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TSUNAMI IMPACT: Lack of Water-Borne Disease a Silent Success

Marwaan Macan-Markar

BANGKOK, Jun 27 2005 (IPS) - Away from the cameras and the headline-grabbing stories is a quiet miracle, of sorts, that has unfolded within the wasteland areas of Asia’s tsunami-devastated countries: There was no massive outbreak of water-borne diseases amongst children as initially feared.

It is reason for public health officials to breathe a sigh of relief as they shape plans for dealing with the health needs of the youngest survivors of the Dec. 26 tsunami that savaged coastal communities in eight Asian countries.

Such good fortune was not predicted by United Nations agencies six months ago, when the powerful waves had destroyed freshwater supply lines and purification systems in the hardest hit areas: Indonesia’s Aceh province, Sri Lanka, southern Thailand and southern India.

The United Nations Children’s Fund (UNICEF) and the World Health Organisation (WHO) issued dire warnings that water-borne diseases such as diarrhoea and cholera could spread easily in the tsunami aftermath, and could kill the most vulnerable in the population: young children.

After all, in Indonesia’s Banda Aceh, a city of some 230,000 people that was flattened by the tsunami, close to 70 percent of the water supply system was destroyed. While in Sri Lanka and southern India, wells, water pipes, hand pumps and public taps were crushed or uprooted.

Yet that initial fear proved far from the case, say water and public health experts.

"There has been a sense of relief and satisfaction about the current outcome: no major outbreak of water-borne diseases," Dr. David Hipgrave, head of UNICEF’s health and nutrition division in Indonesia, said during a telephone interview.

What has happened is "remarkable," adds Dr. Mahamadou Tounkara, Asia regional adviser for water and sanitation at Plan International, a global humanitarian agency. "Deaths due to water-borne disease after the tsunami have been minimum – almost none," he told IPS.

The credit for this silent success has been attributed to the massive response by U.N. and humanitarian agencies in the days after the tsunami, in addition to awareness efforts to educate the survivors.

"The rapid response to supply clean drinking water and the education camps about hand washing and personal hygiene in affected areas made a big difference," says Dr. Stephen Atwood, health and nutrition regional adviser at UNICEF’s East Asia and Pacific office.

Such relief efforts to supply safe drinking water and improve sanitation were part of an unprecedented outpouring of goodwill to aid the countries hit by the natural disaster that claimed close to 300,000 lives. Indonesia was the worst affected, an estimated 200,000 people killed, followed by Sri Lanka, where nearly 38,000 people died.

Children, according to available reports, accounted for nearly a third of the deaths on that Sunday morning after Christmas.

The warnings that UNICEF and the WHO made in January were with good reason, given the trail of death left by water-borne disease globally. Every year, nearly 1.8 million people die from, diarrhoeal diseases, including cholera, according to the U.N. health agency. Of that number, almost 90 percent are children under five years.

Up to 88 percent of water-borne diseases, adds the WHO, arise from unsafe water supplies and inadequate sanitation and hygiene.

South-east Asia, which is home to four of the tsunami-affected countries – Indonesia, Thailand, Burma and Malaysia -, is no exception to such deaths. "Up to 3,000 children under five years die every day in the East Asia and Pacific region due to water-borne diseases," says Atwood.

Another water-related killer, malaria, is just as potent in this region. Some 1.2 million people die annually from this disease, and 90 percent are children under five years, states the WHO.

This vector-borne disease, along with dengue fever, was also a concern among health experts in the wake of the tsunami. More so because heavy rains followed the natural disaster, leaving pools of stagnant water for mosquitoes to breed in.

But six months later, this fear of a spike in lethal diseases like malaria and dengue fever in the tsunami-ravaged communities has proved unfounded.

"We were very worried about malaria and dengue fever. But the cases are very low, much less than what people feared," says Atwood.

The lessons that such a turn of events offer goes beyond the collective success of the emergency relief efforts to supply safe water. It also underscores the importance of a very basic request that health experts made to the child and adult victims of the tsunami: please wash your hands.

"This very simple gesture is so vital and cannot be ignored," says Plan’s Mahamadou. "It saves lives."

The WHO agrees, asserting in a background note that "the simple act of washing hands at critical times can reduce the number of diarrhoeal cases by up to 35 percent."

The likelihood of a child or adult not succumbing to a water-borne disease increases if other conditions are met, adds the WHO, such as improved water supply reducing diarrhoea-related deaths by 21 percent and better sanitation reducing diarrhoea-related deaths by 37.5 percent.

"Not too many people in January would have thought about such a positive result," says Mahamadou. "Most were getting ready for the worst."