Outreach, Relief

These are messages from May 7th & 8th from an Aid worker in Yangon:

May 8th

We received a phone call from our staff in the field this morning. They went out to Bogalay Township and went to a village familiar to them which is south of the town of Bogalay. The situation was very grim. No food, no water, many people with diarrhoea, dead bodies, desperate marauding groups scavenging materials and creating violence with others. The lack of security is bad enough that these teams we’ve supported are coming back today and needing to regroup.

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Back again with another update… Water is on my mind, so I’ll talk about that. I’m getting a crash course in the complexities of providing drinking water, so I’m going to share what I’m learning. Please understand this is all new to me and so I may not be exactly accurate, but I’m trying.

Out in the worst hit areas of the delta, there is already a huge problem with a very severe diarrheal disease. There is no safe drinking water available out there except for the minimal relief supplies that have been sent out there by helicopter by the Myanmar government, a result of various regional governments sending in cargo planes of supplies. So establishing a continuous supply of safe drinking water is an immediate critical need.

At a very minimum for survival, each person needs 2 liters of clean water per day. The more realistic amount is 10 liters a day per person. How can that be produced where it is needed? That is the question that is confounding everyone.

There are all sorts of barriers to helping that be available. Many of the drinking water sources were ponds that have now become too salty because they were contaminated with sea water last weekend and are now too salty to drink. Bodies, both human and animal, have contaminated many of the other water sources. People are dumping bodies in the rivers hoping that they will just go out to sea, but because many of the river banks low on the delta are estuaries and filled with mangroves, the dead don’t actually go out to sea, but get trapped in the mangrove roots.

Imagine a county in your home state losing 40000 people all at once, with more dying as a result of diarrhea, and trying to get rid of the bodies.

Add to that the wild and domestic animals that have died and you start to understand why desperation would drive people to think of sending the bodies into the river and out to sea. Unfortunately, it is not working and it adds to the contamination of the rivers, which aren’t flowing like typical rivers by the time they get to this area anyway.

So that’s the contamination story – but there’s more complexity to this water issue. An organization called PSI has been producing something called WaterGard. It’s a great product – chlorine that can be put into water supplies to make them safe. This stuff is available, but there are several problems. The use of WaterGard assumes that people have containers to put water in before it gets treated. It assumes that people have the ability to calculate the amount of WaterGard that is required to purify the amount of water they can put in their container and it assumes they have something to measure out the right amount of WaterGard. Unfortunately, these requirements aren’t available.

Next comes the issue of culture. People in Myanmar (much as people anywhere) think that dirty looking water is undrinkable. They also think that water that tastes like chemicals (chlorine) is undrinkable. WaterGard makes the water safe to drink, but it doesn’t make the water look clear or taste good. For this reason, people don’t want to use the WaterGard and prefer to use things like alum, which help make the water look clean by catching particles of sediment and making them heavier so they sink to the bottom and don’t hang suspended in the water, and make the water taste better. The bad news is that alum does nothing to reduce the contamination by disease-bearing elements. In order to make the water look and actually BE safe, people have to use the WaterGard along with the alum. This is a hard thing to convince people who are used to trusting their eyes and noses and taste buds to determine whether water is ’sweet’ or not.

So what is being done? One answer, our particular albeit imperfect way of helping to address this at least in the immediate term, is that we have encouraged another organization here, IDE, to give us four trial water baskets. These are plastic tarps that are molded and shaped to be a bit like a trough, a bit rigid and held together with a rudimentary frame, that can be quickly erected, filled with water, have a known volume and then can be treated with WaterGard in a premeasured amount.

We are going to send these out to the health team that left yesterday and see if they seem to hold up or are useful. If they are, IDE is going into production with many more water baskets and we will help resource another team of local people to get out into areas and distribute and set up a supply chain where these products can be used.

Each of these baskets can hold 810 liters of water, so enough to minimally supply 400 people for a single day. As long as there is a reasonable nearby source of water that isn’t salt contaminated, there would then be a hope of getting a temporary water supply answer going until the ponds can be pumped out of their salt water, the rivers can be cleared, etc.

We have never been in a relief situation like this one – it’s a real education for us about all the things that keep responses from being immediate, practical, realistic, etc.

We know you are thinking about all the people here and wondering how you can help. Lots of organizations are here working – the big ones are CARE, World Vision, Save the Children, UN, etc., but there are plenty more – HOPE, PSI, IDE, PACT, MSF, World Concern, and a host of local informal groups who are all trying to help people who desperately need every basic thing we normally take for granted.

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May 7th

As we had feared, initial reports from the affected areas seem to be reporting deaths in the 10s of thousands. I wouldn’t be surprised if the final death toll is in the 6 figures. The island of Pyinsalu alone, lost about 90% of its 40,000 population. Severe diarrhoea is being reported from two townships, with fears about cholera being present.

We just helped organize and resource a local partner with 50 staff going out as mobile medical teams to these areas. They are taking along chlorine concentrate for making safe drinking water, clothes, money to buy food, and medicines. They also have doctors (including surgeons) and nurses along for treating patients. They will be conducting assessments in areas they can access and determining how to best assist in the future.

One of our HOPE staff is going with them and will be leading the assessments and helping think about future activities with these communities. They will report back in one week.

Today we are getting the details pulled together to help send out a team of 50 local medical volunteers to head to the worst hit townships and seewhat the needs are and try to take care of some of the worst injuries. This team will travel with portable surgery suites, generators, medicines, etc. that have been built into small buses. They will go with 4WD vehicles to scout the road ahead and also to carry people from remote areas tothe buses. The initial time they will be gone will be 7 days according tothe current plan. Then they will come back with the information gatheredfrom the first trip, reprovision and head out again.

We have huge concerns about this, even though obviously it needs to be done. We just heard this morning that the Pyinsalone area of Labuttatownship has (so far unofficial) counts of around 40,000 people dead – this info comes from the World Food Program team that has been operating in the area since the tsunami at the end of 2005. Bodies are floating in the mouths of the Ayewaddy River and are being picked up by steamers operating in the area. This poses a major public health crisis for the area, for the health team and for the rest of the country.

We have learned from other situations how traumatized aid workers can become when they are confronted with death and destruction on this type of a scale. So naturally we are very concerned about the people we will be helping to send into this area, and have tried to prepare them for the effect this experience may have on them.

We ourselves can’t travel to these areas, primarily because our presence would draw off resources from others, and we’d just be there to understand the situation first hand, not to actually help with the medical care.

Personally, we continue to operate without any electricity since Friday night. We don’t have running water, but we have two outside groundtanks that are fairly full, so we are rationing our water usage quite tightly so that we don’t run into a crisis. We still have a couple weeks of drinking water if we ration that carefully as well. It is available, but very expensive.

We’ve had trouble sleeping for most nights so far, but once we get tired enough, we’ll be able to sleep regardless of heat, humidity or the buzz of a baby boom of mosquitoes.

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