Thursday, January 14, 2010

The Brutality of Limited Resources

There's an article about the earthquake in Haiti on the front page of today's New York Times.  It begins like this:
“I just want my wife’s corpse,” said Lionnel Dervil, pleading in vain to bury his wife in his home province. But no one at the Doctors Without Borders compound paid much heed to the stricken Mr. Dervil, 38, a money-changer and father of four children. Instead, doctors were frantically tending to those still living who had streamed in.
As someone whose specialization is the psychological impact of traumatic events, my first reaction to this description was pretty negative.  Mr. Devril wants to bury his wife.  He is traumatized and grieving and he wants to exercise some small measure of control in a situation that is totally out of control.  Burial is a ritual that restores normalcy.  Why on earth wouldn't someone help this man with a very typical, understandable and healthy request?  Doctors Without Borders is one of my favorite charities -- surely they understand that this is important.

Quick on the heels of that initial reaction, however, came my (delayed) understanding of the other side of the story.  The question in the scene the Times reported was not whether Mr. Dervil getting to bury his wife was important.  The question was whether it was more important than treating people critically injured and in danger of dying themselves.  Clearly, the answer to that is no. 

Given an infinite number of people with infinite time, Mr. Dervil would get his wife's body and all of the injured would get the care they need.  Surely we can all agree that, short of not having the earthquake in the first place, that would be an ideal situation.  But this is the real world, not an ideal situation, and the number of people and the amount of time are both finite.  Priorities have to be set, and in a mass casualty disaster, those priorities can be pretty harsh.

Maslow's hierarchy of needs tells us to take care of physical needs before helping with psychological ones.  Sometimes that seems cruel.  The reason often given is that people can't process their emotions when they're worried about where their next meal is coming from or where they're going to sleep tonight, and that is true.  It is also true that resources are always limited, and if everyone, even those who specialize in the psychological, concentrates whatever talents they have on the physical, it will be that much faster that those resources can go to the psychological and the second stage of healing will begin.

Once again, I'd like to encourage the Quarterbackers to make a donation of any size to an organization doing relief work in Haiti.  Yesterday I talked about Doctors Without Borders and American Jewish World Service.  I'd also like to add that if you text the word "HAITI" to 90999, $10 will be billed to your cell phone and the money will be given to the Red Cross for their relief efforts.


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Naomi Zikmund-Fisher
is a clinical social worker, former school Principal and a Crisis Consultant for schools and community organizations. You can learn more about her at
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