Challenges and barriers of Humanitarian Aid Management in 2017 Kermanshah Earthquake: A Qualitative Study

Challenges and barriers of Humanitarian Aid Management in 2017 Kermanshah Earthquake: A Qualitative Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research article Challenges and barriers of Humanitarian Aid Management in 2017 Kermanshah Earthquake: A Qualitative Study Hamid Safarpour, Saeideh Fooladlou, Meysam Safi-Keykaleh, Somayyeh Mousavipour, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.2.11139/v3 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 25 Apr, 2020 Read the published version in BMC Public Health → Version 3 posted 4 You are reading this latest preprint version Show more versions Abstract Background: Examining various problems after disasters is important for the affected people. Managing humanitarian aid and donations among the affected people is considered as one of the most important problems after disasters. Therefore, the present study aimed to evaluate the challenges and barriers of humanitarian aid management in 2017 Kermanshah Earthquake. Methods: This study was conducted from November 2017 to January 2018, with qualitative case study design. The population included 21 people including 6 humanitarian aid manager, 6 volunteers, 4 aid workers, and 5 affected people. The data were collected through semi-structured interviews and purposeful sampling, which continued until saturating the data. The strategies recommended by Guba were used for evaluating the trustworthiness of the data. The data was analyzed with conventional content analysis method according to method suggested by Graneheim and Lundman. Results: Based on the results, two themes, nine categories, and 19 sub-categories were identified considering the challenges and barriers of humanitarian aid and donors’ management during the 2017 Kermanshah Earthquake. The categories included education, command and coordination, communication and information, rules, security, traffic and overcrowding, assessment, providing system, and cultural setting. Also, two themes including managerial and structural barriers were extracted. Conclusion: Adopting an effective management and appropriate policies with respect to humanitarian aid and modifying structural and managerial barriers can improve the performance and management of humanitarian aid. Health Economics & Outcomes Research Health Policy Disaster donation management humanitarian aid aid distribution Iran Introduction Community involvement and collaboration in all of the phases in disaster management are essential for achieving a successful disaster management. However, the type of assistance can vary according to the characteristics of each country [1]. In most cases, national and international aid agencies provide technical and financial assistance to the victims after a disaster [2]. UNDRO (1982) introduced the community participation approach as a key success in the post-disaster reconstruction [3]. After disasters, humanitarian organizations mobilize a large amount of aid to disaster area. However, the distribution of these resources creates many challenges such as time, cost, coverage, and eligibility [4]. Extreme disasters like storms, earthquakes, tsunamis, and volcanic eruptions often bring extraordinary acts of helping [5].During the humanitarian aid, the donors want to spend their money on alleviating the immediate distress [6]. The competition of aid agencies for donor resources can be considered as a barrier for collaboration and cooperation [7]. Humanitarian aid distribution is related to many activities such as involving a large number of stakeholders for managing disaster, enormous effort, and different processes. Humanitarian aid distribution is associated with many activities such as accessing up-to-date and appropriate information for effective communication in order to prompt collaboration and improve integration [8]. Regarding disaster management, several stakeholders are involved in managing the distribution of humanitarian aid. The stakeholders such as Governmental Organizations (GOs), Nongovernmental Organizations (NGOs), volunteers, and private sectors are responsible for managing humanitarian aid for disaster victims [9]. In addition, collaboration and coordination are considered as the most important factors in managing donations during disasters[10]. However, humanitarian aid in different situations is always accompanied by many challenges. Due to the lack of political engagement, manipulation by state authorities can result in perverting aid interventions [11]. A powerful earthquake struck Kermanshah province in west of Iran near the Iran-Iraq border at 18:18:16 UTC (21:48:16 local time) on November 12, 2017. More than 600 people lost their lives, about 10,000 were injured, and thousands of building were damaged [2, 12]. Consequently, thousands of the affected people were displaced in Sar-e Pul-e Zahab, Ezgeleh and surrounding villages [2], which needed urgent government and humanitarian assistance, especially in the early days of the disaster. However, humanitarian aid began by GOs, NGOs, and public community immediately after the earthquake. However, some problems and challenges were created for managing humanitarian aid. Thus, the present study aimed to evaluate the challenges and barriers for humanitarian aid management in 2017 Kermanshah earthquake. Methods Study design A qualitative case study design was applied for conducting the study. Case studies designs are in-depth examinations of people, groups of people, or institutions[13]. First, the data were collected directly and without any pre-suppositions. Then, the codes, sub-categories, categories, and themes were derived through an inductive process. In fact, qualitative content analysis is a research method used to interpret the content of text data. In addition, the conventional content analysis is generally used in designing the study aiming to describe a phenomenon. This design is often appropriate when the theory or the research literature about a phenomenon is limited [14]. The researchers avoid using the pre-assumed notions, while they allow the categories and codes to be extracted from the data. In this study, the codes, sub-categories, categories, and themes were extracted by an inductive process and were conceptually ordered by considering developed properties and dimensions [15]. Participants This study was conducted in Kermanshah province, Iran from November 2017 to January 2018. A total of 21 participants were selected for interviews in terms of demographic characteristics. The participants were selected based on purposeful sampling employing maximum variety sampling. The inclusion criteria included the life experience of the current earthquake, either as affected people, manager, or key informant, and the willingness to participate in the interviews. However, those individuals who refused to give informed consent were eliminated. The participants included six humanitarian aid managers, six volunteers, four aid workers, and five affected people. The questions for a semi-structured interview were designed based on a deep interview with the interviewees and the texts were transcribed. The interview questions were reviewed and approved by the researchers several times. After each interview, the researchers listened to the recorded audio file several times and transcribed them as soon as possible. In addition, taking notes, along with recording the data during the interview was considered. Interviews reached saturation in the 21 interview and data collection was stopped at this stage. Data collection and analysis Data were collected through in-depth and semi-structured interviews, and field observation. Since researchers seek for the meaning of individuals' experiences, asking individuals and understand their experiences through interviews is considered as the best strategy for obtaining the meaning of experiences. The participants were requested to read and sign an informed consent form and invited to participate. Initially, the first two in-depth interviews were performed following by semi-structured interview to explore the participants’ experiences. The semi-structured interviews were conducted among well-experienced and/or knowledgeable key person including humanitarian aid mangers, aid workers, and help volunteers. The first question was related to the participants’ experiences. The main points of questions which only served as an interview guide were ‘Please describe your experience of the earthquake?” , “ How about humanitarians and aids and donation?” , and “What are the barriers to aid and donations management?” . Then, these questions continued with in-depth questions such as “ Could you please explain more? ”, and “ Take a sample from your own experience ”. After establishing the basic concepts, the interview questions were designed based on the gaps in the previous interviews. Thus, the questions were different in various interviews. The interview continued to saturate the concepts. Each interview lasted between 30 and 60 minutes. All interviews were recorded, transcribed verbatim, and analyzed using constant comparative method. The interviews were conducted in Persian and then translated into English by a bilingual translator for the purpose of publication. A bilingual translator was asked to confirm the quality of translation to maintain meanings and concepts. Content analysis method was used to analysis the data. Content analysis is used in evaluating the data from qualitative case studies designs[13]. Data was analyzed according to method suggested by Graneheim and Lundman (2004) [16]. All of the interviews conducted by principal investigator (HS). Then, two researchers (HS, and MSK) transcribed and analyzed the data independently. Then, the meaning units as the phrases related to the participants’ experiences were identified. In the next procedure, the data were summarized as condensed meaning units, labeled with codes, and sorted into categories and sub-categories based on their similarities and differences. Finally, the same categories were abstracted and labeled with the related themes. The last two steps of the analysis process were conducted by all authors. When the codes, or categories were different by two researchers, we asked to other authors to help and data analysis. Reliability was checked using the following formula suggested by Miles and Huberman[17]. Reliability= Number of agreements/ Number of agreements + Disagreements As a rule, the minimum percentage to demonstrate adequate levels of agreement is 75%[18]. In this study the total agreement of themes, categories, and sub-categories was 94% which shows well agreement between authors. Data trustworthiness The strategies recommended by Guba [19] were used for evaluating the trustworthiness of the data. Thus, four criteria including credibility, dependability, confirmability, and transferability are necessary for confirming trustworthiness. Prolonged engagement, triangulation, member checks, peer debriefing and negative case analysis were used to ensure the credibility of the data [20]. Regarding the prolonged engagement, the researcher was actively engaged in the disaster field for 2 months while making observations and compiling field notes continually. As for triangulation, multiple researchers were to evaluate the study, which brings different perceptions of the inquiry and helps to strengthen the integrity of the findings. Regarding data triangulation or informant’s triangulation, different sources of data or instruments such as interviews, and field observation were utilized to enhance the quality of the data from different sources. In order to check the members, the analyzed and interpreted data were sent back to the participants to evaluate the interpretation and change the interpreted data if the participants were unsatisfied. In addition, peer debriefing was implemented to provide inquirers with the opportunity to test their growing insights and expose themselves to the searching questions. Finally, negative case analysis was used when the data collected from the inquiry was inconsistent with the researcher’s expectations, leading to an improvement in the credibility of the study. The data dependability was assessed by an audit trail, stepwise replication, code-recode strategy, and peer examination. Reflexive journal or practice, along with the integrity of research findings was used to assess the confirmability of data. In this regard, the researcher’s background and interest on the subject and maintaining the documents of study were used for checking the confirmability of data [20]. Further, a thick description of data, along with theoretical/purposive sampling was utilized to ensure the transferability of data[20]. The context of the interviews, codes, and extracted categories and themes were reviewed by the research team and other professional colleagues in the field of qualitative research. Using sampling with a maximum variation, the researchers were able to collect a wide variety of different comments, observations, and interpretations. Results The mean age of the participants was 31, most of them were male, and had an academic education level (Table 1). First, the transcribed data from 21 interviews were analyzed, along with field note observation. The number of initial codes obtained from the interviews was 1053, which were placed in 19 sub-categories, 9 categories, and 2 themes (Table 2). Managerial and structural barriers were obtained as main themes. The categories included education, command and coordination, communication and information, rules, security, traffic and overcrowding, assessment, providing system, cultural setting. Managerial barriers E ducation Most of the participants claimed that the lack of public and organizational education is considered as the most important barriers. Such an education encounters with weaknesses and challenges in many aspects since people are not familiar with the ways for helping and people who are interested in humanitarian aids are not informed of which kind of donation, to whom, in which time, and how should be delivered. In addition, the volunteers and local trustees are not well familiar with the ways of participation in identifying the needs and the needy people, as well as delivering and distributing the donations. Thus, not only the people affected by disasters are suffering from lack of knowledge, but also the volunteers, managers, and the relief staff and GOs are not sufficiently knowledgeable in this regard. “ Our donors do not know which goods, when, and to which organizations should be delivered. Most of them go to the affected areas individually to provide aids. At the time of distributing the aids to the rural people, we did not know to whom we should deliver the aids. The villages’ trustees were mostly old and were not capable of receiving and distributing the donations.” Command and Coordination According to the participants, the multiplicity of the organizations responsible for the disasters is considered as a serious challenge for managing humanitarian aids and donations. The participants believed that people are confused due to the lack of information about the way they should deliver the aids. Further, the victims were not informed of where to refer for receiving the aids. Lack of a unique commandership led to the multiplicity of decision-taking centers, useless attempts, and lack of efficient and effective accountability. “ Many organizations from governmental ones to NGOs, offices, universities, local councils collected the aids and set out for the affected districts. Some of the people received help from several organizations or institutions while some other could not get any help.” According