Humanitarian Health Action

Purpose statements for panels and sessions

WHO Conference on the Health Aspects of the Tsunami Disaster in Asia

Panel 2.8: Water, sanitation, food safety and environmental health


The Tsunami of December 26 caused major loss of infrastructure, destroying and damaging houses, hospitals, water supply and sanitation, roads and communication links. Very large numbers of people became displaced and many basic facilities were rendered unusable.

The damage and the impact of the damage in the affected countries was rather varied. In Aceh and the Andaman and Nicobar islands damage was such that it took weeks to make a proper assessment, while South India and Sri Lanka had a quick overview of the affected areas and could rapidly mobilize assistance. The Maldives suffered in its entirety, with all islands suffering physical and environmental damage. In all instances water supplies were damaged and the wells that households used were unusable due to salinity and dirt. Debris and damaged housing caused risk of injury and changed the vector borne disease risk potential. The risk of hazardous waste seems to have been limited although some industrial facilities and a nuclear research plant required certification of risk. Health care waste has been registered as a common concern, but has not been linked to any disease outbreaks. Waste management, i.e. safe disposal of human waste, solid waste and hospital waste caused problems due to volume and the absence of functioning or newly designated landfill sites. Inadequacies in waste management may have led to higher risk of recontamination of water sources and water-borne diseases.

Food safety has been monitored, but no outbreaks of note of food-borne diseases have been recorded. Hand-washing was identified as probably the most effective way of avoiding infectious disease in the circumstances.

Governments in the affected countries, with the assistance of citizens, INGOs and UN agencies were quick to provide immediate relief, and especially safe water and rations.

Restoration of water supplies and obtaining safe sources of water for distribution by water tankers was causing some problems and WHO needed to assist in guidance and water quality monitoring. A more serious concern was related to the camps that needed to be established for IDPs. Adequate facilities and adequate water for cooking and personal hygiene needed planning and supervision and took time. Coordination of the watsan activities did not always go easily as communication and sharing of information had its problems. All in all, while safe water in sufficient quantity was needed everywhere, it was provided fairly quickly by the many agencies present. Sanitation was a larger concern, and situations have occurred where facilities were not culturally appropriate or adequate for the numbers of people to be served in the IDP camps. Waste management has been a burden in all countries during this particular emergency.

Key questions

  • Reaching affected people with safe water is imperative. The Tsunami caused existing drinking water sources to become undrinkable due to excessive salinity (except for the rainwater still remaining in small tanks not swept away in the Maldives). Were national and international agencies capable of responding quickly enough through selection and purification of slightly more distant sources, that needed to be tankered in; through provision of reverse osmosis plants, etc.; or even through bottled water?
  • Were adequate technical assistance and materials made available to restore safe water supply and ensure water quality control: to communities/islands, and institutions: hospitals and clinics?
  • Did relief to affected people ensure access to sanitary facilities? Was hand-washing with soap enabled/promoted?
  • Was coordination within the water and sanitation sector and between this sector and local health authorities ensured for containing outbreaks and ensuring acceptable medium-term services?
  • Could SPHERE guidelines be applied in IDP camps with respect to water, sanitation, housing and environmental health? Was adequate additional information available to national authorities and NGOs on water, sanitation and environmental health risks?
  • Waste and debris has been a serious constraint to cleaning up, due to the absence of suitable landfills and inclusion of hazardous waste. Clogged drains and stagnant water may also contribute to a rise in vector-borne disease and fogging with pesticides has been applied in places. How could we be prepared better to handle the consequences of mass physical destruction?