Focus on survival, staying well, and building a healthy future
The focus of health work in the areas worst affected by last week's tsunami is now threefold: survival, staying well, and building a healthy future.
The initial relief effort is continuing, and there are still as many as three to five million people who lack access to the basic needs for life. At the same time, efforts are beginning to plan the rehabilitation and reconstruction of communities and their infrastructure which has been destroyed or seriously damaged.
Survival is still a critical issue and there is a continuing urgent need to find and help people who have been injured. Treating wounds and other injuries continues to be a major need and an issue of pressing importance. That task has been made more difficult by problems of access and security around Aceh, as a result it is hard to locate injured people who need urgent help.
Many communities and people continue to be inaccessible. Travel outside the town of Banda Aceh is difficult and many of the injured and affected people are several kilometres away from the coast. In some place the waves of the tsunami penetrated as much as 7-8 kilometres inland along river courses and inlets. In many countries, there is little or no infrastructure left, apart from a few concrete posts from which houses have been washed away. Helicopter pilots and others who have surveyed the area report that many people are still cut off in mangrove swamps. Getting help to them is fraught with problems.
While an acute relief operation is now well under way, planning for rehabilitation and reconstruction has also begun. Planners from the World Bank and other organizations are beginning to assess the needs and the costs of rebuilding what has been damaged or destroyed.
WHO is playing a strong coordination role in Aceh, working with many other health-related agencies and non-governmental organizations to ensure that the health response is coherent and well coordinated. Rudimentary surveillance for disease outbreaks is starting in as many areas as are accessible. There is still little technical or laboratory support for this work, but sources of this support have been identified and are being moved to the area as rapidly as possible.
In Sri Lanka and the Maldives, teams from WHO continue with the vital work of gathering information about the most urgent health needs and monitoring for rumours and information about potential disease outbreaks. Gathering this health intelligence and information and coordinating it with plans for the response is vital and will continue to be vital in the days and weeks to come.