 An Indonesian psychologist leads a
discussion group of tsunami survivors near the town of Meulaboh. Photo © Sebastian Bolesch |
In the aftermath of
disaster and conflict
Days after an enormous tsunami
battered parts of Indonesia's
coast, MSF teams began working
in cooperation with national
efforts to provide assistance to
people in need of medical care,
food, clean water, shelter and
other basic necessities.
The extent of death and destruction in
Indonesia was severe — more than 100,000
dead, 120,000 missing and several thousand
injured. MSF teams quickly assessed
emergency needs, provided medical care
and responded to outbreaks of diseases
such as tetanus, which was caused by
wounds sustained when survivors waded
through sharp debris.
MSF has a history of emergency work
throughout the archipelago in conflicts,
epidemics and natural disasters, and in a
variety of provinces including Maluku, West
Papua, West Timor and Sunda. This proximity
enabled MSF to dispatch emergency
teams to areas destroyed by the tsunami
soon after the catastrophe. On 28
December, the first team arrived with 3.5
metric tons of relief supplies in Banda
Aceh, the regional capital of Aceh province
on Sumatra's northwest coast. The team
immediately set up a medical clinic and
began assessments and relief operations.
Soon more MSF staff and materials poured
into Indonesia, bolstered by unprecedented
support from international donors.
While the roads were still impassable, MSF
teams traveled by helicopter to areas along
the west and northeastern coasts, rapidly
assessing needs, dropping emergency
materials and mobile teams, and transporting
the most seriously injured to hospitals.
Additional logistical support was provided
by Greenpeace's flagship, the Rainbow
Warrior, allowing MSF to reach isolated
areas quickly. Nearly 200 metric tons of
medical, water-and-sanitation and relief
materials, as well as dozens of MSF doctors,
nurses, psychologists, logisticians, and
water-and-sanitation experts arrived in
Aceh the week following the tsunami.
By the second week, MSF was also supporting
two district hospitals in Aceh's devastated
towns of Meulaboh and Sigli, and
teams carried out assessments on
Simeulue island and in the Banyak
Archipelago, south of Aceh. When another
undersea earthquake hit the island of Nias,
located near Simeulue, on 28 March 2005,
MSF teams distributed tents and relief
items to the island's Tuhenberua district.
By March, the acute emergency phase had
ended. Teams began focusing on rehabilitating
health structures and addressing the
basic health needs of affected communities.
From the beginning of the disaster
response, MSF psychologists had joined
the emergency teams, counseling hundreds
of patients, and now particular attention
was given to communities' mental
health needs. Educational sessions were
also organized to help people understand
the tsunami itself and the many possible
physical and emotional reactions to it.
Between February and April, MSF also distributed
approximately 80 boats to fishermen
in Sigli after the community requested
assistance in obtaining boats to regain
their livelihoods.
Current activities
In the second half of 2005, medical care
has become more easily available in parts
of Indonesia hit by the tsunami. MSF's
effort to distribute emergency aid and to
provide water and sanitation largely have
been completed or handed over to partners.
However, MSF continues to run
mobile clinics in remote areas of Aceh,
where access to medical care is severely
limited due in part to the protracted conflict between rebels and the government,
including inland areas in the Aceh Barat
district, in the town of Takengon in Aceh
Tengah district, and in nearby Bener
Meriah district in the central mountains.
Teams also provide care in the Mane and
Tangse areas of Pidie district. MSF is treating
people in villages and camps for displaced
people in areas affected by the disaster
including Lamno and around Sigli.
Mental health care is one of the greatest
ongoing needs in Aceh. A team of psychologists
travels to camps, relocation centers,
villages and schools, offering a combination
of psychosocial education, group discussions
and individual counseling.
Teachers and health staff receive ongoing
training to recognize common symptoms
of trauma. And MSF has set up mental
health clinics in Banda Aceh and Sigli. In
Aceh, more than 10,000 people affected by
the tsunami have attended psychosocial
and psycho-educational group sessions in
Meulaboh and Lamno on the west coast, in
Sigli and Lhokseumawe on the north coast
and in Banda Aceh. MSF and local psychologists
continue to offer treatment to hundreds
of patients each month.
MSF also continues to monitor disease outbreaks
and other emergencies in
Indonesia. In May 2005, MSF responded to
an outbreak of malaria in the Gorong
Archipelago in the eastern part of Maluku
province. MSF is also carrying out a malaria
study in Indonesia to document the successful
use of artemisinin-based combination
therapy (ACT) in an effort to change
national malaria treatment protocols.
MSF has worked in Indonesia since 1995. |
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