Health-related relief in the former Yugoslavia: needs, demands, and supplies.
BACKGROUND
Many organizations rally to areas to provide assistance to a population during a disaster. Little is known about the ability of the materials and services provided to meet the actual needs and demands of the affected population. This study sought to identify the perceptions of representatives of the international organizations providing this aid, the international workers involved with the delivery of this aid, the workers who were employed locally by the international organizations, the recipients, and the local authorities. This study sought to identify the perceptions of these personnel relative to the adequacies of the supplies in meeting the needs and demands of the population during and following the war in Bosnia-Herzegovina.


METHODS
Structured interviews were conducted with representatives of international organizations and workers providing aid and with locally employed workers, recipients of the assistance, and the authorities of the areas involved. Descriptive and inferential statistics were used to assist in the analysis of the data.


RESULTS
Eighty-eight interviews were conducted. A total of 246 organizations were identified as providing assistance within the area, and 54% were involved with health-related activities including: 1) the provision of medications; 2) public health measures; and 3) medical equipment or parts for the same. Internationals believed that a higher proportion of the needs were being met by the assistance (73.4 +/- 16.4%) than did the nationals (52.1 +/- 23.3%; p < 0.001). All groups believed that approximately 50% of the demands of the affected population were being addressed. However, 87% of the international interviewees believed that the affected population was requesting more than it actually needed. While 27% of the international participants believed that > or = 25% of what was provided was unusable, 80% of the recipients felt that > or = 25% of the provisions were not usable. Whereas two-thirds of the international participants believed that > or = 25% of the demands for assistance by the affected community could not be justified, only 20% of the recipients and authorities believed > or = 25% of the demands were unjustified.


CONCLUSIONS
Many organizations are involved in the provision of medical assistance during a disaster. However, international organizations and workers believe their efforts are more effective than do the recipients.
Rubin
M
M
Swedish Board of Health and Welfare, Department of Emergency Planning, Stockholm, Sweden.
Heuvelmans
J H
JH
Tomic-Cica
A
A
Birnbaum
M L
ML
D017522:Bosnia and Herzegovina; D003625:Data Collection; D004864:Equipment and Supplies; D005260:Female; D006301:Health Services Needs and Demand / Q000458:organization & administration*; D006801:Humans; D007391:International Cooperation; D008297:Male; D005791:Patient Care / Q000379:methods; D015397:Program Evaluation; D012066:Relief Work / Q000458:organization & administration*; D011795:Surveys and Questionnaires; D014857:Warfare; D015022:Yugoslavia