More than two weeks after the earthquake, what is the situation like on the ground today?

The response was important at first, yet after 20 days many aid organisations have already withdrawn. The Indonesian authorities are now trying to identify the gaps that are appearing in order to relocate aid efforts. In the meantime, our teams are still finding remote areas where no aid has arrived yet. It’s not many people; these are small villages yet unattended so far. The inhabitants in these areas have lost their houses and many of their belongings. They clearly need essential relief items. The problem is that access to these villages is very difficult. It has been raining heavily in the past few days and the roads are muddy and in very bad condition. For instance, a new landslide took place last Saturday.

What is the situation people are enduring and what are their most urgent needs?

Even though it has been only 20 days since the earthquake hit the area, the emergency phase is mostly over. We are now entering the recovery stage. Many families that had been displaced are returning to their homes and others who have lost everything are looking for a place to stay. The government has started building temporary shelters (foreseen for people to stay up to one year) where survivors from the most affected areas will be relocated. Our teams are going to intervene to ensure proper water and sanitation conditions in these shelters.

On Saturday I saw a case that illustrates how difficult recovery is going to be for many people. When we were conducting a mobile clinic, we saw one of the survivors of a landslide returning home and we went to visit him. He told us that when the earthquake occurred he was praying. He was caught under the landslide and remained trapped in the mud for over 24 hours together with many more people. He was rescued together with some of them, but many were not so lucky. He was then sent to hospital where his fractured legs were operated on. Now he is back, in a wheelchair, recovering. Yet the wheelchair is not easy to manage in these places.

Generally speaking, do you believe aid is reaching the survivors?

The response has been adequate and even more than needed in some areas, yet coordination was lacking at first. Most of the aid has focused on certain areas while the needs in other remote locations are still unmet. In addition, now that the emergency phase is over, some coordination bodies are being dismantled.

How has MSF responded?

The first teams arrived in the affected areas three days after the earthquake. After rapidly assessing that an intervention in the main hospitals was unnecessary as they were already receiving an important amount of aid and could address the needs, we decided to organize mobile clinics in some of the most neglected rural areas. These were either in remote locations where access was difficult or in other less affected sites, which had however been neglected by the relief efforts. The main health issues observed in the clinics are respiratory tract infections, diarrhoea, and skin diseases, all issues related to the difficult living conditions currently endured by the survivors.

As well, MSF is offering psychological care to the traumatised survivors. The emergency team included several psychologists who have in turn been training Indonesian psychologists – some of these Indonesian professionals had worked with MSF in the aftermath of the 2005 tsunami that also affected Sumatra, as well as another earthquake in 2007. Now we have several teams carrying out psycho-educational sessions where they explain simple ways to cope with these traumatic events. For the most severe cases, the psychologists are also offering individual psychological support sessions.

Another MSF team is working on water and sanitation, installing water tanks in several villages (and ensuring the supply with trucks), and intervening in the temporary shelters being built by the government.

And finally, we have already distributed essential non-food items, including hygiene kits, kitchen utensils, blankets, mats and plastic sheeting to about 1,600 families. These distributions will go on while we are also going to add basic tools for the population to help them rebuild their houses.

How long is the MSF intervention expected to last?

We estimate our intervention should last until mid-November. In the month we have left we will have time to complete the water and sanitation activities, ensuring good conditions for the population, both for those returning to their homes as well as for those who are to move to the shelters.

Medically speaking, we see that health centres are little by little becoming operational again, their staff is returning to work and even though sometimes they have to do it under tents as the actual structures are now destroyed, normalcy is being restored. In the field of mental health, we will have enough time to provide survivors with the initial support they need to cope with their recovery.

Globally, the aim of MSF is always to intervene in the emergency phase addressing the most pressing needs. Then both the government and other organisations will take over and be responsible for reconstruction.