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Coordination in Disaster: A Narrative Review

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International Journal of Medical Reviews

Narrative Review

Coordination in Disaster: A Narrative Review

Mohammadkarim Bahadori 1, Hamid Reza Khankeh2,3, Rouhollah Zaboli 1, Isa Malmir 1*

Abstract

Disaster as an undeniable part of human life, is followed by some adverse 1. Health Management Research Centre,
economic effects. All equipments and facilities available in the society need to Baqiyatallah University of Medical
be mobilized according to their responsibilities and restrictions in the form of Sciences, Tehran, Iran
crisis management in order to combat it and to minimize the effects of crisis. 2. University of Social Welfare & Rehabilitation
Sciences, Tehran, Iran
Moreover, a systematic approach to the design, implementation, monitoring, 3. Department of Clinical Science and Education,
evaluating the specific services, and providing the basic needs, good coverage, Karolinska Institutet, Stockholm, Sweden
improved access and the high quality of service is desirable. It is obvious that
Iran is not excluded from this rule, and like other countries, is an accident-
prone country and can be considered as one of the most vulnerable countries to
disaster. Evaluation of health care during natural disasters in Iran indicates the
lack of coordination in providing health services. A comprehensive
* Corresponding Author
coordination is considered as the core activity before and during crisis.
Therefore, the present review has aimed to study the coordination among Malmir I.
organizations involved in the crisis, and the operational issues and solutions for Health Management Research Centre,
effective and efficient responses, through search in valid Databases using some Baqiyatallah University of Medical
keyword such as Coordination in disaster, Coordination concept, Coordination Sciences, Mollasadra Street, Tehran, Iran
barriers, Coordination facilitators, coordination in response, issue of Tell: +98.2182482417
coordination. Papers between 1995 and 2015 were searched and studied. It is Fax: +98.2188057022
not simple to coordinate among the responsible and service provider E-mail: [email protected]
organizations and institutions, requiring a systematic approach in all actions
and also inserting the coordination issue as a strategy in the comprehensive
plan of crisis management. In order to reduce the adverse effects of crisis, in
addition to apply a comprehensive plan in the crisis response phase, the
coordination among the organizations should be promoted using some
measures in the pre-crisis phase (preparation) Received: 2015/03/14
Revised: 2015/05/27
Keywords: Coordination, Disaster, Narrative Review Accepted: 2015/06/12

1. Introduction and cultural infrastructures of societies are threatened that

Natural disasters are a severe rupture with high intensity, all equipments and facilities available in the society need
and require a high degree of intervention under extreme to be mobilized, and according to their responsibilities and
conditions, and associate with some consequences such as restrictions in the form of crisis management combat it in
financial, health damages and disease, and cannot be terms of national plans to minimize the effects of crisis (8).
controlled effectively using common methods and In this regard, rescue and health management in times of
available resources (1-3). Unexpected events, as irrefutable crisis, with rapid appropriate predictions of events, and
component of human life, always has threatened human determining the needs and potential problems, is an
lives in different forms such as volcanoes, earthquakes, important factor in preserving human being life (9). The
floods, hurricanes, and despite advances in technology, primary objectives of response to the crisis include the
human being still remains incapable of predicting events prevention and reduction of mortality and illness and also
(4-7). Major natural disasters have affected at least 800 encourage to return to normal (10). During the responding
million people worldwide over the past two decades, phase, having a systematic approach to the design,
causing thousands of deaths and more than $ 50 billion implementation, monitoring, evaluating the specific
economic damage. In addition, due to an increase in the services, and providing the basic needs, good coverage,
density of the population in different parts of the world, improved access and the high quality of service is
human settlements in disaster-prone areas has increased desirable (10). An appropriate response to unexpected
(3). At the time of the accident, all the economic, political events needs appropriate preparedness, and since each

International Journal of Medical Reviews, Volume 2, Issue 2, Spring 2015; 273-281

