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WHO Tsunami Disease Warning Questioned

Posted on: Friday, 10 June 2005, 12:00 CDT

LONDON -- Scientists on Friday called into question a World Health Organization warning made two days after the Asian tsunami that the disaster's death toll could double from outbreaks of disease - a situation that never came to pass.

The Dec. 26 tsunami devastated coastal communities around the Indian Ocean, prompting a WHO official to warn disease could double the death toll - an assertion that some experts said Friday had more to do with fundraising than medical science. Others said there was a real risk, but that putting a number on it was unwise.

"There was in fact no danger at all of a huge epidemic, but there was a kind of collective sensationalism," said Dr. Wim Van Damme, a professor of public health at the Institute of Tropical Medicine in Antwerp, Belgium. "It's also a good way of raising resources, and that's, I think, what happened and it's very disappointing that indeed WHO rather sensationalized it."

Speaking at a scientific meeting in London of Medecins Sans Frontieres, an international aid group, Van Damme said communities hit by the tsunami, which killed 176,000 people, were relatively well fed and spread over a huge area.

"It was pretty clear for people who know the situation that there wouldn't be any big epidemics at all," he said.

The tsunami, triggered by an earthquake that struck off the coast of the Indonesian island of Sumatra, also left about 50,000 people missing and hundreds of thousands homeless.

On Dec, 28, two days after the tsunami, as international organizations struggled to get a clear picture of the scope of the disaster, Dr. David Nabarro, a WHO expert, told reporters the death toll - at time thought to be 50,000 - could double from disease.

Experts feared dirty water and cramped conditions in relief camps could spark outbreaks of waterborne diseases such as cholera, dysentery and typhoid. Stagnant flood waters could provide massive breeding grounds for mosquitos that spread malaria and dengue fever, the said.

But most of those displaced by the tsunami in Sri Lanka moved inland into normal environments, and those in the worst-hit zone of Aceh in Indonesia settled into small camps soon after the disaster. Both those factors greatly reduced the chances of outbreaks, and disease did not kill large numbers of people.

WHO spokesman Iain Simpson defended the early assessment Friday, saying Nabarro's statement "was made based on the information which we had at the time ... we don't think it's particularly helpful to go back over that now."

Simpson also declined to comment on the fact that as the picture became clearer in the weeks following the tsunami and the estimated death toll rose above 150,000, the WHO did not back away from the warning that it could double.

Dr. Rowan Gillies, president of the International Council of Medecins Sans Frontieres, said there was no epidemiological or medical basis for the WHO claim.

"We felt there was a risk of epidemics, but to say the death toll would double? There doesn't seem to be a sound basis for that. I'd like to see what they based their data on," Gillies said.

But Dr. Philippe Guerin, an expert from Epicentre, a Paris-based aid group linked to Medecins Sans Frontieres, said no experts had been to some of the areas hit for around four years, making it harder to come up with accurate projections.

"It's a bit simple to say that with this disaster we knew there would be no outbreak. We didn't know. We thought there was a risk, and the risk was there," he said. "There could have been a huge concentration of population. If that had happened there probably would have been outbreaks."

Still, the WHO should not have quantified the risk without evidence, he said.

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Source: Associated Press/AP Online

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