Preparing for the next natural disaster--need for a WHO coordinating centre.

This month is the first anniversary of the 7.6 Richter earthquake which struck Pakistan on 8 October 2005. The medical community’s response to this tragedy was overwhelming. In the hardest hit areas — Bagh, Balakot, Mansehra and Muzaffarabad — there were no hospitals, clinics or trauma centers within 80 km. Initial estimates suggested a death toll of 70 000 with over 150 000 injured. In the first 48 hours, 22 medical aid camps were established by local relief organizations in collaboration with the Pakistani Armed Forces in Balakot. Within 72 hours, physicians, surgeons, and nurses began pouri ing into other affected areas. Medical personnel of Pakistani origin working in Europe, the Middle East and the United States were among the first to arrive, followed by hundreds of doctors from Canada, across Europe, Malaysia, Turkey and the United States. In the first month, more than 1700 doctors from 23 countries came to the affected areas, either as selfimotivated individui als or as part of an organized relief misi sion. We had no shortage of doctors or medical supplies in the affected areas; lack of coordination was our main problem. People did not know where to go and what to do. A year later, medical relief efforts remain uncoordinated. Many people brought medications and surgical supi plies that were never used. There were 165 doctors available at the PIMA field hospital, Bagh, in the last week of October 2005. They all came by themselves without any coordination. In August 2006, we visited medical fai cilities in Balakot, Bagh, Mansehra and Muzaffarabad. There are nine active medical facilities in these areas with a combined outpatient turnover of about 3200 patients per day. These facilities still are run by volunteer doctors on twoiweek rotations. We saw large warei houses full of medications, injections and supplies — worth millions of doli