Tsunami Response: Swift and Massive

The massive earthquake off the Indonesian island of Sumatra and the ensuing tsunami directly affected at least 12 countries, claimed more than 280,000 lives and left many thousands injured. The disaster also destroyed the livelihoods of more than a million people in the affected areas, according to the International Labor Organization.

Jan Egeland, the United Nations' chief relief coordinator, said the sheer scale and speed of the international response had made it the "best-ever emergency relief effort." He noted that within a few weeks, donor countries had pledged some $900 million for relief and recovery efforts.

David Nabarro, who led the World Health Organization's efforts to address the health impact of the disaster, said in early February, "We have managed to prevent any major disease outbreak from affecting the tsunami affected populations. When this started—the relief effort—I did not believe that we would succeed in avoiding outbreaks."

Immediately following the disaster, international health experts predicted that unless the international community took immediate steps to control disease, as many as 500,000 survivors of the disaster could become victims of diseases such as dengue fever, Japanese encephalitis, measles, cholera, malaria, dysentery and diarrhea.

Efforts to restore sanitation services, the provision of food and water, and close surveillance succeeded in prevented any large-scale outbreaks of disease. Nevertheless, survivors in some areas have suffered diarrheal diseases and tetanus, and have developed mental health problems as the full impact of their losses have sunk in. Malaria and dengue remained a concern, as flooding increased the number of breeding grounds for mosquitoes.

PAHO joins relief effort

In support of WHO's role as technical coordinator for all health assistance in tsunami-affected countries, PAHO sent in experts in disaster relief and communications to work with WHO offices in India, Sri Lanka and Indonesia. PAHO emergency preparedness advisor Dana Van Alphen coordinated health actions on behalf of WHO in Banda Aceh, the region hardest hit by the disaster.

The priorities for WHO were supporting countries' efforts to provide adequate supplies of safe water, to put in place strong sanitation and hygiene infrastructure, and to provide basic medical supplies.

Photos by Armando Waak/PAHO

WHO distributed millions of water purification tablets to displaced populations, supplies to provide basic medical care to more than five million people for three months, and kits to provide full surgical care for more than 100,000 patients, as well as anti-diarrhea treatments and oral rehydration salts.

In addition to public health experts, WHO mobilized logisticians to help ensure adequate distribution of supplies and sanitation engineers who worked to ensure safe drinking water.

PAHO/WHO communications experts helped provide an information—hungry press corps with the latest updates on the situation. A PAHO photographer and cameraman spent three weeks documenting the relief efforts in Sri Lanka.

"It was very moving to see WHO experts rolling up their sleeves and working hand in hand with local people," said Manuel Calvit of PAHO's public information office. "We were surprised to find out that many mothers were able to save their immunization cards, because public service campaigns have successfully instilled in them their importance and because they've lived through crises and have an emergency kit where they keep valuables, including the cards. Those who lost their cards were demanding replacements."

PAHO photographer Armando Waak recalled, "The devastation we saw seemed even larger than what we saw in the news at home. People in the affected areas and, in general, in all the places we visited were very appreciative of WHO attempting to help in any possible manner. I noticed a dedicated attitude among the local workers and children who were cleaning up and beginning the process of reconstruction after the disaster."

Waak added, "I found a similar attitude and interest in helping at the International Airport where all the relief aid was arriving. Everybody we met wanted to make a difference."

One of WHO's most important contributions was an effort to ensure safe childbirth services for an estimated 40,000 pregnant women left homeless as a result of the tsunami. The effort, primarily in Indonesia, India, Sri Lanka and the Maldives, focused on providing pregnancy and childbirth services in every temporary shelter, and addressing special medical and nutritional needs of mothers and newborns.