Vulnerability Reduction: Achievements of a Decade
and New Challenges in the Next Century from
a Social and Health Perspective

Dr. Claude de Ville de Goyet, Emergency Response and Disaster Relief Coordination Programme, Pan American Health Organization (PAHO)
mailto:devillec@PAHO.org

Both risk management and humanitarian assistance have changed dramatically over the past few years. We have left behind the improvised, ad hoc response approach that prevailed during the 1970s, and adopted a preventive approach involving institutional strengthening.

The IDNDR has contributed to legitimizing the issue worldwide by providing a global policy and scientific framework and serving as a neutral forum for partners and agencies. It has also kept our attention focused on natural disasters, during a decade obsessed with complex disasters.

One of the chief achievements of the Decade has been the promotion of an approach based on long-term development and the birth of a culture of prevention in Latin America and the Caribbean. The enormous losses caused by hurricanes, particularly hurricane Mitch in Central America, has raised the awareness of political authorities to such a degree that during the 10th summit of heads of government of Central America, Belize and the Dominican Republic, a five-year plan was approved to promote disaster reduction.

Advances in the health sector to prevent the unnecessary destruction of hospital and water supply and sanitation systems are now the pride of the region and have served as a model for other parts of the world. With the support of PAHO/WHO, much progress has been made in the establishment of a regional scientific and technical framework, and in the creation of a critical mass in every country through alliances, changes of attitude, pilot projects and the attainment of concrete political commitments at the national level.

The Declaration of the Decade expresses the international will to face the risk of natural disasters with a spirit of international cooperation. Sectoral achievements in this field would not have been possible without the harmonious and productive synergy established between the Pan American Health Organization (PAHO) and the Regional Unit for Latin America and the Caribbean of the IDNDR Secretariat. Seldom have international agencies collaborated in such a complementary fashion with a common goal of service.

Humanitarian response has also witnessed substantive changes:

• A true vision of inter-sectoral coordination with the participation of civil society – a change from the military-style chain-of-command approach considered ideal 15 years ago.
• A growing awareness of the need for community preparedness and, within this process, the democratization of disaster information, and the growing participation of civil society, favoring changes in the power and communications relations between agencies, countries, local communities, and individuals.
• An acknowledgment of the importance of transparency, good governance and honesty in the management of humanitarian assistance after a disaster has struck. The SUMA System, developed by PAHO with technical objectives, has become an indicator and tool for this political transparency, a demand by national and international public opinion that few countries can afford to ignore in an emergency situation.
  Challenges for the next century

A decade, in the history of human society, is negligible. It should come as no surprise that in such a short span, the achievements should be outnumbered by the challenges that remain, new or recycled.

• The culture of prevention, and the political will to promote disaster reduction, remain fragile. Political commitments, no matter how solemn, generally tend to decrease as normality reinstates itself after fast-paced relief efforts have been replaced by long-term reconstruction. Resources have yet to be allocated systematically to longer-term prevention efforts. One year after hurricanes Georges and Mitch, international funds for health sector technical cooperation (including loans) did not increase in spite of the demand, and of the window of opportunity for change that the disasters opened.
• Economic issues at the macro level, particularly the reestablishment of production capacity, tend to predominate when it comes to political decision-making, at the expense of local communities and groups that have little access to the benefits of globalization. This is true even in the case of international aid agencies. And yet ignoring the fundamentally human and social dimension of disasters is extremely dangerous.
• During the emergency phase, foreign humanitarian assistance still responds predominantly to the priorities, perceptions and internal issues of donor countries or agencies. The needs of the victims and the potential benefits to which they are entitled take a back seat to these external considerations. There is a particular need for dramatic change in the quality of “in kind” donations, since shipments of inappropriate drugs, clothing and food remain regrettably frequent.

The end of a decade given over to disaster reduction is a time for celebration – but not for self-congratulation. A culture of prevention entails a collective attitude that can only be built by means of a long social process. The Decade has merely launched this process, and identified the many challenges facing us in the 21st Century. IDNDR has set the stage for its successor, the International Strategy for Disaster Reduction (ISDR), created by the UN General Assembly.

The Decade’s greatest contribution at the national level has been the recognition that prevention and mitigation call for special skills and attitudes, which are different from those needed for emergency response. The latter requires a good sense of logistics, operational capacity, a sense of urgency, determination and discipline. Vulnerability reduction requires a long-term vision while having access only to short-term resources. It calls for patience and compromise, for experience in urban planning, in economics, engineering and policy development. A combination of such skills is unavailable in any one single institution.

The future demands synergy among the agencies of the UN System, regional organizations, and civil society. It is to be hoped that the symbiosis experienced by IDNDR and PAHO will serve as a model for the true integration of all stakeholders with the new Secretariat, in order to develop a human, social, and health-oriented approach to disaster reduction.

For more information, please contact:
PAHO/WHO Emergency Preparedness and Disaster Relief Coordination Programme
Washington
Tel (1 202) 974 Ext. 3434
Fax (1 202) 775-4578
disaster@paho.org