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