Ewald Stals - If we look back, we should do so in a spirit of humility. It was the local authorities and the survivors in the stricken areas who organised assistance for the tsunami victims in the early hours and days. The relief organisations, including MSF, did not start arriving until a few days later. Within a short space of time, they flew in hundreds of aid workers and thousands of tons of relief goods. Thank goodness, because the effects of the tsunami were so horrendous, especially in Sri Lanka and Indonesia, that no one would have made it without external help. The logistical challenges were awesome.

The infrastructure in the coastal areas had been completely destroyed. We used helicopters and boats, amongst other things, to reach the injured, distribute water containers, hygiene products and other relief goods, and restore the supply of clean water.

In some parts of Aceh, safety was also a problem. The civil war had ended just a few months earlier in August. Once the injured had been brought to safety and cared for, the situation stabilised fairly quickly. There were no outbreaks of disease and no food shortages.

The weather in tropical Aceh did not present a danger either, unlike the weather in Kashmir after the earthquake there in October 2005. As expected, we were able to scale down the direct medical assistance and the distribution of goods in Aceh after a few weeks, once more aid organisations had arrived in the coastal regions.

MSF teams then turned their attention to the less accessible areas in the mountainous area. The aim was to set up psychosocial programmes for people suffering from serious stress. The symptoms can be triggered by all sorts of factors.

Besides the tsunami, decades of civil war had traumatised many people. The peace process seems to be working so far and, recently, the provincial elections went well. The humanitarian situation in Aceh has improved by leaps and bounds. People can move freely again - for example, to go to the nearest health post - and the medical infrastructure is being restored. MSF teams have provided psychosocial support in various villages that were caught up in the civil war.

The psychologists and counsellors helped  people pick up their lives again and get back on track after years of abuse and intimidation. Although chronic mental health needs remain, MSF will close our projects in Aceh during January 2007. We think that as the emergency situation is over it is now up to other actors - especially the state health system - to provide appropriate treatment services.

MSF is currently lobbying in that regard by means of a photo exhibition that is touring a number of villages where our teams have worked. As a form of saying goodbye, we want to acknowledge publicly that people have made progress both on their own and with MSF’s support and that mental trauma can be and needs to be addressed.