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Last Updated: Tuesday, 22 March, 2005, 13:19 GMT
How tsunami diseases were curbed
By Caroline Ryan
BBC News health reporter

Experts charged with preventing the spread of disease in the aftermath of the tsunami say they "got it right" and prevented a major health crisis.

Indonesian soldiers rebuild a bridge in Aceh
Rebuilding is taking place across the affected region
After the Boxing Day disaster, there were fears that diseases such as diarrhoea, typhoid and malaria could claim the lives of many of those who had survived.

But speedy and co-ordinated action from relief agencies and the governments of the countries affected meant the numbers affected were much lower than they could have been.

Isolated outbreaks of diseases ranging from diarrhoea to measles, dengue fever and malaria did occur.

It's very important that people realise that it could have been amazingly terrible - it's just that this time we actually got it right
Dr David Nabarro, World Health Organization

But moves to provide clean water and proper sanitation held down the number of cases.

Agencies also set up "early-warning systems", so cases could be picked up easily and the spread of any infection contained.

Dr David Nabarro, head of the World Health Organization's Crisis Management Team, said: "If we saw an outbreak, we would send in teams, helicopters and vaccines to sort things out.

"So disease outbreaks were common, but they didn't turn into epidemics."

He added: "It's the first time I've seen the international community organise itself so well.

"But it's very important that people realise that it could have been amazingly terrible.

"The conditions in Indonesia and the other countries affected were absolutely fertile for people to get diarrhoea and other infections.

"It's just that this time we actually got it right.

"What we need to be saying is that we've shown that, if we do it properly, we can limit the number of post-disaster deaths."

'Sticking around'

Health workers in the area say they are now dealing with reassuringly routine health problems.

Ann Ottosson, Medicins Sans Frontieres' emergency medical co-ordinator in Aceh, said: "The disease that we are seeing now are respiratory infections, and skin infections, probably due to bad hygiene."

Drinking water
Ensuring clean water was a high priority

Thoughts are now moving to helping the doctors and nurses from the countries hit by the tsunami rebuild their health systems.

In many areas, clinics were destroyed and equipment lost in the tsunami.

And many health workers were killed or injured in the disaster.

The MSF team in Aceh say the area's district hospital was destroyed.

Ann Ottosson said: "It means people have had no access to secondary health care, such as surgery. But you need somewhere that you can refer patients who need that level of care."

The team are now establishing a clinic in the town of Lamno where hospital-level care can be provided.

She added: "We have started to provide support to the health teams here. We work with the staff and train them, give them the equipment, drugs and other materials they need.

"And we are still providing healthcare in the camps for the displaced population."

David Nabarro said: "Organisations like ourselves and MSF will have to stick around for some time.

"Our job will be to co-ordinate, MSF to provide support. Other groups, such as Australia Aid, the UK Department for International Development and the World Bank will then help by putting in the reconstruction funds."

Everyone working in the area says there is still a long way to go before things are back to normal. But Dr Nabarro says that, so far, "things are going pretty well".

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