Disaster preparedness: institutional capacity building in the Americas

Latin American and Caribbean countries are prone to natural, technological and "complex" disasters. This vulnerability to catastrophic events led the region to undertake the long journey away from an ad hoc response towards institutional preparedness and, more recently, to disaster prevention and mitigation. This article attempts to outline the definitions and basic principles of institutional emergency preparedness, including reliance on the more effective use of existing resources, rather than establishment of special stockpiles and equipment; the critical importance of general participation and awareness; and the interrelationship of the health sector with others and the potential for leadership. How to assess the level of preparedness is discussed. Stress is placed on the fact that preparedness is traditionally confused with the existence of a written disaster plan. Preparedness should be seen as a never-ending, complex process that can only be assessed through an in-depth review of coordination, planning, training and logistic elements. There is also a fundamental distinction between preparedness, i.e., "getting ready to respond" and disaster prevention/mitigation, which aims to reduce the health impact. The latter calls for the collaboration of engineers, architects, planners and economists with the health sector. It is illustrated by the regional initiative in the Americas to reduce the physical vulnerability of hospitals to earthquakes and hurricanes. In spite of the encouraging achievements, much remains to be done. Weak areas include preparedness for technological disasters, and a true inter-country preventive approach to common disasters across borders. Electronic communications through the Internet will also help to suppress borders and boundaries, contributing to a truly collective approach to emergency preparedness and disaster relief coordination.