Disease outbreaks 'still a fear'

Towns were destroyed and tens of thousands of lives lost in Aceh

No serious disease outbreaks have been seen in the area hit by the tsunami, health experts say. But they warn it is too soon to say they will not occur.

Experts from the World Health Organization (WHO) say luck has played a part in ensuring outbreaks have not happened.

The fact most people forced out of their homes have lived in relatively small groups has also restricted the spread of disease, they say.

However, the WHO warns outbreaks could still be seen in the days ahead.

Clean water success

Experts from the WHO and other health organisations are now working to ensure there are systems in place in the affected areas to pick up early warnings of outbreaks of disease such as cholera, typhoid, malaria and dengue fever.

So far we haven't seen any major outbreaks of disease. But sadly I think it's too soon to say that we won't Iain Simpson, World Health Organization Medical notes; Cholera Medical notes: Malaria Medical notes: Typhoid

What health workers are currently dealing with are isolated cases of diarrhoeal and respiratory diseases.

Some people have developed respiratory problems simply by being in contact with others who are affected. Others have been affected by taking in large amount of sea water into their lungs.

Experts say the extent of diarrhoeal diseases has been limited in some areas by speedy work to ensure people have access to clean water.

The WHO says that in Sri Lanka, 60% of wells contaminated by sea water have now been cleaned and chlorinated.

Clean water has been highlighted as a priority by aid agencies ever since work began to help the areas affected by the tsunami. They say it remains an "immediate priority".

Thousands of water storage tanks, water purification powder and rehydration tablets have been sent to the affected countries.

Managing the disposal of human waste is also a key priority, say experts. But health experts stress the accumulation of dead bodies is not as great a risk as many believe, as it is the living who pollute the water.

So far, over £3 billion has been pledged to the UN to pay for aid to the region.

Patients 'on the floor'

Iain Simpson, a spokesman for the WHO, told the BBC News Website incidence of diarrhoea was being monitored so that any cases which could be tyhoid or cholera could be tested to ensure the disease did not spread.

He said there were a number of reasons to explain why serious disease outbreaks had not yet been seen.

"Part of it is timescale. And in Aceh, and some other areas, displaced people have generally been living in small, sparsely populated camps.

"If they were living in larger, more densely populated camps, disease would be more likely to spread."

He added: "So far we haven't seen any major outbreaks of disease. But sadly I think it's too soon to say that we won't."

The head of the WHO, Dr Jong-wook Lee, visited Aceh in Indonesia - one of the worst hit areas on Thursday.

At the Zainul Abidin General hospital in Aceh, at least half of the staff have been directly affected by the tsunami. However, medical workers from other provinces are stepping in to help, and enable the hospital to re-open to emergencies.

At another hospital, patients are being treated on mats on a mud-stained floor by medical staff who only have basic equipment, the WHO reported. WHO staff are already in Aceh, helping local health workers to set up an early warning system to identify disease outbreaks.

The organisation's second priority is to bring in laboratory staff who can help identify the cause of any outbreaks.

Dr Lee said: "Homes and communities have been destroyed even several kilometres from the coastline.

"There are still body bags and bodies for all to see. But people are now beginning to clear out debris, clean out houses and hospitals and salvage what they can of their normal lives."