Tsunami Zone Spared Major Disease Outbreaks

JAKARTA, Indonesia, February 11, 2005 (ENS) - Health officials are breathing a sigh of relief that early fears of disease outbreaks in Indian Ocean nations after the December 26, 2004 earthquake and tsunami have not been realized. It was feared that poor living conditions amidst the devastation and lack of clean water and sanitation could lead to outbreaks of cholera, dysentery and other communicable diseases.

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Broken pieces of homes and belongs were strewn for miles in Aceh province on the Indonesian island of Sumatra. (Photo by Rein Skullerud courtesy World Food Programme)
In its latest report issued Tuesday the World Health Organization (WHO) said some cases of dengue fever have been found in Indonesia's Aceh province where destruction from the giant wave was greatest. A confirmed case of dengue fever has been identified in Aceh Utara, and further potential cases of dengue have been discovered, but the disease is not widespread.

No disease outbreaks have been reported in India, Maldives, Sri Lanka, or Thailand, the other countries that sustained the most damage from the tsunami.

An estimated 40,000 pregnant women were among those left homeless as a result of the earthquake and tsunami. As part of its emergency response, WHO quickly dispatched medical professionals and essential supplies to the area affected for care of these women. Now, WHO is collaborating with respective national authorities and other international agencies to ensure pregnant women, particularly those who were displaced, have access to safe childbirth services.

"We need to provide skilled care to these 40,000 mothers-to-be, and pay special attention to the thousands of new lives coming into the world in the coming weeks," said Joy Phumaphi, WHO assistant director for general, family and community health today. "Timely access to health facilities and services for mothers and babies must be a priority."

In most camps in the affected countries, the biggest problem for women is the lack of skilled attendants at birth.

“Even under normal circumstances, maternal and child health is a matter of major concern in the region, said Dr. Samlee Plianbangchang, WHO’s South-East Asia regional director. "Maternal deaths in this region account for one-third of the total number of global deaths and over three million children die below the age of five in this region annually, mostly from preventable causes. The tsunami has further added to the pressure.”

In the hard-hit Indonesian province of Aceh, WHO is assisting the Provincial Health Office to re-establish midwifery services in an integrated manner with other primary health care services in the affected areas.

In each of the 49 points of resettlement in Aceh – planned to be launched in March 2005 - there will be a satellite health post providing 24 hour basic health services with a doctor, a midwife and two nurses. Maternal and child health services, family planning, nutrition, immunization and treatment for common illnesses will be offered.

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A young boy tucks into a World Food Programme (WFP) high energy biscuit at the makeshift primary school set-up up the Gedung Sosial opera house camp for internally displaced persons. (Photo by Rein Skullerud courtesy WFP)
Health officials were concerned about outbreaks of measles among surviving children, but have responded quickly with an immunization campaign that so far has reached more than 90,000 children, or 69 percent in Aceh. Vaccination activities targeting schools and communities outside the camps have also begun.

Vitamin A supplements have been provided to over 20,000 children between the ages of six months and five years.

In the Aceh to Meulaboh area, widespread distribution of bednets is necessary, WHO assessment teams have found. Some settlements are also demanding spraying with insecticides in order to prevent malaria.

A WHO team from Jakarta visited Banda Aceh from January 31 to February 5 to assess tuberculosis control capacity. This assessment will be replicated in other affected districts over the coming weeks. TB drugs and testing equipment are being distributed to Aceh health centers. Information on how to diagnose and treat TB patients are being distributed through the Aceh Provincial Health Office to nongovernmental organizations, mobile clinics, and field hospitals, as many of them are unfamiliar with TB management.

In the Meulobah area of Aceh, where thousands of people died and many thousands were displaced, sanitation and water supplies have improved in some camps, and some people have spontaneously returned to the sites of their previous homes, with their tents, to begin rebuilding, the WHO teams found.

The area hospital was not damaged in the flood and is functional. With WHO support, the hospital laboratory opened this week.

An inter-agency assessment of Aceh and Meulobah carried out between January 7 and February 5 has found that flooding and rain is causing serious hygiene problems in the internally displaced people's (IDP) settlements and camps.

Water containers and latrines are urgently needed, particularly in new settlements, WHO says. Here, the provision of potable water is through tanks, tankers and dug wells or boreholes. Tap outlets on tanks are often broken or leaking. Better coordination is needed amongst tanker operators refilling the tanks and distributing the water.

Although soap bars have been purchased by WHO, further promotion of personal hygiene and cleanliness is required, the assessment teams report.

In Banda Aceh, planning and training for water and sanitation staff to work in IDP settlements is recommended.

The Aceh provincial drug warehouse is now functioning again. A drug supply chain for donated drugs is being established. This will ensure that all donated drugs are from WHO pre-qualified suppliers; are appropriately labeled in Indonesian; and are within their use-by date. The Ministry of Health reported that donations of office equipment and refrigerators for vaccines from AUSaid have arrived in Banda Aceh.

While fears about physical illness have diminished, the same is not true for mental and emotional health. WHO is working with local health officials to train community leaders to create a network of counselors who can help victims cope with the anguish that remains in the loss of loved ones, property, income and community.

The government of Indonesia said February 3 that the first phase of the emergency relief operation in Aceh province has ended and that recovery and reconstruction in tsunami affected areas will begin. Still, government officials emphasized that food and medical supplies are needed for the tens of thousands of survivors living in isolated communities.

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Every day, trucks provided by WFP implementing partners such as CARE and Save the Children, transfer food aid brought in by sea and air to IDP camps across northern Sumatra. (Photo by Rein Skullerud courtesy WFP)
UN World Food Programme (WFP) teams, sent in to assess the hunger risk, estimate that some 790,000 Indonesians will need food aid over the next six months.

Beyond the horrific loss of human life, a World Bank Preliminary Damage and Loss Needs Assessment estimates damages and losses amounting to US$4.45 billion. This is equivalent to 118 percent of Aceh's GDP and 2.7 percent of Indonesia's GDP. Of the total, 63 percent constitutes damages and 37 percent is attributed to lost income flowing through the economy. A more detailed assessment is planned.

The tsunami extensively damaged Indonesia's coastal environment, causing $675 million in losses to natural habitats and important ecosystem functions, the United Nations Environment Programme (UNEP) reports.

In New York, United Nations Secretary-General Kofi Annan has announced that former U.S. President Bill Clinton will head the UN's tsunami reconstruction efforts, and will take office from March 1, 2005.

Two players from the U.S. National Football League's top players are coming to Aceh province on February 12 and 13 to help the UN World Food Programme to feed hungry families.

New York Giants quarterback Kurt Warner and wide receiver Amani Toomer will be lending their support to the WFP relief effort by helping with food distribution, visiting the tsunami-affected areas and generally working on the front lines with WFP staff in this emergency.