to the subsequent interviews and the obtained data, assisting organizations were not sufficiently coordinated and cooperative in various levels from the management and strategic to operational levels. In other words, due to the lack of coordination, resources, staff, and equipment were sent to the affected regions but they were not coordinated. “ The military forces, the NGOs like Red Crescent, and GOs all were simultaneously involved in the aid and rescue operations without any coordination among them. Crowding and congesting the forces and equipment were themselves transformed into a crisis.” Communications and Information These barriers were the main concerns of the participants. They were regarded rumor-fabricating and rumor-mongering as a disturbing factor in preparedness and proper response. They were dissatisfied with the weak performance of the media and lack of control on several social networks. The multiplicity of media and lack of a unique and influential management for organizing supervision and monitoring on the news, and the existence of ample inauthentic news sources were considered as the most significant challenges. “ Different news was heard in any moment. The news broadcasted from governmental and cyber space channels were completely contradicting. There was no unique news about the casualties, damaged areas, and amount and ways of delivering aids. Many rumors were heard from people and different institutions in the cyber space.” Rules Most of the participants regarded the lack of rules and consistent supervising system as important factors. They assumed the lack of control on the performance of celebrities and renowned persons as a significant factor for misusing this group from people’s participation and the appropriation of the gathered humanitarian monetary resources to their own benefits. In such condition, there is no supervision by any accountable organization, governmental organizations, and NGOs, and the celebrities introduce multiple bank account numbers in order to collect people’s cash as in-cash donations. Thus, many cases of misusing the aids were reported. “ Some of the famous cinema actors gave their bank account numbers in the cyber networks to collect people’s cash aids but except for a few, most did not spend the money for the afflicted people. In addition, the supervising organizations did not prosecute the issue. Several account numbers were presented incessantly for receiving the donations from individuals and different organizations”. Structural barriers Security The participants reported that lack of adequate security is the most significant barrier for delivering humanitarian donations and aids. They asserted that the security of the mobilized facilities and equipment, especially the ones sent overland, were not duly provided. Additionally, the thieves’ rush from other regions to the affected areas, overcrowding, and fraud all with malicious intentions created some disorder in security. “ We heard that the trucks having been carrying the same aids were assaulted and the aids were stolen. Perhaps, they were actually in need and did not intend to steal anything, but in my idea, it would rather have been better to escort the trucks by security forces” Assessment Lack of assessing the needs and capacity of the area is influenced by two main challenges reported by the participants. The local trustees and individuals believed that their opinions were not respected in identifying the need. In addition, the responsible organizations distributed the aids without considering the real necessities of people. According to the participants, having no plan for needs and capacity assessment can result in wasting the resources, along with injustice in the distribution. Further, the needs of vulnerable groups, especially the elders, children, disabled, and families with poor custodian or no custodian were disregarded. “ As a rescuer who was the supervisor of an assisting group, I did not know which village or district of the cities was more in need and whether any aid had been sent to those regions or not. Some other people came to receive goods, foods, clothes, and other things. We had no idea which families had disabled members or elders or pregnant women, and who had lost their husbands because they were not able to refer to assisting centers to receive aids”. Providing system According to the interviews, preserving and distributing the humanitarian aids are considered as the barriers and challenges regarding providing system, which can be divided into three main phases. The first phase was the barriers related to the collection and arrival of the aids and donations to the affected areas. In fact, there was no procrastination in common participation in delivering the aids and the inaccessibility of the damaged region due to the damaged connecting roads, and the remoteness of some villages led to the prediction in transferring the aids to the regions. The second phase was the challenge of preserving the goods in the affected areas. The participants reported that foods were preserved under sunlight and rain in an unhealthy condition, and some mercenary persons rushed to the deposit places and stole things many times. The third phase involved the challenges related to the distributions such as having no preceding plan for distribution, non-observation of equivalence in distribution, and untargeted distribution. “ The aids were arrived to some remote villages with delay. In other villages whose roads were damaged, the food packages were thrown down from rescue helicopters which caused the packages to become spoiled due to crashing into the ground. People’s aids were collected in one of the city squares and they were covered by a canvas. The foods on the ground were in contact with the rain water and they were exposed to sunlight”. Cultural setting The participants believed that cultural setting plays a significant role in managing the humanitarian aids. They emphasized that lack of community trust in GOs versus the excessive trust they had in celebrities and renowned persons as one of the main challenges. The responsible GOs and the NGOs were inattentive to people’s culture and customs, leading to some problems in managing humanitarian aids. Furthermore, people’s inattentiveness for waiting in the queues was regarded as another cultural barrier . “ If people had trusted the GOs as they trusted the celebrities, there would not have been that much misuse. People are also to be blamed because they are affected by emotions for collecting aids in the first days after disasters. In addition, the afflicted people rush for receiving the aids. For instance, when a truck arrived for assisting, they did not stand in queues but they wanted to get the goods all at once”. The participants emphasized that the benefactors had remarkable and unbelievable participation during rescuing, relieving, and rehabilitation. They believed that the benefactors had not adequate knowledge in this regard. Further, the benefactors have a tendency for humanitarian actions in health services rather than other domains and they scarcely cooperate with governmental organizations. “ There are many benefactors in Iran but unfortunately they lack adequate awareness and knowledge and they do not act untidily. It would be better if benefactors become coordinated with each other and each supplies some parts of the requirements for the injured people. The benefactors visited the affected areas carrying goods on their own. I wish a unique organization can carry out such things”. Discussion Lack of appropriate education for humanitarian aids during disasters is considered as one of the main challenges. People, managers, relief staff, and benefactors were devoid of the adequate knowledge on humanitarian aids. Since different organizations with different potentialities, capacities, duties, and interests participate in the humanitarian assistance, it is necessary to focus on improving the performances, designing the standards and educations, and promoting the educational courses by means of sharing their experience in the stage of preparedness. Some studies suggested an attempt for reducing unnecessary aids with low priority through public and professional education [10]. The existence of different broadcasting, rumor-fabricating, and rumor-mongering sources is considered as one of the challenges in the study due to the lack of education and regulation of the news sources and their control. In addition, the reliability of the information and confronting with rumors are regarded as the main concerns in the response phase of disasters because the social networks can present inauthentic information, rumors, and fictitious news due to the lack of any control process and the low quality of the information [21, 22]. Therefore, adequate education to the media added to a governmental supervision seems crucial. Further, communication barriers in delivering the humanitarian aids were emphasized by some participants. Todays, the social networks are too comprehensive and play a significant role in creating communication and coordination among the assisting organizations due to their fast broadcasting of information. The NGOs and volunteers can use social networks for collecting donations in the least time possible [23]. Furthermore, collecting exact, authentic, and effective information is considered as one of the key factors in the process of distributing humanitarian aids in disasters. Thus, attention should be paid on the unreal and inauthentic reports, which can negatively affect the participation process in delivering and distributing the humanitarian helps [24]. Managing humanitarian aids during disasters is naturally difficult due to the variety of the beneficiaries. In such cases, receiving and sharing information about the infrastructures and supplying the required resources are significant for effective response and social networks can get information about the number of people afflicted by the disasters through internet and make it accessible in order to have a fast and effective response [25, 26]. According to some participants, the needs of injured people are different during a disaster. Donations should be consistent with the receivers’ requirements rather than the donators’ preferences [27]. Mobilizing the aids without need assessment leads to the accumulation of abundant unnecessary sources in the affected areas. Additionally, ignoring the requirements of vulnerable groups such as women, children, elders, and the disabled at the time of disasters are considered as another barrier for managing aids and donations during the disasters. These groups may not be able to supply their needs due to cultural, religious, and other personal limitations [28, 29]. Some participants maintained that lack of donors' trust in governmental institutions is one of the main barriers for managing donations, which causes donations to be collected through unofficial individuals like celebrities which can result in misusing what has been provided [2]. Another structural impediment regarding donations in disasters is related to lack of any respect for cultural beliefs and values of the affected people. In this regard, donations will not be utilized if they are not congruent with the culture of that community after sending to the affected areas [30]. Lack of a systematic plan for food preservation and food security was considered as another challenge introduced by the participants. The significance of food security and feeding was emphasized in Sendai framework and sustainable development goals [31]. Lack of concern for food variety in the mobilized aids is regarded as another challenge proposed by the participants. It is necessary to guarantee the variation of foods and consumption of nourishing favorite nutrients, particularly in the first days after disasters [32]. Inequality and injustice in distribution and rushing for distributing centers are considered as some challenges regarding distributing the aids. Regarding the inevitability of identification and registration of the beneficiaries, it seems necessary for participants to adopt a controlled and fair strategy for distribution [33]. The participants stated that depositories were defected and the food was exposed to sunlight and insects for a long. Food and medicine are the first priorities in planning for maximizing security in disasters and they should be accommodated in a dry and cool place with air-conditioning systems [34]. In addition, some addressed that coordination among humanitarian organizations is a great challenge in managing donations. Lack of a managing commitment, improper organizational structure for sharing knowledge, as well as lack of a specified policy and planning are considered as the main barriers for coordination [35]. Further, establishing cluster approach and network subgroups in the affected region can lead to the contribution of coordination and collaboration in managing humanitarian donations [36]. Since the government plays a fundamental role in organizing and coordinating the humanitarian assistance operations [37], authorization generates a potential ability for responding to the disasters based on law and constitution [38]. Integrated management of the processes, policies, and legislations can play a fundamental role in managing the aids among people [39]. Additionally, organizing and coordinating the effective participation of government and benefactors can increase the opportunities in responding to disasters and casualties[40]. In addition, providing security in the affected areas is considered as one of the main problems reported by some participants [41, 42]. Further, insecurity brings challenges for humanitarian organizations and puts the distributors of aids and people at risk [43]. Distributing aids through adopting a consistent management of provisional duties such as depository keeping, qualified transfer system, and fair access to aids can be effective in managing donations and preventing forage by thieves [44]. Limitations The present study clearly had some limitations. One potential limitation of the current study was that this study conducted in the Iranian context that it can be limited in generalizability to other countries. However, it seems that given the shared challenges, the results can be applicable in the same countries with same setting. The language was a barrier in the affected area of Kermanshah in which Kurdish is a native language. Although most of the interviewees speak in Persian, some of the affected people could speak Kurdish. To overcome the limitation, HS, DP, and AS, as three native colleagues, helped the researchers to translate Kurdish words into Persian. Conclusions Humanitarian aid management during disasters has many challenges. Adopting an efficient management and appropriate policies for humanitarian aids and donations, as well as eliminating structural and policy barriers can improve the performance of management. Further, developing public education and evaluating the needs based on cultural factors, as well as supervising and clarifying the aids can help reduce the challenges and barriers. In addition, it is essential to establish a lead agency with sufficient authority to supervise the collection, transport and distribute humanitarian aids and donor managements. Since involving a variety of organizations and individuals, especially the celebrities, in collecting and distributing such aids can lead to some sources of misuse and sometimes abuse, it is recommended that the government should provide adequate training and preparation for their intervention and supervision by adopting the related laws. The registry system can help manage this problem. In addition, vulnerable groups such as the elderly, children, homeless people, disabled individuals, and pregnant women should be considered while distributing the aids. Finally, training local authorities and trustees should be highlighted in the preparedness plans. Furthermore, these findings as a scientific document, will be available to managers of NGOs and GOs involved in rescue and relief and humanitarian aid management for use in the field. Moreover, the knowledge created by this study, can lead to awareness of policy makers and managers in other countries about the challenges of humanitarian aid management and help them to better preparedness and respond against future disasters. Abbreviations NGO : Non-governmental Organization GO: Governmental Organization SDGs : Sustainable Development Goals Declarations Ethical consideration The present research was reviewed and approved by the Ethics Committee of Shahid Beheshti University of Medical Sciences. The informed written and oral consent of the participants was obtained by introducing himself and expressing the purpose of the study. Accordingly, all participants were informed about the confidentiality of their names and other private information. Furthermore, they were provided with the possibility of leaving their own interview session at any time. Consent for publication N/A. Availability of data and materials The datasets used during the current study are available from the corresponding author upon reasonable request. Conflict of interests The authors declare no conflict of interests. Funding No fund was received for the present research. Authors’ contributions Concept and designed the study: HS, MSK, and SF. Collection of data: HS. Analysis and interpretation of data: All authors. Wrote the manuscript: All Authors. Revision of the paper: HS, and MSK. All authors reviewed and approved the final manuscript. 