By Shobha Shukla and BobRamakant, Citizen News Service (CNS)
For management of disasters and humanitarian crises, doing something is not enough-but doing the right thing at the right time is. Decision-makers need to know which intervention, actions and strategies would work, which would not work, which remain unproven and which no matter how well-meaning might be harmful. They need to make well informed choices and decisions and for this they need access to reliable evidence.
Evidence Aid was established in The Cochrane Collaboration after the Indian ocean tsunami of December 2004, with the aim to help people deal with natural disasters and humanitarian emergencies by choosing effective strategies and avoiding those that are ineffective, as the latter strategies wastes time, money and resources.
Systematic reviews seek to identify all relevant research and appraise its quality, make best use of research already done and maximise the power of conclusions. Expanding and strengthening evidence based research can help decision makers use evidence for effective interventions and thus save lives, reduce morbidity and enable people and communities to recover more quickly and efficiently.
In an interview given to Citizen News Service (CNS), Mike Clarke, founder of Evidence Aid, spoke at length about the need for improving access to evidence-based systematic reviews for designing interventions and actions of relevance before, during and after natural disasters and other humanitarian emergencies so as to improve health related outcomes. Mike spoke at a symposium organized by Evidence Aid before 22nd Cochrane Colloquium in Hyderabad, India.
“One of the challenges was whether people wanted the sort of evidence we produce in the disaster and humanitarian sector, like they want in healthcare sector from robust research. The first happy learning was that people recognized the value of reliable evidence and right decision-making and there was a clear willingness to use good evidence if it is available. The next learning was that there was good quality evidence out there and we just had to bring it together. Another very important learning was that we have to work with people to generate that evidence and then show them how that evidence is relevant. A typical systematic review in healthcare would try and answer the questions for everyone in the world. It would then be for individual researchers to see its relevance and use it to make decisions. The next learning was that we have to have contextual evidence and we have to make it easy for others to access it. If we have hundreds of reviews, people cannot find what they really need. The main thing is to work with people who need these evidences. People like me who are not a responder, not a practitioner, would not know what information the decision makers would need. So we have to work closely with them to know their needs and then provide them relevant information.”
Mike shared with CNS some threats to evidence-based response to disasters. He said: “Threats are consequences of a rapid climate change. Earlier natural events/disasters used to happen every 10-20 years. But now they are happening far more frequently-probably every single year. So whereas earlier we had 9 or 19 years to recover, now there is little time to recover. It is a major challenge as to how to cope with disasters that are becoming commonplace and more frequent. One of the ways to deal with this is that people need to think more about disaster risk reduction, about how to prepare in advance to face them, and think less about responding to the disaster. In this way they would be better prepared for the next time, because the sad thing is that there will be a next time for it. Challenges for future are those next times, those next disasters that are coming much quicker than we are used to.”
“We need more evidence based research on what is causing the disasters. One of the big areas we need to see much more growth in research is disaster risk reduction. There can be strategies like constructing a building that can withstand a disaster better when it strikes. But even more fundamental is what we as human beings do which makes disasters worse. We may not be causing earthquakes, windstorms and floods. But as human beings we often do make consequences of these natural disasters much worse. We have to think about how to stop the damage we are doing, so that when these natural disasters do happen (and we know they will happen) the extent of devastation caused to people and communities is reduced. We, as people, are making some of these problems much worse and so it is we who have to do something about it. We need to understand that prevention is better than treatment. We need to think more on what human activities are making them more likely to happen and/or making them worse when they do happen. Human beings do not cause rain. But they do change the land dramatically so that it responds differently to rain. Usually the people who are affected by disaster are not the ones who are responsible for causing them. It is an unfair world in which one group of people creates problems for some other groups of people. So whatever research we do should be designed to improve fairness. Just as the geologists might be doing say research on what causes the earthquakes, we need to have more research on what causes more landslides and floods.”
Mike Clarke shared with CNS on what he feels this work around evidence-based responses to natural disasters and humanitarian crises is heading in the next 2-3 years. He said: “The challenge we face is getting adequate results in order to achieve the vision. If we get adequate results to take decisions in disaster planning disaster response, and disaster management, disaster recovery would be able to look at a set of reliable evidence sources provided by in Evidence Aid and make decisions on that basis. They will not look at evidence aid to tell them what to do. Evidence Aid should be able to give them some knowledge which they can then use, (alongside all the other sources of knowledge they have), to make right decisions. The success lies in providing them a reliable evidence base that they can use to make informed choices in order to succeed. In the coming years we need to be able to tell people that if they need reliable evidence to help make a choice Evidence Aid is the place for it and we need to give them that evidence in a way that they can access and use easily.”