Situation report 16
Aceh, Indonesia remains the priority for relief work as the province continues to be in a state of emergency. Strong progress has been achieved in Sri Lanka, but systemic relief must be undertaken alongside planning for rehabilitation and reconstruction.
- Public health teams, convened by WHO and working with the US military, are currently based on the ship Abraham Lincoln off the western coast of Aceh. They will be conducting rapid health assessments of otherwise unreachable populations in an a large area estimated at 350 km by 10 km.
- Communicable disease surveillance systems are in place in most affected countries and daily reports are becoming available. The next two to three weeks will be critical. Expert epidemiologists are on standby in the case that an outbreak is reported. No outbreaks have been reported so far.
- Public health and reference lab capacity has been strengthened.
- WHO is completing an assessment today of supply stockpiling and will inform governments and donors of what is needed where.
- In Sri Lanka, the number of displaced persons has further decreased and now stands at 441,410.
- WHO released a statement on the increased vulnerability of women and girls in circumstances of social upheaval.
|India||2200 km of coastal land; 300m to 3 km inland and 3 million people||897 villages, 157,393 dwelling units, 10260 HA of cropped area, and 1.56B USD||648,820||594 relief camps with 377,906 people. 646,256 people evacuated||3,324 in Tamil Nadu only. N/A for other areas||5628||10,151|
|Indonesia||Aceh: Districts (14 out of 21); 1 mill. people||172 sub-districts, 1550 villages, and 21,659 houses destroyed||605,849||1,443 hospitalized||10,078||113,360|
|Malaysia||NW states of Penang and Kedah||8,000||30,000 in 9 camps||73 in-patient/ 694 outpatient||6||68|
|Maldives||20 atolls||100,000 people affected||21,663||2,214||26||83|
|Myanmar||10-15,000 affected long-term. 5-7000 directly affected||592 houses of 17 villages destroyed||3,205 homeless/ households (638)||43||3||60-80|
|Sri Lanka||Affected families (103,789), houses (103753)||89,323 fully damaged houses and 41,216 partially damaged houses||441,410||457 relief camps||15,256||6,038||30,893|
|Thailand||6 provinces on west Thai coast||6.85M Baht have been provided to assist victims||8,457||47,708 rescue workers mobilized||3,254||5,303|
- India: No outbreaks of communicable diseases have been reported. An Integrated Diseases Surveillance Project Cell supported by WHO will start to collect daily reports of new cases of communicable diseases from all primary health centers at district level in Tamil Nadu. The government of India has successfully completed a measles immunization campaign for 75,338 displaced under five children in Tamil Nadu. WHO and UNICEF supported the campaign.
- Indonesia: A large scale vaccination campaign began after sporadic measles cases were reported. The campaign is targeting 1.16 million children aged 6 months to 15 years. There is a risk of malaria outbreak due to increased mosquito breeding sites and more than 500,000 displaced people unprotected from bites. Weekly tracking of dengue cases is needed. WHO has dispatched supplies for diagnosis and for vector control operations. Mobile laboratories are being constructed and should be operational by the beginning of next week. WHO laboratory experts from Malaysia and NAMRU have arrived in Banda Aceh. Laboratory functioning in Banda Aceh hospital with assistance from Singapore military hospital.
- Maldives: No outbreaks or epidemics have been reported. On January 13, 2005 the Ministry of Health (MOH) reported new cases of diarrhea, acute respiratory infections (ARIs) and viral fever. However the number of cases continues to be within the expected range with no upward trend.
- Sri Lanka: No outbreaks have been reported. Preventative measures such as fogging and increased supply of insecticide-enriched netting should be stepped up in the coming weeks to avoid outbreaks of vector-borne diseases, especially malaria and dengue.
- Thailand: No cluster of disease outbreak has been identified from the daily disease surveillance. Sporadic cases of diarrhoea have been reported. The Disease Control Department is concerned about the possibility of dengue fever outbreak.
Environmental Health (access to safe water and hygiene, sanitation situation)
- India: WHO is supplying district health authorities with material to monitor residual chlorine in drinking water supplies at camps. Following field assessments, water and food samples are being tested for pathogens. In Nagapattinum district, WHO supplied 2500 insecticide impregnated mosquito beds nets for distribution to affected families.
