UK: How Can Healthcare Be Better Delivered In A Humanitarian Emergency Response?

Last Updated: 23 January 2017
Article by Rachel Alsop

This week's blog is from Rachel Alsop, one of our colleagues in our strategy consulting team who spends some of her own time volunteering with the humanitarian mapping charity, MapAction. The importance of this work is evident from the blog and so I'm leaving Rachel to explain, in her own words.

In some of my spare time I volunteer with the humanitarian mapping charity MapAction.i The charity is made up of a group of volunteer Geographical Information Systems (GIS) professionals who are ready to deploy rapidly to natural disasters and conflict-related emergencies. The charity's first emergency deployment was in 2004 in response to the Boxing Day tsunami in the Indian Ocean, and since then it has responded to a number of large scale disasters such as the 2015 Nepal earthquakesii and its 2014 deployment to Iraqiii in response to widespread conflict. My experience has highlighted that there are three essential components that help with the delivery of healthcare in a humanitarian response: information, accreditation and communication.


When MapAction deploys to a disaster, the aim is to assist the humanitarian community by creating a shared operational picture that aids in decision making. In essence, it makes maps that provide people with information to help them make decisions effectively. For example during the 2010 Haiti earthquake, the team created maps to divide the affected areas into the sectors that search and rescue teams would need to cover, as well as providing co-ordinates and directions to reported locations of people caught up in the disaster. This information had to be gathered and collated from many sources including the government of the affected area, other NGO's on the ground and even from SMS messages from trapped individuals. The aim is to collate, visualise and disseminate this information in an easy to use format. Making sure this information is available quickly can have a positive impact on the outcomes of those people affected, ensure that the response is targeted to where it is most needed and that access to healthcare is as timely as possible.


In the immediate aftermath of a disaster, the desire to help is strong, but concerns do arise that individuals may sometimes respond to the situation with inadequate training or preparation. In some circumstances this could lead to inappropriate delivery of care and poor patient outcomes. Medical teams responding to a disaster are usually working in resource poor settings, where infrastructure could have been seriously affected and with limited access to equipment they might commonly use to diagnose and treat, such as x-ray machines. Additionally, there are a number of other complexities that come with treating patients in disaster zones, firstly the size and speed of onset of a disasters, for example in the 2010 Haiti earthquake 222,570 people were killed and over 300,000 people were injured with orthopaedic trauma being the most common diagnosis and surgery needed.iv Secondly a lack of medical records and challenges keeping track of patients given an inevitably chaotic environment increases the complexity of the response needed. These challenges create huge difficulties for the humanitarian effort. In recent emergencies incoming teams have been unaware of local or international facilities, and there have been reports of teams attempting to deliver care without adequate supplies or expertise.

The World Health Organisation (WHO), many of the international/national medical teams and Government Ministries of Health have recognised this and have introduced accreditation initiatives aimed at putting quality of care at the centre of any response. For example, the WHO introduced the Emergency Medical Team Minimum Acceptable Standards in mid-2013, which aims to ensure that teams are self-sufficient so as not to place a burden on already strained national systems, and that they are able to provide appropriate quality of care in a disaster setting.v Moreover, teams are expected to arrive with sufficient personnel, equipment and supplies to meet the needs of a disaster affected community. Although classification by the WHO to become a quality-assured medical team that meets their minimum standards is not mandatory, it is widely encouraged and accredited teams may be more likely to be requested to respond to a This is particularly important as teams need to be prepared for a range of potential presentations including trauma, post disaster infectious disease outbreaks (such as cholera) and people with long term illnesses such as diabetes. Teams are working within increasingly complex emergencies with both natural and man-made hazards at play.vii Accreditation through this system helps raise the standards of the health response and ensures health professionals are as well prepared as possible for whatever they may find when they arrive in response to a disaster.


I recently attended Triplex 2016, one of the world's largest humanitarian training exercises.viii Over 300 people from the humanitarian community across 86 countries came together to train in conditions as close as possible to a true disaster response.

Some of the conditions in the exercise were not planned for but were realistic; a real storm hit the camp and the tent we were working in collapsed forcing us to evacuate. This environment in all its planned and unplanned extremes allows for experimentation and testing of processes in a safe space in preparation for a real disaster.

My experience of the exercise showed how important communication, co-ordination and collaboration are in an emergency response to a disaster. The United Nations Office for the Coordination of Humanitarian Affairs (OCHA) recommends a cluster based approach;ix where multiple organisations working within the same humanitarian sectors, such as shelter, water sanitation and hygiene (WASH) and health collaborate closely throughout the response.x This allows the delivery of aid in each sector to be coordinated and ensures resources are deployed effectively.

Even in a training exercise it was clear how vital it is to have good lines of communication between the different organisations in the field. These are built upon having clear systems within an organisation, so that others can rely on that organisation, even though they may never have worked with a particular individual on the ground. As a MapAction volunteer I was preceded by the organisational reputation my colleagues have built up in their past encounters in the field. These organisational principals and reputations help to deliver a more coordinated and effective response in a disaster.

