An MSF surgical team has started working in Sigli General District Hospital. Sigli, the capital of Pidie district on the eastern coast of Aceh, is an area that was been hit hard by the tsunami that has struck the Indian Ocean region on on December 26.

The 35-bed hospital has remained open with the help of Indonesian volunteer staff (many of the employees of the hospital died in the tsunami), providing treatment and operations.

During the weekend, an MSF exploratory mission found the surgical ward of Sigli hospital overflowing with injured patients.

Every day, more arrive from all over Pidie, but also from Banda Aceh. In the first 60 consultations, MSF had 20 infected wounds and performed surgery on six wounded people. One of the primary tasks for the MSF staff is to improve the sanitation in the hospital, which was described by the exploratory team as 'appalling'.

The next few days will also see an increase in capacity with the opening of another building with 18 rooms. In the same area, MSF has started a mobile clinic in Kembang Tanjung for the displaced population. The displaced live in 60 camps which house an estimated 47,000 people.In the first instance, MSF is concentrating on the bigger sites with around 3,000 people each. Further east from Sigli, in the General District Hospital of Bireuen, MSF donated drugs and infusion materials, and set up a medical supply link with the MSF team in Sigli. In the two hospitals, there are some 400 patients with 50 more arriving daily; in recent days 80% of the new arrivals have been from Banda Aceh.

The MSF mobile clinic in Banda Aceh spent January 4 among the approximately 1,000 displaced around a mosque in the Cot Keung area. The 141 consultations were mainly for injuries, skin diseases and respiratory tract infections. Further logistical difficulties have been posed by Tuesday's closure of the airport in Banda Aceh.

But with the 120 tonnes of relief items that MSF brought in over the previous days, there was enough buffer stock to guarantee continuity for our medical teams, though they were running low on nutritional items. The problems at the airport did not interrupt the schedule of the MSF helicopter. It flew to Lamno and Lampe-Ngo on the west coast to deliver 270 kilos of rice, 100 tarpaulins and drop off a water and sanitation specialist. In both villages, MSF teams are staying overnight.

On the return journey, the helicopter transported seven patients in need of hospitalisation. They are now in Fakine hospital receiving treatment for broken legs and infected wounds. The Rainbow Warrior, offered to MSF by Greenpeace for transport and for increased access to coastal communities, left Medan yesterday carrying a medical team of MSF and supplies. The ship is scheduled to arrive in Banda Aceh on Wednesday. MSF has 57 staff in Aceh, including 37 Indonesian. More will be arriving over the coming days. Sri Lanka MSF has more than 40 aid workers, including doctors, surgeons, nurses, and logisticians, on the ground in Sri Lanka.

They are trying to coordinate their efforts with the already strong response from local authorities and communities. For example, a local brewery has replaced its beer production with bottling water. Charter planes with more than 200 tons of aid supplies have arrived in the capital Colombo.

In addition to relief materials, the cargo contains the equipment and supplies to set up hospitals to care for 40,000 people for a period of three months. Heavy rains in the Ampara and Batticaloa regions, where MSF has focused its work, have severely impeded aid activities. Road and bridges in the area had already been destroyed or severely damaged by the tsunami.

MSF is operating 13 mobile clinics on the east coast. Each is providing an average of 150 medical consultations per day. MSF is supporting the three main hospitals in Ampara, where the Sri Lankan government estimates that more than 180,000 people are homeless, and plans to set up three field hospitals.

MSF teams will distribute shelter materials like tents, mosquito nets, and jerry cans to 6,000 families, roughly 24,000 people, living in 125 settlements in and around Ampara. MSF is also establishing an epidemiological surveillance system as well as providing water-and-sanitation support for 60 settlements of displaced people.

MSF has established an outpatient clinic in Tangalla on the southern coast. Mobile teams will provide assistance to displaced people in the area. An outpatient clinic has also been opened in nearby Hambantoa. MSF is also trying to establish a network of local doctors to provide psychosocial support to people traumatized by the disaster.Thailand MSF conducted exploratory missions during the early days of the disaster in Ranong and north of Phuket, and visited three provincial hospitals and one district hospital in the region of Takuapa. Because of the strong local response MSF determined that its resources would better used elsewhere.

MSF donated medicine to the provincial hospital in Phang Na. India After conducting assessments in southeastern India in Chennai and Nagapattinam, MSF is focusing its operations on psychological support for the victims and establishing an epidemiological surveillance system.

Myanmar

An MSF team has conducted assessments along the southwest coast, from Myeik to Kwanthoung, and in some islands of the Myeik and Kawthoung archipelagos. These assessments indicate that Myanmar has escaped the worst effects of the tsunami.

Somalia

A two-person team from MSF assessed the tsunami damage to the Mudug region. The team found property damage, several deaths, and some contaminated water wells but no disease outbreaks. They donated food, water, blankets, and plastic sheeting to local groups and communities as well as medicines, including antibiotics and oral-rehydration salts.