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J Clin Ethics. 2010 Winter;21(4):328-34.

The elephant in the room: collaboration and competition among relief organizations during high-profile disasters.

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Public Health Readiness Office, American Medical Association, Chicago, Illinois, USA.


The non-governmental organizations (NGOs) that assume the bulk of emergency care during large-scale disasters in the developing world must expend considerable time and resources to ensure donations to sustain their field operations. This long-standing dilemma for the humanitarian community can create a competitive environment that: Compromises the delivery and quality of services, Allows the effectiveness of operations to be compromised by a lack of cooperation and collaboration, Disrupts the timely and accurate coordination and analysis of outcome measures that are crucial to successful response in the future, and Undermines the long-term capacity of indigenous aid organizations. This article addresses problems and potential solutions for improved coordination and long-term capacity-building of humanitarian aid.

[Indexed for MEDLINE]

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