Natural disasters always cause vast mortality and morbidity.

When such natural disasters occur, we doctors can be of immense contributions to saving lives and offering relief. However, regardless of what training we have had in the various different clinical disciplines, physicians who work in such emergency setting will face patients in all ages and with all sorts of medical situations. Whilst certain clinical trainings we have had and in which we have become specialists (such as nephrologists and orthopaedic surgeons) may be more relevant for life-saving effort during these emergencies, family physicians are particularly useful for medical relief effort. Family physicians are accustomed to working in a community setting and adopt a generalist approach in dealing with a wide spectrum of health needs, even in the least expected situation, - for some victims, all that is needed may just be a sympathetic reassurance and a bit of first aid.

Globally, many countries are experiencing an aging of their population and seeing an epidemiological shift of disease patterns from infectious diseases to chronic diseases. These demographic and epidemiological transitions have made chronic medical problems a significant health burden for the general population in both the developed and developing nation, even in days of peace and tranquility. However, natural disasters respect no one, rich or poor, healthy or ill. They strike anyone at any time they like. During the post natural disaster period, in addition to dealing with the many injured victims, relief doctors and health care professionals will also often have to deal with the uninjured patients who also will require medical attention for their existing and underlying chronic health problems present even before the disasters striked. In developing countries, the lacking of medical personnel and resources (drug and diagnostic machines) in peaceful times further complicates the scenario when disasters strike. Frequently, not only would a medical relief clinic meet the needs of such disaster victims seeking treatment, the doctor may also find himself/herself managing not patients from the scene of the disaster but from places afar - from the neighbouring population and unaffected areas, from people who are taking advantage of relief work and attempting to seek free treatment and expert advice which they normally would not have access to. In addition, the relief doctors from out of town may also face ethical dilemma on whether or not to give and extend offer medical/drug treatment to those areas where sustainability of these treatment might be questionable.

As agreed by many physicians who have been out there in the field working in emergency relief settings, less experienced doctors are reminded that life-long learning in all clinical disciplines is important. Doctors who will function well in post disaster emergency settings tend to possess four basic characteristics. These include: i) a good clinical knowledge that ranges from acute emergency medicine to management of chronic diseases,¹ to mental health, ii) adaptability - the ability to work in suboptimal conditions,² iii) eagerness to communicate and the possession of well-developed interpersonal skills, as well as iv) a good sense of humor.

In particular, possession of "universal" adaptability is of paramount importance to work efficiently in disaster settings. Within a short period of time, a relief doctor has to be able to resolve the challenge of working in a different system that is characterized by difference in language, culture, doctors/patients communication, treatment protocols and sometimes underlying incentives among stakeholders in a relief setting. Relief team dynamics could be daunting and sometimes impossible. For example, an external relief doctor may face unexpected rejection by local medical counterparts for his/her willingness to provide free medical care because this practice may disrupt local counterparts from earning their income through fee-for-service consultations and drug prescriptions. A doctor may have to yield to group pressure and endorse clinical decisions or quality of care that might be deem as unethical in his/her own hometown setting.

With all the challenges, people would question why one would still venture to disaster areas to provide medical relief assistance? Perhaps, in addition to the idea that helping population in crisis is truly meaningful and fulfilling, the real reason is the desire to feel useful. After all, in relief setting, a doctor represents hope for survival. Most insightful of all, it serves as an opportunity to remind a physician of his/her true professional calling when he/she was once young.