Indonesia: Aceh earthquake response situation report No. 19

Situation Report
Originally published


SurfAid's Emergency Program officially ended on July 31st 2005. The program was launched to respond to the December 26th 2004 Indian Ocean earthquake and tsunami and was extended following the March 28th 2005 Nias earthquake. As of August 1st 2005 SurfAid has returned exclusively to development program planning and activities in existing and newly defined target areas.

Two marine-based clinical teams from SurfAid International returned to Padang on August 2nd 2005 having spent six weeks in Kecamatan Pulau-pulau Batu between 20/6/2005 and 31/7/2005. During that time the teams took SurfAid's emergency disease prevention program to all of the eighteen inhabited islands and implemented the program in every village throughout the kecamatan (sub-district).

Since the start of the post-tsunami emergency response in December 2004 SurfAid has immunized more than 16,700 children, distributed 24,000 impregnated nets and provided medical treatment to more than 2,900 sick and injured people. (See box below for more complete figures).

Emergency Response Totals

Number of people reached
Number of children aged 6 months to 15 years immunized
Number of people treated
Number of people evacuated
Number of impregnated mosquito nets distributed
Tons of food and emergency aid distributed
325 (approx)



SurfAid's boat-based medical teams started clinics in the Telos Islands on 20th June. They provided measles vaccination, de-worming, nutritional assessment, malaria testing, net distributions and malaria education throughout the island cluster, returning to Padang at the start of July. Following a ten day hiatus to allow teams to rest and re-supply the two boats used for the project, the second phase of the Telos Island program continued on July 13 and ended on July 31st. SurfAid served more than 20,590 people during the two missions.

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.

Malaria in the Telos Islands - Testing and Treatment

One in five children (between the ages of 6 months and 15 years) who passed through the SurfAid disease prevention clinic was tested for malaria using the AIM rapid diagnostic test that uses a drop of blood from the patient and diluent to give a result on a special test strip. Every child that tested positive was then directed to the SurfAid doctor for a comparative clinical diagnosis and treatment. The SurfAid doctor treated the malaria patients with ACT (Artesenate Combination Therapy).

SurfAid's Malaria Findings

SurfAid carried out a total of 683 AIM malaria tests (using the one in five testing methodology). Ninety patients tested positive for only falciparum (13%). Twenty four patients tested positive for only vivax (3.5%). Meanwhile, fifty patients tested positive for both falciparum and vivax (7%). From this sample it would appear that the malaria rate is 24%.

Malaria and the Puskesmas (Community Health Center)

According to the staff at the puskesmas on Pulau Tello, the health centre has no facilities to test for malaria (ie. no RDTs or microscopes). They are only able to carry out clinical diagnosis. They were unable to provide the SurfAid team with any data relating to malaria in the sub-district. The only drug they have available for treating malaria is chloroquine.

Issues Relating to Malaria in the Community

The villagers in Kecamatan Pulau-Pulau Batu have limited education (generally primary school at most) and therefore the concept of modern medicine is quite foreign for them. Furthermore, before the SurfAid team went into the villages they had very little knowledge of malaria. A number of villagers described the death of their children as a result of 'kemasukan setan' (being possessed by Satan). However, when they described the symptoms that their children were showing before their death (shivering, fevers etc.) it was clearly possible that they could have died from malaria. The only real health facility in the kecamatan is the Puskesmas on Pulau Tello and for this reason a lot of the villagers from the outer islands are unable to seek medical treatment if they are showing signs of malaria (no public transport between islands and for most villagers it is not economically viable to charter a boat). The SurfAid team had to go to great lengths with their explanation about the importance of mosquito nets because some villagers explained that when they used them they went into a 'trance' and didn't wake up early enough to do their morning chores. They didn't realize that it was probably the first good night sleep they've had without being disturbed by mosquitoes. There were two villages where the SurfAid team was unable to carry out malaria tests because the villagers did not want blood to be taken from their fingers. Even after long explanations by the SurfAid nurse in the local dialect and examples of how the tests work using team members as guinea pigs the villagers remained suspicious of the tests and requested that the only the other components of the disease prevention program be carried out.

NIAS -- Teluk Dalam

Following the set-up phase of the new Nias Health Program, SurfAid has a field office in Gunung Sitoli, the capital of Nias as well as temporary warehouses in Teluk Dalam (south Nias) and Sirombu (west Nias). Based on discussion with the Government of Nias, SurfAid is committed to operating along the West and South coast of the Island from Teluk Dalam in the south east to Afulu in the north. The health project will focus on malaria control and posyandu revitalization.

SIMEULUE -- Sinebang

SurfAid's program for Simeulue is in the planning phase. Following meetings with local government, SurfAid is committed to working in the northern districts of Alafan, Salang and Simeulue Barat. These are the areas successfully covered by SurfAid's marine-based emergency clinics in January, February and March 2005.


Jude Barrand
Field Communication Officer
Phone: +62 751 7879563
HP: +62 812 6634939