Risk Assessment of Indonesian Satellite Health Clinics Caring for Displaced Survivors Two Years After the December 2005 Tsunami

Tuesday, 31 July 2012: 4:10 PM

Mary Lou Manning, PhD, CRNP, CIC
Jefferson School of Nursing, Thomas Jefferson University, Philadelphia, PA

Learning Objective 1: Demonstrate how disaster relief is a complex process measured not in months but years.

Learning Objective 2: Share lessons learned from disaster relief participation that can be applied to disaster planning and management at the local, regional, national and global levels.

In December 2005 a massive earthquake struck off the western coast of Sumatra, Indonesia triggering an explosive tsunami. More than 175,000 died and over 1.7 million people were displaced and relocated to temporary homes, shelters or camps.  Many villages were completely destroyed and the community infrastructure, including health care services, was decimated. Disaster relief funds supported the construction of small prototype satellite health clinics to care for those displaced. In 2007 significant numbers of people remained in “temporary” shelters and the clinics continued to provide their health care. Consequently, a team of American and Indonesian nurses and physicians were invited to conducted surveys in the clinics in Aceh Baret and Nagan Raya districts to determine quality of care, make recommendations and conduct education. A clinic assessment tool was developed and piloted prior to use. The survey included on-site observations, record reviews, and staff interviews. In addition a targeted infection control risk assessment focused on hand hygiene, availability of running water, patient screening and triage, sharps safety, medical waste, occupational exposure, environmental cleanliness, disinfection and infectious disease transmission including avian influenza. Several areas for immediate improvement emerged and action taken. In the ensuring years we continued to assist the health clinics. Disaster relief is a complex process measured not in months but years. Rebuilding the health care system to care for people who have experienced catastrophic loss of life and property is a slow, deliberate process requiring extensive resources. It was shown that small improvements could help improve the quality of care. Lessons learned from previous disasters must be applied to disaster planning and management at the local, regional, national and global levels. It is imperative that we learn together how to best serve our global community in both the short term and the long term following disasters of any magnitude.