Situation report 24
Summary
- While no disease outbreaks have been reported anywhere in the affected regions, the risk of water-borne and vector-borne diseases remains high among affected populations
- Vector-disease control and prevention programmes are being strengthened throughout the region. Focus is on disease surveillance and environmental prevention activities such as fogging and provision of insecticide-treated bed-nets
- In India, on the mainland, water supply systems have been adequately restored, but sanitation infrastructures need to be strengthened in some of the displacement camps
- In Banda Aceh, emergency medical treatment for malaria, cholera, shigella, measles and meningitis has been sent to the WHO central warehouse, in the event a potential disease outbreak occurs
- Psycho-social support continues to be strengthened across the affected region
Situational Updates
| Areas affected | Damage | Displaced | Relief | Injured | Missing | Deaths | |
| India | 2200 km of coastal land; 300m to 3 km inland and 3 million people | 897 villages, 157,393 dwelling units, 11,827 HA of cropped area, and 1.56B USD | 647,556 | 595 relief camps with 376,171 people. 638,297 people evacuated | 6,898 | 5,553 | 10,747 |
| Indonesia | Aceh: Districts (14 out of 21); 1 mill. people | 172 sub-districts, 1550 villages, and 21,659 houses destroyed | 452,845 | 1,736 hospitalized | 6,222 | 166,760 | |
| 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 | 10,578 | 1,313 | 26 | 82 | |
| Myanmar | 10-15,000 affected long-term. 5-7000 directly affected, 23 villages | 592 houses of 17 villages destroyed | 2,592 homeless/ households (537) | 43 | 3 | 61 | |
| Sri Lanka | Affected families (103,789), houses (103,753) | 90,241 fully damaged houses/ 41,960 partially damaged houses | 431,224 | 404 relief camps | 15,256 | 6,020 | 30,920 |
| Thailand | 6 provinces on west Thai coast | 6.85M Baht have been provided to assist victims | 47,708 rescue workers mobilized | 8,457 | 3,141 | 5,373 | |
| Somalia | Puntland region worst-hit, 650 km of coastline | 600 families have lost properties. 2,600 fishing boats destroyed | Approx. 4,000 | Many sheltering under plastic sheeting or in branch huts | NA | NA | At least 150 |
Health Priorities
Communicable Diseases
India:
Mainland: There are no reports of disease outbreaks.
Sporadic cases of diarrhoeal disease, chickenpox and measles have been reported from affected areas as well as non-affected areas in Tamil Nadu and Kerala. The health situation is under surveillance by the Ministry of Health and Family Welfare.
Vector surveillance and control measures are being carried out by district malaria officers in tsunami-affected areas Tamil Nadu. WHO has supplied insecticide-treated bed-nets (family size) in four districts for use by affected families. Insect repellents have also been supplied by the Central government.
Andaman & Nicobar Islands: The prevention of outbreaks in the Nicobar group of islands has been accorded priority. Since the tsunami, doctors in the affected islands have treated many patients with various conditions including diarrhea, upper respiratory infection and malaria. Over 1,500 children have been immunized and provided with vitamin A supplement.
Indonesia: Three cases of falciparum malaria have been confirmed in Krueng Raya, Aceh Besar. MOH and Mentor Initiative alerted field partners to start environmental control measures. Since Shigella dysentery cases were identified at the Secata Internally Displaced Persons (IDP) camp, Oxfam started soap distribution and is increasing the number of latrines.
Thailand: There are no reports of disease outbreaks. The Bureau of Epidemiology, Ministry of Public Health, has now handed back the responsibility for disease surveillance activities to provincial health authorities, except in Phang Nga Province.
Environmental Health (access to safe water and hygiene, sanitation situation)
India: On the mainland, water supply systems have been restored in most of the affected areas. However, sanitation services need to be improved in some of the displacement camps. Community members are being requested to participate in the environmental sanitation programmes.
WHO has distributed 1,000 chloroscopes to monitor quality of drinking water. WHO is coordinating the initiation of environmental sanitation projects in a number of affected areas.