All rights reserved for official publication of Baqiyatallah University of Medical Sciences©
 Bahadori M. Coordination in Disaster

event is unique and each organization has its own preparation and coordination of the authorities can be
conditions, therefore, preparation programs for unexpected effective in reducing the irreparable effects (13). The
events should exist in each and every organization (9). evaluation of health care during natural disasters in Iran
These crises are due to the extension of incident, huge indicates the lack of coordination in providing health
affected population and the limitations in the response services (10). Due to the lack of coordination and
capacity of agencies responsible in a short time which necessary protocols in this area among organizations and
leads to a high volume of requests for aid and health care. groups associated with the unexpected events in Iran,
Managing such crisis requires coordinated and proper use planning and management decisions are made without the
of all human and material, national and international use of information in this area (9). Many years ago it was
resources (1). According to global statistics, in recent thought that the performance of health sectors is limited to
decades, Asia is inappropriately affected by accidents and the period after the occurrence of event; but according to
incidents (11). Iran is an accident-prone country and can the Ministry of Health and Governmental, non-
be considered as one of the most vulnerable countries to governmental organizations involving the health services
disaster. Almost 31 out of 40 cases of natural disasters after the event occurrence, showed a lot of inconsistency,
occur in Iran. Generally, Iran is among the 10 disaster- therefore, the work on the preparation before the event
prone countries in the world. In other words, Iran is the occurrence in the area of health was introduced to provide
fourth country in Asia and the sixth in the world in terms better services (14). Among the most important
of the statistics of natural disasters (1,10). Destructive requirements related to events, providing relief equipments
events and crises which have occurred in Iran over the past and necessary inner and outer coordination in the relief
few years along with their costs are presented in Table 1. and requesting more support from the authorities cited (5).
Due to the above mentioned items, a comprehensive plan Social and behavioral studies have shown that
for crisis management is vital to reduce the risks and losses coordination is the main challenge among individuals,
resulted from incidents (12). Although disasters may rarely groups and organizations in order to respond to disasters.
occur, they have devastating effects. Therefore, the

Table 1. Destructive events and crises since 1980

Year Disaster type Total deaths Total affected Damage (‘000 US$)
1990 Earthquake 40000 710000 8000000
1999 Drought 37000000 3300000
1992 Flood 63 20000 2969100
1986 Flood 200 40000 1561000
1981 Earthquake 1200 31000 1000000
1993 Flood 407 484728 1000000
2013 Earthquake 37 4350 600000
1992 Flood 15000 500300
2003 Earthquake 26796 267628 500000
2012 Earthquake 306 61546 500000
1991 Flood 28 14 404000
2002 Earthquake 227 111300 300000
1990 Earthquake 21 22400 232300
1993 Flood 370 2000 209000
2004 Earthquake 35 498 165000
1988 Flood 90 150000 150000
1991 Fire 150000
1994 Flood 12 75000 142000
1997 Earthquake 1568 74600 100000

274 International Journal of Medical Reviews, Volume 2, Issue 2, Spring 2015

 Bahadori M. Coordination in Disaster

In fact, studies have shown that coordination among avoiding the conflict (22). Another study mentions the
governmental organizations, volunteers and humanitarian following advantages:
agencies is inadequate (15). To reduce the effects of crisis, Creating a financial stability in organizations, enhancing
the World Health Organization (WHO) has emphasized the creativity of staff in their respective organizations,
that the prevention and preparedness measures not only are obtaining the public and law support on creating such
not less important than relief prevention and preparedness organizations, obtaining more prestige, reducing a
measures in the time of crisis, but also may even be more separation or interruption in service providing, establishing
important than prevention and preparedness measures in and continuing the services, reducing the rework (24).
the time of crisis (16). Coordination and cooperation in Generally, the coordination is the performance of
crisis management among public and private sectors and coordinated activities including the management of
organizations (at local, provincial, national and even dependencies among separate measures, and the clear
international levels) are becoming increasingly necessary definition of procedures, processes, responsibilities and
and vital. On the other hand, the disaster preparedness structure (24). The fundamental and constant assumption
requires a comprehensive understanding of the risks, in all definitions is that when organizations achieve the
planning, coordination, and continuous investment in the conformity and coordination will operate more effectively
National Standards Education and a leader is able to and efficiently (25).
support the coordination at all levels of system (17). For
managing the events, the measures must be continuous and 1.2. Coordination in health
dynamic (6) and the appropriate response includes the Intra sectorial cooperation and coordination is a well-
measures such as establishing the emergency facilities, known relationship between health sectors and other
searching and rescuing survivors, providing medical sectors established to measure in order to obtain the final
services, distributing the relief aid, moving the injured results or the health system outcomes which is more
people, scheduling the relief and rescue forces, and effective, efficient and sustainable than when the health
coordinating all these activities in relevant organizations system operates alone. The major point in the case of inter
(18). The coordination appears as the most fundamental sectional collaboration is that the sectors are all
issue. Therefore, this study has aimed to investigate the governmental and non-governmental organizations
coordination among the organizations involved in the (public, private) and the inter sectoral cooperation should
crisis, and to provide the coordination and operational include all these items (26). The sections and elements
issues for an effective and efficient response. which are required in health sectors are as follows (but not
limited to the following): Efforts and measures in target
1.1. The concept of coordination population; Governmental and local activities in the
According to the dictionary, coordination means affected areas, institutions, multinational organizations;
"coordinated action of departments in order to achieve academic institutions, armed forces and media.
effective results” (19,20). In a study coordination is
defined as a cooperation among two or more independent 1.3. The concept of coordination in disasters
organizations or competitors which share their own The coordination is described as an efficient designation
knowledge and resources of (21). Another definition of of useful recourses in order to effectively achieve the
coordination is thus provided: “Management of the parallel common objectives or is determined as common efforts
efforts to enhance the effectiveness” (22). According to designed to reduce reworks in the measures and also to
another definition, the coordination is presented as reduce gaps in providing services (27).
common measures performed by two or more Another study describes the coordination in natural
organizations in order to solve the problems and issues. disasters as:
Indeed, the coordination among two or more organizations Close relationship of organizations that need their
is a process of designing and implementing programs and services in time of natural disaster occurrence, so that all
policies to achieve common goals. Generally, are aware of their duties against each other, and
intraorgaizational coordination emphasized on the collaborate each other to achieve a common goal, under
collaboration and organization of programs to achieve the the command specified by the predetermined plan (24).
common objectives of organizations (23). The benefits Therefore, the lack of inter organizational coordination and
related to coordination are as follows: involving economic cooperation can lead to detrimental effects on human
efficiency, the quality of services, organizational learning, beings and financial resources (21). For example, poor
accessing to new skills, risk diffusion, improving the coordination among authorities involved in the response to
public accountability, reducing the uncertainty and the tsunami crisis in Indonesia (2004) is described as the
"most important issue" (27), and this debate has always

