Indonesia was most affected by the tsunami leaving Aceh province devastated. The tsunami killed an estimated 121,000 people with another 113,937 reported missing. It displaced another 399,959 individuals.
Initial health concerns revolved around trauma type injuries, infection of open wounds as well as psychological trauma. The lack of access to clean water incurred the risk of waterborne diseases. Within days, cases of pneumonia, respiratory tract infections, diarrhoea, and skin infections were reported. The approach of the rainy season compounded the threat of outbreaks of vector-borne diseases such as malaria and dengue fever. The local health infrastructure was extensively damaged and could not cope with the most pressing needs.
Upon request from the Ministry of Health and the UN, WHO organized a health emergency response team to provide technical support.
In conjunction with the Government of Indonesia, other UN agencies, and the military WHO conducted helicopter-assisted Rapid Health Assessments in areas of difficult access along the western coast of Aceh.
WHO, as the lead health organization, ensured efficient and effective coverage of health needs by ensuring coordination among all the agencies, the Ministry of Health and the provincial and district health authorities. This role has been crucial especially in consideration of the more than 250 NGOs present in Aceh after the disaster.
By keeping a close eye on the epidemiological situation major outbreaks were avoided. WHO implanted a disease surveillance and early warning system with public health mapping and GIS linked surveillance of affected areas. Epidemiological data and maps were regularly shared with health partners in the field and hospital laboratories with test kits and equipment provided to enhance diagnosis capacity.
WHO together with UNICEF strengthened and expanded the programme of immunization (EPI) with measles vaccination and vitamin A campaign reaching 178,490 children by 8 March.
At the peak of the relief phase, 20 metric tons of medical goods were delivered daily. An inventory of these goods enabled to sort Medical supplies from equipment. A drug supply chain ensured that donated drugs were in compliance with WHO standards and within their expiry dates. WHO provided to clinics in Aceh 30 basic health kits, covering the basic needs of 300,000 persons for three months. It also distributed fixed drug combinations to treat tuberculosis in Banda Aceh and Meulaboh and set up a cold chain system for vaccines and drugs in Aceh. Epidemiologists completed data entry for, and analysis of, medical reports from functioning hospitals, health centres and mobile clinics.
WHO also provided bed-nets and fogging machines to the Ministry of Health to minimize risk of disease outbreaks, computers and Internet connectivity to the Provincial Health Office of Banda Aceh and the Meulaboh District Health Office, the latter also benefiting from a Local Area Network (LAN). Plans are under way with the Provincial Health Office in Banda Aceh to establish Information and Communication Technology (ICT) infrastructure and connectivity in 21 District Health Offices in Aceh province.
WHO worked closely with the Ministry of Health to develop plans to manage cases of severe malnutrition through therapeutic feeding schemes. It also works with UNICEF, NGOs and provincial health authorities to ensure that malnourished patients have access to proper treatment.
WHO has prepared a set of recommendations, based on which the Ministry of Health has drawn up an Action Plan. WHO experts have subsequently provided training for psychosocial support to primary care doctors, nurses and community workers in the affected areas.
Water and sanitation
WHO worked closely with the provincial health authorities, providing technical advice and support in assessing water quality in the affected areas. In collaboration with UNICEF and Australian emergency health experts, an assessment of water, sanitation and health situation in camps for internally displaced persons (IDPs) was conducted in Banda Aceh. Similar surveys were also conducted in Meulaboh, and supplies provided in some camps to ensure personal hygiene standards among camp residents.
WHO epidemiologists trained provincial health office staff on how to enter and manage data for disease surveillance. Two WHO SUMA (Humanitarian Supply Management System) experts were in Banda Aceh to assist in training and setting up systems.
WHO is currently focusing on achieving coverage of basic health services to the population. Health facilities were mapped and inventoried and damage to the health system systematically addressed. Initially support was provided to provincial health offices in Banda Aceh, Aceh Besar, Aceh Jaya and Aceh Barat with USD 50,000 each to meet the operating costs to get primary healthcare facilities functioning again. WHO is also working in 49 resettlement points in Aceh to provide satellite health posts with round-the-clock basic health services. An Action Plan is being developed to assess and provide reproductive health needs, refresh midwifery skills, disseminate information, and ensure that maternal and child health is considered an integral part of emergency health services.