Indonesia: While rapid health assessments on the west coast of Aceh suggest that acute health needs are met, the populations remain vulnerable, humanitarian assistance is patchy and water and sanitation continues to be a problem.
Maldives: Discussion has been initiated between UNEP and WHO experts on concerns about risk of contamination from asbestos in the debris of houses and buildings destroyed.
Thailand: A rapid health assessment of water supply and sanitation is being conducted by the department of health.
Other health issues (Mother and child health, mental health)
Thailand: The Mental Health Department plans to implement an immediate and long-term plan for people directly and indirectly affected by the tsunami disaster. A command centre has been established at the regional psychiatric hospital in Surat Thani. Teams of psychologists and counselors are mobilized from psychiatric hospitals across the country to the south, to organize mobile units and visit areas particularly affected by the disaster. More than 7,400 individuals have sought psycho-social support in mental health centres, since the tsunami occurred on 26 December,
Health system and infrastructure (functioning health facilities, access)
India: The Andaman & Nicobar administration has evacuated people from smaller islands to eight bigger islands, where relief efforts are concentrated. A total of 42,161 persons have been accommodated in 172 relief camps. Adequate supplies of food items, clothing, utensils and drinking water are available, and basic healthcare is provided.
In Tamil Nadu, a total of 28 camps for 23,000 residents are functional, and 485 doctors are supported by adequate numbers of paramedical staff to provide medical relief.
WHO has provided surgical and emergency kits to support the relief efforts in Kerala, Andhra Pradesh and Tamil Nadu. In Tamil Nadu, insecticide-treated bed-nets and oral rehydration salts were provided to affected districts.
Indonesia: A MOH inventory has shown expatriate medical staff responding to the tsunami crisis currently number 2075, comprising 325 specialists, more than 500 general practitioners and 540 nurses.
Initial field surveys in Aceh revealed a greater prevalence of dengue carrying mosquitoes and their larvae (AEDES). The combination of destruction caused by the tsunami and heavy rains in Banda Aceh has created innumerable outdoor breeding sites which could result in a steep rise in the number of cases of dengue. Widespread flooding has also greatly increased the risk of malaria and the full extent of mosquito breeding will only be known in about two weeks time. Extensive fogging needs to be carried out.
Maldives: Ms Margareta Wahlstrom, UN Coordinator for Tsunami, OCHA, will meet with all heads of agencies tomorrow to discuss the relief effort.
Myanmar: Some 10,000 affected people in the Irrawaddy delta area are estimated to be potentially in urgent need of food, water, basic health assistance and shelter, along with several thousand more in Tanintharyi division. Furthermore, some 200 villages spread over the southern coast of Myanmar may also have suffered from the economic impact of the tsunami disaster. Most of these villages rely on fishing to sustain their livelihoods, and fishermen and fishing equipment such as boats and nets have been particularly affected by the tsunami.
Thailand: The Ministry of Public Health held a seminar at Patong Hospital, Phuket province, to discuss lessons learnt in health recovery following the tsunami disaster.
WHO Action & Country Information
India: In Tamil Nadu, four disease surveillance units are providing technical support.
WHO has developed a framework for providing psycho-social support for affected populations.
Indonesia: Based on worst-case scenarios for malaria, cholera, shigella, measles and meningitis, required supplies for immediate treatment have been estimated and sent to the WHO central warehouse facilities in Banda Aceh.
WHO teams in the field report a need for additional activities and resources in the areas of water and sanitation/environmental health, psycho-social (mental health), nutrition (possibly in an advisory role), malaria/vector control, information, and medical coordination.
Myanmar: WHO continues to provide technical support to the ministry of health and the coordination groups, focusing on reducing the risk of disease outbreaks and providing emergency medical supplies as requested by the ministry of health.
Thailand: WHO recently facilitated a meeting of mental health experts, with the Department of Mental Health. Field visits are currently underway in Phuket and Phang Nga provinces to conduct assessments of psycho-social support activities. WHO is in the process of completing a preliminary report assessing the mental health situation of populations in areas affected by the tsunami.
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.