Emergency and Humanitarian Action (EHA), WHO Indonesia. Mt. Merapi Volcano Eruption, Central Java Province, Republic of Indonesia

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dormancy. The second-most significant eruption came on Nov. 5, 2010. Up to 20th November 2010 at around 18:00 pm local time, the Centre of Vulcanology and Disaster Mitigation reported that Mt.

1 Emergency and Humanitarian Action (EHA), WHO Indonesia Emergency Situation Report Mt. Merapi Volcano Eruption, Central Java Province, Republic of Indonesia HIGHLIGHTS Mount Merapi began unleashing torrents of hot gas, rock and other debris since 26 th October 2010 after years of dormancy. The second-most significant eruption came on Nov. 5, Up to 20th November 2010 at around 18:00 pm local time, the Centre of Vulcanology and Disaster Mitigation reported that Mt. Merapi s activities remained on the alert level 4. The death toll from Mount Merapi s ongoing eruption is now 304. Crisis Centre also reported number of inpatients are 467, and more than 256,698 person became internally displaced. MOH, Regional Crisis Center of Central Java, D.I Yogyakarta Provincial Health Office and Magelang, Boyolali, Sleman and Klaten District Health Offices are in close collaboration with WHO Indonesia, provided integrated Emergency Health Services according to Standard Operating Procedures. Caption: Indonesian army evacuated the victim in Glagaharjo, Cangkringan, Sleman District Source: Antara Caption: Situation of and IPD camp in Maguwoharjo Stadium, Sleman District, Yogyakarta Province. Source: Antara Situation Analysis The National Agency for Disaster Management (BNPB) stated that volcanic activity has declined sharply and Merapi's current eruptions are not strong enough to endanger people. This situation has led the government to further reduce the restriction zone for the second time since last week. In the most threatened areas, south of the crater, the zone was reduced to 15 kilometers from 20 kilometers. The government has started the construction of 300 temporary housing units for people displaced by the Mount Merapi eruptions. The temporary houses would be prioritized for those living nearest to the volcano s crater as their residences were the most severely damaged by the ongoing volcanic eruptions. The number of IDPs had now declined to 256,698 from a peak of 400,000 two weeks ago. 1

2 Casualties and Damages Table showing casualties & damage: Casualties resulted from series of eruption since 26 October 2010 up to 20 November 2010: Dead Inpatient(s) IDP Damaged Health Facilities , (Source: Crisis Center as per 20 November 2010 at WIB) The number of IDPs in 743 IDP sites is shown in the following table: District Registered IDPs D.I Yogyakarta Province Sleman 109,834 Kulonprogo 9,631 Bantul 19,651 Gunung Kidul 12,162 Yogyakarta 4,293 Sub Total of Yogyakarta Province Central Java Province Magelang 55,020 Boyolali 3,345 Klaten 37,066 Magelang City 3,268 Kab. temanggung 2,428 Sub Total of Central Java Province 101,127 Grand Total 256,698 Source: Crisis Center, Ministry of Health, as per 20 November 2010 The following are number of health problems among IDPs in Yogyakarta Province (Up to 19 November 2010): No Type of Disease Percentage 1 Gastritis 4,88 % 2 Acute Pharyngitis 5,10 % 3 Dermatitis 5,67 % 4 Dyspepsia 5,81 % 5 Eyes Irritation 6,37 % 6 Hypertension 10,19 % 7 Common Cold 11,16 % 8 Myalgia 10,57 % 9 Chepalgia 13,77 % 10 Acute Respiratory Infection 26,48 % Source: Crisis Center, Ministry of Health, as per 13 November 2010 The following are number of health problems among IDPs in Central Java Province (Up to 19 November 2010): 2

3 No Type of Disease Percentage 1 Dental Problem 3,4 % 2 Eye Irritation 4,3 % 3 Diarrhea 5,3 % 4 Gastritis 5,6 % 5 Febris 6,0 % 6 Hypertension 7,1 % 7 Myalgia 8,3 % 8 Headache/Dizziness 9,0 % 9 Skin irritation 11,1 % 10 Acute Respiratory Infection 39,7 % Source: Crisis Center, Ministry of Health as per 19 November 2010 Communication, Transportation and Electricity Power Yogyakarta International airport, which had been closed for about two weeks by the eruption of the Mount Merapi volcano, reopened for operations on Saturday 20 th November 2010, as the mountain's activity level has now decreased, although an alert remains in place. Ministry of Transportation stated that the effect of volcanic ash has been insignificant. Needs Below are the lists of estimated cost needed for the early recovery and rehabilitation activities by the District Health Office of Magelang. No Cost needed Amount 1 Cost due to the damaged health facility and infrastructure 319,500,000 2 Cost due to the risk of the emergence of malnutrition 3,347,181,000 3 Cost due to the damage of Posyandu 689,400,000 4 Cost due to reduced quality of maternal and child health 108,000,000 5 Costs due to increased health risks in elderly 39,000,000 6 Costs due to increase in high-risk pregnant and lactating women in the 21,550,000 disaster-affected areas 7 Cost of post-disaster psychological trauma in children 360,000,000 8 Cost due to increased risk of diseases that can be prevented by immunization 10,000,000 9 Cost due to reduced quality of clean water resources 432,000, Cost of the increased risk of epidemics and potential disease outbreaks 12,500, Cost due to the economic impact vary Total IDR 5,339,131,000 MOH WHO Indonesia Response Setting-Up the Integrated Health information Post - Ministry of Health has assigned Dr. Khrishnajaya as the coordinator of Health Crises Response in Disaster Team. 3

