The earthquake, measuring 8.7 on the Richter scale, badly affected the water supply on Nias as it lifted coral reefs on the west and south coasts by one to two metres, raising the level of many wells above the water table.
Community wells were also destroyed or badly damaged so SurfAid undertook a joint Watsan (water and sanitation) program with UNICEF and NZAID, which started in 2006.
"Awesome, though much overused these days, is really the only single word that can describe the achievements of the Watsan team," SurfAid Program Director Alan Rogerson said. "There are now communities who have clean water for the first time in more than three years, and other communities who have it for the first time in their history."
SurfAid's research on Nias shows a 30 per cent prevalence of diarrhoea in children and it is a big contributing factor to the underfive-year-old child death rate of 66 per 1,000 live births.
"These alarming diarrhoea rates are being addressed by SurfAid through our Community Based Health Program," Rogerson said.
"And it quickly became apparent in this health program that there was a strong relationship between diarrhoea, hygiene, local sanitation facilities and the availability of a reliable source of clean water.
"Plus carrying water is a chore exclusively for women and children. In some communities it has been necessary for individuals to invest several hours per day in this task. This consumes valuable calories transporting heavy loads over relatively long distances, often uphill.
"In communities where malnutrition is common, women, including pregnant women, and children do not have the calories to spare. So it is our expectation that supplying clean water to these communities will have the direct effect of improving health more generally," he said.
The 99 facilities, in 26 villages in Sirombu and Teluk Dalam, include new water tanks, tapped spring water systems, new and reconditioned wells, rainwater harvesting systems and two separate types of latrines.
All have been constructed with community participation - SurfAid's Watsan team provided the materials and expertise, and the local communities provided the labour and any locally available component materials, such as stones and gravel. And all facilities are located in isolated areas so the challenges of logistics, transport and availability of equipment have been common.
"The strong focus on community engagement and ownership has been a successful model for ensuring the long-term maintenance of the facilities," Rogerson said. "And the approach of a hand up, not a hand out, is a central plank of SurfAid's philosophy in working with communities."
Following the success of this first Watsan program, a second phase has already been planned for Nias and will commence with an assessment of eight villages in Afulu and Alasa. SurfAid is currently raising money to fund this program.
SurfAid is also assessing the feasibility of extending the Watsan program to the Mentawai Islands, which lie south of Nias. The Mentawai was badly affected by two major earthquakes, measuring 8.4 and 7.9 on the Richter scale, in September last year.