South Asia: Tsunami & Health Situation Report # 35

from World Health Organization
Published on 11 Feb 2005
Tsunami-affected countries have transitioned from emergency relief work towards more rehabilitation and reconstruction work. Mental health remains a concern; WHO is working with governments for appropriate medical and psychosocial responses. While there are no outbreaks, cases of dengue, hepatitis E and typhoid have been confirmed in Indonesia. HIV/AIDS in the vulnerable populations remain a concern.


  • In Banda Aceh, WHO has established a Planning and Management Support Unit to assist the provincial health authorities in rehabilitation work.

  • In India, eight district-level disease surveillance cells in Andhra Pradesh, Kerala and Pondicherry will be strengthened, with medical officers and paramedical staff being trained in 12 districts.

  • A WHO team visited Chennai to assess the situation and identify and consult with partners to implement HIV prevention activities among the tsunami-affected populations in Tamil Nadu.

  • The WHO document Mental Health in Emergencies (WHO, 2003), which covers social, psychological and psychiatric care interventions during and after acute emergencies, was translated in numerous languages and is being widely disseminated.

  • Livelihood restoration is a priority. Re-settlement and land distribution are important issues in Sri Lanka, Indonesia and the Maldives. The affected governments, with assistance from UN and other agencies should focus on housing and coastal/urban planning.
Health Priorities

Communicable Diseases

India: Disease surveillance continues to be strengthened in Andhra Pradesh, Kerala, and Pondicherry. Medical officers and paramedical staff are being trained in 12 districts. Following this training, the medical officers will train other health staff.

Insecticide-treated bednets are being distributed in relief settlements.

A WHO team visited Chennai to assess the situation and identify and consult with partners to implement HIV prevention activities among the tsunami-affected populations in Tamil Nadu. As has been seen in other emergency situations, HIV infection rates may increase among affected populations due to increased pressures on people. This may cause sexual behaviour to change in harmful ways; disrupted medical services including blood safety screening; financial desperation leading women to turn to sex work to feed themselves and their children; and increased rates of sexual abuse. It was agreed that interventions should be through community workers who will be trained in communication techniques, the identification of people at risk, and referral mechanisms for counseling when needed. Manuals and educational materials will be developed in collaboration with SIAP (an NGO involved in counseling).

Indonesia: Field investigations of a previously confirmed case of dengue hemorrhagic fever in Aceh Utara identified four other family members with laboratory confirmed dengue fever. A previously reported suspect case of hepatitis E in Lan Lhum has been confirmed by laboratory testing. A fatal case of acute jaundice was identified in Sua Beaukah, Sompuyan. A confirmed case of Shigella flexneri infection was reported from Sampinet, Aceh Jaya. Two to three suspected typhoid cases have also been identified in this area. These isolated cases will be further investigated for disease confirmation and extent of spread. While there have been no cases of cholera in Aceh, plans are being made for a cholera vaccination campaign as a preventative measure.

WHO is finalizing a comprehensive report on the Communicable Disease Profile in Tsunami Affected Area: Indonesia. It will be published shortly. A WHO epidemiology bulletin is now distributed twice weekly, in English and Bahasa.

Maldives, Sri Lanka, Thailand: No outbreaks have been reported.

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