Inter-Agency Rapid Health Assessment The West Aceh Picture Michel Roulet SDC (Swiss Agency for Development & Cooperation) & WHO
Indonesian MoH and Army (TNI) WHO, WFP, UNICEF, UNHCR AusAid, USAID IRC, Save the Children
December 26, 2004 January 13-20, 2005 West Coast of Aceh Province 50.000 dead / missing persons n x 10.000 IDPs
200 km Aceh Province 600 x 200 km 4,5 million inhabitants «closed» area GAM
Mission Collect systematic information about the health status of affected populations on West Coast from Banda Aceh to Meulaboh Report on the ground conditions Develop active programming recommendations for the UN and NGOs for immediate and 30 day actions
Rationale for the Mission Little or no reliable information on the geographic area hardest hit by the tsunami Need to determine reliable transportation supply chain by secondary roads and other sustainable methods Concerns about how to reliably get food and humanitarian assistance to these isolated communities Clarification of what roles the UN, MoH, NGOs and local communities would play to respond to the basic needs of the population To take advantage of the resources available from the world community
Assessment Methodology Satellite and aerial imaging to help identify IDP populations and infrastructure destruction Detailed geographic plotting Five person team in each zone with expertise in public health, water and sanitation, primary health care, maternal and child health, nutrition and food security
Formal assessment tool to standardize data collection on health, water and sanitation, food, shelter, non-food items (NFI), livelihood Daily field visits to selected sites Summary of findings into daily situations reports (Sit-Reps) and recommendations Distribution of the Sit-Reps on a daily basis for immediate action Telephone calls to ensure that actions begin
Summary Results of the Assessment Health Water and Sanitation Food Security and Safety Shelter and resettlement Non-food items Livelihood Logistics
Water and Sanitation
Water and Sanitation Severe shortage of potable (general) and non-potable (local) water although various supply systems exist (rivers, wells, tanks, trucks and bottled water) Population used to boil drinking water (no shortage of wood) no waterborne disease (cholera) Overall very poor sanitation systems, either non-existent or overcrowded (no latrines, no landfills, ) Soap and detergent in very limited supply for bathing and clothes washing waterwashed diseases (scabies) Very limited electrical supplies available for pumps (the grid has been completely destroyed)
050117-N-0057P-015 Kuende Panga, Sumatra, Indonesia (17 Jan. 2005) Michel Roulet and Lucy Mize with the United Nations (UN) World Health Organization (WHO) survey the village of Kuende Panga's water supply. Michel, Lucy and a seven member UN team are surveying villages on the Island of Sumatra to help determine how to better concentrate the relief efforts on what is needed most and where.
Recommendations (Water and Sanitation) Agencies involved in water supply should participate to the rehabilitation of hand-dug wells and consider alternatives sources such as boreholes NGOs active in water supply should increase chlorination of drinking water supplies in IDPs settlement (water plant) Water safety campaigns that encourage water boiling should be done NGOs active in sanitation should built up appropriate latrines and encourage waste management Large distribution of soap, detergent, hygiene kits for women
Food Security and Safety
Food Security and Safety No acute moderate or severe malnutrition Unbalanced food basket, in particular with protein deficiency maximum 1500 Kcal and 30 g protein / person / day Very low stocks of food (supply routes no longer functioning), in particular oil, sugar, dried fish and food suitable for infants and children under five years of age Primary distribution is controlled by he Indonesian Army (TNI) and secondary distribution by community groups
No food No cash
Food Safety Food may become contaminated (pathogenic bacteria) in affected area during and following natural disasters, particularly floods and tsunami risk for outbreaks of foodborne disease (infants, pregnant women, elderly) Safe agricultural production (non contaminated crop fields) Safe and hygienic warehouse management Inspection of food businesses Safe food handling during distribution Safe food preparation and consumption (education and information)
Recommendations (Food Security and Safety) Food security has to be improved to meet the basic nutritional needs, in particular in infants, young children and pregnant women The access to a broader range of food has to be facilitated Distribution of food should be coordinated by a single agency and done through the civilian authorities Each household should have access to cooking and eating utensils, and water storage