- Maldives: WHO water and sanitation engineers have completed their evaluation and submitted a report recommending that the government: 1) clean groundwater wells with at least one pump unit per island; 2) measure the water salinity; 3) carry out hygiene education on cleaning rainwater collection areas and 4) undertake a feasibility study on groundwater supplies as septic tanks pose a pollution risk.
- Sri Lanka: The Water Board has requested WHO lead the implementation of a water quality monitoring system. There are still inadequate sanitation facilities in the camps of Ampara. In Batticaloa and Trincomalee the construction of latrines has begun. Other activities include the construction of bathing facilities.
Other health issues (Mother and child health, mental health)
- Sri Lanka: Ongoing registration of tsunami survivors shows that children represent 36 percent of the affected population. Newly arrived WHO mental health experts are assisting MOH with a strategy for mental health and psycho-social issues. Distribution of hygiene packs to women and girls continue through the Family Health Bureau, the National Committee on Women (NCW) and Sarvodaya. Health education is taking place in the camps.
- Thailand: WHO has been asked to provide technical expertise and guidance in areas of post disaster mental health rehabilitation, particularly among children.
- Indonesia: The only mental hospital in Banda Aceh is severely flooded and the supply of medicines is inadequate. All 300 of the hospital’s patients were released at the time of the tsunami and only 100 have since returned. The rest are still missing. A WHO team has developed psychological aid guidelines and materials adapted to the local culture. These psycho-social guidelines will be distributed to NGOs working in the area.
India: The Indian government reports that it is focusing mainly on providing temporary houses the displaced, providing wage employment, restoring infrastructure and rehabilitating affected populations. Some camps have been closed in Kerela as people move to other accommodation.
Indonesia: WHO is leading the coordination of 50 agencies (UN and NGOs), for the public health relief work in Banda Aceh. Three additional epidemiologists have joined the WHO team. Weekly reporting of communicable diseases by selected units has commenced. The number of reporting units is increasing. Mapping of relief health facilities has been completed. Active surveillance of communicable diseases in hospitals has commenced. Due to wound infection, tetanus is currently a major public health threat. Currently, health capacities in Banda Aceh are able to provide effective clinical management of tetanus cases. WHO is working with a local radio station, Voice of Aceh (Suareh Aceh), to deliver public health messages to communities in the local language. Programmes also allow the public to call in questions to the radio station.
Sri Lanka: WHO is strengthening the laboratory network, as well as focusing on the 'cold chain' storage facilities for vaccines as many storage facilities were destroyed. Three basic laboratories in Kalmunai, Batticoloa and Ampara are being established to diagnose epidemic-prone diseases and to test water quality. Three planned WHO sub-offices are being established in Galle, Ampara and Jaffana to strengthen disease surveillance, water and sanitation and mental health activities. Medical supplies have been delivered to the Medical Supplies Division of the Ministry of Health. A further consignment of relief health supplies is expected this week and will be distributed to the hospitals in the affected districts through the Family Health Bureau and the Deputy Provincial Directors.
MAP: Sri Lanka - Number of camps
Thailand: Thailand is moving from emergency relief work towards longer-term recovery work. A WHO Intercountry Crisis Support Unit (ICSU) for Tsunami Response has been set up in Bangkok to strengthen inter-country emergency activities with other UN agencies.
Maldives: There is a need to strengthen reference labs. WHO is flying in people. Daily reporting of 12 communicable diseases from all the atolls and regional hospitals has commenced. In addition, notification of 23 communicable diseases, as and when these are detected, has also started. The WHO SEARO Regional Director visited the Maldives, meeting both the President and the Honourable Minister of Health. The Regional Director assessed health situations, visited the National Disaster Management Centre in Maleh, as well as one of the most affected island Dhaalu Gemendhoo.
Through the Emergency Health Action Programme for South-East Asia, the financial requirements for WHO’s health response over the forthcoming six-months period is assessed at US$67 million. WHO thanks the Vienna Philharmonic Orchestra (cash) and the governments of Australia (cash), Canada (in kind), Denmark (in kind), Finland (cash), France (cash), Germany (in kind), Italy (in kind), Japan (cash), the Netherlands (cash), Norway (in kind), Poland (cash), Portugal (cash), Kingdom of Saudi Arabia (in cash), Sweden (in cash), Switzerland (in kind and in cash), the United Kingdom (DFID in cash and in kind), and the United States (USAID in cash) for recent and early contributions. Expressions of support from individuals around the world are overwhelming.