Three weeks after the Asia tsunami disaster, the death toll is now estimated at more than 159,000, a figure that is expected to rise to over 189,000, with some 24,000 still missing. Some 2.2 million people have been displaced while over 1 million others are believed to be homeless. These figures are also expected to increase.

Relief efforts remain critical. Some populations in remote areas in Banda Aceh Province in Indonesia are difficult to reach and treating injuries from the tsunami and earthquake is still a concern. In India, the Maldives and Sri Lanka, reconstruction efforts have started alongside relief efforts. No disease outbreaks have yet been reported.

Isolated cases of measles in Aceh prompted an immunization campaign and access to safe water and sanitation are critical concerns. An effort is underway to support countries in rebuilding public health infrastructure, while guiding and coordinating public health efforts among national authorities, other U.N. organizations, non-governmental organizations (NGOs), and the civil and military sector.

In Indonesia, a command center has been established in Medan. In neighboring Sumatra province, where the Seventh-day Adventist Church has a hospital, where ADRA activities are being coordinated for that region. ADRA medical teams have been very active for the last two weeks. Two clinics have been established in the Northern coastal region of Aceh Province. A 16-member medical team opened a clinic at the Sibreh Public Health Centre in Sibreh (9 miles or 15 kilometers outside of Banda Aceh); a second clinic has just been opened in Lhokseumawe (250 miles or 400 km from Medan) where there are 8,000 internally displaced persons (IDPs). ADRA-Spain is sending a container of supplies into Banda Aceh in conjunction with Medan Adventist Hospital.

In Meulaboh, ADRA continues to maintain a presence and is coordinating relief efforts with other agencies. They have been able to facilitate the distribution of food and provide shelter. Equipment has arrived that will treat acute respiratory infections and damaged lungs, and ADRA has distributed anti-typhoid and anti-malaria injections and tetanus treatments for about 600 people.

ADRA Indonesia met with the Meulaboh Education Department and is working on a “Memorandum of Understanding” regarding repair and reopening schools, as well as hiring two teachers to help facilitate the process. UNICEF has asked ADRA to be the lead agency in the repair and refurbishing of schools—junior high and senior high—and to help coordinate the donated supplies, logistics and liaisons with education officials and NGO’s in Meulaboh.

In Sri Lanka, two field offices have been set up—one in Tangalle and another in Balapitiya. A medical team, consisting of two doctors, a nurse, and a social worker from ADRA Hungary, is in the Eastern region of Kalmunai and will be there for the next 10 days. A fogger project started there has disinfected three temples and a school. With more fogging and protective equipment that has just arrived, ADRA will start training the Sri Lankan military to continue with this important health work.
ADRA is partnering with the humanitarian organization Heart to Heart International, which is providing water purification units that are due to arrive this week. Medical aid distribution is ongoing and helicopters are being used to airlift in supplies. ADRA will distribute food and non-food items (NFIs) to IDPs in 17 camps.

In India, ADRA has begun a response in the Andaman Islands to set up shelters for 200 families and health education for children and IDPs in the Pondicherry and Karaikel region. A project to deliver NFIs and health education to IDP camps on the Andaman Islands will begin next week. In Andrah Pradesh ADRA will assess the needs of fishing villages and see what types of nets and boats are needed. A medical team of two doctors, three nurses, and two psychologists will provide services to at least 60,000 people. ADRA is also planning to address immediate medical requirements including vaccinations and the chlorination of wells.

In Thailand, ADRA is working in partnership with the Phuket Mission Hospital in the development of additional interventions for the long-term support of tsunami victims. These interventions will focus predominantly on the physical and psychological needs of those affected.

Residents on the islands of Phrathong and Surin were evacuated to the mainland and are being housed in tents while a water system is installed. Assistance is being planned to reinstall all water systems, pump out the wells and help kick-start their livelihood of fishing. ADRA will also assist with the reconstruction of the Kamala District School on a different site.