4 - Integrated health information command centers had been established in the Provincial Health Office of Yogyakarta and Central Java Province. Coordination Meting - Daily coordination meeting for the health sector is conducted in the Hall C of Yogyakarta Provincial Health office at around 13:30 up to 15:30 pm. - Cross-programme coordination meeting is conducted once every two days in MOH central level Jakarta, led by Secretary General. - Coordination meeting for Disease Control & Environmental Health (CD&EH) MOH was conducted on 20 th November 2010 led by DG of CD&EH. Providing Medical Services in the Health Post - The number of patients treated in the health post starting from 26 October 2010 up to 19 November 2010 are 33,841 people (24,248 from Yogyakarta Province and 9,593 are from Central Java). - Sleman District Health Office has temporarily relocated some community health centre (Puskesmas) within the danger zone, radius of 20 kilometers around the summit. Disease Control and Environmental Health - Directorate of Disease Control and Environmental Health, Ministry of Health has been conducting the following activities: a. Surveillance activities for the potential disease outbreaks of respiratory infection, diarrhea, measles, and plague. b. Water quality monitoring and improvement of environmental sanitation. c. Waste management and disinfectant spray. d. Basic immunization. e. Survey to the IDP sites for early detection of diseases which could be prevented with immunization. f. Establish the Environmental Health Contingency Team consisting of the Provincial and District Health Office, to carry out the following activities: 1) Data collection of environmental health surveillance 2) Monitoring of water quality 3) Monitoring of air quality 4) Vector Borne Disease Control 5) Monitoring of environmental sanitation, including food Psychosocial and Mental Health Services - Directorate of Mental Health MOH and Magelang Psychiatric Hospital has conducted the first batch of Psychology First Aid ToT (18-20 November 2010) in Yogyakarta and Klaten, and also has conducted mental health rapid diagnostic test in 15 IDPs camps with the following result: o 595 people (3.5% from 7,223 people) are detected to have mental health problems by using rapid diagnostic test. o Most cases are Insomnia (18 %), Post traumatic Stress Disorders (13.78 %) and mix anxiety & depression (1.68 %), Anxiety (5.37 %), Psikosis (1.84 %), Depression (4.36 %), schizophrenia (0.67%) and others (52.6 %). o Magelang Psychiatric Hospital provided hand exercise for children in 4 IDPs camps in Magelang District. o Directorate of Mental Health, MOH strengthen the cordination with Prof. Dr. Soeroyo, (Magelang), Dr. Soejarwadi (Klaten), Amino Gondohutomo (Semarang), Surakarta, (Solo), and Grhasia (DIY) psychiatric hospitals, Clinical Psychologist Association (IPK), HIMPSI, Indonesian Psychiatric Association (PDSKJI, National Indonesian Nurse Association (PPNI). o Directorate of Mental Health, MOH will mobilize resources from DIY, Klaten, Magelang, Solo, Semarang, Jakarta, Lawang, and Bandung psychiatric hospitals, 4

5 o Emergency Situation Report psychology and psychiatric faculty of UGM and psychiatric faculty of UI. National Indonesian Nurse Association (PPNI) will conduct training of trainer (ToT) divided into 2 batches for human resources for heallth and educational institution from Semarang, Yogyakarta, Solo, Klaten and Magelang. The topic are as follow : (i) volcanology, (ii) mental health and pscychosocial, (iii) role play, (iv) assesment by using Self Rating Questionaire (SRQ) (Riskesdas) and (v) anxiety. Nutritional Services - Directorate of Community Nutrition has delivered the following nutritional service: o Monitor and distribute 85,5 tons of fortified biscuit to 7 affected districts including Maguwoharjo and Youth Center IDP Camps. o Anthropometric screening of Nutritional Status of Under-Fives and Pregnant Women. o Restriction of infant formula distribution, conduct monitoring and Lactation counseling o Deploy 8 breast feeding counselors to 4 IDPs camps (Lembugrejo, Sumber rejo, Catur harjo and Rusmanda) o Conduct mass campaign on the topic of breast feeding, healthy life style and environmental health in 11 IDPs camps. Health Services in the Hospital - 20 hospitals have been providing health service for victims of Mt. Merapi eruption. - The total amount of hospital free service claim is 641,661,392 Rupiahs or equal to 71,894 USD. Health Promotion Activities - Centre for Health promotion conduct the advocacy and socialization activities on Healthy Lifestyle in Klaten, Central Java Province and Sleman, Yogyakarta Province. Disaster Victim Identification - MOH conduct Disaster Victim Identification activity in collaboration with National police Department. Field Hospiptal - Ministry of Health Field Hospital and field hospital s scenario team will be established in Magelang Psychiatric hospital. Human Resources for Health - Board For the Development and Empowerment of Human Resources for Health, MOH will prepare the human resources for health from : o Polytechnic Surakarta for Klaten and Boyolali districts. o Polytechnic Yogyakarta for Yogyakarta districts. o Polytechnic Semarang for magelang districts and city. Those human resources for health will join surveillance team from DI Yogyakarta and Central Java provinces and Gadjah Mada University team led by Prof. Laksono. o D4 health workers for mental health counselors and join the DG of Mental Health, MOH National Institute for Health Research and Development will conduct health impact analysis on volcanic ash. Provincial Health Office A Hospital Forum will be established and daily meetings will be held to discuss data collection and process development; a feed back system with SMS Getaway and will be developed. Di Yogyakarta Provincial Health Office provides 24-hour hotline for better data and information update as well as better coordination. Main Post of Yogyakarta Provincial Health Office is located on Jln. Tompeyan TR III 201. Phone. (+62274)

