NIAS ISLAND, NORTH SUMATERA, BANYAK ISLANDS & SIMEULUE ISLAND, ACEH
Two medical field teams returned this week from the Telos Islands in North Sumatra District. The teams were on board the boats Saranya and Indo Jiwa. Their main function was to continue the post emergency immunization, nutrition and malaria control clinics in the remote outer islands off the west coast of Sumatra. Since the start of the post-tsunami emergency response in December 2004 SurfAid has immunized more than 16,500 children, distributed 20,500 impregnated nets and provided medical treatment to more than 2,840 sick and injured people. (See box below for more complete figures). In addition, SurfAid staff have returned from a fact-finding mission in Simeulue where SurfAid had an office that was destroyed in the March 28th earthquake. The team's findings are outlined below. While the SurfAid team in Nias continues to forge ahead establishing a new office, setting up the program, building relationships with local government and preparing for village assessments and base-line data collection.
Figures to date
Tsunami disaster response (January -- March 2005)
More than 52 clinics held in Nias, The Hinako Islands and Simeulue.
More than 35,920 people covered.
More than 10,480 children aged between six months and 15 years immunized for measles and given vitamin A supplements.
More than 12,023 insecticide treated nets distributed along with malaria education.
More than 766 medical consultations carried out.
Earthquake disaster response (March 30 -- May 2, 2005)
More than 1500 medical consultations carried out in Nias and Simeulue.
The majority of the consultations were emergency related. Main injuries included fractures, lacerations and wound infections.
More than 65 medical evacuations from remote villages facilitated
More than 200 tons of emergency supplies distributed. Items distributed have included food, water and temporary shelter.
Regular program response (25 April -- 2 May 2005 )
More than 1,836 children between the ages of six months and 15 years immunized for measles and given vitamin A supplements.
More than 1,319 children treated for worms.
More than 100 medical consultations carried out.
More than 1,784 impregnated family size nets distributed.
Regular program response (4 May - 16 May 2005)
More than 3,769 children between the ages of six months and 15 years immunized for measles and given vitamin A supplements.
More than 4,583 children treated for worms
More than 182 medical consultations carried out
More than 3,869 impregnated family size nets distributed.
Regular program response (20 June -- 2 July 2005)
More than 500 children immunized for measles and 1,096 given vitamin A supplements.
More than 848 children treated for worms More than 295 medical consultations carried out More than 2,885 impregnated nets distributed
- SurfAid's boat-based medical teams started clinics in the islands on 20th June. They provided measles vaccination, de-worming, nutritional assessment, malaria testing, net distributions and malaria education throughout approximately half of the 60 villages in the island cluster. Between 40,000 and 42,000 people inhabit these islands. The teams are now in Padang preparing for the second leg of the Telos mission scheduled for mid July.
- SurfAid partner Helen Keller International was also part of the successful Telos mission. The HKI nutrition team has worked alongside SurfAid since the initial emergency response conducting anemia tests and mother/child pair nutritional assessments. HKI also provides micro-nutrient supplements to all patients.
SurfAid Assessment of the Telos Islands
- The Telos are known administratively as Kecamatan Pulau-pulau Batu. They form a group of more than forty islands. The kecamatan (sub-district) is part of Kabupaten Nias Selatan (South Nias District) and is located 100 km south of Nias and 260 km west of Padang. There are forty six villages dispersed throughout the eighteen inhabited islands. The total population of these islands is 18,700 people or 4,500 families. The other islands are primarily used for coconut plantations.
Effect of the Tsunami and Earthquake
- The kecamatan was not as severely affected by either the December 26 tsunami or March 28 earthquake that hit the northern part of the kabupaten. In some parts of Pulau Telo (the main island) and Pulau TanahMasa the water did surge 50m into the villages, but it did not cause any serious damage. Some wells were contaminated by sea water but have since been re-dug or replacement wells have been found. One person was airlifted to Medan in North Sumatra from the kecamatan with a broken leg after the March 28 earthquake. Although there was little destruction, the villagers remain traumatized by the stories they heard from their northern neighbours or the scenes that they've seen on the limited number of televisions in the islands. Some villages have a 50% IDP rate. However, they are not full time IDP's as most of them return to their villages by day and retreat to higher ground and temporary houses at dusk.
- The primary form of inter-island transportation is by sampan (canoe) or small boat. There are regular boats to and from Teluk Dalam in South Nias, but their departure is dependent on weather conditions. On the main island of Pulau Telo there are very few motor bikes and even fewer four wheel vehicles, the main form of transport is by becak (motorcycle rickshaw) or bicycle. There is a road that runs the whole circumference of the island which is tarred for most part -- parts far from the main market are still gravel. There are no four wheeled vehicles or motorbikes on Pulau TanahMasa.
