- The Washington Times - Thursday, February 3, 2005

International health officials are increasingly optimistic that the quick response to the Dec. 26 tsunami has averted a “second wave” of deaths from disease that some experts had said might kill more people than the original disaster.

“We have managed to prevent any major disease outbreak from affecting the tsunami-affected populations,” David Nabarro, a senior official from the World Health Organization’s crisis department, told reporters in Indonesia yesterday. “When this started — the relief effort — I did not believe that we would succeed in avoiding outbreaks.”

But he cautioned: “We must remain vigilant.”

The optimism was echoed by the United Nations.

“It was predicted that more people would die from the aftereffects of the tsunami than the tsunami itself. No epidemics — touch wood,” Jan Egeland, the United Nations’ tsunami aid coordinator, told reporters and editors at The Washington Times on Tuesday.

“After one month, we took stock, and we could see that the second wave of death and destruction did not happen.”

An undersea earthquake on Dec. 26 produced a tidal wave that left at least 300,000 people in 12 countries dead or missing.

At the time, health officials were nearly unanimous in their opinion that unless the international community responded quickly, as many as 500,000 more people could perish from dengue fever, Japanese encephalitis, measles, cholera, malaria, dysentery and diarrhea.

But Mr. Nabarro, one of the first to raise the alarm, said last week in Geneva that the situation was much improved.

“We’ve now got the systems in place to make it very, very unlikely that we will get any enormous outbreak of diseases,” he said.

Asked at a press conference whether he had exaggerated the danger, Mr. Nabarro said he had not been crying wolf.

“We were right to do that because the evidence from so many other disasters and emergencies has shown us that … I do not think we cried too loud. I think we did the right thing,” he said.

Other experts say it is still too early to declare the danger over.

“We haven’t had a massive outbreak of anything, but the danger has not been eradicated,” said Shantha Bloemen, a UNICEF communications officer in Banda Aceh, Indonesia, the hardest-hit area.

“We are still facing huge challenges. The potential, the ingredients for a major outbreak are still here.”

There are an estimated 400,000 people living in 66 makeshift camps, with high levels of malnutrition, Miss Bloemen told The Washington Times on Wednesday.

“It is not acute malnutrition, but they are still undernourished,” she said. This leads to a weakened immune system and susceptibility to diseases.

The water and sanitation conditions are improving, but remain inadequate, she said.

“We have averted disaster, but the public health situation is still not great,” she said.

Mr. Egeland said food has been distributed to 1.2 million victims, and more than 500,000 people have access to clean drinking water. Militaries from 24 nations provided help, but that is being scaled back.

“Malaria is still a very real threat in this region,” said Miss Bloemen, noting that 20,000 mosquito nets are in the process of being distributed. “Mosquitoes, which carry malaria and dengue, are incredibly dangerous in this part of the world.”

She said Indonesian government officials are spraying the camps and surrounding area to keep the mosquitoes down.

Roger Bate, of the American Enterprise Institute for Public Policy Research and director of Africa Fighting Malaria, just returned from a tour of the tsunami-affected areas in Sri Lanka. He said Wednesday that the numbers were encouraging, but that it is too soon to tell whether the affected nations, now in the middle of the rainy season, have averted a new wave of malaria and dengue.

“The fogging of insecticides has no long-run effect. We may well see rates climb later on, since … breeding occurs again and complacency sets in, as it always does,” he said.

A report released yesterday by Pharmaprojects, a research group that tracks drug development, said the disease rate could rise because of a lack of availability of drugs for post-tsunami diseases.

Dengue fever “has no vaccines or drugs available for prevention or treatment,” the report said.

This is particularly worrisome because the World Health Organization reported 58,000 new cases of dengue fever in Indonesia last year, before the tsunami, leading to 650 deaths.


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