International Journal of Medical Reviews, Volume 2, Issue 2, Spring 2015 275

 Bahadori M. Coordination in Disaster

been a challenge in disaster management (28). So often, making decision by more than one level of government,
the lack of national and regional disaster management including the work of international organizations with the
plans results in the lack of coordination among agencies national governments or the work of national governments
responsible for disasters (29). The disaster coordination with state, local or provincial government to consider the
requires understanding the different types of risks, complex challenges of politics (26). A study conducted on
planning, coordination, investing in continuing education facilitating the nods and barriers of coordination among
and involves the national standards and a leadership who humanitarian organizations focused on the factors
support at all levels (30). Disaster managers must affecting coordination using a comprehensive literature
cooperate and organize all miscellaneous and scattered review (Table 2) (22). According to Table 2, the above-
measures under a single flag. As multiple institutions have mentioned factors are shown in 4 categories: (1)
a role in disaster management systems, there is a potent environmental factors, (2) the factors related to the role of
collision and conflict with each other. So, as far as donors, (3) the organizational factors and (4) and inter
possible, the concept of coordination among these aorganizational factors. The environmental factors points
institutions should be extended (31). Coordination out the national and local available resources, as well as
mechanism is a mechanism that prevents the loss of time, the unpredictable or demand uncertainty and infrastructure
investment and human actions in the time of crisis, and in the target area. The donors and related factors play a
increases the efficiency and effectiveness of crisis strong role in promoting the coordination measures among
management elements and the public forces in the relief organizations. However, some concerns about affecting
and rescue operations, and even in the pre-crisis period, the tendency of organizations to participate in programs or
temporary housing and rehabilitation (24). The principle of hear the Donors’ instructions. In terms of the third item
coordination in the crisis management mechanisms, (organizational factors), variation or contradiction among
indeed, represents important and fundamental the rules or objectives (strategic) and standards, the
responsibilities of acquiring all components of institutional operational and time approaches, and the variation internal
working group to achieve the objectives and duties of policies in measures will lead to a poor coordination. In
crisis management (32). Intersectoral cooperation divided terms of the last one (intra organizational factors), the
into a variety of vertical and horizontal types. The potential or present benefits of coordination with other
horizontal collaboration occurs across sectors or subsectors organizations is not obvious in the response setting of
in a separate section. Generally, this type of collaboration disasters. Despite the many advantages related to intra
includes individuals or groups that are at the same level in organizational coordination, the managers have some
making decisions, judgments or working in a set of defined concerns about the costs of coordination that can affect the
objectives. The vertical collaboration is working across the common actions and discourage them from going to work.
government to consider the political challenges that needs

Table 2. Factors Influencing the Coordination Effort among Humanitarian Organizations