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A modified approximate dynamic programming algorithm for community-level food security following disasters. arXiv preprint arXiv:180400250. 2018 Nozue M, Ishikawa-Takata K, Sarukura N, Sako K, Tsuboyama-Kasaoka N. Stockpiles and food availability in feeding facilities after the Great East Japan Earthquake. Asia Pacific journal of clinical nutrition. 2014;23(2):321-30 Kabra G, Ramesh A, Arshinder K. Identification and prioritization of coordination barriers in humanitarian supply chain management. International Journal of Disaster Risk Reduction. 2015;13:128-38 Handayani NU, Mustikasari A, editors. Coordination and Collaboration Functions of Disaster Management Centers for Humanitarian Logistics: A Case Study at Merapi Eruption. MATEC Web of Conferences; 2018: EDP Sciences. Hesama L. Review of the commitment of governments to accept and send humanitarian aid in natural disasters. Journal of Public Law Studies of Tehran University 2019: Mar 21;49(1):231-48 Rumbach A. Decentralization and small cities: Towards more effective urban disaster governance? Habitat International. 2016;52:35-42 Elbert R, Gerdes U-T, Kaiser G, Sarnow T. Governance and moderating effects of environmental uncertainty: The impact on performance in horizontal logistics cooperations. Logistics Research. 2018;11(4):1-29 Pirani D, Yousefi K, Sahebi A. Disasters; The Opportunity of Reconstruction and Development: The Successful Experience of the 2017 Kermanshah Earthquake. Iran Red Crescent Med J. 2019;21(2):e90216 Roth S. Aid work as edgework–voluntary risk-taking and security in humanitarian assistance, development and human rights work. Journal of Risk Research. 2015;18(2):139-55 Ghodsi H, Khani Jazani R, Sohrabizadeh S, Kavousi A. The Resiliency of Humanitarian Aid Workers in Disasters: A Qualitative Study in the Iranian Context. Iran Red Crescent Med J. 2019;21(2):e80366 Schneiker A. Humanitarian NGOs,(in) security and identity: Epistemic communities and security governance: Routledge; 2016. Varella L, Gonçalves MB, editors. A Gestão das Doações na Logística Humanitária: Estratégias para Evitar o Caos. XXIX ANPET, Ouro Preto, MG XXIX ANPET-Congresso de Pesquisa e Ensino em Transportes; 2015. Tables Table1. Demographic information of the participants Variables Number (%) Affected people 5(23.80%) Participants Aid workers 4(19.04%) Volunteers 6(28.58%) Humanitarian aid manager 6(28.58%) 25-35 8(38.1%) Age 36-45 7(33.33%) 46-55 6(28.57%) Sex Male 14(66.66%) Female 7(33.33%) Education Level High School degree 3(14.28% Bachelor's degree 9(42.86%) Master's degree 5(23.80%) Ph.D. degree 4(19.05%) Table 2. Themes, categories, and sub-categories related to the challenges and barriers of humanitarian aid management in 2017 Kermanshah Earthquake Themes Categories Sub-categories Example of codes Managerial barriers Education Public education Lack of education of humanitarian aids in the schools Lack of education for managing the affected society Lack of familiarity with the involved organizations in humanitarian aids Organizational education Inappropriate education and management of the enthusiastic persons Insufficient knowledge about the ways of assisting Inappropriate education and management of the local trustees Lack of enough education of the volunteers Command and Coordination Incident Command System Several decision-making centers Lack of an official administrator for disaster management Lack of unified incident command system Coordination and Cooperation No coordination among the assisting organizations Lack of an organization for coordinating the aids and donations Interference of the duties of responsible organizations Communication and Information Social media Weakness of the media in managing the rumors Ineffective social media Multiplicity of sources of information and news Organizational communication Weakness of the inter-organizational communication Weakness of the intra-organizational communication Rules Rules and Regulations Lack of participation rules for the celebrities Lack of rules and regulations for collecting cash and non-cash donations Lack of specified protocols Supervision and Transparency Weakness of the participation rules for organizations Weakness of participation rules for the communities Insufficient transparency of the aids gathered by GOs and NGOs Insufficient supervision on the celebrities’ accounts Multiplicity of the governmental and non-governmental institutions for collecting donations Structural barriers Security The security of affected area The existence of thieves in the affected area Lack of a proper plan for recognizing affected people from abusing persons The security of intercity area Insufficient security of trucks carrying the donations in the intercity routes Insufficient security of donors and volunteers in the intercity routes Traffic and Overcrowding Overcrowding of affected area People overcrowding Volunteer overcrowding Traffic of the intercity area Congestion of vehicles Inappropriate management of intercity traffic Heavy traffic Assessment Need assessment Lack of assessing the needs of the affected area Inadequate consideration of sanitary needs, especially for women, kids, and elders Lack of using local capacities in identifying the needs Capacity assessment Lack of assessing the capacity of the affected area Lack of using local people in identifying the capacities Providing system Distribution Remoteness and impracticability of some rural areas Insufficient distribution of the aids to the villages and distant regions Inequality in distributing the aids Delay in sending the vital aids Preservation Ambushing the food under sunlight Lack of enough equipment for saving Peoples’ interferences in the preservation process Cultural setting Community trust People’s low trust in the governmental institutions People’s excessive trust in the celebrities Community discipline People’s rush to the distribution places The poor culture of waiting in the queues Benefactor and charity culture Tendency to work in the health section more than another sections Distrust of the benefactors in the governmental institutions Parallel services of the charity organizations Cite Share Download PDF Status: Published Journal Publication published 25 Apr, 2020 Read the published version in BMC Public Health → Version 3 posted Editorial decision: Accept 16 Apr, 2020 Editor assigned by journal 13 Apr, 2020 Submission checks completed at journal 12 Apr, 2020 Editor invited by journal 12 Apr, 2020 You are reading this latest preprint version Show more versions Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-2049","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research article","associatedPublications":[],"authors":[{"id":489550,"identity":"212e276a-4431-47d2-a576-49ba1575dc05","order_by":1,"name":"Hamid Safarpour","email":"","orcid":"","institution":"Shahid Beheshti University of Medical Sciences School of Public Health","correspondingAuthor":false,"prefix":"","firstName":"Hamid","middleName":"","lastName":"Safarpour","suffix":""},{"id":489551,"identity":"393ec6c8-0ad8-4930-a3d2-2872ae2dd105","order_by":2,"name":"Saeideh Fooladlou","email":"","orcid":"","institution":"Tabriz University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Saeideh","middleName":"","lastName":"Fooladlou","suffix":""},{"id":489552,"identity":"5d14c9a2-29a5-4c64-80c9-27dc04f7f69a","order_by":3,"name":"Meysam Safi-Keykaleh","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA50lEQVRIiWNgGAWjYFAD5oONDxgYDpCihS2x2YBULQlsEkRp0W3vMf7wM4fBnr+Nua2ap+aOHD8D88NHN/BoMTtzxkyydxtD4oxjjG23eY49M5ZsYDM2zsGn5UaOGQPvNoYEhvuNQC1shxM3HOBhk8ar5f4b449/tzHYywNtKeb5R4yWGzwG0kBbGDcAtTDzthGj5UxambTsNonEjccYmyXn9h02lmwm5Jfjhzd/fLvNxl7uGPvDD2++HZbjZ29++BifFgYGDmAEMkiAmUw8IJIZr3IQYH8AZzL+IKh6FIyCUTAKRiIAAKKJTpIIRWJ3AAAAAElFTkSuQmCC","orcid":"","institution":"Shahid Beheshti University of Medical Sciences School of Public Health","correspondingAuthor":true,"prefix":"","firstName":"Meysam","middleName":"","lastName":"Safi-Keykaleh","suffix":""},{"id":489553,"identity":"2d8330f7-3336-4855-9f35-7d92416143fc","order_by":4,"name":"Somayyeh Mousavipour","email":"","orcid":"","institution":"Shahid Beheshti University of Medical Sciences School of Public Health","correspondingAuthor":false,"prefix":"","firstName":"Somayyeh","middleName":"","lastName":"Mousavipour","suffix":""},{"id":489554,"identity":"7f436545-5af2-44d4-8a3f-97f8ae8b293b","order_by":5,"name":"Davoud Pirani","email":"","orcid":"","institution":"Shahid Beheshti University of Medical Sciences School of Public Health","correspondingAuthor":false,"prefix":"","firstName":"Davoud","middleName":"","lastName":"Pirani","suffix":""},{"id":489555,"identity":"4b38cb37-c48b-45db-a85f-5ae74a495913","order_by":6,"name":"Ali Sahebi","email":"","orcid":"","institution":"Shahid Beheshti University of Medical Sciences School of Public Health","correspondingAuthor":false,"prefix":"","firstName":"Ali","middleName":"","lastName":"Sahebi","suffix":""},{"id":489556,"identity":"4bf28482-5c0f-49ed-b5b1-304eedb02834","order_by":7,"name":"Hassan Ghodsi","email":"","orcid":"","institution":"Neyshabur University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Hassan","middleName":"","lastName":"Ghodsi","suffix":""},{"id":489557,"identity":"17c01852-5318-40a2-a84b-eaa729412815","order_by":8,"name":"Iman Farahi-Ashtiani","email":"","orcid":"","institution":"Shahid Beheshti University of Medical Sciences School of Public Health","correspondingAuthor":false,"prefix":"","firstName":"Iman","middleName":"","lastName":"Farahi-Ashtiani","suffix":""},{"id":489558,"identity":"0b378500-458c-4193-ad6e-a61f5feab181","order_by":9,"name":"Arezoo Dehghani","email":"","orcid":"","institution":"Shahid Beheshti University of Medical Sciences School of Public Health","correspondingAuthor":false,"prefix":"","firstName":"Arezoo","middleName":"","lastName":"Dehghani","suffix":""}],"badges":[],"createdAt":"2019-07-05 15:30:39","currentVersionCode":3,"declarations":"","doi":"10.21203/rs.2.11139/v3","doiUrl":"https://doi.org/10.21203/rs.2.11139/v3","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12889-020-08722-5","type":"published","date":"2020-04-25T21:06:08+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":13498889,"identity":"4b25c950-ba44-4815-9e85-edbb42e68a9e","added_by":"auto","created_at":"2021-09-16 22:59:55","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":604721,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-2049/v3/ad811f0e-7d57-4097-b27c-4daaa8ce736b.pdf"}],"financialInterests":"","formattedTitle":"Challenges and barriers of Humanitarian Aid Management in 2017 Kermanshah Earthquake: A Qualitative Study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eCommunity involvement and collaboration in all of the phases in disaster management are essential for achieving a successful disaster management. However, the type of assistance can vary according to the characteristics of each country [1]. In most cases, national and international aid agencies provide technical and financial assistance to the victims after a disaster [2]. UNDRO (1982) introduced the community participation approach as a key success in the post-disaster reconstruction [3]. After disasters, humanitarian organizations mobilize a large amount of aid to disaster area. However, the distribution of these resources creates many challenges such as time, cost, coverage, and eligibility [4]. Extreme disasters like storms, earthquakes, tsunamis, and volcanic eruptions often bring extraordinary acts of helping [5].During the humanitarian aid, the donors want to spend their money on alleviating the immediate distress [6]. The competition of aid agencies for donor resources can be considered as a barrier for collaboration and cooperation [7]. Humanitarian aid distribution is related to many activities such as involving a large number of stakeholders for managing disaster, enormous effort, and different processes. Humanitarian aid distribution is associated with many activities such as accessing up-to-date and appropriate information for effective communication in order to prompt collaboration and improve integration [8]. Regarding disaster management, several stakeholders are involved in managing the distribution of humanitarian aid. The stakeholders such as Governmental Organizations (GOs), Nongovernmental Organizations (NGOs), volunteers, and private sectors are responsible for managing humanitarian aid for disaster victims [9]. In addition, collaboration and coordination are considered as the most important factors in managing donations during disasters[10]. However, humanitarian aid in different situations is always accompanied by many challenges. Due to the lack of political engagement, manipulation by state authorities can result in perverting aid interventions [11].\u003c/p\u003e\n\u003cp\u003eA powerful earthquake struck Kermanshah province in west of Iran near the Iran-Iraq border at 18:18:16 UTC (21:48:16 local time) on November 12, 2017. More than 600 people lost their lives, about 10,000 were injured, and thousands of building were damaged [2, 12]. Consequently, thousands of the affected people were displaced in Sar-e Pul-e Zahab, Ezgeleh and surrounding villages [2], which needed urgent government and humanitarian assistance, especially in the early days of the disaster. However, humanitarian aid began by GOs, NGOs, and public community immediately after the earthquake. However, some problems and challenges were created for managing humanitarian aid. Thus, the present study aimed to evaluate the challenges and barriers for humanitarian aid management in 2017 Kermanshah earthquake.