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Averting a Post-Tsunami Medical Emergency in Sri Lanka

January 19, 2005

January 19, 2005 - Tonia Marquardt, MD, is a veteran Doctors Without Borders/Médecins Sans Frontières (MSF) volunteer who has eight missions, of which five were emergency missions, under her belt. She was dispatched on December 31, 2004 to Sri Lanka, where she served as a field coordinator for the Trincomalee emergency on the eastern coast of Sri Lanka.



Street scene 2 days after the devastating tidal wave that hit the Sri Lankan coast line killing tens of thousands of people.
© Gary Knight-VII

Dr. Marquardt arrived in Trincomalee on January 1 with a logistician and a nurse to conduct a preliminary assessment of the region, which had been badly affected by the tsunami. They were joined the following day by another doctor, a midwife, and a second logistician. The assessment comprised of evaluating the medical, logistical and water sanitation needs of the population. The first day was spent in meetings with other international organizations, including the Red Cross and Oxfam, to gather information relating to the impact of the tsunami on the region. The team then organized mobile clinics throughout the district to get a first-hand sense of the impact, and determined that the area most in need was in the Kuchchaveli district. The medical needs related to upper respiratory tract infections and the common cold, cut wounds, skin diseases, and a few cases of diarrhea and pneumonia.

While doing an exploration north of Kuchchaveli town, they found an area where approximately 1,000 people were isolated on an island after a bridge had been destroyed by the tsunami. The team walked 200 feet through knee-deep water to get to the camp, and started their medical assessment of the families. The Kuchchaveli regional hospital had been partially destroyed by the tsunami. Many homes had also been destroyed, forcing the families to move into the local school and mosque. The sanitation conditions were poor, with garbage and plastic sheeting strewn everywhere from debris caused by the tsunami. With the help of Sri Lankans, the team started reorganizing and cleaning up the hospital. The hospital and a local mosque were used as a clinic to screen children for malnutrition levels. Mothers who brought their children to the hospital were also asked if their children had been vaccinated for measles. This assessment determined that 86 percent of the children had been vaccinated, a number that concurred with reports from the ministry of health, and that no child was suffering from malnutrition.

Shortly after their arrival, the team was informed by locals that landmines had been found around the hospital. The mines had been lifted by the force of the incoming waves and moved from a nearby military base to settle near the hospital grounds. The MSF team, as well as the local population, left the premises of the hospital, and alerted a de-mining organization to have the mines removed.

MSF's overall assessment was that there were less medical needs than originally believed. The local health system was effective even before the tsunami hit, and the Sri Lankan Ministry of Health’s response to the crisis was excellent. Due to this rapid response, the likelihood of epidemics was diminished. Another factor contributing to reduced morbidity rates was the reaction to the crisis by the local community, which had rallied around their neighbors, and took care of their family, friends, and neighbors. The overall response from local government, nongovernmental organizations, community organizations, and international governments was fast and thorough enough, that a post-tsunami medical emergency crisis was averted.

Tags: Sri Lanka, South Asian Tsunami

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