On 7 August 1998 truck bombs destroyed the US Embassies in Kenya and Tanzania.(1) The response in both countries was characterised by an absence of incident command, limited pre-hospital care, a disorganised hospital response and a lack of transportation for those injured. In the next five years USD 50 million was provided by the United States Agency for International Development (USAID) to alleviate the resulting suffering, support reconstruction and strengthen disaster preparedness capacity in the two countries. These two programmes have enhanced awareness of disaster management issues, improved training capacity, built response structures and provided material resources. Their design and implementation provide lessons for future disasters in developing countries. The assistance programmes evolved very differently. In Kenya the programme largely excluded the public sector and the potential for government coordination, while the Tanzanian programme concentrated heavily on central government and regional hospital structures-largely omitting the non-governmental or civil society sector. Excluding key stakeholders raises concerns about programme sustainability and the ability to respond effectively to future emergencies.
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