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cstrong\u003e\u003cem\u003eStudy design\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA qualitative case study design was applied for conducting the study. Case studies designs are in-depth examinations of people, groups of people, or institutions[13]. First, the data were collected directly and without any pre-suppositions. Then, the codes, sub-categories, categories, and themes were derived through an inductive process. In fact, qualitative content analysis is a research method used to interpret the content of text data. In addition, the conventional content analysis is generally used in designing the study aiming to describe a phenomenon. This design is often appropriate when the theory or the research literature about a phenomenon is limited [14]. The researchers avoid using the pre-assumed notions, while they allow the categories and codes to be extracted from the data. In this study, the codes, sub-categories, categories, and themes were extracted by an inductive process and were conceptually ordered by considering developed properties and dimensions [15].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eParticipants \u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conducted in Kermanshah province, Iran from November 2017 to January 2018. A total of 21 participants were selected for interviews in terms of demographic characteristics. The participants were selected based on purposeful sampling employing maximum variety sampling. The inclusion criteria included the life experience of the current earthquake, either as affected people, manager, or key informant, and the willingness to participate in the interviews. However, those individuals who refused to give informed consent were eliminated. The participants included six humanitarian aid managers, six volunteers, four aid workers, and five affected people. The questions for a semi-structured interview were designed based on a deep interview with the interviewees and the texts were transcribed. The interview questions were reviewed and approved by the researchers several times. After each interview, the researchers listened to the recorded audio file several times and transcribed them as soon as possible. In addition, taking notes, along with recording the data during the interview was considered. Interviews reached saturation in the 21 interview and data collection was stopped at this stage.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eData collection and analysis\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData were collected through in-depth and semi-structured interviews, and field observation. Since researchers seek for the meaning of individuals' experiences, asking individuals and understand their experiences through interviews is considered as the best strategy for obtaining the meaning of experiences. The participants were requested to read and sign an informed consent form and invited to participate. Initially, the first two in-depth interviews were performed following by semi-structured interview to explore the participants\u0026rsquo; experiences. The semi-structured interviews were conducted among well-experienced and/or knowledgeable key person including humanitarian aid mangers, aid workers, and help volunteers. The first question was related to the participants\u0026rsquo; experiences. The main points of questions which only served as an interview guide were \u003cem\u003e\u0026lsquo;Please describe your experience of the earthquake?\u0026rdquo;\u003c/em\u003e, \u0026ldquo;\u003cem\u003eHow about humanitarians and aids and donation?\u0026rdquo;\u003c/em\u003e, and \u003cem\u003e\u0026ldquo;What are the barriers to aid and donations management?\u0026rdquo;\u003c/em\u003e. Then, these questions continued with in-depth questions such as \u0026ldquo;\u003cem\u003eCould you please explain more?\u003c/em\u003e\u0026rdquo;, and \u0026ldquo;\u003cem\u003eTake a sample from your own experience\u003c/em\u003e\u0026rdquo;. After establishing the basic concepts, the interview questions were designed based on the gaps in the previous interviews. Thus, the questions were different in various interviews. The interview continued to saturate the concepts. Each interview lasted between 30 and 60 minutes. All interviews were recorded, transcribed verbatim, and analyzed using constant comparative method. The interviews were conducted in Persian and then translated into English by a bilingual translator for the purpose of publication. A bilingual translator was asked to confirm the quality of translation to maintain meanings and concepts.\u003c/p\u003e\n\u003cp\u003eContent analysis method was used to analysis the data. Content analysis is used in evaluating the data from qualitative case studies designs[13]. Data was analyzed according to method suggested by Graneheim and Lundman (2004) [16]. All of the interviews conducted by principal investigator (HS). Then, two researchers (HS, and MSK) transcribed and analyzed the data independently. Then, the meaning units as the phrases related to the participants\u0026rsquo; experiences were identified. In the next procedure, the data were summarized as condensed meaning units, labeled with codes, and sorted into categories and sub-categories based on their similarities and differences. Finally, the same categories were abstracted and labeled with the related themes. The last two steps of the analysis process were conducted by all authors. When the codes, or categories were different by two researchers, we asked to other authors to help and data analysis. Reliability was checked using the following formula suggested by Miles and Huberman[17].\u003c/p\u003e\n\u003cp\u003eReliability= Number of agreements/ Number of agreements + Disagreements\u003c/p\u003e\n\u003cp\u003eAs a rule, the minimum percentage to demonstrate adequate levels of agreement is 75%[18]. In this study the total agreement of themes, categories, and sub-categories was 94% which shows well agreement between authors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eData trustworthiness\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe strategies recommended by Guba [19] were used for evaluating the trustworthiness of the data. Thus, four criteria including credibility, dependability, confirmability, and transferability are necessary for confirming trustworthiness. Prolonged engagement, triangulation, member checks, peer debriefing and negative case analysis were used to ensure the credibility of the data [20]. Regarding the prolonged engagement, the researcher was actively engaged in the disaster field for 2 months while making observations and compiling field notes continually. As for triangulation, multiple researchers were to evaluate the study, which brings different perceptions of the inquiry and helps to strengthen the integrity of the findings. Regarding data triangulation or informant\u0026rsquo;s triangulation, different sources of data or instruments such as interviews, and field observation were utilized to enhance the quality of the data from different sources. In order to check the members, the analyzed and interpreted data were sent back to the participants to evaluate the interpretation and change the interpreted data if the participants were unsatisfied. In addition, peer debriefing was implemented to provide inquirers with the opportunity to test their growing insights and expose themselves to the searching questions. Finally, negative case analysis was used when the data collected from the inquiry was inconsistent with the researcher\u0026rsquo;s expectations, leading to an improvement in the credibility of the study. The data dependability was assessed by an audit trail, stepwise replication, code-recode strategy, and peer examination. Reflexive journal or practice, along with the integrity of research findings was used to assess the confirmability of data. In this regard, the researcher\u0026rsquo;s background and interest on the subject and maintaining the documents of study were used for checking the confirmability of data [20]. Further, a thick description of data, along with theoretical/purposive sampling was utilized to ensure the transferability of data[20]. The context of the interviews, codes, and extracted categories and themes were reviewed by the research team and other professional colleagues in the field of qualitative research. Using sampling with a maximum variation, the researchers were able to collect a wide variety of different comments, observations, and interpretations.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe mean age of the participants was 31, most of them were male, and had an academic education level (Table 1). First, the transcribed data from 21 interviews were analyzed, along with field note observation. The number of initial codes obtained from the interviews was 1053, which were placed in 19 sub-categories, 9 categories, and 2 themes (Table 2). Managerial and structural barriers were obtained as main themes. The categories included education, command and coordination, communication and information, rules, security, traffic and overcrowding, assessment, providing system, cultural setting.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eManagerial barriers\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eE\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003education \u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMost of the participants claimed that the lack of public and organizational education is considered as the most important barriers. Such an education encounters with weaknesses and challenges in many aspects since people are not familiar with the ways for helping and people who are interested in humanitarian aids are not informed of which kind of donation, to whom, in which time, and how should be delivered. In addition, the volunteers and local trustees are not well familiar with the ways of participation in identifying the needs and the needy people, as well as delivering and distributing the donations. Thus, not only the people affected by disasters are suffering from lack of knowledge, but also the volunteers, managers, and the relief staff and GOs are not sufficiently knowledgeable in this regard.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026nbsp;\u0026ldquo;\u003c/em\u003e\u003cem\u003eOur donors do not know which goods, when, and to which organizations should be delivered. Most of them go to the affected areas individually to provide aids. At the time of distributing the aids to the rural people, we did not know to whom we should deliver the aids. The villages\u0026rsquo; trustees were mostly old and were not capable of receiving and distributing the donations.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eCommand and Coordination \u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAccording to the participants, the multiplicity of the organizations responsible for the disasters is considered as a serious challenge for managing humanitarian aids and donations. The participants believed that people are confused due to the lack of information about the way they should deliver the aids. Further, the victims were not informed of where to refer for receiving the aids. Lack of a unique commandership led to the multiplicity of decision-taking centers, useless attempts, and lack of efficient and effective accountability.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;\u003c/em\u003e\u003cem\u003eMany organizations from governmental ones to NGOs, offices, universities, local councils collected the aids and set out for the affected districts. Some of the people received help from several organizations or institutions while some other could not get any help.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAccording to the subsequent interviews and the obtained data, assisting organizations were not sufficiently coordinated and cooperative in various levels from the management and strategic to operational levels. In other words, due to the lack of coordination, resources, staff, and equipment were sent to the affected regions but they were not coordinated.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;\u003cem\u003eThe military forces, the NGOs like Red Crescent, and GOs all were simultaneously involved in the aid and rescue operations without any coordination among them. Crowding and congesting the forces and equipment were themselves transformed into a crisis.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eCommunications and Information \u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThese barriers were the main concerns of the participants. They were regarded rumor-fabricating and rumor-mongering as a disturbing factor in preparedness and proper response. They were dissatisfied with the weak performance of the media and lack of control on several social networks. The multiplicity of media and lack of a unique and influential management for organizing supervision and monitoring on the news, and the existence of ample inauthentic news sources were considered as the most significant challenges.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;\u003cem\u003eDifferent news was heard in any moment. The news broadcasted from governmental and cyber space channels were completely contradicting. There was no unique news about the casualties, damaged areas, and amount and ways of delivering aids. Many rumors were heard from people and different institutions in the cyber space.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eRules\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMost of the participants regarded the lack of rules and consistent supervising system as important factors. They assumed the lack of control on the performance of celebrities and renowned persons as a significant factor for misusing this group from people\u0026rsquo;s participation and the appropriation of the gathered humanitarian monetary resources to their own benefits. In such condition, there is no supervision by any accountable organization, governmental organizations, and NGOs, and the celebrities introduce multiple bank account numbers in order to collect people\u0026rsquo;s cash as in-cash donations. Thus, many cases of misusing the aids were reported.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;\u003cem\u003eSome of the famous cinema actors gave their bank account numbers in the cyber networks to collect people\u0026rsquo;s cash aids but except for a few, most did not spend the money for the afflicted people. In addition, the supervising organizations did not prosecute the issue. Several account numbers were presented incessantly for receiving the donations from individuals and different organizations\u0026rdquo;.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStructural barriers\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSecurity\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe participants reported that lack of adequate security is the most significant barrier for delivering humanitarian donations and aids. They asserted that the security of the mobilized facilities and equipment, especially the ones sent overland, were not duly provided. Additionally, the thieves\u0026rsquo; rush from other regions to the affected areas, overcrowding, and fraud all with malicious intentions created some disorder in security.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;\u003cem\u003eWe heard that the trucks having been carrying the same aids were assaulted and the aids were stolen. Perhaps, they were actually in need and did not intend to steal anything, but in my idea, it would rather have been better to escort the trucks by security forces\u0026rdquo;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAssessment\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eLack of assessing the needs and capacity of the area is influenced by two main challenges reported by the participants. The local trustees and individuals believed that their opinions were not respected in identifying the need. In addition, the responsible organizations distributed the aids without considering the real necessities of people. According to the participants, having no plan for needs and capacity assessment can result in wasting the resources, along with injustice in the distribution. Further, the needs of vulnerable groups, especially the elders, children, disabled, and families with poor custodian or no custodian were disregarded.