Indonesia: the humanitarian response since the tsunami
13-04-2005 Operational Update
Aceh province, on the northern tip of Sumatra island, was the region hardest hit by the earthquake on the seabed and tsunami that struck on 26 December 2004. To date, nearly 127,000 people are confirmed dead while another 37,000 are still missing.
About 500,000 displaced people are living either in camps or with host families. Barracks are being built in semi-permanent camps to which the displaced are now gradually being relocated.
When the tsunami struck, the emergency response of the Movement started on day one thanks to a dedicated team of PMI volunteers working in the most difficult conditions. Their initial task, the recovery and disposal of countless bodies, was the hardest of all.
The ICRC, permanently present in Aceh province since 1999, was able to support PMI in its relief effort from the very beginning of the response. It had relief, medical and water and habitat stocks and evacuation materials available on the spot and could rely on a well-functioning logistics set-up. There are currently 75 ICRC expatriates and 450 national staff working in Indonesia.
The ICRC, the International Federation of Red Cross and Red Crescent Societies and a number of National Societies have been supporting the PMI’s activities for the population. A Movement coordination framework has been established to ensure a coherent and consolidated Movement response.
Evacuation of the dead
The ICRC continues to provide the PMI with material for evacuating the dead. Teams of PMI volunteers have so far evacuated 60,000 bodies throughout the province.
Shelter, clothing, and household necessities
The ICRC and PMI have visited over 260 locations in eight districts where the displaced have gathered (Banda Aceh town, Aceh Besar, Sabang (Weh), Pidie, Aceh Utara, Bireuen, Aceh Timur and Aceh Tenga). They have been conducting rapid assessments then distributing household kits (shelter materials, mats, cooking equipment, hygiene articles, etc). The last distributions brought the total number of kits distributed to 60,000 for 300,000 people along the north-east and west coasts. In addition, 35,000 IDP and host families have received underwear kits to supplement the second-hand clothes distributed by other agencies.
Clean water and adequate sanitation
ICRC water and sanitation engineers have been assessing access to water and the IDP sanitation conditions. Teams have installed water tanks and are trucking 290 cubic metres of water per day to various locations. The ICRC is also improving sanitation facilities where necessary; to date it has cleaned more than 60 wells that had been contaminated by mud and saltwater. Furthermore, the ICRC continues to supply the water treatment plants in Banda Aceh and Lhokseumawe with purification chemicals – 75 tonnes in total.
Medical specialists have been monitoring the remaining hospitals in Banda Aceh and ad hoc health facilities in places where displaced people have gathered and providing them with medical supplies when necessary – surgical gloves, suture materials, dressings, plaster casting material, kits of basic medicines and equipment for dispensaries.
Surveys of health facilities have been conducted in the coastal areas of Aceh Besar, Pidie and Aceh Utara in order to gauge how well they are functioning and what support they are receiving from the other organizations or the Ministry of Health. The tsunami destroyed a number of puskesmas (primary health-care centres), increasing the workload for those that remain standing. Large quantities of analgesics, antibiotics, disinfectant, various medicines and medical equipment have been given to puskesmas in Banda Aceh and along the north coast.
A 100-bed ICRC/PMI field hospi tal, provided by the Norwegian Red Cross, was set up in the Lhong Raya stadium, Banda Aceh, and started receiving patients on 15 January. There are currently more than 70 patients in the hospital and, to date, over 608 patients have been admitted and more than 6,732 patients have been treated at the dispensary. At present, 11 patients and 31 relatives are staying in the nearby camp for discharged patients. Furthermore, an ambulance service has been set up together with the PMI to enable patients to reach the hospital and the PMI blood bank was given the necessary assistance to resume its services to the community and the hospitals.
Restoring family links
In the aftermath of the disaster, the ICRC, in close cooperation with the PMI, developed a comprehensive system to help re-establish contact between family members who have lost contact with one another.
Since early January, family links have been restored in nearly 2,500 cases, the majority of which took place using satellite phones made available to survivors particularly on the west coast. For survivors who are unable to reach family members by phone, ICRC and PMI teams offer the Red Cross message service.Some of these successes were possible owing to two databases that the ICRC set up together with the PMI. These " I am alive " and " Person sought " databases contain over 34,000 names so far, lists of which are widely available to the public in printed form, on the Internet ( www.familylinks.icrc.org ) and via the media. If a person recognizes his name or the name of a person he is looking for in one of the lists, the ICRC and PMI can help him get in touch with his relative.
The ICRC and the PMI are paying particular attention to restore family links for children who have been separated from all close family members. To date, 39 such children have been registered, half of whom have already been successfully reunited with their families.
The ICRC has resumed its visits to places of detention –on hold immediately after the disaster – with the consent of the national police and the Ministry of Law. The aim of these visits is to monitor detainees’ conditions of detention and treatment.
Strategy for 2005
As the humanitarian situation in Aceh province has stabilized and the emergency phase has come to an end, the authorities, the international aid agencies and the International Red Cross and Red Crescent Movement are shifting the focus of their activities to recovery, rehabilitation and reconstruction. The ICRC's initial response focused on short-term involvement at field level to cover the needs of about two-thirds of all people affected by the tsunami, and will shift to a guidance and coordination role in the longer term, given the many National Societies who will be present.
The PMI has submitted a plan of action for the recovery phase of the operation to the government authorities, with a view to integrating PMI activities – undertaken with Movement partners – into the government's own plan for recovery and reconstruction. This is in line with PMI's widely acknowledged auxiliary role.
