Friday, April 15, 2011

Preventative vs. Interventional Global Aid

Mark Ward, the Acting Director in the Office of U.S. Foreign Disaster Assistance in the Bureau for Democracy, Conflict and Humanitarian Assistance was the speaker at one of our seminars that was very interesting to hear. Mark’s role and his department’s role is one of great importance in acute global disaster response. He provided some very chilling revelations about the nature of the situations that he has been experiencing with the department. The 2010 Haiti earthquake was a disaster that truly was a benchmark disaster for the response team. On the bright side, the level of response and aid was a record high; however, this was thrown into sharp relief by the sheer scope of the disaster, which also was recordbreaking. What Mark Ward touched on was the issue of preventative planning, and I’d like to explore this topic a bit further.

Just from a financial perspective, we have to consider what all goes into a barebones reconstructive effort—not only does physical infrastructure need to be rebuilt, from transport, housing, amenities, agriculture, to civil and legal structures that ensure a stable community. In addition, seed money must be poured into a community to jumpstart local activity—much like cellular processes, the macroscopic progress follows the microscopic changes. This doesn’t even include the maintenance care and infrastructure required to hold a displaced/refugee population while the main reconstruction is taking place.

Such a burden can be somewhat alleviated by preventative planning/maintenance. Unfortunately, this means an increase in basal activity costs, which from a policymaker’s point of view is not necessarily feasible. Or, as so often is the case, myopic leadership decides it to be wasteful spending.

But in a day and age where the costs of disaster relief and, as Mr. Ward stressed, the frequency of which are rising at an alarming rate, financing and planning with the least common denominator approach is irresponsible and increasingly costly in the long term.

Here in the United States, with our own insurance and health care issues reigning dominant in the medico-political arena, we see the implementation of screenings and preventive health care practices on the rise. Baby steps—yes—but essential to an increased level of community health in the long term. Small changes, for instance, dietary regulations in adolescent school children have ramifications down the road for rates of diabetes, heart disease, and obesity rates, if projections are to be trusted. Such small changes, with an initial financial investment can free up billions of dollars of money in the health care industry for better treatment and better outcomes. I use this analogy because it illustrates how a paradigm shift in approaching a problem can create a more responsive powerful system.

I’ve always been interested in the financial aspects of medicine, and it is true that each effort must be viewed individually to see which model works better—preventative care or intervention, based on the scope of the issue at hand. On the global level, disaster relief is similar—the spontaneity of some disasters requires interventional approach, however, much like the most recent Japanese earthquake, preventative investment was able to absorb and nullify a lot of what could have been catastrophic to a lesser prepared country. It is scary to imagine the humanitarian crisis that could have been, had not Japanese lawmakers and engineers had the foresight to build earthquake resistant structures.

With a new international crisis perpetually on the horizon, perhaps it is time to start applying a preventative approach more actively.

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