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;\u003c/em\u003e\u003cem\u003eAs a rescuer who was the supervisor of an assisting group, I did not know which village or district of the cities was more in need and whether any aid had been sent to those regions or not. Some other people came to receive goods, foods, clothes, and other things. We had no idea which families had disabled members or elders or pregnant women, and who had lost their husbands because they were not able to refer to assisting centers to receive aids\u0026rdquo;.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eProviding system\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAccording to the interviews, preserving and distributing the humanitarian aids are considered as the barriers and challenges regarding providing system, which can be divided into three main phases. The first phase was the barriers related to the collection and arrival of the aids and donations to the affected areas. In fact, there was no procrastination in common participation in delivering the aids and the inaccessibility of the damaged region due to the damaged connecting roads, and the remoteness of some villages led to the prediction in transferring the aids to the regions. The second phase was the challenge of preserving the goods in the affected areas. The participants reported that foods were preserved under sunlight and rain in an unhealthy condition, and some mercenary persons rushed to the deposit places and stole things many times. The third phase involved the challenges related to the distributions such as having no preceding plan for distribution, non-observation of equivalence in distribution, and untargeted distribution.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;\u003cem\u003eThe aids were arrived to some remote villages with delay. In other villages whose roads were damaged, the food packages were thrown down from rescue helicopters which caused the packages to become spoiled due to crashing into the ground. People\u0026rsquo;s aids were collected in one of the city squares and they were covered by a canvas. The foods on the ground were in contact with the rain water and they were exposed to sunlight\u0026rdquo;.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eCultural setting\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe participants believed that cultural setting plays a significant role in managing the humanitarian aids. They emphasized that lack of community trust in GOs versus the excessive trust they had in celebrities and renowned persons as one of the main challenges. The responsible GOs and the NGOs were inattentive to people\u0026rsquo;s culture and customs, leading to some problems in managing humanitarian aids. Furthermore, people\u0026rsquo;s inattentiveness for waiting in the queues was regarded as another cultural barrier\u003cem\u003e.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;\u003cem\u003eIf people had trusted the GOs as they trusted the celebrities, there would not have been that much misuse. People are also to be blamed because they are affected by emotions for collecting aids in the first days after disasters. In addition, the afflicted people rush for receiving the aids. For instance, when a truck arrived for assisting, they did not stand in queues but they wanted to get the goods all at once\u0026rdquo;.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe participants emphasized that the benefactors had remarkable and unbelievable participation during rescuing, relieving, and rehabilitation. They believed that the benefactors had not adequate knowledge in this regard. Further, the benefactors have a tendency for humanitarian actions in health services rather than other domains and they scarcely cooperate with governmental organizations.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026ldquo;\u003cem\u003eThere are many benefactors in Iran but unfortunately they lack adequate awareness and knowledge and they do not act untidily. It would be better if benefactors become coordinated with each other and each supplies some parts of the requirements for the injured people. The benefactors visited the affected areas carrying goods on their own. I wish a unique organization can carry out such things\u0026rdquo;.\u003c/em\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eLack of appropriate education for humanitarian aids during disasters is considered as one of the main challenges. People, managers, relief staff, and benefactors were devoid of the adequate knowledge on humanitarian aids. Since different organizations with different potentialities, capacities, duties, and interests participate in the humanitarian assistance, it is necessary to focus on improving the performances, designing the standards and educations, and promoting the educational courses by means of sharing their experience in the stage of preparedness. Some studies suggested an attempt for reducing unnecessary aids with low priority through public and professional education [10].\u003c/p\u003e\n\u003cp\u003eThe existence of different broadcasting, rumor-fabricating, and rumor-mongering sources is considered as one of the challenges in the study due to the lack of education and regulation of the news sources and their control. In addition, the reliability of the information and confronting with rumors are regarded as the main concerns in the response phase of disasters because the social networks can present inauthentic information, rumors, and fictitious news due to the lack of any control process and the low quality of the information [21, 22]. Therefore, adequate education to the media added to a governmental supervision seems crucial.\u003c/p\u003e\n\u003cp\u003eFurther, communication barriers in delivering the humanitarian aids were emphasized by some participants. Todays, the social networks are too comprehensive and play a significant role in creating communication and coordination among the assisting organizations due to their fast broadcasting of information. The NGOs and volunteers can use social networks for collecting donations in the least time possible [23].\u003c/p\u003e\n\u003cp\u003eFurthermore, collecting exact, authentic, and effective information is considered as one of the key factors in the process of distributing humanitarian aids in disasters. Thus, attention should be paid on the unreal and inauthentic reports, which can negatively affect the participation process in delivering and distributing the humanitarian helps [24]. Managing humanitarian aids during disasters is naturally difficult due to the variety of the beneficiaries. In such cases, receiving and sharing information about the infrastructures and supplying the required resources are significant for effective response and social networks can get information about the number of people afflicted by the disasters through internet and make it accessible in order to have a fast and effective response [25, 26].\u003c/p\u003e\n\u003cp\u003eAccording to some participants, the needs of injured people are different during a disaster. Donations should be consistent with the receivers\u0026rsquo; requirements rather than the donators\u0026rsquo; preferences [27]. Mobilizing the aids without need assessment leads to the accumulation of abundant unnecessary sources in the affected areas. Additionally, ignoring the requirements of vulnerable groups such as women, children, elders, and the disabled at the time of disasters are considered as another barrier for managing aids and donations during the disasters. These groups may not be able to supply their needs due to cultural, religious, and other personal limitations [28, 29].\u003c/p\u003e\n\u003cp\u003eSome participants maintained that lack of donors' trust in governmental institutions is one of the main barriers for managing donations, which causes donations to be collected through unofficial individuals like celebrities which can result in misusing what has been provided [2]. Another structural impediment regarding donations in disasters is related to lack of any respect for cultural beliefs and values of the affected people. In this regard, donations will not be utilized if they are not congruent with the culture of that community after sending to the affected areas [30].\u003c/p\u003e\n\u003cp\u003eLack of a systematic plan for food preservation and food security was considered as another challenge introduced by the participants. The significance of food security and feeding was emphasized in Sendai framework and sustainable development goals [31]. Lack of concern for food variety in the mobilized aids is regarded as another challenge proposed by the participants. It is necessary to guarantee the variation of foods and consumption of nourishing favorite nutrients, particularly in the first days after disasters [32]. Inequality and injustice in distribution and rushing for distributing centers are considered as some challenges regarding distributing the aids. Regarding the inevitability of identification and registration of the beneficiaries, it seems necessary for participants to adopt a controlled and fair strategy for distribution [33]. The participants stated that depositories were defected and the food was exposed to sunlight and insects for a long. Food and medicine are the first priorities in planning for maximizing security in disasters and they should be accommodated in a dry and cool place with air-conditioning systems [34].\u003c/p\u003e\n\u003cp\u003eIn addition, some addressed that coordination among humanitarian organizations is a great challenge in managing donations. Lack of a managing commitment, improper organizational structure for sharing knowledge, as well as lack of a specified policy and planning are considered as the main barriers for coordination [35]. Further, establishing cluster approach and network subgroups in the affected region can lead to the contribution of coordination and collaboration in managing humanitarian donations [36].\u003c/p\u003e\n\u003cp\u003eSince the government plays a fundamental role in organizing and coordinating the humanitarian assistance operations [37], authorization generates a potential ability for responding to the disasters based on law and constitution [38]. Integrated management of the processes, policies, and legislations can play a fundamental role in managing the aids among people [39]. Additionally, organizing and coordinating the effective participation of government and benefactors can increase the opportunities in responding to disasters and casualties[40].\u003c/p\u003e\n\u003cp\u003eIn addition, providing security in the affected areas is considered as one of the main problems reported by some participants [41, 42]. Further, insecurity brings challenges for humanitarian organizations and puts the distributors of aids and people at risk [43]. Distributing aids through adopting a consistent management of provisional duties such as depository keeping, qualified transfer system, and fair access to aids can be effective in managing donations and preventing forage by thieves [44].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLimitations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe present study clearly had some limitations. One potential limitation of the current study was that this study conducted in the Iranian context that it can be limited in generalizability to other countries. However, it seems that given the shared challenges, the results can be applicable in the same countries with same setting. The language was a barrier in the affected area of Kermanshah in which Kurdish is a native language. Although most of the interviewees speak in Persian, some of the affected people could speak Kurdish. To overcome the limitation, HS, DP, and AS, as three native colleagues, helped the researchers to translate Kurdish words into Persian.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eHumanitarian aid management during disasters has many challenges. Adopting an efficient management and appropriate policies for humanitarian aids and donations, as well as eliminating structural and policy barriers can improve the performance of management. Further, developing public education and evaluating the needs based on cultural factors, as well as supervising and clarifying the aids can help reduce the challenges and barriers. In addition, it is essential to establish a lead agency with sufficient authority to supervise the collection, transport and distribute humanitarian aids and donor managements. Since involving a variety of organizations and individuals, especially the celebrities, in collecting and distributing such aids can lead to some sources of misuse and sometimes abuse, it is recommended that the government should provide adequate training and preparation for their intervention and supervision by adopting the related laws. The registry system can help manage this problem. In addition, vulnerable groups such as the elderly, children, homeless people, disabled individuals, and pregnant women should be considered while distributing the aids. Finally, training local authorities and trustees should be highlighted in the preparedness plans. Furthermore, these findings as a scientific document, will be available to managers of NGOs and GOs involved in rescue and relief and humanitarian aid management for use in the field. Moreover, the knowledge created by this study, can lead to awareness of policy makers and managers in other countries about the challenges of humanitarian aid management and help them to better preparedness and respond against future disasters.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003e\u003cstrong\u003eNGO\u003c/strong\u003e: Non-governmental Organization\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eGO:\u003c/strong\u003e Governmental Organization\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSDGs\u003c/strong\u003e: Sustainable Development Goals\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical consideration \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe present research was reviewed and approved by the Ethics Committee of Shahid Beheshti University of Medical Sciences. The informed written and oral consent of the participants was obtained by introducing himself and expressing the purpose of the study. Accordingly, all participants were informed about the confidentiality of their names and other private information. Furthermore, they were provided with the possibility of leaving their own interview session at any time.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eN/A.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used during the current study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no conflict of interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo fund was received for the present research.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConcept and designed the study: HS, MSK, and SF. Collection of data: HS. Analysis and interpretation of data: All authors. Wrote the manuscript: All Authors. Revision of the paper: HS, and MSK. All authors reviewed and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to express their gratitude to all people who participated in this study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eJahangiri K, Izadkhah YO, Jamaledin Tabibi S. A comparative study on community-based disaster management in selected countries and designing a model for Iran. Disaster Prevention and Management: An International Journal. 