In times of emergency, the International Federation is ready to respond and provides quick and effective health relief. Health response aims to fill temporary gaps in basic health care services that are caused by damaged and often overloaded health care systems in the affected countries.

The focus is on community health care, supported by basic clinics. Referral hospitals (field hospitals) can carry out emergency surgery and deal with gynaecological and obstetric complications. Paediatric care, treatment of infectious diseases and Maternal and Child health care are particularly important considerations in times of emergency. Many disasters generate large population displacements and can spread outbreaks of measles and other infectious diseases.

The Red Cross Red Crescent employs standards laid down by the World Health Organization (WHO) with regard to treatment of patients and selection of essential drugs. It also applies technical standards as outlined by the Sphere Project's

humanitarian charter and minimum standards in disaster response. All Federation emergency operations and management tools adapt to these standards, including Field Assessment and Coordination Teams, Emergency Response Units and the process for designing emergency appeals for funding operations.

Earthquakes
Earthquakes strike with no early warning and can be devastating. Quakes are measured according to the Richter scale - the most devastating effects are seen on level 6 and above, and if the epicentre of the earthquake is located in highly populated areas. Earthquakes can cause high numbers of deaths and injuries as well as serious destruction of buildings and infrastructure.

When earthquakes hit, local Red Cross Red Crescent volunteers carry out search and rescue - this is more effective than rescue teams who are flown in from abroad as these teams generally arrive too late. High numbers of seriously injured people may require surgery within 48-72 hours, after that little lifesaving surgery can be done.

After an earthquake, the Federation response concentrates on relief and shelter, water and sanitation, basic health care and field hospitals. Psychological support should always be addressed, as well as possible tracing mechanisms for reuniting families.

Earthquakes require substantial rehabilitation efforts and the Federation plays a vital role not only in providing support for community health and basic health care, but also by helping strengthen disaster preparedness and capacity building for the National Society.

Cyclone/high winds
Cyclones and high winds can be predicted several days in advance. The onset is extensive and often very destructive. Serious flooding often follows cyclones and high winds and complicates matters further. Infrastructure can collapse in poor areas and crops are often destroyed.

During these disasters, Red Cross Red Crescent volunteers often make heroic efforts, saving many lives. The Federation response concentrates on relief and shelter, water and sanitation, basic health care and field hospitals. Psychological support should always be addressed, as well as possible tracing mechanisms. The risk for epidemics such as cholera, malaria and dengue becomes high after two to three weeks, and all possible preventative measures are taken.

Rehabilitation is always considered after this type of disaster as needs may continue for many years.

Floods
Floods can be predicted in advance, except in the case of flash floods. The impact of flooding can include destruction of housing, crops, cattle and people. Volunteers assist well in the early days of these situations, helping to move people around and save belongings. Floods pose specific challenges for relief health as sometimes vast areas of land are covered with water, making coordination very difficult. Organising logistics, transport and distribution of relief goods is complicated, since the country's infrastructure is often damaged.

There are usually two phases following flood disasters. During the first phase, people crowd on patches of high, safe ground, together with cattle and other animals, even snakes and scorpions. Drinking water is often very difficult to find and sanitation is terrible.

During the second phase, people start to move back to their homes as soon as possible. This is often a prolonged process (certain areas dry up quicker than others) and once home, people face new challenges including destroyed water systems, wells and bore holes that need cleaning up and disinfecting. A couple of weeks after the flood, high risks for epidemics like cholera, malaria and dengue emerge.

The Federation response adjusts to meet the needs of each specific circumstance, during the two phases and into rehabilitation. Mobile clinics can be used successfully, and additional efforts are concentrated on water and sanitation in particular, along with shelter, distribution of emergency food supply, basic health care and field hospitals.

Refugees/population movements
Population movements usually escalate slowly but fast large-scale population movements have been seen in the last decade, for example, the Great Lakes in 1994 and tha Balkan. When population movements occur, initially teams determine whether those moving are refugees, economic migrants, internally displaced people or asylum seekers. This needs to be identified since support mechanisms and the legal status of the people can affect the response operation.

Population movements demand comprehensive relief support. Camps can house more than 200,000 people - involving many non-governmental organisations working together - or can be smaller, sheltering 20-30,000 people, in which case they are often managed by one or two organisations (such as the Federation).

The Red Cross Red Crescent response provides for the whole health care spectrum and follows district health care norms, with provision of public health care covering most primary health care elements. Much focus is on community health, using Health Information Teams (HIT), small clinics and a competent referral system.

Reproductive Health and Psychological Support programmes become more and more prominent during these types of disaster and are now integrated components in Federation programmes. Many refugee operations tend to last for decades and a "slimlined" operational approach is often needed - this is more or less dictated by donor fatigue.

Post conflict
It is often not entirely clear when a conflict has come to an end but nevertheless, the International Federation intervenes as early as possible after the conflict to support National Societies. Somalia, Iraq and Afghanistan are recent examples of such countries that needed post-conflict support.

Health needs are nearly always great in post-conflict situations. The Red Cross Red Crescent response upholds the district health care norms, focusing on basic health care, public health, and immunisation programmes. The Federation often focuses on how to sustain programmes, upgrade human resources and standardise approaches, treatments and essential drugs.

Famine/nutritional emergencies
Famine and nutritional emergencies can happen quite suddenly. The Federation carries out a lot of food distribution in these situations. Occasionally the Federation carries out supplementary feeding, targeting certain vulnerable groups suffering from poor nutrition. This often includes women who are pregnant or breast-feeding and children under the age of five.

Humanitarian Aspects of Technological disasters
The Federation has more of an advocacy/information sharing role and does not involve itself with the technical aspects, e.g. cleaning up, irradiation sickness or (advanced) treatment of people, which have been exposed. Sixteen years on, the Federation is still running a programme to assist victims of the Chernobyl nuclear reactor explosion of 1986, providing medical assistance and check-ups, and psycho-social support.

Chemical and Biological warfare (CBW)
The Federation provides basic information about symptoms and effects of agents, antidotes and protection.

Again, National Societies and the Federation take care of people displaced or fleeing from chemical or biological attacks, providing shelter, food, basic medical care, water and sanitation.