INDIA

Total current MSF staff: 6 international staff

National staff and counselors: Over 30

A first team of two people arrived in Chennai (formerly known as Madras), the state capital of Tamil Nadu, on December 27. Shortly afterwards, other assessment teams arrived on the Andaman Islands and in cape Kanniyakumari, the southern most tip of mainland India. Initially, they found the situation to be better than expected. The damage to the coastal area was limited and the authorities and local population were organizing health care, food distribution and clean-up activities. The team found no shortage of safe drinking water in Chennai. During the two days following the tsunami, 220 wounded arrived at the government hospital with minor injuries. On December 28 and 29, the MSF team went further south to Cuddalore and Nagapattinam, the districts that had been hit the hardest. The coastal areas had been severely affected and families were still searching for missing people. The government and local communities had quickly mobilized: bodies had been collected and incinerated; electricity supplies were being re-established, enabling water pumps to run and provide clean water; the Ministry of Health had employed extra staff and set up ‘health camps' with free access for all. Hospitals seemed well supplied with drugs and materials. The principal problem for the community was found to be psychological trauma, with some people suffering from post-traumatic stress disorder (PTSD). MSF decided to offer counseling and assistance to people affected by trauma, and has now started different psychosocial support programs, for example training NGO community volunteers as counsellors. MSF offered to start epidemiological surveillance in the Tamil Nadu districts of Nagapattinam and Cuddalore, but the Indian authorities declined the proposal since they felt the needs for epidemiological surveillance were covered. An MSF team arrived on the Andaman Islands on 31st December to carry out an assessment, but found no real need to set up operations there. Local mobilization had been very strong, with sufficient medical supplies, medical staff and relief materials reaching the most affected populations. MSF also tried to get access to the Nicobar islands, especially Car Nicobar, but was informed by the authorities that there was no reason for MSF to intervene.

THAILAND

Five MSF international staff were involved in assessing post-tsunami needs in Thailand; currently three national staff. Days after the tsunami, teams provided emergency support to several hospitals and carried out assessments in Phang Nga, the most heavily affected province north of Phuket, in Ranong province and on islands in the Andaman sea. The team also visited the region of Takuapa, where fishing villages had been devastated and were almost completely empty. In general, the Thai emergency response was found to be fast and well organised, with enough resources and supplies reaching the region. The team found that the need for an MSF intervention was limited, but identified several vulnerable populations:

Burmese migrant workers

Prior to the tsunami, 50,000 legally registered Burmese migrants worked in six provinces on the west coast of Southern Thailand. The real total number of Burmese migrant workers in these provinces was possibly 500,000 or more. More than 5000 Burmese people have gone missing following the tsunami. MSF assessed the situation of these migrant workers in two locations, and decided to start a program with the aim of helping them get better access to health care.

Moken Sea Gypsies

MSF met with five families of Moken Sea Gypsies in Kheuk Khak, where 60 sea gypsy families live in an IDP camp. This group may be ignored by the official mental health support teams and their needs in terms of mental health support will be one focus of MSF's next visit.

MYANMAR (BURMA)

Two MSF teams were deployed along the south coast of the country. One team arrived on 31st December in Kawthuang to begin an assessment. It found no serious unmet needs. The other team surveyed the Myeik archipelago from north to south using an MSF boat. It found some material damage but did not identify areas in need of emergency assistance.

MALAYSIA

In the days following the tsunami, two MSF medical doctors completed an assessment from Penang up to the Thai border. Although they found people grouped in schools and mosques, the authorities were providing clean water, various local organizations had mobilized aid to the displaced and affected populations and health facilities were not overwhelmed. It was decided that no MSF operation was required.