In the UK we are in the privileged position of having access to the NHS, underpinned by the core principle that good healthcare should be available to all based on clinical need, regardless of ability to pay. It seems to me that healthcare in humanitarian disaster response abides by that same principle. However, the circumstances that teams operate under in a humanitarian disaster mean that there are challenges to effectively deliver quality healthcare. By applying the three essential components (information, accreditation and communication), the humanitarian response within a disaster zone has a greater chance of being better co-ordinated, efficient and effective; leading to a lasting and sustainable impact for affected communities.

Please note that Deloitte LLP do not have any associations with MapAction.


i MapAction, [Online], Accessed 04/01/2017, Available from

ii The United Nations Refugee Agency (UNHCR), Nepal: 2015 Earthquake, [Online], Accessed 04/01/2017, Available from

iii MapAction, Iraq conflict, June 2014, [Online], Accessed 04/01/2017, Available from

iv Centres for Disease Control and Prevention (CDC), 2011, Post-Earthquake Injuries Treated at a Field Hospital – Haiti, 2010, [Online], Accessed 04/01/2017, Available from

v World Health Organisation (WHO), 2016, Emergency Medical Teams and World Health Organization, [Online], Accessed 16/12/2016, Available from

vi World Health Organisation (WHO), 2016, Emergency Medical Teams: World Health Organization EMT Initiative, [Online], Accessed 04/01/2017, Available from

vii International Federation of Red Cross (IFRC) and Red Crescent Societies, Complex/manmade hazards: complex emergencies, [Online], Accessed 16/12/2016, Available from

viii International Humanitarian Partnership (IHP), IHP trainings and exercises, [Online], Accessed 16/12/16, Available from

ix United Nations Office for the Coordination of Humanitarian Affairs (OCHA), Cluster Coordination, [Online], Accessed 16/12/2016, Available from

x World Health Organisation: Health Cluster, Health Cluster participated in a major simulation exercise, [Online], Accessed 16/12/2016, Available from

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

To print this article, all you need is to be registered on

Click to Login as an existing user or Register so you can print this article.

In association with
Related Topics
Related Articles
Up-coming Events Search
Font Size:
Mondaq on Twitter
Register for Access and our Free Biweekly Alert for
This service is completely free. Access 250,000 archived articles from 100+ countries and get a personalised email twice a week covering developments (and yes, our lawyers like to think you’ve read our Disclaimer).
Email Address
Company Name
Confirm Password
Mondaq Topics -- Select your Interests
 Law Performance
 Law Practice
 Media & IT
 Real Estate
 Wealth Mgt
Asia Pacific
European Union
Latin America
Middle East
United States
Worldwide Updates
Registration (you must scroll down to set your data preferences)

Mondaq Ltd requires you to register and provide information that personally identifies you, including your content preferences, for three primary purposes (full details of Mondaq’s use of your personal data can be found in our Privacy and Cookies Notice):

  • To allow you to personalize the Mondaq websites you are visiting to show content ("Content") relevant to your interests.
  • To enable features such as password reminder, news alerts, email a colleague, and linking from Mondaq (and its affiliate sites) to your website.
  • To produce demographic feedback for our content providers ("Contributors") who contribute Content for free for your use.

Mondaq hopes that our registered users will support us in maintaining our free to view business model by consenting to our use of your personal data as described below.

Mondaq has a "free to view" business model. Our services are paid for by Contributors in exchange for Mondaq providing them with access to information about who accesses their content. Once personal data is transferred to our Contributors they become a data controller of this personal data. They use it to measure the response that their articles are receiving, as a form of market research. They may also use it to provide Mondaq users with information about their products and services.

Details of each Contributor to which your personal data will be transferred is clearly stated within the Content that you access. For full details of how this Contributor will use your personal data, you should review the Contributor’s own Privacy Notice.

Please indicate your preference below:

Yes, I am happy to support Mondaq in maintaining its free to view business model by agreeing to allow Mondaq to share my personal data with Contributors whose Content I access
No, I do not want Mondaq to share my personal data with Contributors

Also please let us know whether you are happy to receive communications promoting products and services offered by Mondaq:

Yes, I am happy to received promotional communications from Mondaq
No, please do not send me promotional communications from Mondaq
Terms & Conditions (the Website) is owned and managed by Mondaq Ltd (Mondaq). Mondaq grants you a non-exclusive, revocable licence to access the Website and associated services, such as the Mondaq News Alerts (Services), subject to and in consideration of your compliance with the following terms and conditions of use (Terms). Your use of the Website and/or Services constitutes your agreement to the Terms. Mondaq may terminate your use of the Website and Services if you are in breach of these Terms or if Mondaq decides to terminate the licence granted hereunder for any reason whatsoever.

Use of

To Use you must be: eighteen (18) years old or over; legally capable of entering into binding contracts; and not in any way prohibited by the applicable law to enter into these Terms in the jurisdiction which you are currently located.

You may use the Website as an unregistered user, however, you are required to register as a user if you wish to read the full text of the Content or to receive the Services.

