Abstract

Recent experience of humanitarian and disaster relief efforts have demonstrated the critical importance of the local health infrastructure and its response to a disaster in both the short and long term. With increasing involvement of Foreign Medical Teams (FMT), both military and civilian, in these relief efforts, there is a necessity to review how best a FMT can involve and develop the local response; it is no longer valid to design an intervention insular from the local population. Key themes found in interventions that have damaged the local infrastructure and response include: bypassing, undermining and overstretching local capacities; poaching local staff; aid-fuelled inflation; lack of accountability; developing an intervention that the local population is incapable of providing once the FMT has gone and using the local infrastructure for service delivery for the FMT. Principles written by the Organisation for Economic Co-operation and Development summarise concepts that can be used when designing an intervention so as to avoid damaging the local response and their infrastructure. They focus on involving the local population, understanding the complexities and history of the area and the requirement to develop and instil resilience to future crises.