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Cablegate: Burma: Health Situation in Irrawaddy Delta

VZCZCXRO4043
RR RUEHCHI RUEHDT RUEHHM RUEHNH
DE RUEHGO #0379/01 1351123
ZNR UUUUU ZZH
R 141123Z MAY 08
FM AMEMBASSY RANGOON
TO RUEHC/SECSTATE WASHDC 7597
RUCNASE/ASEAN MEMBER COLLECTIVE
RUEHBJ/AMEMBASSY BEIJING 1878
RUEHBY/AMEMBASSY CANBERRA 1191
RUEHKA/AMEMBASSY DHAKA 4883
RUEHLO/AMEMBASSY LONDON 2028
RUEHNE/AMEMBASSY NEW DELHI 4735
RUEHUL/AMEMBASSY SEOUL 8279
RUEHTC/AMEMBASSY THE HAGUE 0682
RUEHKO/AMEMBASSY TOKYO 5841
RUEHRO/AMEMBASSY ROME 0166
RUEHFR/AMEMBASSY PARIS 0585
RUEHCN/AMCONSUL CHENGDU 1477
RUEHCHI/AMCONSUL CHIANG MAI 1598
RUEHCI/AMCONSUL KOLKATA 0335
RUEAUSA/DEPT OF HHS WASHDC
RHHMUNA/CDR USPACOM HONOLULU HI
RUEHPH/CDC ATLANTA GA
RUCLRFA/USDA WASHDC
RUEHRC/USDA FAS WASHDC
RHEHNSC/NSC WASHDC
RUCNDT/USMISSION USUN NEW YORK 1613
RUEKJCS/SECDEF WASHDC
RUEHBS/USEU BRUSSELS
RUEKJCS/JOINT STAFF WASHDC

UNCLAS SECTION 01 OF 03 RANGOON 000379

SENSITIVE
SIPDIS

DEPT FOR EAP/MLS, SES-O
BANGKOK FOR REO OFFICE, USAID/RDMA, USAID/OFDA
PACOM FOR FPA

E.O. 12958:N/A
TAGS: ECON TBIO EAID SOCI PGOV AMED BM
SUBJECT: BURMA: HEALTH SITUATION IN IRRAWADDY DELTA

REF: A) RANGOON 376 and previous

RANGOON 00000379 001.2 OF 003


1. (SBU) Summary. According to the World Health Organization
(WHO), health conditions in the Irrawaddy Delta continue to
deteriorate, as hundreds of thousands of people lack access to food,
potable water, shelter, and medicines. Shipments of water were
beginning to reach the delta and a senior WHO medical officer
encouraged international donors, including the U.S., to continue to
send bottles of water with our relief supplies. Health
professionals remain concerned about the spread of diseases,
including cholera, dysentery, and measles. Many people in both
Rangoon and the Irrawaddy Delta suffer from diarrhea and dehydration
as a result of post-Nargis conditions, although the Ministry of
Health (MOH) has yet to confirm any cholera cases. The MOH has sent
more than 150 medical officers to Irrawaddy Division to provide
medical treatment, medicines, and supplies to thousands of displaced
people living in more than 70 temporary camps and shelters. The MOH
claims there is no shortage of doctors in the delta area; instead
the challenge is how to best deliver medicines and treatment to the
people. Working with Ministry of Health and NGO officials on the
ground, UN agencies have provided water purification tablets, basic
medicines, cholera test kits, tetanus shots, and measles
vaccinations for those in need. End Summary.

Medical Care in Irrawaddy
-------------------------

2. (SBU) According to Dr. Nihal Singh, the WHO Medical Officer
responsible for coordinating cyclone-related health assistance,
health conditions in the Irrawaddy Delta continue to deteriorate.
Hundreds of thousands of people have been displaced from their homes
and are living in unsanitary conditions in more than 70 camps and
shelters, located in schools, churches, and monasteries across the
region. They have limited access to potable water, food, and
medicines. Dr. Singh confirmed that Cyclone Nargis destroyed the
majority of health facilities in the Irrawaddy Delta, including the
private medical clinics where more than 80 percent of the local
population had previously sought care. Many Ministry of Health
(MOH) townships clinics and laboratories were also destroyed. The
WHO reported that larger local hospitals, including the Bogalay
General Hospital and Labutta General Hospital, remain open for
business, although they lack electricity, basic medicines, and
available beds. Hospitals are only providing basic care, Dr. Singh
noted.

3. (SBU) MOH officials claim that while there is an overall lack
of medical facilities, there is no shortage of doctors to provide
necessary care. Dr. Singh emphasized that MOH doctors are not the
only ones providing care. Many private doctors from Irrawaddy
Division and Rangoon have traveled to the affected areas to assist.
PSI Country Director John Hetherington told us that many PSI Sun
Clinic and staff doctors traveled to Irrawaddy Division to provide
free care to patients in need. Additionally, MSF-Holland sent 35
medical staff to the Delta region, where they set up temporary
clinics for medical consultations and treatment. Other NGOs, such
as Merlin, Medicins du Monde, and Malteser, also sent medical teams.
In addition to providing doctors, NGOs such as Save the Children,
CARE, PSI, and Action Contre la Faim (ACF), are also providing
relief supplies, such as water purification tablets, mosquito nets,
food stuffs, and medical kits, Hetherington stated.

