Regulating the helping hand: improving legal preparedness for cross-border disaster medicine.

Medical care is a highly regulated field in nearly every country. Therefore, it is not surprising that legal issues regularly arise in cross-border disaster operations that have with the potential to profoundly impact the effectiveness of international assistance. Little attention has been paid to preparing for and addressing these kinds of issues. This paper will report on research by the International Federation of Red Cross and Red Crescent Societies (IFRC) on International Disaster Response Law, and discuss new developments in the international legal framework for addressing these issues. For seven years, the IFRC has studied legal issues in cross-border disaster assistance. Its activities have included several dozen case studies, a global survey of governments and humanitarian stakeholders, and a series of meetings and high-level conferences. The IFRC has found a consistent set of regulatory problems in major disaster relief operations related to the entry and regulation of international relief. These include some issues specific to the health field, such as the regulation of drug donations and the recognition of foreign medical qualifications. To address the gaps in domestic and international regulatory structures, the IFRC spearheaded the development of new international guidelines. The legal risks for international health providers in disaster settings are real and should be better integrated into program planning. Governments must become more proactive in ensuring that legal frameworks are flexible enough to mitigate these problems.