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DHS news release

Jan. 26, 2005


Tsunami recovery needs to take a long-term view


This guest opinion is by Mel Kohn, M.D., state epidemiologist in the Oregon Department of Human Services.

For a photograph of Dr. Kohn, call Bonnie Widerburg at (530) 731-4180 or email at bonnie.l.widerburg@state.or.us


Length: 478 words

As international tsunami relief gets into full swing, other headlines are crowding the disaster from the front page. Public sympathy, money and resources will soon shift elsewhere, even as needs in these ravaged countries persist.

That is why immediate help must be designed to bring long-term benefit.


One sound investment is a public health system. The delivery of relief services is an opportunity to train local staff in public health methods, build facilities and technologies that will last, and create disease reporting and response systems. For example:

Clean water: We depend on getting safe water from the tap, thanks to our water treatment facilities and systems that deliver and monitor drinking water. But in the developing world, most people drink surface water, such as streams or ponds. When waste and sewage are washed into these waters, they become sources of disease.

Establishing clean water supplies is a major immediate recovery task. If these systems are built with sustainable technologies and local staff are trained to maintain them, clean water will be available long after acute disaster relief has ended.

Immunization and nutrition systems: Refugee camps are ideal settings for disease outbreaks. Introduce a highly contagious bacteria or virus--like measles--into these crowded conditions, and the stage is set for widespread illness and death.

Immunizations and nutritional supplementation can prevent these misfortunes. Delivering these services requires local infrastructure and staff who know how to acquire, store and dispense vaccines and nutritional supplements, how to educate communities and how to target those most in need. These assets can be used to prevent disease into the future.

Injury prevention: Photographs of barefoot tsunami victims picking their way through rubble highlight the potential for cuts, broken bones, burns and other avoidable injuries. Monitoring where and how injuries occur is a basic prevention step. As hazards are identified, public education can follow and resources can be directed to remove these hazards from the environment.

Our public health systems record the frequencies and kinds of injuries that occur. These data are used to educate the public and advocate for policy changes, such as seatbelt and bicycle helmet laws. Again, during the relief phase, local workers can learn to monitor injury hazards. These skills can then help protect community health for years to come.

Organized disease and injury monitoring systems do not exist in much of the developing world. We need to help rebuilding countries create these systems, which will be important tools for the future.

Of course, political will and resources are required to reap the benefits of these efforts in the long run. But training staff and establishing appropriate facilities and technology are solid steps in the right direction. In the wake of this enormous tragedy, the world wants to help. Let’s assure these gifts of human kindness will last, by using them to build public health systems that have long-lasting benefit.


Mel Kohn, M.D., M.P.H., is state epidemiologist in the Oregon Department of Human Services. He is largely responsible for disease monitoring and prevention programs, as well as injury and chronic disease prevention programs.