Global disasters, health needs and the medical response: From historical lessons to evidence-based practice

Modern disaster medicine faces a critical tension between humanitarian impulse and evidence-based necessity. And while disaster risk is the product of Hazard and Vulnerability, socio-economic factors are the primary predictors of crisis outcomes. Therefore, a paradigm shift from reflex-driven (surgical) interventions to resilience-oriented public health strategies should be considered. Through analysis of the 2010 Haiti earthquake, the 2023 Turkey earthquake and the ongoing Gaza conflict, a recurring "Inverted Pyramid of Resources" is identified, where specialised surgical teams are often deployed at the expense of primary healthcare and basic health needs. A professionalisation of aid through the WHO Emergency Medical Team (EMT) initiative, which prioritises standardisation, generalist clinical flexibility and the strengthening of local health systems is a way forward. Ultimately, effective disaster response must be context-specific, with focus shifting toward mitigating significant indirect mortality caused by the collapse of societal support systems.