Challengers in the Delta Weather
Not only are the current rains a major threat to the health of the population, but are also hinder access to the most isolated communities in the Delta. The rains are very heavy and last for one to two hours. This rain means the survivors have increased exposure to disease because of the damp and cold. In addition, it makes it difficult for people to go about their daily activities - such as farming or fishing - in order to make a living. During the monsoon season, there are always tropical storms. However, since the cyclone, people have become anxious about bad weather. Boatmen, needed to help carry the MSF supplies and teams to remote areas, often refuse to go out on aid deliveries when weather is bad, fearful that there is another cyclone on the way. This hinders the speed with which MSF can get vital aid to survivors that need it.
The scale of this emergency operation is considerable because the Delta is such a large area with so many villages scattered around. A complicated and time-consuming system of large trucks, big boats and small boats are still required to get relief supplies and medical aid to communities in isolated areas. To access people you have to make your way through a labyrinth of waterways and, once at the destination, many jetties have been destroyed. In certain areas, MSF staff push through thick expanses of mud to access communities. Other areas can only be accessed by walking six hours through the mountains. Logistically it is very difficult to get adequate medical aid and relief supplies into such areas. It has been two months since Cyclone Nargis, which struck Myanmar on May 2, devastating entire communities and killing thousands and destroying the lives of thousands more. Though eight weeks have passed, the needs facing survivors remain critical. While the disaster has dropped from the media headlines, the suffering of those who survived has not. Thousands of people in the worst affected Irrawaddy Delta area continue to struggle with day-to-day survival and there is a significant shortage of adequate aid and assistance in many areas. As the people of Myanmar attempt to rebuild their lives and communities, MSF is clear that an urgent need for basic aid, including food, water, shelter and medical supplies, will continue. The delivery of aid in Myanmar remains vitally important. MSF now has full access to people in the Delta region and over the past weeks MSF teams on the ground have significantly increased their emergency activities and medical coverage to reach survivors who had still not received adequate levels of aid. MSF teams are working to reach up to 350,000 people with emergency aid in the Delta area. MSF is running both mobile and fixed clinics to reach the greatest numbers of people in the area. Since the start of its emergency response two months ago, MSF has reached more than 460,000 people through its emergency aid programme, delivered 939 tons of medical and relief supplies and carried out more than 30,000 medical consultations.
Medical issues in the Delta
MSF has carried out more than 30,000 medical consultations and is treating people for diarrhoea, respiratory tract infections, malaria, dengue fever and malnutrition. Currently there are no reports of disease outbreaks or epidemics, and pathologies remain relatively stable. However, future outbreaks of disease among the survivors are a concern, particularly as the heavy rains continue. Many diseases, including malaria and dengue, are endemic in Myanmar. Currently, it is the season for these two diseases and as heavy rains continue and people lack adequate access to food, shelter or clean water, their vulnerability to disease increases. Currently, cases of diarrhoea represent more than one tenth of MSF medical consultations (approx 11.77 percent), caused by a combination of poor sanitary conditions, contaminated water and exposure to the weather. The number of respiratory tract infections represents around 12.5 percent of MSF medical consultations. As the heavy rains continue and people lack adequate shelter, the constant damp and cold is a serious concern and could lead to higher numbers presenting with respiratory conditions in the future. While construction of more permanent shelter is taking place, many people remain in temporary structures constructed out of plastic sheeting distributed by aid agencies, or other materials that people managed to find. There have been a small number of cases of measles and the WHO/Ministry of Health carried out a vaccination campaign in Labutta Camp. Though the figures for dengue fever currently remain relatively low, MSF is carefully monitoring the disease in areas where it is working. MSF is also taking part in the WHO-led initiative to prevent further transmission of dengue, a disease particularly risky for children and international aid workers who have little resistance to it, by improving drainage systems and reducing stagnant water in high-risk areas. Malnutrition is an ongoing concern. Due to the lack of regular access to food for survivors in remote regions of the Delta, MSF is closely monitoring malnutrition levels for groups that are most at risk in these areas - particularly children under five. MSF teams are increasing the number of children that it screens and teams in Bogaley, Setsu and Pyapon have found that there is a high proportion (15 percent) of children at risk of malnutrition. In a number of its clinics, MSF has already treated some cases of severe acute malnutrition in children. Numbers are low (between 0 and 0.5 percent of children). MSF is also providing food supplements to groups of people who have been identified as moderately malnourished to ensure their rapid recovery, and to other vulnerable groups, such as pregnant and breastfeeding women.