Magazine article Newsweek International

Surprise Killers; Health: The Post-Tsunami Challenge in Aceh Isn't the Contagious Disease Outbreak That Many Expected. It's Cases of Tetanus and Pneumonia

Magazine article Newsweek International

Surprise Killers; Health: The Post-Tsunami Challenge in Aceh Isn't the Contagious Disease Outbreak That Many Expected. It's Cases of Tetanus and Pneumonia

Article excerpt

Byline: George Wehrfritz and Joe Cochrane

Sabirin lays contorted on a hospital bed, writhing and delirious. "No! I can't believe it!" he screams as his wife pumps gruel down his throat with a syringe. The 38-year-old survived the massive tsunami that tore through his Aceh village on Dec. 26. But like countless others he was swept away by the water and suffered cuts and bruises. Within two weeks he developed lockjaw and agonizing spasms--classic symptoms of tetanus, a bacterial infection contracted through open wounds. "The U.N. textbook didn't warn us about this," says Singaporean physician Charles Johnson, referring to the 16 tetanus cases admitted to his small emergency ward at Zainal Abidin Hospital in the provincial capital of Banda Aceh since Jan. 10. "We'll never know, but there are probably thousands of them out there."

Cholera, malaria and gastrointestinal disorders are usually what haunt the world's disaster zones. Yet in Indonesia two other diseases have caught emergency medical teams off balance. "Tetanus resulting from minor wounds, and aspiration pneumonia from sucking in seawater and all the cruddy stuff that goes with it--they're the most common medical problems we face," says Capt. Charmaine Tate, a military doctor from New Zealand. "There are wards full of them." Such patients constitute a second phase in the post-disaster health crisis in Indonesia, and ultimately will outnumber those who sustained major injuries as the tsunami hit, say doctors working in Banda Aceh. (Indonesian health agencies are also bracing for a potential malaria outbreak as unusually large mosquito breeding grounds multiply in the tsunami's wake.)

Tetanus, in particular, wasn't anticipated. In the late 1980s Jakarta won plaudits from the World Health Organization for achieving a 90 percent inoculation rate across the sprawling archipelago--a major step toward total eradication. …

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