The Second Tsunami That Wasn't
24 July 2005
NY Times: Averting epidemics of disease after the tsunami was “a story of aid done right.”
In the days after the Christmas tsunami, public health experts worried about a second wave of deaths from waterborne diseases affecting huge, concentrated populations with no clean water or sanitation. Throughout the history of this sort of emergency, waterborne disease has been the major killer, more deadly than bullets are to civilians caught in armed conflicts. The vast majority of victims are children under 5. The World Health Organization warned that disease could kill more people than the tsunami itself.
There were good reasons to fear that standing water could be as deadly as moving water. Normal water supplies had been destroyed; in the capital of Indonesia's Aceh region, 70 percent of the water supply system vanished. Much of what remained was contaminated with seawater, debris and the bodies of dead people and animals. Many of the tsunami's survivors were packed into camps with very little water and sanitation, and were already in a weakened state.
But six months later, there has been no spike in diarrheal disease, cholera, giardiasis and dysentery. The affected areas have had no increase in malaria or dengue fever -- diseases spread by mosquitoes, which breed in standing water. In many places, tsunami survivors living in camps have suffered less from waterborne diseases than countrymen in comparable areas who were not affected.
This was not a case of aid officials exaggerating the peril in a bid to increase donations. Instead, it is a story of aid done right. Governments, international organizations such as Unicef and the World Health Organization, and charities like Oxfam had a head start in India and Sri Lanka, where they have long had trained workers in place to deal with flooding from monsoons. In Aceh, a war zone all but walled off by the Indonesian government, there had been little international presence, yet there was no rise in waterborne diseases.
Coordination was the key. The response to an emergency is always mired in confusion and turf battles, but this time such problems were less apparent. Officials quickly established what was needed and who was in charge of providing it. Some areas could chlorinate standing water, but others had to bring in tankers of fresh water. In Sri Lanka, the Lion brewery, the country's largest, switched to bottling water for emergency distribution. Contaminated wells had to be emptied and cleaned. It was a hugely complex job successfully done.
Aid workers had also learned a lot from past emergencies. Water tankers carried messages in the local language about how to keep clean and about the importance of hand washing. Relief workers trained armies of the tsunami's survivors to teach others how to assure their water was clean. They generally promoted home boiling, which was well known and accepted, rather than confusing people by pushing other purification methods that were not as easy to keep going and that could ultimately diminish the use of boiling.
The safe water campaign was so effective that there are even preliminary indications that it helped to cut down on the annual monsoon death toll this year. Relief workers are now trying to make clean water permanently available in tsunami-affected areas -- some of which had no water systems or barely functioning ones before. People worldwide who gave generously to help the victims of the tsunami can be satisfied their money saved lives, and will go on saving them.
Copyright © 2005 by The New York Times Co. Reprinted with permission.
