The response

For the acute phase of the emergency, the Aceh Provincial Health Office was augmented by staff from the Ministry of Health in Jakarta and with teams from the WHO. The latter included representatives from the Global Outbreak Alert and Response Network (GOARN) (Ministry of Health, Indonesia et al., 2005). The major goal of the Provincial Health Office and GOARN was to establish an early warning and surveillance response network (EWARN) system for prompt detection of epidemic-prone diseases, to facilitate outbreak investigation, and to implement control measures.

The EWARN was rapidly established. The target population included displaced persons and residents. The major sources of information were health facilities and public health laboratories under the supervision of national and international governmental and non-governmental organizations. The system was developed for syndromic surveillance to identify acute diarrhea, bloody diarrhea, fever of unknown origin, dengue, jaundice, measles, meningitis, malaria, tetanus, and URIs. Data were collected on morbidity and mortality on a weekly basis for persons under or over the age of five years. The system was complemented by an alert system based on daily telephone calls, text messages, and e-mail reporting. Alerts were followed by verification and investigation. The results of these activities were presented and discussed at conferences held twice weekly, with the involvement of over 50 agencies.

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