Funded by Elrha, the CAMERA tool is the result of a three year study aimed at empowering urban communities and city managers by providing a tool to measure and score the life saving capability of their city’s health system in the immediate aftermath of a mass casualty event. The tool was tested for reliability in three high-risk cities (Fortaleza, Karachi and Port Harcourt) and validated with a disaster drill in two high-risk cities in low-middle income countries (Karachi and Port Harcourt). The CAMERA tool was designed to help city leaders gauge their own performance and guide future preparedness efforts without engaging in resource intensive exercises.