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A doctor working for the disaster relief programme of the Pan American Health Organisation and the World Health Organisation (Claude de Ville de Goyet.Lancet 2000;356: 762–4) has made some pungent points about response to disasters. He points to five “myths”: that dead bodies are a major health hazard; that immediate outside help is always needed and helpful; that people behave badly after disasters; that the local population is usually too shocked to help itself; and that things soon get back to normal. The reality, he insists, is that dead bodies do not cause epidemics and the belief that they do leads to hasty, unceremonious, and unseemly disposal of the dead. Foreign teams of experts may have a false idea of local needs, they are not always needed urgently, and when they do arrive they should cooperate more with local workers. Most people respond well to catastrophe, and lawlessness and corruption are the exception rather than the rule. Similarly, far from being too shocked, local people are usually enthusiastic and dedicated volunteers. The effects of disaster are long lasting but international interest and attention are short lived and help may dry up. Early donations are often plentiful but may include inappropriate goods when money would be better. The World Bank recently announced that, in future, 15% of its emergency relief grants will go towards reducing vulnerability to disasters and Dr de Ville de Goyet commends this approach to others.
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