Tsunami Disaster in South and Southeast Asia

Tsunami in South and Southeast Asia: A Year Later

On Boxing Day 2004, a massive tsunami in the Indian Ocean destroyed hundreds of coastal communities and took the lives of over 200,000 people. One of the hardest hit regions was Banda Aceh in Indonesia.

Tragically, many Indonesian nurses were victims of the disaster. However, many more survived and went on to provide valuable care to those who so desperately needed it. One year later, the tsunami disaster provides nurses with hard-won lessons on catastrophe preparedness.

CNA is now working with the Indonesian National Nurses Association (INNA) to gain from the experience by identifying together what was done right and what could be improved. CNA brings valuable resources and expertise in emergency preparedness, especially when it comes to the role of nurses in a strong, effective response to emergency situations.

For INNA, the first step in the disaster response was to look for surviving nurses, since they could be a support to others. Unfortunately, damaged phone lines and electrical outages made it extremely difficult to contact many of them. Most were in tents with other survivors.

“We learned quickly how important it was to treat nurses as survivors first. Sometimes, the best thing was to keep them busy helping others,” explains Achir Yani S. Hamid, president of INNA. “Other times, they needed to vent their feelings of helplessness and hopelessness. Slowly and gradually, they took on more active roles as caregivers.”

As many as 80 per cent of the nurses in Banda Aceh were left destitute. INNA collected money, clothing, uniforms and notepads from Indonesia and other countries like Canada to help them.

INNA also mobilized 1,000 nurses from non-affected Indonesian provinces to join forces with the surviving nurses. Together, they cared for fractured limbs, infected wounds and broken hearts. Working side-by-side with doctors, they cleaned up any health facilities left standing and set up nursing care units in hospitals, field hospitals and camps.

INNA worked closely with government, non-governmental organizations (NGOs) and other health professional associations. According to Hamid, “Coordination of activities, resources and expertise was essential. I can’t tell you how important this is.”

A few months following the initial disaster response, INNA moved into the stage of rehabilitation and reconstruction. With support from the World Health Organization and national nursing associations like CNA, Indonesian nurses created a nursing development centre. It became the focal point for coordinating nursing care in Banda Aceh.

In collaboration with government, nursing faculties and local NGOs, INNA trained 330 nurses to attend to victims living in temporary barracks. Psychosocial support was a key component of the training, which encouraged self-help groups among nurse survivors. As well, training in community mental health nursing was provided for those nurses working in community health centres.

According to Hamid, “So much has been learned from the massive human tragedy caused by the earthquake and tsunami. With guidance from other national nursing associations like CNA, we’d like to integrate disaster nursing in the curriculum for undergraduate nursing studies. We also want to develop master’s programs in disaster nursing.

“We plan to provide continuing nursing education, workshops and seminars, in collaboration with CNA and other members of the International Council of Nurses. We’re even developing distance learning technologies for nurses working in remote areas of the country.”

Hamid’s future ambitions include working more closely with the Indonesian Ministry of Health, so that policy related to disaster nursing is strengthened. She’d also like to write a book about her experience with the tsunami response, so nurses can be better prepared for disasters in the future.

“Perhaps the biggest lesson I’ve learned is that, even after so much has been done by nurses, their work is still invisible. We have to find a better way for nurses to be recognized, here and around the world.”