CONCEPT: Just-In-Time

Just-in-Time (JIT): Almost inextricably associated with Japanese manufacturing and transportation industries, the JIT principle is a crucially important component of savvy logistics management in war and peace -- and during all sorts of emergencies and disasters. The underlying idea is to reduce to near zero the temporal and financial costs of warehousing or storing of supplies, components or finished goods -- and of getting them to the intended recipients or users. 

JIT relies massively on the soundness of established transportation routes, modes and means -- and related systems. Moreover, the forms of social overhead capital (SOC) ideal for specific large-scale deliveries and other kinds of response are usually beyond the control of those directly involved in sending and receiving goods and/or services. It is for such reasons that Government Service Packages (GSPs), for example, have been set up. They mitigate barriers to the timely delivery of humanitarian services during extremely large emergencies -- such as we saw during the 1994 genocide in Rwanda and, a decade later on 26th December 2004, the "Indian Ocean Rim" Tsunami. 

CONCEPT: Triage

Triage: Sometimes called surgical triage (see Perrin, 1996: 226-232), triage has been defined as the “classification of the injured... undertaken by medical or paramedical personnel on site on the bases of seriousness of the injury and the chances of recovery" (UNDRO, 1984: 63-64). Likewise, WHO points out that "The underlying principle of triage is allocation or resources in a manner ensuring the greatest health benefits for the greatest number". 

As a principle, triage gives care givers, in situations of widespread trauma and shortage of care, the power and authority to decide who will be given available medication or surgery or other kind of help ( first or at all) and who will not -- based on their professional assessment of the course(s) of action that will do the most good. Thus, if they determine that a person is dying anyway, they may choose to withhold further medication. This principle extends to deciding, for example, who in a danger zone (or war zone, or sinking ship, or refugee camp) will be evacuated first, and who will have to wait; who, in a famine situation, will be fed first, or at all, and who will not.

The humanitarian community has been accused of being slow to translate that principle (or concept) into firm standards for classifying injuries and prioritizing the injured for emergency medical care. However, attempts have been made to rectify this. 
Indeed, during the 1980 earthquake in Algeria's El Asnam region, for example, four triage categories were adopted to prioritize medical care for the victims -- under conditions of severe supplies, HR and facilities constraints. 

Ranked by assessed need for urgent attention, these now iconic categories were specified as follows: 
1) Vital organs affected; 
2) Serious injuries which, after 'adequate' first aid (given by nurses and trained volunteers, under "general supervision"), could wait for up to 12 hours for an operation; 
3) Hopeless cases "needing comfort as much as treatment"; and 
4) Slightly injured persons whose fretting and noisy demand for attention might cause panic within the triage facility or camp (UNDRO, 1984: 63-4).  

READ: Pierre Perrin (1996) Handbook on War and Public Health. Geneva: ICRC


Updated: March 31, 2018

CONCEPT: Government Service Packages (GSPs)

Government Service Packages (GSPs): The idea of GSPs, which had been tried before in Sarajevo and elsewhere, really took off during the Rwanda genocide of 1994. As their name suggests, GSPs (sometimes called simply "Service Packages") were conceived of as "a last resort in exceptionally large emergencies" justifying the use of "military and civil defence assets" (UNHCR, 2000: 359). 

It was argued that the scale of GSP missions, such as the one in Rwanda, was so large as to restrict involvement to UN member states with the requisite logistical and related material capacity for 'extra-budgetary donations in kind'. The mobilizing and coordinating functions of GSPs were assigned to UNHCR's top management in Geneva, obviously with allowance for behind-the-scenes consultations with the UN's most influential member-states. 

However, as the Rwanda crisis quickly and amply showed, the host-government's 'organic' involvement in the operations of a GSP intervention was too critical a requirement for success to wish away (Kent, 1996: 64-85; Wright, 1996: 54-56). That was a hard lesson learnt on the ground. On the other hand, built into GSP operations from the start was a formal undertaking that operations (a) would be of 'limited' duration; and, (b) would not "replace the traditional response capacity of NGOs". 

There are now over 20 GSPs (a number of them looking from a distance like nation-building propositions). Prior to 2004, these  included: Air Operations Cell, Strategic Airlift, Theatre Airlift, Airport Ground Handling, Warehousing/Storekeeping, Road Transport, Field Hospital, Hydrological Survey, Water Tanker Operation, "Surface Water", Borehole Drilling, Water Treatment, Water Distribution, Water Storage, Latrine Construction, Vector Control, Solid Waste Management, Waste Water System, Site Development and Road Construction (UNHCR, 2000: 359). The hugely destructive Indian Ocean Tsunami of December 26, 2004 brought rise, in actual practice (if not formally, to two or three new GSP: The Field/Tented Mortuary, DNA Identification and related Forensic/Tracing Services.


REFERENCES

Humanitarian Practice Network (1996) 'Service Packages': The Role of Military Contingents in Emergencies

Kent, Randolph (1996) "The Integrated Operations Centre in Rwanda: Coping with Complexity", pp. 64-85, in Jim Whitman and David Pocock, Eds., After Rwanda: The Coordination of United Nations Humanitarian Assistance. London: Macmillan Press Limited.

Wright, Neill (1996) "The Hidden Cost of Better Coordination", pp. 54-56, in Jim Whitmann and David Pocock, Eds. After Rwanda: The Coordination of United Nations Humanitarian Assistance. London: Macmillan Press Limited.