South Asia: Tsunami & Health Situation Report # 38

Report
from World Health Organization
Published on 22 Feb 2005
Health education and food safety efforts are receiving greater attention. The safe disposal of medical waste is becoming an issue in some areas. Construction of temporary shelters is progressing well, with shelter for 1000 families completed, or nearly completed, in Sri Lanka and 139 of the proposed 418 barracks for the displaced completed in Indonesia.

Summary

An intensified measles vaccination campaign in Banda Aceh is planned for 28 February - 5 March, 2005 as coverage to date is less than 40%.

In Sri Lanka, 6019 of 12 000 contaminated wells have been cleaned so far. The Ministry of Urban Development and Water Supply reported 16 000 temporary toilets (cost 3 M USD) need to be constructed at IDP campsites.

WHO will send a mission to assist Thailand's Ministry of Public Health to assess forensic services and provide recommendations for further actions.

Reconstruction has begun in the Indonesian town of Calang, which was completely destroyed by the earthquake and tsunami. More medical aid for pregnant women and coordination of the health sector, led by the district health office, is required.

Communicable Diseases

Indonesia: A new case of bloody diarrhoea from Doapoo (Aceh Besar), confirmed as Shigella flexneri, was reported by the Portuguese Field Hospital. Treatment with ciprofloxacin has begun, with antibiotic sensitivity testing of the isolate pending. One of 3 previously reported cases of bloody diarrhoea from Meulaboh Hospital was confirmed as Shigella sonnei. Antibiotic sensitivity testing is ongoing.

A suspected case of typhoid fever from Bandara, Sultan Iskandar Muda (Aceh Besar) was identified by the Portuguese Field Hospital. Blood culture results are pending.

A laboratory confirmed case of dengue from Seulimeum (Aceh Besar) was reported by the U.S. Naval Army Medical Research Unit II (NAMRUII). No new cases have been reported. A previously suspected case of dengue in Banda Aceh has been ruled out by confirmatory testing.

A new case of measles was reported in an adolescent from a village in Seunodon (Aceh Utara). A meeting was held on 17 February 2005 between district health offices, provincial health offices, UNICEF, WHO and NGOs to increase measles vaccine coverage. Repeat vaccination campaigns targeting Banda Aceh are planned for 28 February to 5 March, 2005.

A previously reported case of hepatitis A from Lam Lhom (Aceh Besar) has been confirmed. No further cases have been reported. Health education and other public health interventions have been implemented.

Communicable disease surveillance continues to be implemented in 8 of 14 tsunami-affected districts. Reporting is predominantly conducted by NGO-operated or supported clinics, military and foreign government hospitals, and district health offices. The 6 districts not reporting have only been mildly affected and consequently have low NGO presence. Plans are underway to train new NGO personnel on disease surveillance, improve epidemiological support to the WHO Meulaboh sub-office, and identify and address needs of district health offices to facilitate surveillance reporting.

Thousand of insecticide-treated bednets will be distributed at a mass campaign for bednet distribution which begins on 23 February 2005 on the west coast of Aceh. MENTOR will provide training on malaria prevention. In Lambaro District, 10 of the 13 barracks have been sprayed indoors while in Lambaro Siron 11 barracks of 18 have been similarly treated. In Calang, experts from the Ministry of Health,from Jakarta, have begun assessing the threat of malaria, identifying the malaria vector and its breeding places.

Maldives: An outbreak of mumps in an internally displaced persons (IDP) camp in Hulhumale began on 30 January 2005. Up to 20 February 2005, 10 clinical cases have been reported, 9 of whom are between the ages of 3 and 16 years. Nine of the 10 cases come from 4 of 13 displaced families within the camp. 79 other residents living on the island are being closely monitored. Investigations, including identification of cases of mumps in Male', the previous location of these families up until 20 January 2005, are ongoing. Diagnostic kits for laboratory confirmation are being procured by WHO.

Myanmar, Sri Lanka, Thailand: No communicable disease outbreaks or unusual events have been reported.

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