before the quake and the disaster worsened the situation. Haiti and Port-au-Prince will need aid for years to come. The disaster attracted a lot of people and aid to Haiti. The world has discovered what the situation is like and now they care.

Doctors without borders deputy director Marie-Noelle Rodrigue
Marie-Noelle Rodrigue of Doctors Without Borders

We do not want to be cynical about this but once you have dealt with many disasters you can see these cycles.

Now with Chile, the world’s attention has already moved on from Haiti. Medical and public attention concentrates on the most immediate disaster.

But look at the situation in Congo, there is no big disaster but the population is suffering and people are dying there from a lack of access to food and health care. This has been going on in Congo for 20 years. Unless there is something really big going on there very few people hear about Congo.

Somalia is another problem area that needs a big response. There is the ongoing war there and there are so many problems. The population is having a very difficult time. Nigeria has areas where people are having terrible difficulties. But these countries have not had the big disaster that has brought the cycle of response: the media attention, the public identification, the political attention and the donor response.

I know how the world works. The world’s attention goes to the emergencies. I am pleased that people now know what Haiti looks like and what the situation is like there. But now I don’t want them to forget completely about Haiti because there has been an earthquake in Chile.

Do emergencies like earthquakes and floods divert attention and funds away from the long-term development challenges?

Disasters attract a lot of people and aid to a country. The disasters can divert attention for a while but it is up to all people and organizations to return to the long-term needs.

It is not easy to raise questions to keep the focus on long-term problems but we try to keep donors focused on those long-term problems, which include medical response to epidemics, the gaps in health care, the lack of access of populations to primary and secondary health care.
TB and HIV/AIDS are big long-term challenges. We at MSF have advocated treatment for HIV for several years but there was resistance. Now finally the donor community has made the availability of anti-retroviral (ARV) drugs a priority. We are engaged in this battle.

TB is an important channel. There needs to be medical progress on how to treat TB. The drugs for TB are 50 years old. There needs to be new research but the drug companies are not so interested. We are still fighting this on a daily basis.

What is the most effective way to deal with long-term health problems? Is the international donor community up to the challenges?

I think donors are generous and I am always surprised the way they get interested and contribute. People are generous by nature and they give a lot.

We have to fight to get the attention through the media so people see the important issues around the world. We must bring the problems up to many different platforms. This is how MSF sustains solidarity and support from the donor community. Many of our ongoing projects are not on the top 10 of world emergencies, but they deserve continued support because they are long-term problems.

MSF has a balance, about half of our resources go to the disasters that create immediate health emergencies. And about half goes to the long-term health problems.

It is difficult. We cannot solve all the problems as quickly as we would like. But it is rewarding work and we are grateful that there are so many generous people to help us in this work.


Marie-Noelle Rodrigue is currently the deputy director of operations for Doctors Without Borders/Médecins Sans Frontières (MSF). Prior to assuming this position, she was the director of the emergency desk for MSF, where she has coordinated the organization's aid operations in Gaza, Pakistan, Nigeria, Haiti, Nigeria, Uganda, Somalia, Sri Lanka, and Guatemala. In these capacities she has had overall responsibility for MSF’s surgical, sexual violence, primary care, and mental health programs assisting civilians caught in violence in Uganda, Nigeria, and Haiti, and for HIV/AIDS treatment programs in all four countries.

A nurse with a wealth of experience working in conflict, Ms. Rodrigue has MSF experience in conflict zones including assignments in Rwanda, Kosovo, Uganda, Sierra Leone, Liberia, Angola, Democratic Republic of Congo (DRC), Guinea, Iraq, and Nepal. She graduated from nursing school in Lyon, France, in 1991 and worked in intensive care there before joining MSF in 1996.