6 Main Post of Central Java Provincial Health Office (Regional Coordination Agency of Magelang) is located on Jln. Diponegoro No. 1. Magelang. The contact Person is Dr. Djoko Mardiyanto, M. Kes ( ). Central Java Provincial health office will establish trauma center and measles immunization response object in each IDPs camps. North Sulawesi and South Sumatera Provincial health offices will provide medical service in DI Yogyakarta province. District Health Office So far MOH has mobilized 1,163 medical and non-medical resources with the following details : Type of Resources Magelang Klaten Boyolali Sleman External District District District District 1. Specialists GP Dentist Nurses Midwives Pharmacist Sanitarian Nutrition Nurse Surveillance Driver Immunization Health promotion General Administration Loboratorist Others Total Follow-Up Actions Directorate of Mental Health, MOH, Magelang Psychiatric Hospital and Crisis Center Psychology University of Indonesia and National Disaster Management Agency will conduct Psychology First Aid for 200 health workers in 5 Psychiatric Hospital in (Yogyakarta, Solo, Semarang, Klaten and Magelang) which will be held as follow : o Yogyakarta and Klaten on November 2010 o Magelang and Semarrang on November 2010 Ministry of Health will conduct verification for 2 nd batch of hospital free-service claim on November MOH is considering to evacuate the patients treated in hospital. Dr. Sardjito if the danger zone is expanded to 25 km (additional field hospital has been prepared). MOH will conduct the screening of nutritional status of children and pregnant women in the IDP camps. Around 5,000 people are targeted for measles vaccination in Yogyakarta Province. UNICEF will provide hygiene kit along with the promotive and preventive leaflets. Central Java PHO will conduct the rehabilitation activities for the IDPs, establishing trauma center (psychology) and measles immunization in each IDP Camps. In cooperation with UNICEF, a joint measles campaign and vaccination program will be conducted in the IDP sites in Yogyakarta and Central Java Province. 6

7 To conduct the ARI- related research on the impact of volcanic ashes to human health. Develop the area mapping of the damage health facilities. To develop the repatriation procedures for the IDPs concerning the environmental health aspects. To undertake the water samples and inspection of air and soil in the resettlement. MOH will do the bacteriological quality control of processed food in the IDP camps Risk Factor and Vector Control: a. To continue the disinfectant spray b. MOH in coordination with BNPB will continue the disinfectant of animal carcasses in the red area. c. Plague disease control by conducting surveys in the alert zone. d. Addition of polybags to intensify the waste management in the IDP Camps. Status of International Aid So far the government has not officially requested any international aid. The local authorities, with support from central government and ministries, are trying their best to manage the situation so far. Important Contacts JAKARTA OFFICE FOCAL PERSON CRISIS CENTER -MOH No Name Designation Phone Fax Address 1 Mr. Mudjiharto, SKM, MM Head of Department ppkdepkes@yahoo.com 2 Dr. Lucky Tjahjono Head of Emergency ppkdepkes@yahoo.com Response & Recovery Unit 3 YusRizal, M.Epid Head of Information and Monitoring Unit ppkdepkes@yahoo.com EHA-WHO JAKARTA No Name Designation Phone Fax Address 1 Dr. Nagi M. Shafik Medical Officer shafikn@searo.who.int 2 Dr. Suci Melati Wulandari Program Officer wulandaris@searo.who.int 3 Ms. Intani Nur Kusuma Information Officer kusumai@searo.who.int Source of Information from Indonesia Information is gathered from the following sources. This report is for reference only and should not be quoted as factual accuracy can change. 1. WHO 2. Crisis Center (PPK), MoH 3. UN System 4. BNPB 5. Local and international news media 7

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