You may not modify, publish, transmit, transfer or sell, reproduce, create derivative works from, distribute, perform, link, display, or in any way exploit any of the Content, in whole or in part, except as expressly permitted in these Terms or with the prior written consent of Mondaq. You may not use electronic or other means to extract details or information from the Content. Nor shall you extract information about users or Contributors in order to offer them any services or products.

In your use of the Website and/or Services you shall: comply with all applicable laws, regulations, directives and legislations which apply to your Use of the Website and/or Services in whatever country you are physically located including without limitation any and all consumer law, export control laws and regulations; provide to us true, correct and accurate information and promptly inform us in the event that any information that you have provided to us changes or becomes inaccurate; notify Mondaq immediately of any circumstances where you have reason to believe that any Intellectual Property Rights or any other rights of any third party may have been infringed; co-operate with reasonable security or other checks or requests for information made by Mondaq from time to time; and at all times be fully liable for the breach of any of these Terms by a third party using your login details to access the Website and/or Services

however, you shall not: do anything likely to impair, interfere with or damage or cause harm or distress to any persons, or the network; do anything that will infringe any Intellectual Property Rights or other rights of Mondaq or any third party; or use the Website, Services and/or Content otherwise than in accordance with these Terms; use any trade marks or service marks of Mondaq or the Contributors, or do anything which may be seen to take unfair advantage of the reputation and goodwill of Mondaq or the Contributors, or the Website, Services and/or Content.

Mondaq reserves the right, in its sole discretion, to take any action that it deems necessary and appropriate in the event it considers that there is a breach or threatened breach of the Terms.

Mondaq’s Rights and Obligations

Unless otherwise expressly set out to the contrary, nothing in these Terms shall serve to transfer from Mondaq to you, any Intellectual Property Rights owned by and/or licensed to Mondaq and all rights, title and interest in and to such Intellectual Property Rights will remain exclusively with Mondaq and/or its licensors.

Mondaq shall use its reasonable endeavours to make the Website and Services available to you at all times, but we cannot guarantee an uninterrupted and fault free service.

Mondaq reserves the right to make changes to the services and/or the Website or part thereof, from time to time, and we may add, remove, modify and/or vary any elements of features and functionalities of the Website or the services.

Mondaq also reserves the right from time to time to monitor your Use of the Website and/or services.


The Content is general information only. It is not intended to constitute legal advice or seek to be the complete and comprehensive statement of the law, nor is it intended to address your specific requirements or provide advice on which reliance should be placed. Mondaq and/or its Contributors and other suppliers make no representations about the suitability of the information contained in the Content for any purpose. All Content provided "as is" without warranty of any kind. Mondaq and/or its Contributors and other suppliers hereby exclude and disclaim all representations, warranties or guarantees with regard to the Content, including all implied warranties and conditions of merchantability, fitness for a particular purpose, title and non-infringement. To the maximum extent permitted by law, Mondaq expressly excludes all representations, warranties, obligations, and liabilities arising out of or in connection with all Content. In no event shall Mondaq and/or its respective suppliers be liable for any special, indirect or consequential damages or any damages whatsoever resulting from loss of use, data or profits, whether in an action of contract, negligence or other tortious action, arising out of or in connection with the use of the Content or performance of Mondaq’s Services.


Mondaq may alter or amend these Terms by amending them on the Website. By continuing to Use the Services and/or the Website after such amendment, you will be deemed to have accepted any amendment to these Terms.

These Terms shall be governed by and construed in accordance with the laws of England and Wales and you irrevocably submit to the exclusive jurisdiction of the courts of England and Wales to settle any dispute which may arise out of or in connection with these Terms. If you live outside the United Kingdom, English law shall apply only to the extent that English law shall not deprive you of any legal protection accorded in accordance with the law of the place where you are habitually resident ("Local Law"). In the event English law deprives you of any legal protection which is accorded to you under Local Law, then these terms shall be governed by Local Law and any dispute or claim arising out of or in connection with these Terms shall be subject to the non-exclusive jurisdiction of the courts where you are habitually resident.

You may print and keep a copy of these Terms, which form the entire agreement between you and Mondaq and supersede any other communications or advertising in respect of the Service and/or the Website.

No delay in exercising or non-exercise by you and/or Mondaq of any of its rights under or in connection with these Terms shall operate as a waiver or release of each of your or Mondaq’s right. Rather, any such waiver or release must be specifically granted in writing signed by the party granting it.

If any part of these Terms is held unenforceable, that part shall be enforced to the maximum extent permissible so as to give effect to the intent of the parties, and the Terms shall continue in full force and effect.

Mondaq shall not incur any liability to you on account of any loss or damage resulting from any delay or failure to perform all or any part of these Terms if such delay or failure is caused, in whole or in part, by events, occurrences, or causes beyond the control of Mondaq. Such events, occurrences or causes will include, without limitation, acts of God, strikes, lockouts, server and network failure, riots, acts of war, earthquakes, fire and explosions.

By clicking Register you state you have read and agree to our Terms and Conditions