Response and recovery.

Once again, the lack of universal terminology is hampering efforts to move disaster medicine forward—this time, as it relates to the longitudinal phases of a disaster. During a World Health Organization (WHO) meeting I attended in December, confusion ensued as meeting participants discussed the transition period between the response and development phases of a disaster. Participants generally agreed this period has been largely neglected, but disagreed over how it should be defined. Some refused to recognize this period as anything more than a transition between two phases while others, myself included, believed that between relief and development there is yet another phase—the recovery phase. Failure to recognize the recovery phase of the disaster has resulted in dire consequences. Because this phase has not been recognized fully, resources allocated for this period have been inadequate. Between the relief phase, the phase in which the response to a disaster focuses on life saving, and the development phase, the phase in which the effected society becomes stronger and more resilient than it was before the disaster occurred, a society must first return to its pre-event status. Or in other words, recover. Some of the WHO meeting participants who did not recognize a recovery phase seemed to believe that it was not a phase because responders’ goals should and most often do aim higher than recovery from a disaster.These participants argued that because the overall disaster response goal aims not only to restore society to its preevent status, but to make the society stronger and more resilient than it was before the disaster so that a disaster is less likely to occur again. For example, following the devastating 2004 Indian Ocean tsunami, former US President Bill Clinton said the aim of the disaster response should be to “build it back better”. But just because an affected society and responders aim to “build back better” does not mean they can skip the critical step of recovery in between. Debate and confusion over the longitudinal phases of a disaster were deepened by the misconception that there are distinct cutoffs between longitudinal phases. In realEDITOR’S CORNER