Infectious Diseases After Tsunami Aceh (Indonesia) Experience

An earthquake of magnitude 9 on the Richter scale followed by a tsunami devastated large swaths of northern Indonesia within minutes on December 26, 2004. The response to this disaster has been a rapid, national and international co-coordinated effort. Combined teams were multidisciplinary, consisting of health workers such as surgeons, anesthetiststraumatologists, emergency primary care workers, nurses, microbiologists and laboratory technicians, public health physicians, very importantly logisticians, and others. The need for critical clinical care was greatest in the first 1-2 weeks, then it quickly declined. After the initial crisis period, needs quickly changed to reestablishing public health care with an emphasis on Sphere standards such as promoting access to clean water, good sanitation, adequate nutrition and access to health workers for treatment and control of common conditions such as diarrhea, malaria, and respiratory diseases. The introduction of immunization programs for diseases to victims in vulnerable location was also an important public health intervention. No major disease outbreaks occurred following the Aceh tsunami. This was in part because of most of the displaced population settled into many small places/areas with at least rudimentary sanitation. No large camps that would support the rapid spread of disease were built. There were, however, still many diseases with epidemic potential found in tsunami-affected areas. In Aceh, the rate of diarrhea as a disease of immediate concern was 16%. Acute upper respiratory infection and pneumonia as diseases related to over-crowding were found to be 21%, 20% and 3%, respectively. The number of persons with malaria as a disease posing threats in the first month was no greater (4%) than previously, because there was an established-large vector control project. Proper national and international coordination and total health response considering public health, laboratory capacity and medical needs are important lessons to learn for anticipating the possibility of infectious disease outbreaks following the tsunami in Aceh.