4. (SBU) WHO assessment reports confirm that local hospitals and

RANGOON 00000379 002.2 OF 003


doctors in the affected areas continue to treat hundreds of patients
with cyclone-related injuries. Many hospitals, including the 50-bed
hospital in Bogalay, are full, so doctors can provide only
outpatient services, primarily for trauma, acute respiratory
infection, and diarrhea. Dr. Singh noted that hospitals often have
long lines during the day as people queue for care. Embassy
contacts witnessed the Bogalay General Hospital turning away
patients. There is a shortage of basic medicines, he emphasized.
The WHO and other UN agencies continue to provide hospitals,
clinics, and doctors with medicines, basic first aid kits, and
surgical masks and gloves.

5. (SBU) In addition to providing relief supplies and health
treatment, UN agencies are also conducting assessments of the health
situation in the Irrawaddy Delta, Singh stated. UNICEF staff are
monitoring hospitals and clinics in Bogalay, Labutta, and Ngapudaw
and should release a report on available services by the end of the
week. The WHO on May 10 sent eleven medical officers to the
affected areas to identify the greatest health needs and conduct
disease surveillance.

No Confirmed Outbreaks of Cholera
---------------------------------

6. (SBU) According to Dr. Singh, there is a significant threat of
water and vector borne diseases, particularly cholera, typhoid, and
dysentery, so access to clean water is the highest priority. While
the UN, GOB, and NGOs are providing water purification tablets and
bleach powder to those living in infected areas, the shortage of
water containers in the Irrawaddy Delta makes it difficult to treat
and store potable water, Dr. Singh admitted. Shipments of purified
water have begun to reach the Delta, and he encouraged international
donors, including the U.S., to continue to send bottles of water
with our relief supplies.

7. (SBU) Dr. Singh disputed news reports of cholera outbreaks in
the Irrawaddy Delta and Rangoon, although he acknowledged many
reported cases of diarrhea and dehydration, particularly among
children, in the cyclone-affected areas. Outbreaks of diarrhea in
this situation are normal, he opined, noting that people were living
in unsanitary conditions with limited access to clean water.
However, just because someone has diarrhea does not mean they have
cholera, he noted. The MOH is conducting stool sample tests at the
Pathein laboratory to determine whether there was a cholera outbreak
in the region. Sample testing takes a minimum of three days; the
MOH has yet to confirm any cholera cases as of May 13, Dr. Singh
informed us.

8. (SBU) The WHO is also monitoring cholera outbreaks in Rangoon.
According to WHO figures, there have been more than 150 diarrhea
cases and 40 dysentery cases in two townships in Rangoon since the
cyclone. Private doctors and government hospitals continue to refer
potential cholera cases to the government-run Webagi Hospital, which
handles all infectious disease cases. To date, there have been no
confirmed cases of cholera in Rangoon. WHO and MOH officials
continue to monitor the situation closely.

Combating Other Diseases
-------------------------

9. (SBU) While cholera and dysentery are the most immediate threats
to health in the affected areas, the MOH and WHO remain concerned

RANGOON 00000379 003.2 OF 003


about other infectious disease epidemics, including malaria, dengue,
and measles. Those providing health services in Irrawaddy Division,
including NGOs, are using the WHO disease surveillance form to
collect and report on any diseases. Using this information, WHO
officials monitor the situation and can prepare to treat any
epidemics, should they occur, Dr. Singh observed.

10. (SBU) Doctors in Labutta, Bogalay, and Pyapone on May 11 began
administering measles vaccines and vitamin A shots, provided by
UNICEF, to children under 10 years old living in temporary shelters.
Tetanus shots should be available in the next few days, Dr. Singh
noted. Doctors in the region have also begun to watch for malaria
outbreaks, and should use WHO-donated malaria rapid test kits to
detect the disease. UN agencies and international donors continue
to provide internally displaced persons with long lasting
insecticide-treated mosquito nets to ward off malaria and dengue.

Comment
-------

11. (SBU) The death toll from Cyclone Nargis is already high - the
UN estimates that approximately 100,000 people are dead or missing.
As health conditions in the Irrawaddy Delta continue to deteriorate
and access to clean water remains limited, the number of deaths
could increase dramatically. Without relief supplies, people will
die from dehydration, cholera, and other infectious diseases. The
UN and many NGOs have begun successfully delivering relief supplies
to some of the people, but supplies of clean water, food, and
medicines remain far short of the needs. Continued U.S. assistance
will help meet the needs of the two million Burmese affected by the
cyclone and will help save thousands of lives.

VILLAROSA

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