- The majority of the villages on Pulau Telo are Christian with the exception of Desa Rapa-rapa, Sinarau and Sialuaya which are Muslim. The majority of the villages in Pulau Tanah Masa, Kecamatan Pulau-pulau Batu are Christian with the exception of Desa Koto which is Muslim.
- Although Kecamatan Pulau-Pulau Batu are resource rich, very little of this wealth directly benefits the people. Thai fishermen with heavy fishing trawlers are said to fish its waters and Korean woodcutters are reported to harvest it rich forests. The economy is centered on the main island (Pulau Telo) where there is a reasonably large ethnic Chinese-Indonesian community that plays a large role in the local consumer economy. The main occupation of the villagers in Kecamatan Pulau-pulau Batu is fishing (approximately 65% of the population). Their catch is consumed personally or sold on the local market and to
Teluk Dalam. About 30% of the population farm coconut and cloves. Cocoa has been planted but they are yet to reap a yield. The remaining 5% of the population are either civil servants or laborers.
Health status and facilities
- In terms of health facilities, Kecamatan Pulau-pulau Batu is limited. There is a Puskesmas (Community Health Center) on the main island of Telo with 15 staff, including 1 doctor, Dr. Tambunan. There are no pustu (local branches of the community health center) or polindes (village level clinics) on the island. The posyandu (mobile clinic for babies and pregnant mothers) system works well on the main island, Pulau Telo -- a posyandu is held monthly in each village in the village meeting hall and there are four cadres in each village. Different to the main island (Telo), the posyandu system is very limited in the outer islands, taking place between once or twice each year. Sometimes the posyandu staff are required to go house to house to implement their program because the community is yet to be accustomed to the normal system where the villagers come to the village hall.
- The data collected from Pulau Telo and Pulau Tanah Masa indicates a high prevalence of malaria. There were numerous cases of falciparum malaria and some cases of vivax. The cold chain in the kecamatan is unreliable as the electricity for the island is only turned on at night.
Water and Sanitation
- The villagers on both Pulau Tello and Pulau TanahMasa have adequate water. They get their water from either wells or in some cases, springs. Even in the dry season they have sufficient water. Approximately 95% of the population on Pulau Telo and Pulau TanahMasa have wc alami (natural toilets -- bush/sea).
- According to the respondents interviewed there have not been any other organizations which have worked in Kecamatan Pulau-pulau Batu with the exception of the World Bank. There is very clear evidence of the World Bank's Kecamatan Development Program (KDP) in the villages in both Pulau Telo and Pulau TanahMasa. KDP provided electricity for three villages on Pulau Telo and a stone entrance structure to one village. On Pulau Tanah Masa KDP provided the village with funds to build a jetty in Desa Teluk Limo. The KDP program has since been put on hold in Kecamatan Pulau-pulau Batu as the sub-district did not perform well.
NIAS -- Teluk Dalam
- SurfAid is in the process of setting up its new office in Nias while preparing to carry out assessments of 12 villages in which SurfAid committed to work in when we signed the MoU with the Nias Health Department during the disaster phase of our operations earlier this year. Staff have also been meeting with the Bupati (Regent) and the health departments in Gunung Sitoli and Teluk Dalam in the south. The Nias program manager is preparing a Nias-wide strategy for the region.
SIMEULUE -- Sinebang
SurfAid's program manager Brian O'Callaghan and medical director Dr Dave Jenkins visited Simeulue in June to assess the situation on the ground and decide on SurfAid's future role on the island. These are the main findings from their trip.
- Simeulue remains seriously affected by the Tsunami/Earthquake with lack of reliable water supplies, delayed reconstruction, and health delivery systems affected.
- The government, NGOs and the local population face severe logistical and communication difficulties due to isolation. Many of the northern areas remain cut off except by sea.
- Large NGOs are having problems with recruitment and gaining access to supplies. Some are pulling out leaving big gaps in service provision despite the ongoing needs
As a result SurfAid has committed to helping Simeulue over the long term. Amongst other things, SurfAid will:
- Reconstruct completely damaged clinics (to be identified by the local health department), restock clinics and train nurses
- Reestablish posyandu (village health centre). Posyandu includes immunization, mother and child health and nutritional assessments, nutritional supplement provision
- General health, hygiene and nutrition education
- Worm control
- Malaria control
- Conduct needs assessment of isolated areas in the north once the initial project is established.
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