Health authorities on 'high alert' in Banda Aceh

WHO has warned of a possible second wave of carnage caused by disease, unless aid reaches the tsunami-hit areas swiftly.

Two weeks after tsunamis wrought havoc on Indian Ocean shores, there may not have been any serious disease outbreaks among the hundreds of thousands of people left homeless by the disaster, but health officials say they are preparing for the worst.

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As the enormous scale of the tragedy has become more and more apparent, global health and relief agencies have become increasingly concerned about epidemics breaking out in countries worst hit by the December 26 tsunamis.

With the bodies of the more than 155,000 people killed by the giant waves either buried, burned or still missing, one health threat has mostly been eliminated, leaving health officials to shift their focus to prevention.

The World Health Organisation (WHO) has warned of a possible second wave of carnage caused by disease, unless aid, particularly clean water supplies, reaches the areas swiftly.

UN Secretary General Kofi Annan recently appealed for nearly a billion dollars immediately to save survivors of the killer waves from disease.

Since the disaster hit, there have been cases of diarrhoea, skin and respiratory illnesses in Indonesia, Sri Lanka, India and other areas, health officials say.

But while there are no signs of any epidemics, conditions created by the tsunamis are a natural breeding ground for a host of potentially deadly diseases, they say.

"There is no epidemic in Indonesia," said WHO spokeswoman Fadela Chaib, referring to the hardest hit country, where at least 104,000 people were killed in Aceh province and at least, half a million were displaced.

"There are also cases of diarrhoea in Sri Lanka and India, but nothing that would constitute an epidemic surge of cholera or other (diseases)," she said.

The organisation's chief in Asia said on Friday the global health body was on "high alert" for possible outbreaks.

"The situation across the region is ripe for cholera," said Regional Director Samlee Plianbangchang, reiterating warnings about damaged water supplies and sanitation in affected areas.

The UN's health agency has particularly been concerned about Aceh.

Chaib on Friday emphasised that half the health infrastructure in the province had been destroyed or damaged. The eight hospitals there were damaged.

"Lots of health staff have not come forward, we do not know if they are dead or missing," Chaib said.

The main hospital in Aceh province reopened its emergency ward on Thursday amid hopes that other wards could be reopened with the help of the International Committee of the Red Cross soon.

The WHO has set up mobile health laboratories in Aceh to compensate for the loss of blood banks and diagnostic equipment, and to help detect and stifle outbreaks of serious disease.

He said the lack of basic health facilities was greatly amplifying the risk of large-scale disease outbreaks in the wake of the tsunamis.

"We are far from ensuring no more life will be lost. We are on high alert for possible disease outbreaks," he said. Upto five million people had been displaced by the disaster, he added.

Samlee said the greatest immediate challenge was providing clean drinking water in countries such as Indonesia and Sri Lanka, which along with other hard-hit areas, faced outbreaks of dysentery, typhoid and malaria, among other diseases.

Another concern for the WHO is that many of the 500,000 people that it estimates suffered injuries in the disaster, may have not been able to receive treatment soon enough in a region where simple cuts and abrasions can turn into gaping tropical ulcers.

But some officials are even more concerned about the long-term threat from stagnant water created by the tsunamis that went as far as eight kilometres inland.

These are ideal for mass breeding by mosquitoes that carry diseases such as malaria and dengue fever.