Humanitarian Health Action

Situation report 26

24 January 2005

No disease outbreaks have been reported. However, the threat of water-borne and vector-borne diseases remains a concern. Disease surveillance is high on everybody's agenda. In Aceh, an assessment of health, water and sanitation in 50 camps began on 24 January. A similar assessment in Jaffna, Sri Lanka confirmed there is work needed for better water quality and hygiene in camps. In Indonesia, close to 55,000 children were vaccinated against measles, and in Thailand, progress is being made in addressing the mental health needs of people in the tsunami-affected areas.


  • No disease outbreaks have been reported.
  • Disease surveillance systems have been strengthened. In Thailand, surveillance activities have been handed over to provincial health authorities. Cases and suspected cases of melioidosis, shigellosis and tetanus are being investigated.
  • WHO is completing a preliminary report assessing the mental health situation of people in tsunami-affected regions.
  • Ms Margareta Wahlstrom, the UN Special Coordinator for Humanitarian Assistance to Tsunami-affected communities met heads of agencies in the Maldives and emphasized that all activities should be implemented within the six-month timeframe of the Flash Appeal.

Health Priorities

Communicable Diseases
  • India: There are no reports of disease outbreaks in either the Mainland or the Andaman & Nicobar Islands. Indonesia: Two patients with suspected cases of melioidosis are hospitalized in Meulaboh. The cases are being investigated. One case of shigellosis has also been identified. WHO and Médicins Sans Frontières (MSF) have reviewed tetanus cases in Banda Aceh, Sigli and Meulaboh. A total of 87 cases of tetanus have been registered as of 23 January 2005. The number of new cases is decreasing. A measles immunization campaign has covered 54,410 children in the affected areas, as of 21 January 2005. However there is still an urgent need for field partners to support the ongoing measles immunization campaign in Aceh Jaya. Maldives: There are no reports of disease outbreaks.
  • Sri Lanka: There are no reports of disease outbreaks. According to the WHO team in Batticaloa, acute respiratory infections (ARI) are the leading causes of illness. Reported cases of ARI however remain under the epidemic threshold.
  • Thailand: There are no reports of disease outbreaks. The Thai Ministry of Public Health has handed over disease surveillance activities to provincial health authorities. The hardest hit Phang Nga Province however, still needs help from both regional and central level.
Environmental Health (access to safe water and hygiene, sanitation situation)
  • Indonesia: There are plans for the construction of barracks for the relocation of Internally Displaced Persons (IDP). Water and sanitation facilities will be a priority concern.
  • Sri Lanka: In Batticaloa, water and sanitation facilities were found to be gradually improving.
  • Thailand: The Ministry of Health and the CDC are conducting rapid environmental health assessments and have forwarded a report to the Permanent Secretary.
Other health issues (Mother and child health, mental health)
  • India: A two-day sensitization workshop was organized for teachers of nursing schools and colleges in Naggapattinam, Kanyakumari, Chennai and Cuddalore. The aim of the workshop was to define and promote the role of nurses in providing psychosocial support to affected communities.
  • Thailand: The Mental Health Department has set up a command centre for psycho-social services at their regional centre in Surat Thani (about 2 hours drive from Phuket and Phang Nga). Teams of local psychologists and counselors are visiting areas affected by the disaster. They are rotating every six days in order to avoid burn out among staff.
Health system and infrastructure (functioning health facilities, access)
  • India: A manual on surgical care at district hospital/first referral units was provided to the government of Tamil Nadu to help with the reconstruction of health services in affected areas. Guidelines on the treatment of reproductive tract infections/sexually transmitted infections were also passed on to Tamil Nadu health officials.
  • Indonesia: SurfAid International has obtained four WHO emergency health kits -- each large enough to provide enough medical supplies to 10, 000 people for three months – and plans to distribute the supplies to five affected districts. Two new field hospitals, the French Army Hospital in Aceh Barat and the German Army Hospital in Aceh Jaya are operational.
WHO Action and Country Information

Indonesia: WHO and UNICEF will provide support for an assessment of health, water and sanitation in 50 priority camps in Banda Aceh, starting on 24 January 2005.

India: WHO supported the Indian Nursing Council and the Tamil Nadu Nursing Council to develop an action plan to strengthen nursing services in affected areas in Tamil Nadu.

Sri Lanka: A WHO water and sanitation expert visited several camps in Jaffna and found a number of problems related to water quality and hygiene. WHO has made recommendations to the local Water Board, and is providing guidance to the health department and other partners, to improve chlorination and to make water more palatable to IDPs who are reluctant to drink it due to the chlorinated taste.

WHO facilitated discussions between organizations working on psycho social activities. A sub-group has been formed to address the following issues: guidelines and protocols for district health workers; greater consideration of socio-cultural factors when implementing psychosocial programmes; and possible tensions between IDP camps and nearby villages over service provision.

Thailand: WHO facilitated a meeting on 20 January of the CDC, the TUC (Thai-US Collaboration on Health) Mental Health Expert team and the Department of Mental Health. WHO is completing a preliminary report assessing the mental health situation of the people in the tsunami-affected areas.

MAP: Situation map as of 22 January 2005

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 following:

Donor Contributions received (USD) Firm Pledges (USD) Soft Pledges (USD) Location
WHO Director General Office 100,000 Region
Australia 774,593 Indonesia
Canada 1,229,508 Region
Denmark 2,313,058 Indonesia
EC/ECHO 678,426 Indonesia
Finland 2,035,278 Region
France 5,427,408 Region
Ireland 678,426 Region
Japan 6,000,000 Indonesia, Sri Lanka, Maldives
Luxembourg 1,017,639 Region
Republic of Korea 1,000,000 Region
Netherlands 2,442,334  Indonesia
Netherlands 1,000,000 Sri Lanka
Norway 6,000,000 Region
Poland 100,000 Region
Portugal 542,741 Region
Saudi Arabia 500,000 Region
Sweden 5,295,008 Region
Switzerland 884,956 Region
UK/DFID 100,000 Region
UK/DFID 3,831,418 Region
UK/DFID 1,149,425 Indonesia
UK/DFID 1,149,425 Indonesia
USA/USAID 291,500 Indonesia
TOTAL 7,840,466 27,540,604 6,717,739
Vienna Philharmonic 156,038 Region
Online donations 90,588 Region
SMS donations, South Africa 206,157 Somalia
Other private donations 200,549 Region
TOTAL 653,332
GRAND TOTAL: 42,752,141