We were curious whether Doctors Without Borders (“DWB”) had a team on the ground in the Gulf Coast region so we took a look at their website. Much to our initial surprise, DWB is not providing Katrina disaster relief. There is a lesson in DWB’s decision...
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for those who want their disaster relief contribution to go only toward food and medical supplies as opposed to those much maligned administrative expenses.
According to a Press Release on the DWB website,
On Friday, September 2, a Doctors Without Borders/Médecins Sans Frontières (MSF) team made up of two physicians, a nurse, and two logisticians headed to the Gulf Coast region of the United States to directly assess the unmet emergency medical needs following the disaster. Dr. Darin Portnoy, MSF-USA president, was part of the assessment team that traveled to Louisiana.
The post then goes onto explain DWB's past activities in the United States, stating
MSF works primarily in the developing world providing assistance to people affected by war and disease, as well as natural disasters. Other than a modest psychosocial support program for first-responders after 9/11, we've never worked in the United States and therefore have limited logistical capacity and expertise here. Given the resources and response capacity in the United States, we initially did not anticipate that there would be a need for the limited role we could play in responding to unmet emergency medical needs. Nevertheless, after watching the horrible impact of Hurricane Katrina and the relief response unfold, we decided to carry out an assessment mission in the state of Louisiana, and particularly in New Orleans.
As for providing relief, DWB’s post indicates that DWB does not anticipate providing any support to Katrina victims, with the post explaining
At this point, it does not look like MSF has a role to play in providing assistance to the victims of Hurricane Katrina. Everyone on our team was and remains deeply affected by what we saw and what we heard from those who had endured such suffering. But, as we've seen in other natural disasters, the initial acute emergency phase — when MSF medical teams might really be able to help — is almost always over in the first few days, perhaps weeks, following a disaster. We weren't on the spot in New Orleans when the disaster happened, but from what we saw and heard during our time in the region, we really felt that by Friday and Saturday, the established local and national efforts were beginning to meet the immediate medical and humanitarian needs of the victims of this tragedy, particularly in the shelters and reception areas for the hundreds of thousands of evacuees from the worst-affected areas. We have concerns for those remaining in New Orleans, but there are few people left following the large-scale evacuation that has been carried out and there is capacity to respond to their needs. The displaced and those who have been evacuated will also continue to require assistance, but the number of volunteers and organizations arriving to help them is impressive. There are now significant resources being devoted to helping people and the situation is improving.
Relief Requires Infrastructure. Does this mean that DWB is an uncaring organization? Absolutely not. What it means is that DWB never developed the infrastructure to support a relief effort in the United States. It is possible to argue with DWB's decision to stay out of the United States, but that decision is a very real fact. Without an infrastructure in place before a disaster, DWB simply can’t mobilize its resources in an efficient manner. The need for infrastructure is why donors should be reluctant to restrict funds to immediate relief efforts in response to a particular disaster. It takes years of planning and network building to get the food, medicine and other physical-manifestations of disaster relief to the victims of any disaster. Contrary to popular perceptions, a lot of on-the-ground, people-to-people disaster relief is not provided by employees of the major disaster relief organizations that receive the bulk of donor money. These organizations have spent years developing capacity on the ground in various locations by developing local organizations. When the disaster strikes, much of the effort by the large relief organizations involves filling the pipeline with the necessary supplies so that they are available to local providers. Now that is not to say that the large relief organizations don't mobilize their own people and get directly involved in on-the-ground operations. But people need to understand how important these pre-existing networks are to providing effective and timely relief.
Now, we are just as guilty as the next person when it comes to restricting relief. This past weekend we made our contribution to Katrina Relief and we wanted our money directed to the victims—who wouldn’t after watching TV for the last ten days. But what we did was designate 70% of our contribution for Katrina relief and 30% to general activities. That means some of our contribution will go to maintain the ongoing infrastructure necessary to provide immediate relief to the next group of disaster victims.
A Lesson for Those Wanting to Start New Charities. DWB's decision also has meaning for our friends who want to start new charities to provide relief to Katrina's victims. As we pointed out yesterday, we view this as a very unwise and wasteful decision. DWB's decision not to participate in Katrina relief recogizes the importance of pre-planning in the disaster relief process. DWB believes that without adequate advanced planning, there is no point in participating. How can people who two weeks ago had no idea that they wanted to start a charity have undertaken the necessary planning to effectively deliver disaster relief to Katrina's victims? Quite simply, they can't. Consequently, rather than wasting resources, these well-intentioned people should contribute money to existing relief organizations. If they believe they must make a larger commitment reflected by a contribution of their time, they should contact an established relief organization or a governmental entity to find out how to volunteer their services. They should remember that volunteering their services does not require them to travel to New Orleans of Biloxi. Given the dispersion of victims to locations around the county, people should consider first contacting local charitable organizations to learn how they can volunteer their time.
A Marekting Lesson for DWB. As for DWB’s basic decision to work outside of the United States. It certainly is understandable given the problems in the Third World. Yet, the organization is named “Doctors Without Borders,” a name that clearly implies that aid is provided to victims regardless of the political context in which they reside. In our minds, DWB’s decision to stay out of the United States does create a border. But as we said, philosophically we can understand that border.
At the same time, we think DWB’s immediate decision regarding Katrina was a bad one from the standpoint of maintaining its goodwill with the United States donor population. The better approach would have been to assemble a team of ten or twenty European doctors, ask the Red Cross where they were needed, and then fly them in. The cost would have been relatively small, but the symbolism would have been highly beneficial to DWB. More importantly, there would have been twenty more doctors on the ground.
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