Rescue efforts in the first hours are mainly carried out by people already on-site, including community members and any local authorities and aid organisations already present when the disaster struck. Indeed, we treated our first patient shortly after the Haiti earthquake, as we were already providing medical care through programmes in the country.

The urgent priority is to rescue the victims, and to quickly re-establish means of communication, transport and supply routes for deployment of external relief.

From large-scale catastrophes to local emergencies, our network of aid workers in more than 70 countries and supply centres around the world mean we can quickly respond to natural disasters.

With over 40 years experience working in natural disasters, we’ve developed tools to deploy rapid relief and life-saving assistance. This can include surgical kits, relief items, or even entire mobile hospitals. Our first response staff can be reinforced with additional teams if a larger response is needed.

The more transport routes are disrupted and communities are isolated, the longer it will take for external relief to arrive. It can be a race against time to access isolated areas, especially for people needing to be rescued, the wounded needing medical treatment, and those living in terrible conditions without any shelter.

In Nepal in 2015, many villages were cut off by landslides, or just simply inaccessible by road, so our natural disaster teams flew by helicopter to assess needs and provide relief.

One of our priorities is to evaluate whether there are many wounded and whether local health capacities have been hit by the disaster. If people suffering from cuts and fractures do not access treatment, including proper post-operative care, their wounds can quickly become infected.

We’ll send medical units to perform surgical procedures, provide post-operative care and physiotherapy. We may deploy mobile hospitals, such as an inflatable hospital, which is particularly appropriate after an earthquake when there are after shocks.

The destruction of homes often means that people are displaced and are forced to regroup in makeshift settlements. Overcrowding, insufficient access to drinking water and lack of medical treatment can encourage the spread of common infectious diseases. Sleeping outdoors and in temporary shelters can lead to respiratory infections, especially in children.

In these cases the restoration of routine health services and the distribution of shelter and basic relief items are also among the priorities. Providing mental health support is also necessary to help people recover from the trauma of the event.

Our response is developed through extensive collaboration with national actors, taking into account the importance of local efforts and strategies, and the limitations of an international intervention in regards to time, quality and pertinence.

We analyse the added value of the assistance we can bring, and regularly question the pertinence of our continued presence. Our aim is to 'hand back' any medical activities to local authorities or partners once they no longer need our support.