2011;20(1):82-94\u003c/li\u003e\n\u003cli\u003eSafarpour H. Donors Management in Disasters: Kermanshah Earthquake Experience. 2018;20(11):e84942\u003c/li\u003e\n\u003cli\u003eChang Y, Wilkinson S, Potangaroa R, Seville E. Donor-driven resource procurement for post-disaster reconstruction: Constraints and actions. 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Governance and moderating effects of environmental uncertainty: The impact on performance in horizontal logistics cooperations. Logistics Research. 2018;11(4):1-29\u003c/li\u003e\n\u003cli\u003ePirani D, Yousefi K, Sahebi A. Disasters; The Opportunity of Reconstruction and Development: The Successful Experience of the 2017 Kermanshah Earthquake. Iran Red Crescent Med J. 2019;21(2):e90216\u003c/li\u003e\n\u003cli\u003eRoth S. Aid work as edgework\u0026ndash;voluntary risk-taking and security in humanitarian assistance, development and human rights work. Journal of Risk Research. 2015;18(2):139-55\u003c/li\u003e\n\u003cli\u003eGhodsi H, Khani Jazani R, Sohrabizadeh S, Kavousi A. The Resiliency of Humanitarian Aid Workers in Disasters: A Qualitative Study in the Iranian Context. Iran Red Crescent Med J. 2019;21(2):e80366\u003c/li\u003e\n\u003cli\u003eSchneiker A. Humanitarian NGOs,(in) security and identity: Epistemic communities and security governance: Routledge; 2016.\u003c/li\u003e\n\u003cli\u003eVarella L, Gon\u0026ccedil;alves MB, editors. A Gest\u0026atilde;o das Doa\u0026ccedil;\u0026otilde;es na Log\u0026iacute;stica Humanit\u0026aacute;ria: Estrat\u0026eacute;gias para Evitar o Caos. XXIX ANPET, Ouro Preto, MG XXIX ANPET-Congresso de Pesquisa e Ensino em Transportes; 2015.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp style=\"text-align: center; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-family: 'Times New Roman',serif;\"\u003eTable1. \u003c/span\u003e\u003c/strong\u003e\u003cspan style=\"font-family: 'Times New Roman',serif;\"\u003eDemographic information of the participants \u003c/span\u003e\u003c/p\u003e\n\u003ctable style=\"border-collapse: collapse; border: none;\"\u003e\n\u003ctbody\u003e\n\u003ctr style=\"height: 16.95pt;\"\u003e\n\u003ctd style=\"width: 6.65in; border: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 16.95pt;\" width=\"638\"\u003e\n\u003cp style=\"text-align: center; tab-stops: 301.5pt;\"\u003e\u003cspan style=\"font-family: 'Times New Roman',serif;\"\u003eVariables\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003cstrong\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;Number (%)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 135.3pt;\"\u003e\n\u003ctd style=\"width: 6.65in; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 135.3pt;\" width=\"638\"\u003e\n\u003cp style=\"text-align: left; tab-stops: 175.5pt 301.5pt; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Affected people\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; 5(23.80%)\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: left; tab-stops: 175.5pt 301.5pt right 463.5pt; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-family: 'Times New Roman',serif;\"\u003eParticipants\u003cstrong\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Aid workers\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; 4(19.04%) \u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: left; tab-stops: 175.5pt 301.5pt; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cspan style=\"font-family: 'Times New Roman',serif;\"\u003eVolunteers\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cspan style=\"font-family: 'Times New Roman',serif;\"\u003e6(28.58%)\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: left; tab-stops: 175.5pt 301.5pt; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Humanitarian aid manager\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; 6(28.58%)\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: left; tab-stops: 2.5in 301.5pt; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: left; tab-stops: 175.5pt 301.5pt; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; 25-35\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; 8(38.1%)\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: left; tab-stops: 175.5pt 301.5pt right 463.5pt; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-family: 'Times New Roman',serif;\"\u003eAge \u003cstrong\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;36-45\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; 7(33.33%)\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: left; tab-stops: 175.5pt 301.5pt; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;46-55\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; 6(28.57%)\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: left; tab-stops: 2.5in 301.5pt; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: left; tab-stops: 175.5pt 301.5pt right 463.5pt; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-family: 'Times New Roman',serif;\"\u003eSex\u0026nbsp;\u0026nbsp; \u003cstrong\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;Male\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; 14(66.66%)\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: left; tab-stops: 153.0pt 301.5pt; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Female\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;7(33.33%)\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: left; tab-stops: 2.5in 301.5pt; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-family: 'Times New Roman',serif;\"\u003eEducation Level\u003cstrong\u003e\u0026nbsp;\u0026nbsp; High School degree\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; 3(14.28%\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: left; tab-stops: 2.5in 301.5pt; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Bachelor's degree\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; 9(42.86%)\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: left; tab-stops: 2.5in 301.5pt; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Master's degree\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; 5(23.80%)\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: left; tab-stops: 2.5in 301.5pt; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Ph.D. degree\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; 4(19.05%)\u003c/span\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cspan style=\"font-family: 'B Nazanin';\"\u003e\u0026nbsp; \u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cspan style=\"font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp style=\"text-align: center; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003eTable 2.\u003c/span\u003e\u003c/strong\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003e Themes, categories, and sub-categories related to the challenges and barriers of humanitarian aid management in 2017 Kermanshah Earthquake\u003c/span\u003e\u003c/p\u003e\n\u003ctable style=\"width: 517.25pt; margin-left: -49.75pt; border-collapse: collapse; border: none;\" width=\"690\"\u003e\n\u003ctbody\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 70.15pt; border: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"94\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: center; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-family: 'Times New Roman',serif; color: black;\"\u003eThemes\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 79.7pt; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"106\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-family: 'Times New Roman',serif; color: black;\"\u003eCategories\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 133.65pt; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"178\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-family: 'Times New Roman',serif; color: black;\"\u003eSub-categories\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 233.75pt; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-family: 'Times New Roman',serif; color: black;\"\u003eExample of codes\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 70.15pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" rowspan=\"26\" width=\"94\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: center; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eManagerial barriers\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 79.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" rowspan=\"7\" width=\"106\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: center; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eEducation\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 133.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" rowspan=\"3\" width=\"178\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: center; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 9.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003ePublic education\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eLack of education of humanitarian aids in the schools\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eLack of education for managing the affected society\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eLack of familiarity with the involved organizations in humanitarian aids\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 133.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" rowspan=\"4\" width=\"178\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: center; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 9.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eOrganizational education\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eInappropriate education and management of the enthusiastic persons\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eInsufficient knowledge about the ways of assisting\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eInappropriate education and management of the local trustees\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 12.1pt;\"\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 12.1pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eLack of enough education of the volunteers\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 79.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" rowspan=\"6\" width=\"106\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: center; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eCommand and Coordination\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 133.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" rowspan=\"3\" width=\"178\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: center; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 9.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eIncident Command System\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eSeveral decision-making centers\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eLack of an official administrator for disaster management\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 13.45pt;\"\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 13.45pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eLack of unified incident command system\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 133.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" rowspan=\"3\" width=\"178\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: center; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 9.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eCoordination and Cooperation\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eNo coordination among the assisting organizations\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eLack of an organization for coordinating the aids and donations\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 24.7pt;\"\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 24.7pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eInterference of the duties of responsible organizations\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 79.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" rowspan=\"5\" width=\"106\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: center; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eCommunication and Information\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 133.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" rowspan=\"3\" width=\"178\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: center; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 9.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eSocial media\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eWeakness of the media in managing the rumors\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eIneffective social media\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eMultiplicity of sources of information and news\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 133.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" rowspan=\"2\" width=\"178\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: center; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 9.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eOrganizational communication\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eWeakness of the inter-organizational communication\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 11.2pt;\"\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 11.2pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eWeakness of the intra-organizational communication\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 79.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" rowspan=\"8\" width=\"106\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: center; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eRules\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 133.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" rowspan=\"3\" width=\"178\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: center; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 9.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eRules and Regulations\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eLack of participation rules for the celebrities \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eLack of rules and regulations for collecting cash and non-cash donations\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eLack of specified protocols\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 133.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" rowspan=\"5\" width=\"178\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: center; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 9.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eSupervision and Transparency\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eWeakness of the participation rules for organizations\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eWeakness of participation rules for the communities\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eInsufficient transparency of the aids gathered by GOs and NGOs\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eInsufficient supervision on the celebrities\u0026rsquo; accounts\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 27.4pt;\"\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 27.4pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eMultiplicity of the governmental and non-governmental institutions for collecting donations\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 70.15pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" rowspan=\"28\" width=\"94\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: center; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eStructural barriers\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 79.