Mobilizing cash quickly, safely and cost-effectively during adisaster is unfamiliar territory for most corporate treasurers. ButRemi Obert, director of finance for the French branch of DoctorsWithout Borders/Médecins Sans Frontières (MSF), the humanitarianaid organization, does it all the time. It's his job to turn cashinto urgently needed medical equipment and supplies for devastatedareas like Haiti after the 2010 earthquake and Japan in the wake ofthis year's disasters.

The secret, Obert says, is to start with international reserves(typically six to nine months' expenditures, or $400 millionto $600 million) that can be monetized and moved quickly,centralize as much of the spending as possible at headquarters, andorganize a flexible, responsive network of global accounts forreceiving and concentrating donations.

“We try to anticipate what we'll need, so we can respond toemergencies quickly before receiving dedicated funds,” Obert says.“We have a centralized 'emergency desk' at headquarters staffedwith people who specialize in designing and implementing emergencyresponse plans. The primary cash flows for purchasing medicalequipment, drugs, tents, transportation and salaries of people onthe ground at the emergency site are all ordered and funded by thatdesk. Import constraints generally are waived for emergencyresponse. We saw that in Haiti.”

Of course, some things have to occur on the ground in conditionsthat may be chaotic. One of the first duties of on-the-groundcoordinators is to meet with legal and financial authorities andopen accounts at the most functional banks, so headquarters canwire cash in the local currency to those accounts.

After the initial funding, the accounts usually are refreshedwith monthly wires in amounts estimated to meet needs, Obertexplains. “To maintain controls and minimize the need for localcash, we try to persuade as many local suppliers as possible totake payment from headquarters,” he says.

Only two or three people—including a project coordinator and afinance coordinator—are authorized to use those local accounts, headds. In Japan and Haiti, it helped that MSF already had a presenceand local bank accounts before the disasters hit. In the firstthree months following the earthquake in Haiti, 85% of expenditureswere paid by headquarters, and only 15% locally, Obert reports.

Managing inflows is the other half of the equation. Here 19 MSFnational sections around the world come into play. Five of them,designated as operational centers, run programs in the nearly 70countries where MSF is active. All 19 sections serve as collectioncenters for the contributions that pour in after a well-publicizeddisaster.

After the Haiti earthquake, the Paris operational center, whichpartners the with the U.S., Japan and Australia sections, received$140 million in donations designated for Haiti. In the first monthafter the Japan disasters, the total was $5 million.

All channels are open. Mail flows into post office boxes,usually as checks or debit authorizations, and the donations aredeposited in appropriate accounts. Donations are made online at theWebsites operated by all 19 MSF sections (such as www.doctorswithoutborders.orgfor the U.S.), either by authorizing direct debits or paying bycredit card. Some donors wire contributions to an account numberlisted on the Websites and in MSF mailings and TV ads.

More than two-thirds of the funds raised come in as euros orU.S. dollars, and donations in other currencies are generallyconverted into either euros or U.S. dollars, depending on thecurrencies needed and the rates. Currency conversions are handledat the spot rate or sometimes with forward contracts. Accounts arenot segregated by disaster, but data processing keeps track of howmuch was donated for specific disasters or countries.

The national sections coordinate fund-raising to avoidcollecting more earmarked funds than are needed. MSF's policiesstrongly encourage unrestricted donations that can be used in anyemergency, Obert explains. For example, after the Japaneseearthquake and tsunami, MSF stopped accepting restricted donations,since its operations in Japan were relatively small, and insteadasked donors to contribute to the general emergency fundinstead.

MSF's procurement has been polished by experience. Two supplycenters are responsible for sourcing the best products that meetMSF medical and logistical standards at the best prices. Someemergency supplies, such as vaccines, surgical kits and tents arestored in the warehouses MSF has in each country in which itoperates. The organization cuts the best deals with air and seafreight companies to move supplies to where they are needed, Obertsays.

“Experience has taught us what we're likely to need on theground during the first days of a disaster without being physicallypresent, and that helps us contain costs,” Obert says. “Key peoplewho arrive first on the ground are authorized to move quicklywithout waiting for approval from headquarters, but we've learnedto minimize the amount of cash that changes hands locally.” MSF funds its relief work strictly with reserves anddonations, he adds, and never taps a line of credit for emergencyexpenditures.