Philosophers have asked the question, “What is a life worth?” for ages and we still don’t have an answer. The value of a life as set by the US medical insurance field is $50,000 per year. According to Standford Graduate School of Business, a year of life is worth $129,000. Or if you prefer the Russians, you could go by their 2010 standard reimbursement for loss of life at USD$118,900. But no matter how many numbers you shuffle around, they don’t gain more meaning.
During my time as an Emergency Medical Technician, we had to do Mass Casualty Incident Trainings. These varied from 2 vehicle accidents to poisoned labs or downed aircrafts. (The scenarios where up to the creativity of the designer.) I hated being the first person to respond to these fake calls. Because even giving people fake triage tags for fake injuries on a fake call was too much for me. I became in EMT to help people, not to say they are beyond help and walk on.
These two interrelated debates are what face disaster relief specialists every day. The value of a life and the need to triage that life against the circumstances surrounding it. Is bringing one person back from the island worth the cost of a tank of fuel? What if the trip is doubled up so that it brings food and water out and that person back? Does that outweigh a reconnaissance flight over another island? What if that island wasn’t in the direct path of the cyclone? Or is only sparsely populated?
These are not decisions I envy anyone. I’ve had to make fake decisions to let an actor die of a fake heart attack so that I could get more actors into the fake safe zone in a fake chemical leak coming from a fake lab. And I still questioned that choice, and wondered if there was a way I could do both. (Spoiler, I couldn’t.)
As much as we act like we want to play God, when it comes down to it, we want to save everyone. We want to rush aid and relief to everyone, all at once. But that isn’t possible. So relief workers have had to make choices, brutal choices, about where to prioritize aid. They will have to continue making those choices for the next weeks and months. And the best people will cry themselves to sleep over the choices they made because they couldn’t find a way to save everyone.
There are going to be people who die just hours before the plane arrives. And maybe the plane had been earlier, they would be alive. But really, probably not, because that plane would take a dying person on a low-pressure flight, land on a runway and put the person in a bouncy taxi where it would deliver the person to a crowded, storm-ravaged hospital where the person would wait until they could be seen. Or until they died.
There are going to be people who could have been saved, “If only…” but what is the cost of that one life? Is it a plane carrying food and water for three villages? Is one person’s life worth another 6 hours of starvation and dehydration? What if the cost is another day before contact with an outer island? How many people on that island need lifesaving interventions?
These decisions are never easy. We make rules for ourselves, so we don’t give into the urge to save the first person we see. We practice mass casualty incidents and discuss best practices. Because no one wants to see someone suffer and no one wants unnecessary deaths. But we have to look at the big picture and what that one life is costing elsewhere.
It’s cold, but also reassuring. We want what’s best for everyone. These horrible, frigid rules ensure that we can maximize our impacts to benefit as many people as possible. Even if that sometimes means the loss of an individual. That’s the reality facing the National Disaster Management teams, the Red Cross volunteers and the dozens of other relief workers. I, for one, do not envy their job.