Thailand’s health-based response to tsunami disaster

Jenifer Lee

The following is a summary of the Centers for Disease Control and Prevention (CDC) report “Rapid Health Response, Assessment, and Surveillance After a Tsunami - Thailand, 2004 - 2005”. The report highlights Thailand’s response to health related needs following the 2004 Asian tsunami disaster.

Key groups involved in the response efforts included: Thai Ministry of Public Health (MOPH), World Health Organization (WHO) representative to Thailand, Armed Forces Research Institute of Medical Sciences (AFRIMS) and Thai MOPH-United States CDC (TUC).

Rapid Response

MOPH immediately activated mass casualty plans including:

Established a central command center in Bangkok, and a command post in each of the six impacted Thai provinces.
Personnel and resources rapidly deployed to meet local health care needs.
Disease outbreak risks, sanitation and mental health needs quickly assessed and addressed.
Initiated health education programs on hygiene, safety, and mental health.
Disease surveillance laboratories enhanced with additional staff and resources.

Health and Needs Assessment

Health assessments conducted one week after the tsunami indicated that Thailand’s medical system was functioning effectively despite the substantial number of patients.

Utilized WHO’s rapid assessment tool to gather data on hospital conditions, damages, available medical personnel and supplies
Adequate amount of available medical staff resulted from rapid mobilization of supplemental health professionals from multiple areas of Thailand.
Hospitals activated mass casualty plans that had been previously documented and drilled.
Shortage of blood and medical supplies only occurred during the first two days following the tsunami.
Because morgue capacities were inadequate, hospitals established temporary morgues in temples.
By December 30, 2004, hospital patient loads returned to normal levels. By January 4, 2005, medical staffing and supply needs were fully met.

Public Health Surveillance

MOPH initiated active surveillance for twenty known infectious diseases, wound infections and electric shock.
Teams analyzed surveillance data daily to identify cases that required investigation or a need to establish preventative measures.
CDC attributes an increase in the number of acute diarrhea cases to Thailand’s active searching for cases rather than passive reporting that occurs normally. Even so, post tsunami rates of diarrheal disease reported in Thailand were much lower than outbreaks studied during disasters in other countries.
CDC attributes an increase in the number of wound infections to tsunami survivors injured by debris.

Existing Challenges

CDC has noted several challenges still facing Thailand including:

Continued identification of bodies and reconciliation of human remains within Thailand and other countries;
Maintaining active surveillance for disease outbreaks, treating infections, preventing posttraumatic injuries and addressing mental health needs; and
Maintaining safe drinking water and sanitation.

The CDC concludes that Thailand’s health response activities were rapid and effective at mitigating the health consequences of tsunami survivors. Thailand’s success emphasizes the importance of documented and tested disaster plans, the capacity for rapid mobilization, the local coordination of relief activities, and active public health surveillance.

To view the report in its entirety: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5403a1.htm