One of the lessons learnt from emergencies or disasters in the South-East Asia Region is that information and knowledge management is a weak area. The Indian Ocean tsunami of 26 December 2004 was no exception. In any emergency, no matter how difficult, information needs to be collected, stored, and retrieved systematically for analysis. This should be done before, during and after any event. By having a disciplined structure and practice around these activities, we can be more effective in turning information into knowledge and knowledge into action. This was one of the goals of this book; the other was to take up the challenge of documenting a mega-event. This way one can review what happened on 26 December 2004 by correlating diverse information from various sources and how this impacted health. This book, in two volumes, serves as a reference textbook for the event itself as it happened in each country of study and provides a method for documenting emergencies in the larger discipline of emergency risk management in health. Populations will always live with risks and managing them better can only come with well-informed, evidence-based action, especially those that have a bearing on health. The book contributes to this practice–the information is relevant for future events and contributes to better Volume-I public health practice in emergencies. Volume-I ISBN 978 92 9022 435 8 Tsunami 2004: A Comprehensive Analysis Volume-I WHO Library Cataloguing-in-Publication data World Health Organization, Regional Office for South-East Asia. Tsunami 2004: a comprehensive analysis. 2 vol. set. 1. Disasters – history - statistics and numerical data. 2. Tsunamis. 3. Earthquakes. 4. Delivery of Health Care. 5. Public Health. 6. Economics. 7. India. 8. Indonesia. 9. Maldives. 10. Sri Lanka. 11. Thailand. ISBN 978-92-9022-435-8 (NLM classification: HC79.D45) © World Health Organization 2013 All rights reserved. Requests for publications, or for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – can be obtained from Bookshop, World Health Organization, Regional Office for South-East Asia, Indraprastha Estate, Mahatma Gandhi Marg, New Delhi 110 002, India (fax: +91 11 23370197; e-mail: [email protected]). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. This publication does not necessarily represent the decisions or policies of the World Health Organization. Printed in India Acknowledgements his publication is an initiative of the Emergency and Humanitarian Action unit, a Thuge endeavor that would not be possible without the support of the Regional Director and Deputy Regional Director; the collective efforts of various people are gratefully acknowledged. This work was developed in conjunction with the World Association for Disaster and Emergency Medicine. Marvin Birnbaum For providing the big picture of how to go about developing the Lead writer and researcher framework of the book and for guidance in writing, developing key chapters and parts for the analysis. For his patience in seeing this to completion. Supriya Bezbaruah For chasing and verifying information through interviews and adjunct Patrice Kohl sources. Co-writers and researchers For writing out and putting life into the data and information collected into a more engaging and readable narrative. J Tuli For painstakingly editing the manuscripts to WHO style and his Style and language editor supporting role in managing design and printing. Elaine K. Daily For her extensive editing of the manuscripts and proofs as well as providing valuable consultation. Anchalee Chamchuklin, A Sharma and Deepti For meticulously reviewing and checking references, reformatting as Munjal needed and confirming with the writers as appropriate. WHO SEARO Library Poonam Bevli Sahi and team at FACET design For the patience in putting together the book part by part and maintaining an overall vision for the design of the book. Nand Kishore For coordinating with the press, graphic designers and editor and writers. Grateful thanks are also extended to the staff of technical units in WHO SEARO and WHO Country Offices who worked tirelessly during the tsunami response together with the hundreds of people who agreed to be interviewed and the those who facilitated release of documents, and reports. Contents Foreword i Preface iii Acronyms v Part I - Introduction and Methods Chapter 1: Introduction 1 References 5 Chapter 2: Methods 7 Organization 11 Summary 12 References 12 Part II - Events Chapter 3: The Events 19 The Tsunami 23 The Earthquake 26 The making of the Tsunami 28 Summary 29 References 29 Part III - Country Reports Chapter 4: India 35 Events 37 Public health and disease control in India 42 Medical care in India 47 Water and sanitation 53 Shelter and clothing in India 59 Food and nutrition in India 62 Energy supply system 63 Public works and engineering 65 Social system 66 Transportation and logistics system 71 Security systems 72 Communications system 74 Economic system 74 Education system 76 Coordination and control system 77 Summary 79 References 80 Chapter 5: Indonesia 95 Events 97 Public health system 99 Medical care system 108 Water and sanitation system 115 Shelter and clothing system 117 Food and nutrition system 120 Energy supply system 123 Public works and engineering system 124 Social system 125 Transport and logistics system 130 Security system 131 Communication system 134 Economy system 137 Education system 139 Coordination and control system 140 Summary 145 References 147 Chapter 6: The Maldives 171 Events 173 Public health system 175 Medical care system 180 Water and sanitation system 185 Shelter and clothing system 193 Food and nutrition system 196 Energy supply system 198 Public works and engineering system 199 Social system 201 Transport and logistics system 202 Security system 204 Communication system 204 Economy system 205 Education system 206 Coordination and control system 207 Summary 209 References 211 Chapter 7: Sri Lanka 231 Events 233 Public health system 235 Medical care system 241 Water and sanitation system 246 Shelter and clothing system 250 Food and nutrition system 254 Energy supply system 258 Public works and engineering system 259 Social systems 260 Transport and logistics system 265 Security System 266 Communication system 268 Economy system 269 Education system 270 Coordination and control system 271 Summary 273 References 275 Chapter 8: Thailand 299 Events 301 Public health system 304 Medical care system 307 Water and sanitation system 311 Shelter and clothing system 312 Food and nutrition system 314 Energy supply system 315 Public works and engineering system 315 Social systems 317 Transportation and logistics system 320 Security system 321 Communication system 321 Economy system 322 Education system 323 Co-ordination and Control system 324 Summary 326 References 327 i Foreword esearch in emergencies has always been a debatable issue. How can one engage Rin research when the priorities are basic needs for living and survival? Even with resources available and with capacities in place- research and even basic information management always takes a backseat. Indeed, the earthquakes and tsunami of 26 December 2004 were too huge an event to even think of undertaking some form of research, get a better picture of the events and the actions information collection in real time. But within taken for it. In simpler words, the book is a six months of the disaster, WHO-SEARO documentation of evidence behind the events, started thinking of this and developed several the actions and their impact. publications. As some of the early documents were being completed and disseminated, it This pioneering initiative has been done to the was clear that a more comprehensive technical efforts of those who worked during the tsunami review was needed. Efforts in planning for and, more importantly, those who suffered its a publication such as this were initiated and, impact. in the end, a comprehensive, multi-sectoral restrospective study was conducted. This book is With the thought that many would not have the output of that work. suffered in vain or those who have worked tirelesly may have planted seed for better The challenge was and remains that a lot of practice in the future, it is hoped that this book the evidence available for emergencies are will, not be just an academic exercise but in