Category Evidences
Environmental factors
Changes in the political environment
Changes in the military
Unpredictable situation
The location and timing of disasters
Availability of adequate and reliable information
Demand Characteristics and requirements of the affected population urgency of relief response
Intensity of damage to local infrastructure (i.e. Communications, transportation)
Supply Available local and international resources
The presences of a considerable number of HOs (mostly new and inexperienced actors)
Donors’ factors
Limitations on the usage of resources Usually available after the disaster spending the provided resources in a short period of time
Incentives mechanisms The use of renewable and short term contracting
Inter-Organizational Factors
Strategic compatibility The differences among organizational objectives, missions or mandates
Operational Differences among organizations’ organizational structure, operational or internal policies,
compatibility programming approaches, standards and techniques, or timeframes
Competition for funds
Competition
Competition for visibility and media coverage
The extent of disparity in organizations’ power and resources
Power
Political imperatives and jockeying for power symmetry between the parties (i.e. size)
Coordination Mechanisms to allocate joint costs, benefits or risks
process Accountability over the performance

276 International Journal of Medical Reviews, Volume 2, Issue 2, Spring 2015

 Bahadori M. Coordination in Disaster

Clarified roles and responsibilities

Lack of tools or technical skills for coordination
Availability and use of technology (e.g. cell phones, radios…)
The principles of transparency and responsibility
Organizational Factors
Lack of transparency regarding existing and potential benefits
Increasing bureaucracy & decreasing flexibility
Threatening timely response
Concerns associated with Accountability complications
collaboration Threatening the value of being independent from other agencies or being a sovereign entity
Threatening impartial and neutral humanitarian action
Threatening the value of strengthening their humanitarian identity
The possibility of losing competition after sharing their own competencies with other agencies
Limited resources (personnel, money (i.e. staff salary or travels) dedicated to collaboration efforts
Short-term volunteers or temporary employees
Resources Frequent changes in team leaders and point persons
The presentence of organizations’ junior staff at the coordination meetings (having little
leadership/ decision making capacity)
Propensity towards command and control mentality
Collaborative Management capacity and leadership style (i.e.collaborative leadership)
Capabilities Capabilities of staff carrying out the coordinating efforts(i.e. skills, attitude, knowledge,
experience)Lack of incentives towards collaborative efforts
(Adapted from Moshtari 2012 (22)).
1.4. Problems and challenges of the coordination to Coordination issues within and between the fire fighting
deal with disasters organization and the police were combined with
In the time of crisis, the need for necessary resources will bureaucratic rivalries. Contradictory reports had been
be intensified and the ability to meet the demands reduces published about the hijackers. Therefore, the study is
(33). Some needs for the coordination of emergency performed a comprehensive analysis on the coordination
services during crisis, and key challenges associated with issue in the event of a terrorist incident and mentioned that
rapid response efforts are proposed (34). Although the in the time of event (such as terrorist incidents) a further
coordination issue in the crisis management is important, coordination is vital among the organizations such as the
success in emergency conditions may be impossible and in police, medical emergency, firefighting and, etc (17).
real terms during the response to the crisis may not be easy Another study indicated the fundamental problems of
(35). In a research in which the coordination problems coordination as follows (35): 1. Lack of coordination
were studied, the September 11 attack was mentioned and among organizations and responsible institutions; 2. Lack
it was noted that during the occurrence of the attack, the of communication and information sharing; 3. Having a
coordination issue had a vital importance in crisis competitive performance; 4. Lack of honesty and trust; 5.
management. In the mentioned study, the coordination Slow and pacific response; 6. Lack of enough appropriate
issue was considered important and necessary, not only in knowledge; 7. A weak definition of demand chain; 8.
preventing terrorist incidents, but also in ensuring an Failure in integrated response.
effective response to disasters. The attack on the World Another study was done using a workshop method
Trade Center led to overwhelming coordination discussing the barriers for the coordination and
problems. Some problems arising from the lack of cooperation in the crisis (33).
coordination are as follows (17): 1. Legal Challenges
1. Director of emergency services in the towers lobby had The occurrence of crisis and disasters is not associated
no authoritative data about the events occurred on the with legal boundaries.
upper floors or outside the buildings. Responsibilities and Commitments are not clear in
2. TV viewers’ information who had watched the fire various levels of government (federal, state and local). The
spread throughout the country was better than the director Communications and trust among the different levels of
of emergency in the towers lobby who had no access to government, and even affiliated organizations, are seen as
television programs. barriers to the collaboration. In addition, putting the
3. There were no safety issues in the first response to the organizations into organizational silos can further provide
fire. competition than cooperation and interaction.
4. The police helicopter was over the towers, but there 2. Concerns and fears from additional monitoring
was no communication link between firefighter leaders Nowadays organizations are often overwhelmed by the
and police data. governmental rules and regulations. Fearing of additional