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" rowspan=\"4\" width=\"106\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: center; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eSecurity\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 133.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" rowspan=\"2\" width=\"178\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: center; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 9.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eThe security of affected area\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eThe existence of thieves in the affected area\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eLack of a proper plan for recognizing affected people from abusing persons\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 23.5pt;\"\u003e\n\u003ctd style=\"width: 133.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 23.5pt;\" rowspan=\"2\" width=\"178\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: center; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 9.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eThe security of intercity area\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 23.5pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eInsufficient security of trucks carrying the donations in the intercity routes\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 23.5pt;\"\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 23.5pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eInsufficient security of donors and volunteers in the intercity routes\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 79.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" rowspan=\"5\" width=\"106\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: center; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eTraffic and Overcrowding\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 133.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" rowspan=\"2\" width=\"178\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: center; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 9.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eOvercrowding of affected area\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003ePeople overcrowding\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 12.1pt;\"\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 12.1pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eVolunteer overcrowding\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 133.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" rowspan=\"3\" width=\"178\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: center; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eTraffic of the intercity area\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eCongestion of vehicles\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eInappropriate management of intercity traffic\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eHeavy traffic\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 79.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" rowspan=\"5\" width=\"106\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: center; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eAssessment\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 133.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" rowspan=\"3\" width=\"178\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: center; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 9.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eNeed assessment\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eLack of assessing the needs of the affected area\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eInadequate consideration of sanitary needs, especially for women, kids, and elders\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eLack of using local capacities in identifying the needs\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 133.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" rowspan=\"2\" width=\"178\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: center; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 9.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eCapacity assessment\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eLack of assessing the capacity of the affected area \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eLack of using local people in identifying the capacities\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 79.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" rowspan=\"7\" width=\"106\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: center; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eProviding system\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 133.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" rowspan=\"4\" width=\"178\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: center; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 9.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eDistribution\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eRemoteness and impracticability of some rural areas\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 25.6pt;\"\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 25.6pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eInsufficient distribution of the aids to the villages and distant regions\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eInequality in distributing the aids\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 12.1pt;\"\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 12.1pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eDelay in sending the vital aids\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 133.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" rowspan=\"3\" width=\"178\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: center; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 9.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003ePreservation\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eAmbushing the food under sunlight\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eLack of enough equipment for saving\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003ePeoples\u0026rsquo; interferences in the preservation process\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 79.7pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" rowspan=\"7\" width=\"106\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: center; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eCultural setting\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 133.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" rowspan=\"2\" width=\"178\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: center; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 9.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eCommunity trust\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003ePeople\u0026rsquo;s low trust in the governmental institutions\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003ePeople\u0026rsquo;s excessive trust in the celebrities\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.0pt;\"\u003e\n\u003ctd style=\"width: 133.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" rowspan=\"2\" width=\"178\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: center; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 9.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eCommunity discipline\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.0pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003ePeople\u0026rsquo;s rush to the distribution places\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 18.4pt;\"\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 18.4pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eThe poor culture of waiting in the queues\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 18.4pt;\"\u003e\n\u003ctd style=\"width: 133.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 18.4pt;\" rowspan=\"3\" width=\"178\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: center; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 9.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eBenefactor and charity culture\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 18.4pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eTendency to work in the health section more than another sections\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 18.4pt;\"\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 18.4pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eDistrust of the benefactors in the governmental institutions\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 15.7pt;\"\u003e\n\u003ctd style=\"width: 233.75pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 15.7pt;\" width=\"312\"\u003e\n\u003cp style=\"margin-bottom: .0001pt; text-align: left; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black;\"\u003eParallel services of the charity organizations\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp style=\"text-align: justify; line-height: normal; direction: ltr; unicode-bidi: embed;\"\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Disaster, donation management, humanitarian aid, aid distribution, Iran","lastPublishedDoi":"10.21203/rs.2.11139/v3","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.2.11139/v3","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eBackground: Examining various problems after disasters is important for the affected people. Managing humanitarian aid and donations among the affected people is considered as one of the most important problems after disasters. Therefore, the present study aimed to evaluate the challenges and barriers of humanitarian aid management in 2017 Kermanshah Earthquake. \u003c/p\u003e\u003cp\u003eMethods: This study was conducted from November 2017 to January 2018, with qualitative case study design. The population included 21 people including 6 humanitarian aid manager, 6 volunteers, 4 aid workers, and 5 affected people. The data were collected through semi-structured interviews and purposeful sampling, which continued until saturating the data. The strategies recommended by Guba were used for evaluating the trustworthiness of the data. The data was analyzed with conventional content analysis method according to method suggested by Graneheim and Lundman. \u003c/p\u003e\u003cp\u003eResults: Based on the results, two themes, nine categories, and 19 sub-categories were identified considering the challenges and barriers of humanitarian aid and donors’ management during the 2017 Kermanshah Earthquake. The categories included education, command and coordination, communication and information, rules, security, traffic and overcrowding, assessment, providing system, and cultural setting. Also, two themes including managerial and structural barriers were extracted. \u003c/p\u003e\u003cp\u003eConclusion: Adopting an effective management and appropriate policies with respect to humanitarian aid and modifying structural and managerial barriers can improve the performance and management of humanitarian aid.\u003c/p\u003e","manuscriptTitle":"Challenges and barriers of Humanitarian Aid Management in 2017 Kermanshah Earthquake: A Qualitative Study","msid":"","msnumber":"","nonDraftVersions":[{"code":3,"date":"2020-04-17 01:49:35","doi":"10.21203/rs.2.11139/v3","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Accept","date":"2020-04-16T12:00:00+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2020-04-13T12:00:00+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2020-04-12T12:00:00+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2020-04-12T12:00:00+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}},{"code":2,"date":"2020-03-13 18:37:50","doi":"10.21203/rs.2.11139/v2","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Minor revision","date":"2020-03-31T12:00:00+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2020-03-23T12:00:00+00:00","index":2,"fulltext":"Recommendation: Accept after discretionary revisions\nForm responses:\n---\n\nComments to Author:\n---\nPEER REVIEWER ASSESSMENTS:\n\nOBJECTIVE - Full research articles: is there a clear objective that addresses one or several testable research questions? (Brief or other article types: is there a clear objective?)\nYes - there is a clear objective\n\nDESIGN - Is the current approach (including controls and analysis protocols) appropriate for the objective?\nYes - the approach is appropriate\n\nEXECUTION - Are the experiments and analyses performed with sufficient technical rigor to allow confidence in the results?\nYes - experiments and analyses were performed appropriately\n\nSTATISTICS - Is the use of statistics in the manuscript appropriate?\nN/A - there are no statistics in this study\n\nINTERPRETATION - Is the current interpretation/discussion of the results reasonable and not overstated?\nYes - the author's interpretation is reasonable\n\nOVERALL MANUSCRIPT POTENTIAL - Has the author addressed your concerns sufficiently for you to now recommend the work as a technically sound contribution? If not, can further revisions be made to make the work technically sound?\nYes - current version is technically sound\n\nPEER REVIEWER COMMENTS:\n\nGENERAL COMMENTS: The manuscript is very much improved. The authors took great care to respond to each reviewer criticism.\n\nREQUESTED REVISIONS:\nThere are no mandatory revisions. This is a strong study with a good design and excellent conclusions. Strong editorial decisions were made by the native English editor. Ideally, another pass through for overly long sentences and problematic grammar would be useful. But frankly, the manuscript is fine for submission as it is.* Are the methods appropriate and well described?: **Yes**\n* Does the work include the necessary controls?: **Yes**\n* Are the conclusions drawn adequately supported by the data shown?: **Yes**\n* Are you able to assess any statistics in the manuscript or would you recommend an additional statistical review?: **Not relevant to this manuscript**\n* Quality of written English: **Acceptable**\n* Declaration of competing interests: **This reviewer has been recruited by a partner organization, Research Square. Reviewers with declared or apparent competing interests are not utilized for these reviews. This reviewer has agreed to publication of their comments online under a Creative Commons Attribution License attributed to Research Square and was paid a small honorarium for completing the review within a specified timeframe. Honoraria for reviews such as this are paid regardless of the reviewer recommendation.**\n* I agree to the open peer review policy of the journal. I understand that my name will be included on my report to the authors and, if the manuscript is accepted for publication, my named report including any attachments I upload will be posted on the website along with the authors' responses. I agree for my report to be made available under an Open Access Creative Commons CC-BY license (http://creativecommons.org/licenses/by/4.0/). I understand that any comments which I do not wish to be included in my named report can be included as confidential comments to the editors, which will not be published.: ** I agree to the open peer review policy of the journal**\n"},{"type":"editorInvitedReview","content":"","date":"2020-03-13T12:00:00+00:00","index":1,"fulltext":"Recommendation: Accept after minor essential revisions\nForm responses:\n---\n\nComments to Author:\n---\nPEER REVIEWER ASSESSMENTS:\n\nOBJECTIVE - Full research articles: is there a clear objective that addresses one or several testable research questions? (Brief or other article types: is there a clear objective?)