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Situation report 28

WHO continues to work with local governments and partners to strengthen public health surveillance and response systems as many of the affected countries enter the rainy season, traditionally known for high transmission of mosquito-born diseases. No disease outbreaks have been reported. As the acute emergency relief needs subside, WHO is working with countries to strengthen longer term responses such as mental health assistance and rehabilitation of damaged health systems

Summary

• No outbreaks or epidemics of communicable diseases have been reported.
• In Indonesia, poor water sanitation continues to be the major health issue in Aceh. WHO is currently working with the Ministry of Health to develop an action plan to improve water and sanitation conditions.
• In Sri Lanka, a psychosocial support unit has been set up in Batticaloa district to coordinate the work of all agencies offering psychosocial support.

Health Priorities

Communicable Diseases

• Indonesia: The Ministry of Health, WHO, UNICEF and the American Red Cross propose to extend the measles vaccination campaign targeting more than 68,000 children, aged from six months to 15 years in North Sumatra. Following the detection of malaria cases, insecticide spraying was completed in Krueng Raya.
• Sri Lanka: No unusual cluster of communicable diseases have been reported. Insecticide spraying for malaria prevention is ongoing in Internally Displaced Persons (IDPs) camps in Ampara district.
• Thailand: Some measles cases were reported from a temporary shelter in the province of Phang Nga. The cumulative dengue hemorrhagic fever case count in the aftermath of the tsunami is slightly above the epidemic threshold in Phuket and Phang Nga provinces. The Bureau of Epidemiology, Department of Disease Control, Ministry of Public Health are to investigate both events.

Environmental Health (access to safe water and hygiene, sanitation situation)

• Indonesia: Poor water and sanitation continues to be the major health issue in Aceh. The situation is currently exacerbated by bad weather conditions and large numbers of displaced people. The joint WHO/UNICEF assessment of water, sanitation and health issues in priority Internally Displaced Person (IDP) camps is ongoing. WHO has been working with the Ministry of Health (MoH) on an action plan to improve water and sanitation conditions.
• Sri Lanka: Clean water supplies to affected areas in the south are now reported to be stable, however sanitation remains a problem, particularly in camps. Lack of clarity over plans for relocating Internally Displaced Peoples (IDPs) makes it difficult to properly plan new sanitation facilities. Nonetheless, latrine construction is ongoing in camps in Galle, Batticaloa and Ampara. Well cleaning is also continuing, but it will be some time before wells can be used again, as the surrounding ground is saturated with salt.

Other health issues (Mother and child health, mental health)

• Sri Lanka: A psychosocial support unit has been established in Batticaloa district to coordinate psychosocial agencies which provide services such as setting up a psychosocial programme at schools, promoting best practices in play-therapy activities, and organizing training on supervision of psychosocial staff. In the north-east, a systematic child protection program will be started in all relief camps.
• Thailand: Cases of depression and other psychological problems among survivors continue to be reported. Preparations are underway for a mental health assessment study on displaced persons, communities and relief workers in affected areas. Next week, WHO will join other UN agencies in an assessment of the situation for migrants affected by the tsunami.

Health system and infrastructure (functioning health facilities, access)

• Indonesia: The Ministry Of Health has set up a system to recruit medical personnel on short term contracts to work at health centers in Aceh.
• Sri Lanka: UNICEF in Trincomalee has reported serious concerns over unauthorized health care providers. A seven month old child is reported to have died as a result of overdosing in an unregulated health care setting.

MAP: Number of deaths in Sri Lanka

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Map: Number of deaths in Thailand

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Contributions/pledges to WHO for the Indian Ocean Tsunami response 25 January 2005

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