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August 1, 2001

Improving Standards in International Humanitarian Response: The Sphere Project and Beyond

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorJody W.ZylkeMD, Contributing EditorIndividualAuthor

JAMA. 2001;286(5):531-532. doi:10.1001/jama.286.5.531

To the Editor: The very high mortality resulting from epidemics of cholera and dysentery among Rwandan refugees in Goma, Zaire, in 1994 was a turning point for humanitarian aid organizations. Wide-scale clinical mismanagement of cholera by inexperienced relief workers was reported in both the scientific literature1 and in the news media. Prior to this time, many humanitarian organizations had recognized the need to improve professional standards within their own organizations to improve the effectiveness of their humanitarian response. Events in Goma, however, increased the impetus to improve accountability within the humanitarian system as a whole.2