\nYes - there is a clear objective\n\nDESIGN - Is the current approach (including controls and analysis protocols) appropriate for the objective?\nNo - there are minor issues\n\nEXECUTION - Are the experiments and analyses performed with sufficient technical rigor to allow confidence in the results?\nNo - there are minor issues\n\nSTATISTICS - Is the use of statistics in the manuscript appropriate?\nN/A - there are no statistics in this study\n\nINTERPRETATION - Is the current interpretation/discussion of the results reasonable and not overstated?\nNo - there are minor issues\n\nOVERALL MANUSCRIPT POTENTIAL - Has the author addressed your concerns sufficiently for you to now recommend the work as a technically sound contribution? If not, can further revisions be made to make the work technically sound?\nProbably - with minor revisions\n\nPEER REVIEWER COMMENTS:\n\nGENERAL COMMENTS: The paper has greatly improved over the previous version. However, there are still some points that need to be addressed.\n\nREQUESTED REVISIONS:\nIn the Study design subsection, you should report information on the type of research study design (e.g., experimental, longitudinal, descriptive) that was used in the current study, not about qualitative content analysis. Qualitative content analysis is the type of analysis.\nYou are saying that there was well agreement among the authors and, at the same time, you did not test the inter-rater reliability. Inter-rater reliability provides the degree of agreement among raters. Therefore, it is not clear me to me on what grounds you are claiming that there was well agreement among the authors. Please calculate inter-rater reliability so we can have information about the extent to which there was well agreement among the authors.\nThis previous comment was left unanswered: Theoretical and practical implications should be fleshed out. Please discuss the generalizability, or external validity, of the results. What problems remain unresolved or arise anew because of these results?\nYou say that \"The present study clearly has some limitations.\" However, you mention only one limitation. Are there differences between the target population and the sample? Are the conclusions equally valid for other countries or cultural settings?* Are the methods appropriate and well described?: **No**\n* Does the work include the necessary controls?: **No**\n* Are the conclusions drawn adequately supported by the data shown?: **No**\n* Are you able to assess any statistics in the manuscript or would you recommend an additional statistical review?: **Not relevant to this manuscript**\n* Quality of written English: **Acceptable**\n* Declaration of competing interests: **This reviewer has been recruited by a partner organization, Research Square. Reviewers with declared or apparent competing interests are not utilized for these reviews. This reviewer has agreed to publication of their comments online under a Creative Commons Attribution License attributed to Research Square and was paid a small honorarium for completing the review within a specified timeframe. Honoraria for reviews such as this are paid regardless of the reviewer recommendation.**\n* I agree to the open peer review policy of the journal. I understand that my name will be included on my report to the authors and, if the manuscript is accepted for publication, my named report including any attachments I upload will be posted on the website along with the authors' responses. I agree for my report to be made available under an Open Access Creative Commons CC-BY license (http://creativecommons.org/licenses/by/4.0/). I understand that any comments which I do not wish to be included in my named report can be included as confidential comments to the editors, which will not be published.: ** I agree to the open peer review policy of the journal**\n"},{"type":"reviewerAgreed","content":"","date":"2020-03-10T12:00:00+00:00","index":2,"fulltext":""},{"type":"editorAssigned","content":"","date":"2020-03-08T12:00:00+00:00","index":"","fulltext":""},{"type":"reviewersInvited","content":"","date":"2020-03-08T12:00:00+00:00","index":"","fulltext":""},{"type":"reviewerAgreed","content":"","date":"2020-03-08T12:00:00+00:00","index":1,"fulltext":""},{"type":"checksComplete","content":"","date":"2020-03-07T12:00:00+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2020-03-07T12:00:00+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}},{"code":1,"date":"2019-07-10 14:20:39","doi":"10.21203/rs.2.11139/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Major revision","date":"2020-02-10T12:00:00+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2020-02-06T12:00:00+00:00","index":3,"fulltext":"Recommendation: Major revisions required\nForm responses:\n---\n* Are the methods appropriate and well described?: **Yes**\n* Does the work include the necessary controls?: **Yes**\n* Are the conclusions drawn adequately supported by the data shown?: **Yes**\n* Are you able to assess any statistics in the manuscript or would you recommend an additional statistical review?: **I am able to assess the statistics**\n* Quality of written English: **Needs some language corrections before being published**\n* Declaration of competing interests: **This reviewer has been recruited by a partner organization, Research Square. Reviewers with declared or apparent competing interests are not utilized for these reviews. This reviewer has agreed to publication of their comments online under a Creative Commons Attribution License attributed to Research Square and was paid a small honorarium for completing the review within a specified timeframe. Honoraria for reviews such as this are paid regardless of the reviewer recommendation.**\n\nComments to Author:\n---\n\"PEER REVIEWER ASSESSMENTS:\n\nOBJECTIVE - Full research articles: is there a clear objective that addresses a testable research question(s) (brief or other article types: is there a clear objective)?\nYes - there is a clear objective\n\nDESIGN - Is the current approach (including controls and analysis protocols) appropriate for the objective?\nYes - the approach is appropriate\n\nEXECUTION - Are the experiments and analyses performed with technical rigor to allow confidence in the results?\nYes - experiments and analyses were performed appropriately\n\nSTATISTICS - Is the use of statistics in the manuscript appropriate?\nN/A - there are no statistics in this study\n\nINTERPRETATION - Is the current interpretation/discussion of the results reasonable and not overstated?\nYes - the author's interpretation is reasonable\n\nOVERALL MANUSCRIPT POTENTIAL - Is the current version of this work technically sound? If not, can revisions be made to make the work technically sound?\nMaybe - with major revisions\n\nPEER REVIEWER COMMENTS:\n\nGENERAL COMMENTS:\nThe actual methodology, insights, and conclusions of this study are good and valuable. The major problem is the quality of the English writing, which needs substantial work before this is publishable.\n\nREQUESTED REVISIONS:\nThe major issue with this paper is the English writing. The authors are well advised to employ a good English editor to fix the many errors. Below is a sample of some of the errors. But there are many more.\n\n\np5:\n\"\"The complete of Aid agencies for donor resources can be a barrier to collaboration and cooperation\"\". I think the authors mean \"\"the competition\"\"\n\n\"\"Distribution in humanitarian aid is associated with many activities, plenty of disaster management stakeholders, great effort and different processes.\"\" I don't know what this sentence means.\n\nBackground paragraph #1 is an information dump. It needs to be re-written with separate ideas teased out.\n\n\"\"Help urgently needed for affected people, especially in the first days of the earthquake.\"\"\nThis sentence has no verb.\n\np6\n\nMethods: There is no need to explain to the expert reader what thematic content analysis is. Just say that you are using it.\n\n\"\"Also some affected people in earthquake area were participated.\"\" This sentence is poor English.\n\nPlease mention how participants were identified and recruited. What were the inclusion/exclusion criteria?\n\nWere the data collection conducted in English? If not, specify the language. The actual questions provided have been poorly translated into English.\n\np6: Data analysis was done simultaneously with data collection? Is this standard procedure? Please comment on this.\n\nI suspect the authors are using the word \"\"categories\"\" rather than \"\"themes\"\", though the latter is more standard.\n\nMethods are defensible and solid (e.g., journaling, reflection, coding, etc) but need to be described with better English.\n\np8:\n\nStrange decision to present mean age, then number of codes. Instead, please summarize all demographic data, then summarize analytical data (e.g., number of codes), then go into the actual themes. Surely there was more demographic information than just age. What about gender? profession? education level?\n\nResults are actually very good for this type of study in a challenging arena. They just need to be described better.\n\nDiscussion and conclusion are scholastically proper in that the authors have made the right conclusions and have extracted the right insights from their data. The biggest issue is the English. This paper needs more work with a translator and editor.\nADDITIONAL REQUESTS/SUGGESTIONS:\nIt's all about the quality of the writing, which is actually the easy thing to fix. The actual science is proper.\""},{"type":"reviewerAgreed","content":"","date":"2020-01-24T12:00:00+00:00","index":3,"fulltext":""},{"type":"editorInvitedReview","content":"","date":"2019-12-06T12:00:00+00:00","index":2,"fulltext":"Recommendation: Major revisions required\nForm responses:\n---\n* Are the methods appropriate and well described?: **No**\n* Does the work include the necessary controls?: **No**\n* Are the conclusions drawn adequately supported by the data shown?: **No**\n* Are you able to assess any statistics in the manuscript or would you recommend an additional statistical review?: **Not relevant to this manuscript**\n* Quality of written English: **Acceptable**\n* Declaration of competing interests: **This reviewer has been recruited by a partner organization, Research Square. Reviewers with declared or apparent competing interests are not utilized for these reviews. This reviewer has agreed to publication of their comments online under a Creative Commons Attribution License attributed to Research Square and was paid a small honorarium for completing the review within a specified timeframe. Honoraria for reviews such as this are paid regardless of the reviewer recommendation.**\n\nComments to Author:\n---\nPEER REVIEWER ASSESSMENTS:\n\nOBJECTIVE - Full research articles: is there a clear objective that addresses a testable research question(s) (brief or other article types: is there a clear objective)?\nYes - there is a clear objective\n\nDESIGN - Is the current approach (including controls and analysis protocols) appropriate for the objective?\nNo - there are major issues\n\nEXECUTION - Are the experiments and analyses performed with technical rigor to allow confidence in the results?\nNo - there are major issues\n\nSTATISTICS - Is the use of statistics in the manuscript appropriate?\nN/A - there are no statistics in this study\n\nINTERPRETATION - Is the current interpretation/discussion of the results reasonable and not overstated?\nNo - there are major issues\n\nOVERALL MANUSCRIPT POTENTIAL - Is the current version of this work technically sound? If not, can revisions be made to make the work technically sound?\nMaybe - with major revisions\n\nPEER REVIEWER COMMENTS:\n\nGENERAL COMMENTS:\nThis is an interesting study which reports interesting findings about challenges and barriers of humanitarian aid management. It is difficult for me to say what have the authors done well and in what ways does it not meet best practice. The main reason is that the procedures were not fully explained and details are missing.\n\nREQUESTED REVISIONS:\nIt reads that questions for a semi-structured interview were designed based on a review of the literature and a deep interview with first interviewees who had begun the study. Please provide more detail about the procedure. Which scientific articles were reviewed? If questions were derived from specific studies, this must be acknowledged. During the deep interview with first interviewees, which insights were obtained and how were they used for preparing the questions?\nPlease make clear how respondents were selected. What about non response and refusal to take part? It is important to discuss any limitations of the data.\nIt is not clear to me who collected the data and who was involved in the analysis and in what manner.\nHow were themes, concepts and categories generated from the data? Did you test the inter-rater reliability of themes? It is important that at least two reviewers independently analyze the data.\nIt is not clear how member checks, negative case analysis, and persistent observation were used to ensure data credibility.\nIt is not clear how triangulation has been achieved.\nPlease acknowledge the limitations of your research. In addition, please address alternative explanations of the results.\nTheoretical and practical implications should be fleshed out."},{"type":"reviewerAgreed","content":"","date":"2019-10-15T12:00:00+00:00","index":2,"fulltext":""},{"type":"editorInvitedReview","content":"","date":"2019-09-15T12:00:00+00:00","index":1,"fulltext":"Recommendation: Accept after minor essential revisions\nForm responses:\n---\n* Are the methods appropriate and well described?: **Yes**\n* Does the work include the necessary controls?: **Yes**\n* Are the conclusions drawn adequately supported by the data shown?: **Yes**\n* Are you able to assess any statistics in the manuscript or would you recommend an additional statistical review?: **Not relevant to this manuscript**\n* Quality of written English: **Needs some language corrections before being published**\n* Declaration of competing interests: **'I declare that I have no competing interests.'**\n\nComments to Author:\n---\n"},{"type":"reviewerAgreed","content":"","date":"2019-09-10T12:00:00+00:00","index":1,"fulltext":""},{"type":"reviewersInvited","content":"","date":"2019-07-29T12:00:00+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2019-07-16T12:00:00+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2019-07-15T12:00:00+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2019-07-04T12:00:00+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"925c318d-6827-4023-a748-9e2453991939","owner":[],"postedDate":"April 17th, 2020","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[{"id":69988,"name":"Health Economics \u0026 Outcomes Research"},{"id":69989,"name":"Health Policy"}],"tags":[],"updatedAt":"2021-08-06T02:10:32+00:00","versionOfRecord":{"articleIdentity":"rs-2049","link":"https://doi.org/10.1186/s12889-020-08722-5","journal":{"identity":"bmc-public-health","isVorOnly":false,"title":"BMC Public Health"},"publishedOn":"2020-04-25 21:06:08","publishedOnDateReadable":"April 25th, 2020"},"versionCreatedAt":"2020-04-17 01:49:35","video":"","vorDoi":"10.1186/s12889-020-08722-5","vorDoiUrl":"https://doi.org/10.1186/s12889-020-08722-5","workflowStages":[]},"version":"v3","identity":"rs-2049","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"identity":"rs-2049","version":["v3"]},"buildId":"_2-kVJe1T_tPrBINL-cwx","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}