The tsunami caused a total of 9,572 deaths and a further 5,914 reported as missing. More than 600,000 people were initially internally displaced and sheltered in 532 temporary camps. The Andaman and Nicobar islands as well as more than 2,000 kilometres of coastline along the southern Indian states of Tamil Nadu, Andhra Pradesh, Kerala and the Union territories of Pondicherry were devastated.
Initial health concerns revolved around trauma type injuries, infection of open wounds as well as psychological trauma. The lack of access to clean water posed the threat of waterborne diseases. Within days, cases of pneumonia, respiratory tract infections, diarrhoea, and skin infections were reported. The approach of the rainy season posed the risk of outbreaks of vector-borne diseases such as malaria and dengue fever. The local health infrastructure was extensively damaged and could not cope.
Ministry of Health and Family Welfare, Government of India sent 32 medical officers to Andaman and Nicobar Islands immediately, and another 80 to the mainland states. WHO provided technical support.
Four Disease Surveillance Units were equipped in Tamil Nadu (Nagapattinam, Kanyakumari, Cuddalore and Kancheepuram districts), with supportive supervision and training provided by a team from WHO and the National Institute of Communicable Diseases (NICD). Medical officers and paramedical workers in Kanyakumari, Cuddalore and Chingleput districts of Tamil Nadu were sensitized to the importance of accurate and timely surveillance reporting. Sporadic outbreaks of communicable disease have been detected and controlled: there have been no major epidemics in the Tsunami-affected populations in India.
One of WHO's key tasks is to help national authorities co-ordinate and liaise with partners. Immediately after the tsunami, an Operations Cell was established in the WR India and regular liaison was maintained with the Government of India, state governments and development partners. A WHO Coordination Cell was established in Chennai to coordinate health-related activities with the Tamil Nadu government. An epidemiologist was also positioned in Trivandrum.
To prevent malaria, insecticide-treated bed nets have been provided to affected districts in Tamil Nadu. In Nagapattinum, for example, 2,500 insecticide-treated bed nets have been distributed. WHO also provided technical support for spraying and fogging to prevent vector-borne diseases.
WHO, along with UNICEF and UNDP, developed a framework for providing psychosocial support to the affected population. Under WHO guidance, NGOs are being trained in psychosocial support. Three WHO collaborating centres are engaged in providing training and services for mental health, disaster management for children and adolescents, and disease surveillance.
WHO has provided technical assistance in Tamil Nadu, Kerala, Andhra Pradesh, Pondicherry and the Andaman and Nicobar islands for measles vaccination, vitamin A supplementation for children aged 6-59 months and oral polio vaccine for children under 60 months. To date, 71,338 children have been vaccinated by the government with the support of UNICEF, WHO and others.
WHO is working on strengthening maternal and child healthcare services in the temporary camps, in collaboration with UNICEF, UNFPA and professional organizations like the Federation of Obstetrics and Gynecological Societies of India (FOGSI) and the Indian Academy of Paediatrics (IAP). A plan is also being developed, with the Indian Nursing Council and Tamil Nadu Nursing Council, to strengthen nursing services, provide training in psychosocial support and develop a curriculum in disaster management for nurses.
Water and sanitation
WHO has provided assistance for monitoring microbial contamination of water and laboratory surveillance of Shigella and cholera. WHO has also supplied 1000 chloroscopes to monitor the quality of drinking water in the affected areas. In collaboration with the Gandhigram Rural Institute, WHO also provided technical assistance to district authorities for strengthen the monitoring of drinking-water quality, hygiene education, and waste management in Nagapattinam, Kanyakumari and Karaikal. Another proposal is being developed with the Tamil Nadu Water and Drainage Board to assess the changes of drinking-water quality on the coast after the tsunami.
Twenty eight WHO technical guidelines were provided to the Government of India, relevant state governments, and other partners, on subjects ranging from Tsunami: Anticipated Health Problems and Interventions and Communicable Diseases Early Warning System to Mortuary Service and Handling of dead persons.