Due (Kirsh et al, 2012). In addition,

Due to thecomplexity of operations of all the different actors, there is a need forcoordination during disaster situations, to increase efficiency, effectivenessand harmony of relief efforts (Abramson et al, 2007). When there is nocoordination, it can lead to further losses in lives and properties (Kaynak andTuger, 2014). Coordination, which the United Nations led, is a process ofensuring a collaboration of all the actors involved in responding to adisaster, through dissemination of information, strategic planning andefficient use of available resources (Abramson et al, 2007; Kirsh et al, 2012).The United Nations staff and infrastructure was affected by the earthquake, however,they still provided technical support in organising relief efforts and settingup clusters to manage different critical sectors (Kirsh et al, 2012).  Command, which describes the agency in chargeof operations and with the authority to coordinate efforts of others, isessential for coordination and was provided by the government of Haiti, albeitineffective (Haver, 2011).

Command should be geared towards guiding all actorstowards the achievement of a common goal despite varying interests (Comfort,2007). The government of Haiti, despite being devastated by the impact of anearthquake, set up a response framework within weeks to guide recovery efforts ofall agencies involved (Kirsh et al, 2012). In addition, teams and militarypersonnel provided by countries such as the United States, together with otherorganisations led the search and rescue efforts (Kirsh et al, 2012). The cluster systemwas introduced in 2006 as a means of facilitating collaboration and partnershipamong international agencies and organisations in a particular sector involvedin relief efforts (UNHCR, 2017). It helps in defining roles of the differentagencies to achieve a common agenda, effective management of availableresources and provision of technical assistance to disaster relieforganisations (IASC, 2006).

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Following the earthquake in Haiti, numerousinternational organisations, countries, and agencies provided support to the Haitigovernment. The health cluster was one of the 12 clusters formed after theearthquake and was led by the World Health organisation (Dhillonand Annunziata, 2012). Although, the cluster system in theory, aims at improving the work ofaid organisations, it was not associated with improvement in collaboration orefficient use of resources in Haiti (Dhillon and Annunziata, 2012). According to Kirsh et al (2012)about 400 organisations were in Haiti to provide health care, includingmilitary teams of countries and individual volunteers. This led to a situationwhere it was difficult to coordinate their activities. Apart from the largenumber of health organisations, most were largely inexperienced with littleknowledge on working in such complex situations (Haver, 2011).  Collaboration requires effectivecommunication, and this was hampered due to inadequate data collection systemsand information sharing within the organisations (Haver, 2011).

In addition,more efforts were put by the health organisations on immediate emergency care,with little planning for long term care and rebuilding of ailing health systemswhich led to an increased burden on the health sector (Kirsh et al, 2012).Review ofliterature shows that there was little cooperation between internationalnon-governmental organisations who came in to help in Hiaiti and localorganisations; leading to duplication of efforts, inefficient operations andconfusion in relief efforts (Akl et al, 2015; Dhillon and Annunziata, 2012; Kirshet al, 2012). Benefits of interactions of health organisations involved inrelief efforts in Haiti with the local health agencies included rebuilding of healthfacilities that had been destroyed and also provision of medical workers tofill the gap in health workforce (Kligerman et al, 2015).

A large proportion ofthese health facilities had both local and international staff providing freemedical care for citizens; thus facilitating information sharing and skilltransfer between the staffs (Kligerman et al, 2015).  Nevertheless, these short term benefits canlimit the development of the health system, as it is largely dependent on thedonor organisations. Effective collaboration between the organisations and thenational health ministry’s should focus on the health needs of the country,rather than organisation agenda in order to ensure sustainability of the healthsystem (Kligerman et al, 2015). Other issues of poor staffing, poor knowledgeand experience, insufficient resources and ineffective communication betweenlocal and international organisations impacted the interactions betweenagencies negatively (Kirsh et al, 2012). In conclusion, there is a need fortemplates that facilitate collaboration and provide information and trainingfor organisations that want to participate in relief efforts. Also, communityengagement and participation is essential for the success and sustainability ofcoordination and collaboration for disaster management (Patrick, 2011).



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