COMMENTARY
Tsunami horror has just begun
By Nancy Lewis
The full impact of the Indian Ocean earthquake and tsunamis will not be known for years.
Vincent Thian • Associated Press
The huge waves and flooding have had a devastating impact on Southeast Asia, South Asia, islands in the Indian Ocean and as far away as eastern Africa.
The tsunamis resulting from the Dec. 26 earthquake off Sumatra may be part of a larger disaster. Death-toll numbers continue to climb as rescuers reach isolated communities. This survivor at Pamadura, south of Colombo, Sri Lanka, scrounges for his belongings among the debris.
But long term, the more serious impact may in public health and in development setbacks to an already struggling region.
It is estimated that more than 120,000 have died, and the death toll is still mounting. Many thousands of people have been injured.
In addition, critical infrastructure (including hospitals and health centers) has been destroyed, and millions have lost their homes, possessions and livelihood.
The United Nations warned that this could prove to be the worst natural disaster in modern times.
The longer-term impacts may, however, be greater than the tsunamis.
Specifically with respect to health, contaminated water, lack of sanitation, crowded resettlement camps, lack of adequate food, shortages of medical supplies and personnel, and stagnant water that encourages the breeding of insects that transmit diseases such as dengue fever and malaria could greatly magnify the impact of the Dec. 26 event.
Andy Wong • Associated Press
Children and the elderly are most vulnerable. For the young, the elderly and those with compromised immune systems, there is a synergism between malnutrition and infection.
Malaysians at a temple in Kuala Lumpur were busy Friday packing clothing to ship to tsunami survivors. Government officials in this mostly Muslim country called for special prayers, banned fireworks displays and canceled concerts and celebrations as a sign of mourning for thousands who died, and the thousands more who lost their homes in the Dec. 26 disaster.
Carol Bellamy, executive director of UNICEF, has been quoted as saying: "Standing water is as deadly as moving water."
The greatest needs are for safe water, sanitation, food, health and medical personnel and supplies. Contaminated water will rapidly lead to outbreaks of diarrhea and dysentery.
Cholera, a water-borne disease often found in coastal areas, is a serious threat.
Poor sanitation and poor nutrition compound the situation. Stagnant water increases the likelihood of mosquito and other vector breeding, increasing the potential for the transmission of malaria and dengue, two endemic diseases in the region, as well as other vector-borne disease.
Another ecologically complex disease, leptospirosis, is endemic in the region, and increases are often seen after flooding (we had several cases in October on the University of Hawai'i campus after the Manoa flash flood!)
The crowding in resettlement facilities increases the likelihood of both water-borne disease and vector-borne disease. It also sets up conditions for the transmission of acute respiratory infectious which can be fatal. In addition to the lack of adequate sanitation and toilet facilities, the lack of adequate water for hand-washing and bathing increases the potential for disease transmission.
Unburied bodies, while increasing the psychological distress, are not a particular disease threat, according to the WHO and other sources.
Gurinder Osan • Associated Press
Family members should be allowed to identify the dead and follow appropriate cultural and religious practices to the degree possible. A particular threat exists in Sri Lanka, where the flooding has exposed land mines, the product of nation's long civil war.
A boy reaches out for food being distributed to tsunami survivors at Nagappattinam in the southern Indian state of Tamil Nadu. As the death toll from the catastrophe soared, relief poured in from around the world, but in many areas, it was difficult to get it to those who need it most because of lack of roads and trucks.
The World Health Organization, the International Red Cross, a number of U.N. agencies, international nongovernmental organizations, foreign governments and others are responding to the critical needs.
The East-West Center is the managing partner of the Hawaii-based Pacific Disaster Center, and that organization is providing information support to a number of agencies, including the Federal Emergency Management Agency, the Office of Foreign Disaster Assistance and the military, through the Pacific Command.
And on Thursday, the Pacific Disaster Center launched the Indian Ocean Tsunami Geospatial Information Service to support emergency managers responding to the disaster.
We will not know the full impact of this devastating event for months or years. All the nations affected were experiencing development challenges before Dec. 26.
The fact that the tsunamis affected heavily populated and impoverished coastal areas as well as tourist resorts (important economic engines for these economies) will undoubtedly magnify the impact.
Nancy D. Lewis is director of research programs at the East-West Center.
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The East-West Center is organizing Asian cultural performances today to raise money for victims of the tsunamis. The event will be held from 2 to 5 p.m. at the organization's Imin Center. Michael Schuster, curator of the East-West Center Gallery, said dances and music will be performed by center international students and other members of the community. The audience will be asked for monetary contributions to help the tsunami victims. Checks or money orders also can be made out to the East-West Center Tsunami Relief Fund and dropped off at the center information desk or mailed to 1601 East-West Road, Honolulu, HI 96848-1601. Monetary contributions also can be dropped off at all First Hawaiian Bank branches. For more information, call 944-7111.
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