Situation analysis: Earthquake & tsunami Sulawesi, Indonesia, 13 October 2018

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A 7.4 magnitude earthquake hit Donggala District Central Sulawesi, Indonesia on 28th September 2018, followed by aftershocks. The epicenter 8 KM northwest Donggala with the depth of 10 Km. A tsunami hit Palu City, province capital of Central Sulawesi, around fifteen minutes after the quake. Total affected population stands at1.5 million people (exposed to moderate and strong shaking). Initial reports (as at 9 October) from BNPB have confirmed 2,037fatalities with over 4,084 injuries, 671 missing persons, 152 are requiring immediately rescue efforts. There are currently almost 74,044 displaced populations in 120 sites. Emergency response operations is gradually improved as 100% power plant have functioned, 60% cellular operators have function, 75% fuel needs are in place, additional heavy equipments arrived to open road access to isolated affected areas to mobilize additional items but constraint remain due to size of the affected areas.

So far, 21 health facilities were affected including one hospital to be damaged whereas damage to other health facilities is being assessed. Interruption of general medical services, including child and maternal health, is affecting first aid and primary health care services.
While deaths and trauma are likely to increase in coming days, the level of risk is intermediate due to existing in country disaster preparedness and response capacity. However, the affected areas are at intermediate risk of considerable levels of excess mortality or morbidity due to infectious diseases in the coming days and months. In addition to Acute Diarrheal Diseases (ADD) and Acute Respiratory Infection (ARI), malaria is of major concern as Sulawesi is endemic for malaria including drug resistant malaria. Measles and other VPDs such as diphtheria and tetanus are other public health concerns due to insufficient immunization coverage and widespread injuries. Lack of shelter and broken water sanitation facilities could lead to diarrhoea outbreaks and other communicable diseases. Pre-disaster EWARS data from Donggala, Sigi and Palu indicate ongoing activity of acute diarrheal diseases and acute respiratory infections.

The emergency response is being led and managed by the Government of Indonesia using its disaster management mechanisms and resources across sectors. As of 13 October 2018, there are a total of 112 humanitarian partners in Indonesia that have offered assistance.
Government of Indonesia, through BNPB and Ministry of Foreign Affairs, welcomed offers for international assistance and will select based on the humanitarian needs. Urgent needs identified by the Government are: air transportation, tents, water purification, generators, field hospital and vector control.

The earthquake and following tsunami have severely affected localized areas of Danggola district, Sigi district and Palu city. An urgent response will help mitigate the risks due to different public health threats. However, the disaster is complicated by unknown threats and risks of biological agents or safety and security concerns due to non-state actors or anti-government elements. Importantly, Indonesia has well developed in country disaster preparedness and response capacity including stockpiles of relief materials and health/medical supplies. Yet, on 01 October 2018, Government of Indonesia, through BNPB and Ministry of Foreign Affairs, welcomed offers for international assistance and will select based on the humanitarian needs.
As part of the HCT team, WHO INO has been part of efforts to coordinate international support especially on situation assessment and response support planning. Key areas identified for support and to be offered to the Government include deployment of WHO classified and certified EMTs and support to an EMT Coordination Centre.