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Obstacles to foreign aid

Physical conditions aren’t the only impediments to relief efforts. For example, Hoffman says, foreign relief agencies that would like to serve in Aceh need permits and must apply to the central government in Jakarta, which is swamped with other requests and its own relief responsibilities. Volunteers also must provide their own food and tents, because donations are inadequate for victims.

“The Indonesian Red Cross is possibly the most effective in the worst-hit area here, as they have a long history of dealing with government bureaucracy and armed rebels and have proven to be successful getting into areas that other aid groups cannot penetrate,” Hoffman says.

After the bombing in Bali, she adds, “I could write volumes on why volunteers untrained in disaster relief can be more in the way than useful. The Balinese and expatriate residents learned many disaster lessons the hard way.”

Untrained people at a disaster site are “serious hazards, not only to themselves, but to victims and emergency teams,” says Heidi Hotz, RN, a member of the Society of Trauma Nurses and trauma program manager in the surgery department at Cedars-Sinai Medical Center, Los Angeles. “They can impede the search and rescue process.” If nurses want to help later, she suggests they contact local disaster response teams through their county health department’s EMS and trauma division.

“Everyone in the world of trauma has been stunned, and it’s taken days to start dialogues on listservers about resources and good information,” she says. “The World Health Organization and the Red Cross are still gathering information, and until recently the CDC [Centers for Disease Control and Prevention] has been silent. The sole source of information has been from the media and anecdotal.”

U.S.-based teams from Doctors Without Borders and several other organizations are among those being dispatched to affected countries.

“If the infrastructure is not in place, you can’t put volunteers to work in a coordinated fashion. And they create a bigger problem because others must deal with them, especially when they don’t know the language or culture,” says Nancy McKelvey, RN, MSN, chief nurse of the American Red Cross.

The organization has provided members for teams, including the initial international assessment and first aid.

Unlike with domestic disasters, says McKelvey, “the response differs, because we are guests in that country and don’t just show up without a request. The affected country puts in requests through the International Federation of Red Cross and Red Crescent Societies for what is required. We have a robust response capacity with a roster of bilingual, internationally experienced relief workers.”

McKelvey adds that the American Red Cross thanks all potential volunteers for their interest and urges them to contact local chapters.

The scope of the disaster, including the number of countries affected and their varied range of development, means relief efforts will have many more ramifications, McKelvey says. “It will take a coordinated effort between government and nongovernment organizations,” she says.

Professional nursing groups that want to reach their Asian counterparts can reach out directly or through the International Council of Nurses.

Nurses eager to do something can donate to reputable organizations that help provide necessities ranging from baby food to body bags.

Every dollar donated goes further than most givers know, Hotz says: “A colleague’s Sri Lankan student, who lost friends and cousins, said that $10 replaced a roof.”

Nurses willing to do something later on will be able to. “Just because nurses aren’t trained in disaster aid doesn’t mean they can’t be useful later,” Hoffman says.

“Cleanup and recovery 85 will be ongoing for years. As soon as international associations finish initial assessments, contact them for ongoing needs and assignments. The people of the affected countries haven’t even begun the long journey toward a normal life.”

Wendy Bonifazi, RN, CLS, APR, is a senior staff writer for Nursing Spectrum.