International Journal of Medical Reviews, Volume 2, Issue 2, Spring 2015 277

monitoring by government is a deterrent factor to NGO Strategies and operational measures for the
organizations and others such as religious organizations coordination in order to prepare to deal with disasters
3. Issues related to the commitments and responsibilities In order to succeed in the coordination among
Concerns about commitment and responsibilities can beneficiaries and to begin the crisis management measures
establish a barrier to interaction and collaboration among as a mainstream, the cooperation among beneficiaries is
organizations, and act as a major obstacle. Confusion and vital. Budget and political will can be seen as well as
ambiguity regarding the responsibilities may seriously factors affecting the coordination of crisis management
impact on the results and coordination. (35,37). Also, some factors affect the coordination among
4. Language barriers executive bodies such as clarifying the duties of
It is usually said that language translation is often poor to organizations involved in crisis management, holding the
different audiences. The lack of a common understanding pre-crisis readiness maneuvers, establishing a flexible
of the concepts and terminologies can be a barrier to organizational structure, and managing the capacity of
effective communication. In other words, the lack of a crisis management, establishing suitable communication
common language (even among those who are looking for centers, having a systematic trend and lacking the
results and performance) may make it difficult to interruption in affaires with changes in the management,
coordinate. Therefore, it is preferred to create and establish the timely availability of organizations during the crisis,
an appropriate communication system before measuring optimal use of resources and prevention of their loss, and
the coordination strength. The lack of a proper lacking parallel work in organizations (38). The
communication could be a reason for the collapse of coordination through the Joint Plans is another good
coordination in the event of a disaster. strategy to assist the responsible organizations in the
5. Trust effective use of available resources. The coordination
The lack of trust is as the primary obstacle to effective through joint procurements by external sources can lead to
networking activities. The trust varies by time and an increased negotiating power and reduced costs which
circumstances. It is worth noting that no single formula is could eventually effect on improving service providing
applicable for all communities and even a community over and also reducing competition (22). Noteworthy, whenever
time. Keeping the trust is a much greater challenge. The there is a predetermined network composed of local staff,
lack of public understanding on the human issues such as the coordination can be effective and successful, which the
trust prevents the effective use of technology, methods and logistical preparations can establish “quick measures" to
strategies in order to resilient the society. deal with the created crisis (39). Members of the medical
6. Resource challenges
emergency teams need to establish a reliable
Stable funding sources are one of the primary obstacles
communication with the coordination centers (39), and
to form and maintain the cooperation and the coordination.
also free communications among other categories active in
The funding sources are often limited and short-term, and
the crisis can considerably enhance the coordination and
forming coordination is a long-term process. Another
shorten the probable problems. According to a study
study focused on the issues of misunderstanding and
prepared by the enforcement working group of emergency
ambiguity and noted that in terms of the coordination, a
preparedness and health law, four operational measures
number of responsible institutions might face conflict with
were identified as follows (40):
each other on the application method for responding
1. Organizing to implement applicable measures
operations and sometimes a misunderstanding occurs
In order to have a comprehensive preparation at all
among them (35). Another problem is that participations
administrative and justice levels, (local, provincial,
are unpredictable and the study focuses on the fact that
national, etc.), the institutions and organizations must have
much of the information about the resources available is
a comprehensive understanding about the plans,
unknown and the participation of institutions can be
responsibilities, authority and etc, of each other, to provide
unpredictable (34). Therefore, when the uncertainty factor
a proper response to natural and unnatural disasters. So,
is high, additional barriers to the coordination could be
every field first needs to be organized through the
created (22). The study also pointed out that despite
establishment of a periodic framework by senior
considerable efforts to establish the coordination, an
representatives in each section.
ambiguity in the balance between the power and the
The operational measures include:
responsibility, can lead to some problems in this respect
A) Establishing a steering committee to guide initiative
among the organizations involved (36). Studies have also
designs to promote the coordinate and multisectoral
mentioned the fact that the coordination in reconstruction
response.
and improvement phases can be even more challenging
than the initial relief and pacification measures (27).

