Policy Development in Disaster Preparedness and Management: Lessons
Learned from the January 2001 Earthquake in Gujarat, India
Authors: Bremer Rannveig 
Published: August 2016

Introduction:

During the last decades, several humanitarian emergencies have
occurred, with an increasing number of humanitarian organizations taking
part in providing assistance. However, need assessments, medical
intelligence, and coordination of the aid often are sparse, resulting in
the provision of ineffective and expensive assistance. When an
earthquake with the strength of 7.7 on the Richter scale struck the
state of Gujarat, India, during the early morning on 26 January 2001,
nearly 20,000 persons were killed, nearly 170,000 were injured, and
600,000 were rendered homeless. This study identifies how assigned
indicators to measure the level of health care may improve disaster
preparedness and management, thus, reducing human suffering.

Methods:

During a two-week mission in the disaster area, the disaster relief
provided to the disaster-affected population of Gujarat was evaluated.
Vulnerability due to climate, geography, culture, religion, gender,
politics, and economy, as each affected the outcome, was studied. By
assigning indicators to the eight ELEMENTS of the Primary Health Care
System as advocated by the World Health Organization (WHO), the level of
public health and healthcare services were estimated, an evaluation of
the impact of the disaster was conducted, and possible methods for
improving disaster management are suggested. Representatives of the
major relief organizations involved were interviewed on their relief
policies. Strategies to improve disaster relief, such as policy
development in the different aspects of public health/primary health
care, were sought.

Results:

Evaluation of the pre-event status of the affected society revealed
a complex situation in a vulnerable society with substantial
deficiencies in the existing health system that added to the severity of
the disaster. Most of the civilian hospitals had collapsed, and army
field hospitals provided medical care to most of the patients under
primitive conditions using tents. When the foreign field hospitals
arrived 5 to 7 days after the earthquake, most of the casualties
requiring surgical intervention already had been operated on. Relief
provided to the disaster victims had reduced quality for the following
reasons: (1) proper public health indicators had not yet been developed;
(2) efficient coordination was lacking; (3) insufficient, overestimated,
or partly irrelevant relief was provided; (4) relief was delayed because
of bureaucracy; and (5) policies on the delivery of disaster relief had
not been developed.

Conclusion:

To optimize the effectiveness of limited resources, disaster
preparedness and the provision of feasible and necessary aid is of
utmost importance. An appropriate, rapid, crisis intervention could be
achieved by continual surveillance of the world's situation by a Relief
Coordination Center. A panel of experts could evaluate and coordinate
the international disaster responses and make use of stored emergency
material and emergency teams. A successful disaster response will depend
on accurate and relevant medical intelligence and socio-geographical
mapping in advance of, during, and after the event(s) causing the
disaster. More effective and feasible equipment coordinated with the
relief provided by the rest of the world is necessary. If policies and
agreements are developed as part of disaster preparedness, on
international, bilateral, and national levels, disaster relief may be
more relevant, less chaotic, and easier to estimate, thus, bringing
improved relief to the disaster victims.