The city of Chennai was greatly affected by the 2004 Sumatra Earthquake Tsunami. Ms. Usha Kakarla outlined the city’s recovery efforts, and her plan for maternal and child healthcare provision in the event of flooding.

1. The City

Lying on a flat plain with a low shelving beach, in the southeast corner of India, Chennai is subject to cyclones, floods, and tsunamis, natural disasters that bring epidemics to add to the physical and human destruction. That parts of the city are under sea level only adds to the city’s vulnerability when the natural disasters strike.

The city of more than four million has grown rapidly in the past half century to be a major sea and fishing port and India’s fourth largest city. It has also seen the progressive development of an effective urban infrastructure. Its primary and maternal and child health care systems provide effective immunization and reproductive health services. An extensive system of clinics staffed with trained professionals provides good public service, abetted by an equally extensive private medical system.

The most recent very serious natural disaster to hit Chennai was the great Tsunami of 2004. This brought death to more than 10,000, destroyed over 125,000 homes and hundreds of fishing boats as well as port and rail facilities. However, the destruction was limited to the immediate coastal area, leaving the resources of the rest of the city available to assist in rescue and rehabilitation. Some 30,000 survivors were sheltered in rapidly developed relocation centers. These were provided with medical facilities, food, water and sanitary facilities. They were also fogged for vector control. A measles vaccination campaign was speedily launched in the affected areas, using the disaster as an opportunity to promote child health. Special attention was given to maternal and child health services, and an innovative program of psychosocial support was developed to manage the trauma felt especially by women and children. One of the more tragic aspects of the disaster was that it hit women and children most heavily. Many men were away fishing on the sea; their boats easily road out the rise and fall of the waters only for them to return to find their families gone.

The city administration has wisely taken advantage of this disaster to strengthen its health services, especially with the help of international organizations like WHO and UNICEF.  The latter used the event to inaugurate its Integrated Management of Neonatal and Child Illness (IMNCI). The city also recognized that the disaster increases the vulnerability of girls and women, and steps were taken to protect against trafficking; and HIV services were added, almost as an afterthought. In this way, the disaster has had a positive impact.

Chennai’s location on a relatively low lying plain on the southern Indian Ocean subjects it to almost annual flooding from the monsoon rains. Although the nation, state and city have standing Crisis Management Committees, they lack any special attention to problems of maternal and child health care. This is considered especially important since women and children are typically the most vulnerable members of society and are often hardest hit by natural disasters.

Chennai’s tsunami devastated coastline

To TOP

2. The Proposed Action Plan

Ms. Usha Kakarla developed a plan of action to address this issue. The project basically aims to create a structure to plan for maternal and child health care during the predictable annual flooding. This will focus on preparedness for the first 48 hours after the disaster, when outside help has not yet arrived on a large scale. It will also generally strengthen the preparedness for any type of natural disaster, such as the 2004 tsunami. The plan will evaluate the risk of flooding for all areas of Chennai, produce maps of risk areas and safe areas, locate safe shelter areas, and plan for the mobilization of relevant officials to deal with the flooding. It will also plan for the stockpiling of medicines, water and equipment at designated shelter areas, and especially for water, washing and sanitary facilities where women and children have special needs and where they are often most vulnerable. The plan will call for all relevant agencies to develop their own disaster plans, closely integrated with the city wide plan. Finally, the plan calls for local governments in the city to appoint a local disaster coordinator who will be responsible for linking government and NGO services at the local level.

Chennai Action Plan Time Frame: September 2007 – July 2008