Emergency on the Subcontinent

Capacity building of local physical rehabilitation providers began in July 2005, during the post-emergency phase of Handicap International’s intervention in Indonesia, and continued throughout 2006 and 2007. Training sessions were conducted for teachers, clinical physical rehabilitators, and physical rehabilitation students. Paradoxically, the devastation inflicted by the tsunami offered a unique opportunity to ensure that renovated or new buildings conformed to international accessibility standards. This was a huge advantage not only for people with disabilities, but also for people with reduced mobility, such as the elderly or persons with chronic diseases.

Four major lessons emerged from external and internal evaluations of Handicap International’s emergency and post-emergency response December 2004 tsunami in Indonesia. Two of the lessons point to the need for rapid mobilization of (1) appropriate staff and (2) funds in the event of a disaster. Time matters in an emergency, in terms of the ability to both saves lives and lessen disabilities.  The other two lessons are (3) the importance of anticipating an appropriate immediate intervention, including community-based care and meeting the basic needs of those affected, and (4) the importance of transitioning to a longer-term development perspective.  All four of these “lessons” have now been applied to the organization’s current emergency response efforts in Haiti.  Below, is a fuller explanation of each.

Rapid mobilization of appropriate emergency response personnel

Before the tsunami, Handicap International had no staff on the ground in Indonesia."The tsunami caught all of us off guard and we were really not prepared to respond to a disaster of this magnitude,” said Thomas Calvot, a physical rehabilitator and disability and emergency advisor for Handicap International.  “In retrospect, we could have used the three initial weeks following the disaster in more proactive way as this is the key time period in terms of life saving interventions,” added Calvot, who was part of Handicap International’s 2005 emergency response team in Indonesia.   

 Indeed, 11 days after the tsunami Handicap International’s emergency assessment team reached Aceh province. Six days later, the first emergency response team of physical rehabilitators arrived on January 16. Most of these expatriates were professionals drawn from the private sector in France, Belgium and Switzerland.

“While we were oriented toward quality interventions and mostly did very well, we were less focused on providing simple but immediate and efficient care and transferring practical care-giving skills to the families and caretakers of injured patients, who are instrumental in ensuring long-term follow-up,” Calvot said.  Handicap International recruited and sent 20 short-term expatriate physical rehabilitation staff for the emergency and post-emergency response in Indonesia.

However, the first assessment report in early January 2005 identified a significant need for physical rehabilitation in the hospitals visited -- a need that was confirmed by national and international medical staff involved in emergency care management to the tsunami wounded, mainly lower limb and hands injuries, fractures, severe infections with high risk of further amputation and respiratory infections. The fact that Handicap International was the only international NGO providing rehabilitative support during the emergency phase demonstrates the advantages of including a disability specialist with experience in an emergency context in the first operational teams deployed.

To increase its capacity to intervene in natural and humanitarian disasters, Handicap International merged with Atlas Logistique, another international solidarity organization based in France, in 2006. At the time, Atlas Logistique had more than 13 years of experience in providing logistical solutions to humanitarian aid organizations. Handicap International’s emergency response division now has a four-person “flying team” of crisis specialists available at all times to respond to humanitarian emergencies, ideally within the first 72 hours. 

A roster of experienced, pre-validated short-term professionals allowed Handicap International to send a project manager specializing in the case-management of injured people in Haiti within 72 hours of the earthquake, as well as some of the first shipments of emergency supplies, including water and high-energy biscuits, to arrive in Haiti. The project manager was soon joined by a team of physical rehabilitation professionals and logisticians. Within eight weeks after the earthquake, Handicap International had sent 90 appropriate and experienced professionals to Haiti. By early May 2010, the team had grown to more than 400 staff members, including 70 expatriate staff.