When a cyclone hit the Orissa coast of India on Friday morning (October 29, 1999), it struck from the north with windspeeds reaching 250km/h. When it reduced force and windspeeds fell to 100km/h, it turned and struck from the south with gale force winds with speeds up to 280km/h.

The next day brought torrential rains. Windspeed remained above 100km/h. A tidal surge that measured in places up to 10 meters in height hit the coast and carried water as far inland as 15kms.

Cyclone warnings had been given up to 24 hours in advance, but few people expected the winds to have such force. Damage from the wind was so severe as to uproot trees as far as 200km inland. The most affected areas are Bhadrak, Kendrapara and Jagatsinghpur

MSF had an exploratory mission in the region by Sunday, sending staff from our New Delhi base to assess the conditions and needs.

Relief has been slow to arrive, mostly because of inaccessibility. MSF reports from the field indicate an incredible number of telephone and electricity poles along with tress blown all over the countryside, often blocking roadways. The electricity and communications networks have been virtually destroyed.

There is a shortage of essential items such as food and water - this has brought some tensions in the local populations.

Immediate concerns for MSF is the rise of diarrhoea. Some of the worst off areas are likely to be away from the main roads where local addition, access will be an even greater problem given the damage.

The worst off areas are likely to be along the coastal belt of the districts of Bhadrak, Jagatsinghpur and Kendrapara. Other districts affected by wind and water damage are Puri and Baleshwar.

Many people are constructing temporary shelters however a safe water supply remains a key concern.

In the Bubaneswar region, where wind damage is the largest concern, damage seems to have been caused mostly by wind and falling debris. There is no power nor telephone communications as of this report. Fuel is in shortage and there are signs that the prices of other essential items are increasing rapidly.

Along the coastal region, where there is dammage from the wind, tidal surge and also rain damage, the damage is overwhelming. The more one drives to the cost, the less there is to see as it has mostly been either blown down or submerged.

Safe drinking water is scarce. Sanitation is virtually non-existent and radio or telephone communication is extremely limited.