An earthquake measuring of 6.9 on Richter scale hit the southern Departments of Arequipa, Moquegua and Tacna in Peru on June 23, 2001. The first death and injury figures indicated 115 dead, 1,529 injured, 55 missing and 88,387 people affected. Over 25,000 homes were either damaged or destroyed (source: INDECI, the civil defence structure as of June 27). Although more recent figures are not currently available the rates are increasing quickly. As the earthquake took place during the daytime, there were fewer injuries and deaths as people were better able to react to the situation.

An emergency situation has been declared by the national government in the departments of Tacna, Arequipa and Moquegua and two provinces of the department of Ayacucho (Paucar del Sara Sara province and the one of Parinacochas). Schools have been closed and it is not known when they will resume, 170 educational centers are seriously damaged. According to the government representatives, sufficient food stocks have been supplied to feed 75.000 persons for 10 days. In addition, there has been an open appeal to the local population for blood donations as supplies are considered dangerously low.

The risk of important aftershocks is still present and, according to the Chilean geo-physical center, the biggest earthquake is still to come. MSF, already active in Peru, dispatched two emergency teams to the earthquake zone. In Arequipa, a doctor, psychologist, log and water and sanitation (watsan) specialist arrived on June 25. In Moquegua, a doctor and logisitician arrived on June 26. On June 28, a cargo flight with 31 tonnes of supplies, along with an additional three staff members, landed in Arequipa. Relief material included medicines and medical material, tents, blankets, jerrycans and water and sanitation material. A nurse, logistician, and watsan specialist were sent with the cargo to reinforce MSF teams already in the field. Three teams have now been placed (one per Department), consisting of one medical/paramedical, one logistician and one watsan staff member. Distribution of relief items will be done while they evaluate the health and watsan needs to define the extent of the MSF intervention. Distribution of relief items will be done mainly in rural areas and the most affected zones of urban areas. Medical material will be distributed in hospitals and health care centres. MSF will focus activities in health care, psychological support, shelter and water and sanitation.

MSF using experience gathered in El Salvador

With MSF's involvement at the earthquake in El Salvador earlier this year, MSF teams in El Salvador are sharing their experience, especially on psycho-social support, with the team in Peru and have sent a list of existing medical and watsan material in stock in San Salvador. Psychological support is going to be organised with local psychologist of the Ministry of Health. MSF teams in neighbouring countries are ready to provide support, if needed. "Having worked in the aftermath of last two earthquakes that shook El Salvador, I can say that physical damage has been very similar here," said Jose Lopez, MSF logistics co-ordinator. "Adobe houses have collapsed and water distribution systems destroyed. However the great difference here is the access to small communities, which is very difficult or impossible."

First findings of the MSF teams in Peru AREQUIPA

First impression of MSF team in Arequipa is that the situation is under control so the teams are concentrating on assessing the situation in rural areas of the three Departments (Arequipa, Moquegua, Tacna), where as of June 27, aid had not yet arrived yet and there are reports of huge damages. "In the Department of Arequipa, there are around 10,000 people totally isolated", said Juan Hilares, logistics co-ordinator with the MSF team there, "For example, the road to La Union province is blocked. It takes 18 hours by foot to get there. Around 90% of health care posts are functioning, but they only assist urgent cases, such as wounds or fractures. Since the earthquake, there have been many aftershocks, producing some psychological distress in the population. In small communities, people are still in shock."

MOQUEGUA

"People are experiencing fear, anxiety and sadness, which are normal reactions in the first phase of a natural disaster. They are still in shock," Barbara Laumant, psychological programme co-ordinator. We are going to concentrate our activities in implementing a prevention programme to avoid severe post-traumatic stress disorders. A network of health care staff and teachers will be trained to offer support and counselling," Barbara Laumant. There is a lot of destruction and international aid had not yet arrived. Earthquakes present fundamental problems in transport with roads and airports often damaged to the point of being unusable.

The MSF team visited the Moquegua Department on June 26. It took them six hours to arrive from Arequipa - a trip that normally takes just six hours. The main roads are expected to take up to one week to be restored. According to the Ministry of Health (MoH), there are 18,000 people affected in the Department. The number of affected people for Moquegua town is increasing and currently numbers about 6,000. "The situation is catastrophic", according to Jose Lopez, a logistician from El Salvador now supporting the team in Peru. "The situation is very much like the one in El Salvador last January and February."

Health

An old hospital building is being used under precarious conditions. The electricity system was not functioning well; there was no surgery or delivery room available, and there was a lack of beds, medical material and equipment. Some health care structures in the Department have also reported severe damage. According to health authorities, people are starting to present stress syndrome, with symptoms including headaches and anxiety. The MSF psychologist met with local psychologists of the Ministry of Health (MoH) to organise a psychological support system. MSF is co-ordinating the intervention with the coordinator of the Mental Health Programme of the Ministry of Health at the Departmental level. In Lima, the co-ordination team is also co-ordinating with the MoH at a national level. For the 30 days following the earthquake, health care centres are providing drugs for free but people have to pay for sutures and other type of health services.

Shelter

In total 16,351 houses have been damaged, of which 8,670 have been totally destroyed. The San Francisco neighbourhood heavily damaged and 2,000 families are going to be relocated.

Water and sanitation

Approximately 80% of the water distribution system, and 70% of the drainage system, has been damaged.

Waste disposal

The garbage collection system has hardly functioned since the earthquake due to lack of fuel and Municipality's economic hardship.

The 200-bed Departmental "Hipolito Unanue" hospital is destroyed and certain services have been transferred to a 30-bed psychiatric hospital. Health staff have been working under precarious conditions and lack medical material and electric supplies.

They have set-up a surgical theatre but have electricity problems. In the compound of the hospital, a mobile medical team sent from Lima (Ministry of Health) have organised an outpatients service in provided from tents.

MSF has donated two dispensary kits (1,000 persons, three months) to the departmental reference hospital, and one dispensary kit to the Yarada Health care centre.

The team also visited health care centres or posts in the most affected districts near Tacna city:

Alto de la Alianza

No deaths registered but there are wounded. There is a lack of drugs, dressing and suture material. There was no water service in one area of the district.

Ciudad Nueva

The MSF team visited the northern area, but health care post was closed. Local residents said there is water and electricity services but they needed tents, blankets and food.

Esperanza

The local health care centre has enough drugs. There has been an increase of acute respiratory infections in children under five, as well as cases of hypertension and nervous breakdowns. There is water, electricity and phone services.

La Yarada

This district has eight sectors with a total population of 5,000 people. The team had visited two sectors and the situation is a bit chaotic. There is lack of drugs, water, tents and blankets. Electricity is being restored little by little.