278 International Journal of Medical Reviews, Volume 2, Issue 2, Spring 2015

 Hoseinpourfard M. et al, Reward System; Mini Review in Cognitive Neuroscience

B) Implementing a careful planning in order to achieve the national, provincial and municipal levels based on the
peak of coordination and multisectoral response to the cycle of crisis management. Different scenarios must be
disasters prepared and run in each region considering the frequency
C) Integrating the committee program to leadership in the and probability of disasters, and the experiences on how to
national incident management system. manage the crisis in non-critical condition must also be
D) Creating a direct link among the steering committee obtained by establishing regular and scheduled exercises,
management system and emergency planning and necessary preparedness to encounter principally the
E) Creating a direct link with the counterparts in other probable crisis be achieved based on the results obtained
provinces and neighboring countries from training and education (44). Scientific studies
2. Roles and responsibilities indicate that the training in the field of crisis management
Beyond organizing in order to implement the measures, and the preparedness against disasters could lead to saving
some other steps are required to comprehensively thousands of lives, reducing costs, maintaining assets, and
understand the roles, responsibilities and authorities. In preventing the secondary complications (44). Another
other words, the roles and responsibilities for each action study has suggested that in order to achieve the desired
and intrasectoral and coordinated response in consistent cooperation in response to the natural disasters, it is
with the National Incident Management System must be necessary to consider some measures in pre disaster phase,
clear and unambiguous. to precisely determine the duties, the exact details of the
3. Communication and information sharing process of organizations, and how to cooperate and
The coordinated emergency response and preparedness coordinate in the frame of specific instructions and
needs to have access to intra communications and also the programs. The study also suggested that in the preparation
types of key information. In this field, the communication phase, these programs must be run and trained to achieve
is referred to a network of interactions among specialists an effective coordination among the organizations in the
and organizations in all fields and communicational response phase (24). Finally, the application of
network created with other departments, chosen officials, cooperation should be applied in the framework of crisis
the media, the public, as well as electronic systems that management community to leave a positive effect in
support the communication. The word of information is reducing the impact of disasters. A study also confirmed
referred to the main content which experts need in all this fact that coordinating an acceptable strategy in crisis
fields in order to perform their duties (before, during and management has a significant and positive results (45).
after the events). Coordination requires the exchange of
special information from all organizations involved to 2. Conclusion
acknowledge the specific details of time, costs, and the As mentioned, the coordination among the organizations
needed measures to achieve common goals. and service providers is not simple and requires a
In other words, efforts will lead to failure without systematic approach in all measures. In order to reduce the
accurate, and timely information, and providing them to adverse effects of the crisis, in addition to applying a
organizations involved to match their measures to comprehensive model in the crisis response phase, some
changing circumstances and preferences in order to measures need to be performed in the pre-crisis
achieve a coordinated action (41). For an optimal and (preparation) phase in order to promote the coordination
effective decision making, it is essential to face the crisis between organizations. In other words, without the
to have an accurate and real-time information about the coordination and the preparation in the pre-crisis phase, a
type, location and the extent of incident, in addition to the successful response cannot be expected. The coordination
location, type and the availability of resources needed (42). patterns used in other countries and copying them will not
In other words, having correlated information is one of the be beneficial for the country. It is worth noting that the
most important prerequisites for a successful coordination. experiences of other countries, besides considering the
For instance, it includes accurate and timely information social, economic, cultural conditions of our country, can
on the needs of target population and information on reduce considerable losses occurring due to disasters and
responding to organizations, their situation, capability and crises. It is hoped that this study and similar studies can be
capacity to respond (43). helpful even small in improving the knowledge of crisis
4. Education and training management in order to reduce the impact of disasters and
If the required preparedness becomes achieved prior to crises. In this regard, studies in the field of coordination
the crisis and people get sufficiently trained, experiences problems among the responsible organizations at the time
get sufficiently obtained from previous crises, there will be of event in terms of structural, political, social and cultural
more chances of success in managing the crisis. Therefore, can be beneficial to our country. The comprehensive
it is required to perform necessary planning at different

International Journal of Medical Reviews, Volume 2, Issue 2, Spring 2015 279

model of crisis management needs to be designed and 19. Vlassis I. Civil-Military Health coordination in major
implemented at different national, provincial, regional and disasters. The case of Haiti.
20. Oxford Dictionaries, Definition of Coordination. Available
local levels to establish more coordination effectively from: http:// www. oxforddictionaries. com/ definition
among responsible organizations. /english/coordination.
21. Kaynak R, Tuğer AT. Coordination and Collaboration
Functions of Disaster Coordination Centers for Humanitarian
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