BioEd Online

Health experts discussing the aftermath of the Indian Ocean tsunami have concluded that the huge influx of aid did help to stave off disease, but also had its downsides.

"Doctors and nurses from around the world arrived in great numbers," says Mukesh Kapila, director for emergencies at the World Health Organization (WHO). "But some of them made demands on the already stretched local health infrastructures that actually did more harm than good."

And other well-meaning aid workers brought unnecessary supplies. "The tsunami was limited to a very narrow strip of land, sparing hospitals and infrastructures farther inland," points out Kapila. "So most of the field hospitals flown in were actually underused."

Hundreds of agencies have been involved in post-tsunami relief activities, but they haven't always communicated with each other in the best way, said Kapila at a conference about health lessons from the tsunami, held this week in Phuket, Thailand.

The conference attendees concluded that in some of the most severely damaged areas, such as Indonesia's Aceh province and southern Sri Lanka, fewer but better-prepared aid workers might have achieved more.

Still, the WHO has been monitoring diseases characteristic of refugee areas, such as cholera, dysentery or malaria, and it has not seen these increase hugely in the Indian Ocean region. Although there have been some cases of measles, diarrhoea and chest infections, these were common diseases before the disaster. International aid, says Kapila, has had a very positive effect in keeping such problems in check.

Pre-packaged aid

Experts at the meeting called for the organization of pre-planned packages of assistance, so that countries and aid agencies will know what to do in the event of a major disaster. Parcelling out responsibilities for different kinds of aid (doctors, food, housing) to various parties ahead of time should prevent confusion, they suggested. The WHO offered to coordinate such activities.

Speakers also called for money to be spent on reducing countries' vulnerability to natural disasters.

Kapila reckons that at least 10 to 20% of the estimated US$5-billion pot for tsunami aid should be spent on education, establishing warning systems, and ensuring that buildings are being constructed properly.

"You can reduce the costs of disasters by reducing losses," says Kapila. "Now is the time to capitalize on political good will."