MEDICAL REPORTS FROM SIMEULUE WEST COAST

Batavia's medical teams can work jointly or can split up into 2 or 3 teams depending on the requirements in the field. It was not possible to provide advanced warning of our visit to the local authorities during our initial visits to these areas and it is reasonable to assume that the number of patients that did not hear in time will far exceed the number who could get to the clinics. Ideally Batavia should spend 3-4 days in each area to ensure that more remote villages are given sufficient time to travel to the clinic location or alternatively, to give our teams time to reach these remote areas.

ACCESS ISSUES
Each location visited presents specific challenges. All locations to date are isolated from 4 wheel transport. Motorbikes are the only option for towns on the mainland and the condition of roads is very poor especially after rain. Bridges are either destroyed by tsunami/quake damage or under construction with temporary coconut pole causeways limited to very light traffic. Many of the coconut causeways were damage in the March 28th quake. About 50% of smaller bridges have suffered abutment collapse resulting in very steep approaches and level changes of between 30cm and 60cm. Timber is available in some locations but not all making even motorbike travel dangerous in wet conditions.



Heavy surf restricts landings to a few beaches or coves. Uplift has complicated approaches to these locations and no revised marine charts are available. Each location requires a detailed survey and final approach by speed boat. Very few local boats remain in service after the Dec 26th tsunami.

No security issues encountered by our medical teams and the local community very appreciative of help offered. Rental of local vehicles is expensive. High prices paid by international aid agencies are 3 to 4 times local rates and it is a sellers market. Fuel prices are 200% of the official retail rate. (Rp5-6,000 per ltr).

PROGRESS - COMPLETION
Total catchment we have been asked to assess totals 24,000 persons. The villages included in the clinics to date total less than 6,000 so there is a pressing need to continue this work as soon as possible. A total of 1,310 patient consultations were completed and medications provided to most.

Medical Mission to Simeulue is 25% complete based on RI Govt requests. The remote Salang subdistrict has not been assessed yet.

SUPPORTING MEDICAL AGENCIES
Northwest Medical Teams International, Mirta Peduli, and Obor Berakat.
Total team:
2 Doctors NWM, 1 Surgeon's Assistant, 1 Reg Nurses
5 Doctors OB, 2 Reg Nurse
3 Doctors MP, 1 Reg Nurse
Total 15 persons

In response to a request by the BUPATI of Simeulue, our teams have visited the following locations:

Date: 8 April 2005
Location: Palau Teupah, Simeulue. Mobile, non permanent site. Access by boat and foot.
Availability of medical care: inadequate
Total Providers: 9
Total Support staff : 6
Total Consultations: Outpatient-154
Total Emergent Referrals-0
Top 3 diagnosis: Upper Respiratory infections, Rashes, Anemia, Suspected Malaria

Date: 8 April 2005
Location: Catchment area** of Sumur (including Puskesmask) Access by boat and foot.
Availability of medical care: Adequate in town but transport very difficult for IDPs in more remote camps.
Total Providers: 1
Total Consultations: Outpatient—survey, less than 10 persons
Total Emergent Referrals—0

Date: 9 April 2005
Location: Catchment area** of Kampung Aie (including Puskesmask) Access by boat and motorbike/trike & borrowed vehicle
Availability of medical care: Adequate in town but transport very difficult for IDPs in more remote camps.
Total Providers: 9
Total Consultations: Outpatient-562
Total Emergent Referrals-0
Top 3 diagnosis: Gastrointestinal complaints, Rashes, Upper Respiratory infections
**Desa Kuta Baru
Desa Latitih
Desa Laureeh
Desa Aie
Desa Lemayang
Desa Kuta Padang

Date: 10 April 2005
Location: Catchment area** of Kampung Aie (including Puskesmask) Access by boat and motorbike/trike & borrowed vehicle
Availability of medical care: Adequate in town but transport very difficult for IDPs in more remote camps.
Total Providers: 9
Total Consultations: Outpatient-594
Total Emergent Referrals-0
Top 3 diagnosis: Anemia, Gastrointestinal complaints, Rashes
**Desa Luansurip
Desa Lambayah
Desa Latubang
Desa Seube
Desa Borengan