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Charles S. Krin, a retired family and emergency physician from Salem, Mo., and a group of trauma surgeons, say despite the frightening regularity of humanitarian disasters like the earthquake in Haiti, international responses remain fragmented and must be improved.

In a commentary published in the British Medical Journal, the group of trauma surgeons warns an uncoordinated push to get people and equipment into the affected zone as soon as possible can worsen the situation and reduce the effectiveness of relief efforts.

Many healthcare professionals from developed countries do not know what to do when faced with the horrors of a major humanitarian disaster, so proper preparation is key to providing prompt relief, Krin and colleagues say.

Volunteers in the United States are required to undertake a National Incident Management System course so that they are aware of the likely systems and where they will fit.

Medical volunteers should have a basic understanding of field and trauma medicine, be able to treat wounds and fractures with limited equipment and in non-sterile conditions, and know basic field sanitation and water purification techniques, the surgeons say.

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