Analysis of the international and US response to the Haiti earthquake: recommendations for change.

The 2010 earthquake in Haiti was unprecedented in its impact. The dual loss of the Haitian government and United Nations (UN) leadership led to an atypical disaster response driven by the US government and military. Although the response was massive, the leadership and logistical support were initially insufficient, and the UN cluster system struggled with the overwhelming influx of nontraditional agencies and individuals, which complicated the health care response. Moreover, the provision of care was beyond the country's health care standards. The management of the US government resembled a whole-of-government domestic response, combined with a massive military presence that went beyond logistical support. Among the most important lessons learned were the management of the response and how it could be strengthened by adapting a structure such as the domestic National Response Framework. Also, mechanisms were needed to increase the limited personnel to surge in a major response. One obvious pool has been the military, but the military needs to increase integration with the humanitarian community and improve its own humanitarian response expertise. In addition, information management needs standardized tools and analysis to improve its use of independent agencies.