The protection activities planned for 2005 will remain central to the ICRC response in Indonesia, but with the necessary adaptations following the tsunami.
All activities to restore family links are undertaken in close partnership with the PMI, whose branch network and volunteers provide the operational backbone of the whole system. This enables the two organizations to spread out and offer their services quickly and effectively throughout the affected areas.
Additional assistance activities aim to bridge the gap until the Indonesian authorities are able to fulfil their responsibilities again, supported by national and international organizations. Such activities should therefore come to an end soon and the ICRC will again concentrate again on the activities it had planned b efore the tsunami.
In the meantime, since the ICRC already has an active programme of identifying and delivering assistance to communities, where feasible, the ICRC will follow the objectives planned for 2005, though on a larger scale. At all stages of the process, the PMI will be involved and volunteers will actively participate with the ICRC teams.
The response to needs in the recovery phase will be community-based. During the ongoing distributions, the ICRC is establishing contact with various communities that will enable it to gather further information and, in the longer term, help the Movement to work more easily in certain areas and make better decisions about recovery activities.
The ICRC is responding to the additional needs that have arisen in detention facilities as a result of the tsunami: rehabilitation of water and sanitation systems, restoring family links for detainees anxious for news.
Given the scale of destruction, most IDPs lack the means to resume their traditional means of earning a living – be it farming, fishing, trades, or commerce. The recovery and reconstruction of those industries will provide the people with the best chance of long-term recovery. It is of utmost importance to help communities restore and re-establish their means of income.
In terms of water and sanitation, the aim will initially be to provide access to basic facilities ad inter im to allow residents to return to their homes. This will involve placing small storage tanks in appropriate areas and refilling them, initially, by trucking in water, but for only a very limited period – long enough to allow people to return home, or for the ICRC to improve or upgrade existing facilities.
Plan of action
provide 15,000 IDP, host and returnee families with 300 clean-up kits (tools and cleaning items) to facilitate community-based clean-up and enable them to salvage damaged belongings
provide 10,000 IDP, host and returnee families with 200 community reconstruction kits (comprising a tool kit, reconstruction material and cleaning kit) to facilitate the repair of and move back to their homes
Water and habitat
improve public health for an estimated 27,000 people (IDPs, residents, returnees) in villages not assisted by other organizations, by rehabilitating and/or constructing wells and latrines
continue to provide technical support to the water authorities by providing chemicals and assistance with emergency maintenance of water-treatment facilities in the main urban areas of Aceh province
maintain stocks to improve access to basic water and sanitation facilities where the health of resident populations is threatened
The disaster resulted in large uncoordinated IDP movements of survivors. In most parts of Aceh, survivors and their families are managing to re-establish family links by phone or by personally seeking each other out, particularly if one party is not displaced. It can be assumed that some of the short-term needs will be significantly less within a few months, but questions regarding the fate of the missing will continue in the mid- and long-term as human remains have largely been buried unidentified.
Restoring family links
offer comprehensive services to enable people to restore contact with their relatives – satellite phones, Red Cross messages, “I am alive”/”Person sought” forms, website; make lists of registered names available in print and on the Internet and circulate them in the media
with the PMI, continue to register unaccompanied minors and separated children and take the lead role in tracing family members, particularly if these are outside the affected disaster areas
with the PMI, continue to monitor and support family reunifications involving children and other vulnerable groups such as the elderly and sick
from April onwards, offer the use of ICRC phones or exchange Red Cross messages to separated family members who have located each other but cannot or do not wish to be physically reunited and are unable to maintain contact owing to the lack of phone networks, postal systems and/or public transport
PEOPLE DEPRIVED OF THEIR FREEDOM
The ICRC will continue to visit detainees held in connection with armed conflict. One important need in places of detention after the tsunami is for detainees to be able to trace and restore contact with their relatives.
Plan of action
enable surviving detention staff members and detainees to restore contacts with their families
WOUNDED AND SICK
Although, infections have led to numerous cases of tetanus, and pneumonia w as the second most common tsunami-related illness, diseases with epidemic potential have been satisfactorily controlled.
Plan of action
with the PMI, maintain the field hospital, provided by the Norwegian Red Cross in the Lhong Raya stadium, until the end of May 2005 and secure a proper exit strategy; give amputees physiotherapy at the hospital
enable up to 200 discharged patients still requiring medical care to stay in the camp located in the Lhong Raya stadium and receive adequate care and food, until July 2005
assess the PMI blood bank and facilitate a partnership programme between the PMI and a partner National Society
if adequate care cannot be provided in the district, ensure that patients are evacuated by the PMI ambulance service to an appropriate hospital in Banda Aceh, particularly to the ICRC/PMI field hospital
monitor whether public health centres in the province of Aceh have sufficient medical supplies to treat the patients, and provide additional supplies if required
The ICRC will seek to restore the capacity of the PMI in Aceh to respond to needs arising from conflict or natural disaster. While ICRC support will largely be directed towards recruitment, equipping and training new volunteers, it will also focus on the chapter and branch infrastructure to ensure that it i s capable of supporting such activities. Such support is an extension of that already planned for 2005.
Plan of action
support the PMI in recruiting, training and equipping 600 new members of emergency response teams
provide financial support to the PMI Aceh chapter and its branches to help them function efficiently and retain trained and motivated staff and volunteers
assist the PMI in appointing and training tracing coordinators at chapter and branch level to help meet the dramatic increase in need for the ICRC/PMI tracing programme in Aceh.