The twinning of local communities for the prevention and alleviation of the consequences of a disaster is a very valuable means of assistance.1 Twinning involves the conclusion of an agreement between communities, providing for various types of activity such as:
1For example, following the 1980 earthquake in Italy, which took a toll of over 3000 lives in the Naples region, the assistance sent by Italian towns situated at various distances from the scene of the disaster proved in many cases speedier and more effective than other forms of assistance. In most cases teams were sent who had their own means of shelter and survival and brought with them the necessary machines, equipment or, particularly, specialized staff. A few hours after the earthquake each of the local communities stricken by the disaster was twinned with an Italian town (or sometimes more than one) for immediate assistance. These twinnings in some cases lasted several months and provided very important help in the reorganization of community life and the return to normality.
· collaboration, joint initiatives and exchanges for preventive activities: organization of a health information network, mapping resources, training of staff, education of the population, sanitation plans, strengthening or recuperation of the building stock, study seminars, volcanic, seismic or hydrological zoning, etc.;
· determination and preparation of the resources to be sent in the event of a disaster: equipment and machines for clearing rubble, specialized personnel, health equipment and personnel, communications equipment and personnel;
· provision for means of transport and temporary accommodation in the event of evacuation;
· organization of joint exercises.
The local health personnel of the twinned communities work periodically together on types of action to be taken in an emergency, for example:
· training schemes on how to behave in different types of emergency,
· equipping and preparing the local health establishment to receive a large number of injured and sick people,
· previous agreement on evacuating cases that cannot be dealt with on the spot to a properly equipped hospital,
· joint initiatives for public health action in the event of a disaster: disease monitoring, sanitation, health education, rehabilitation, mental health and its community management, etc.
Twinning should be reported to and agreed by the regional and national authorities, to avoid duplications and gaps.2 Twinnings are very important: they make it possible to prepare disaster relief plans which can be rapidly put into effect. They presuppose educational and preparedness activities that commit the two communities in a broad and systematic way; they develop a feeling of cooperation and solidarity; they encourage community actions and the assumption of responsibilities; they prevent the development of a feeling of dependence in regard to assistance, and the twinned communities often share the heavy burdens resulting from disasters.
2 Various criteria for twinning can be adopted. In some countries certain areas are much more liable to disasters than others. In such cases towns in high-risk areas may be twinned with low-risk towns. In other cases, however, the fact of being exposed to the same dangers in two different areas may encourage the conclusion of twinning agreements. In yet other cases emotional, economic, cultural or political reasons provide a basis for twinning.