Infectious diseases pose a grave threat to flood and landslide victims across Aceh, North Sumatra, and West Sumatra. A concerning surge in cases of fever, diarrhea, and Acute Respiratory Infections (ARIs) was recorded in these three provinces between November 25 and December 2, 2025, according to the Ministry of Health.
In Tapanuli Tengah Regency, North Sumatra, for instance, patients presenting with complaints of “cough, flu, fever, and itching” skyrocketed by an alarming 400%, reported the local health agency. BBC News Indonesia investigations in Sibolga City and Tapanuli Tengah Regency uncovered a severe clean water crisis, widespread garbage, and overcrowded displacement camps, exacerbating these public health concerns.
What are the conditions like in Sibolga City and Tapanuli Tengah?
Vehicles traversing the asphalt roads churn up thick clouds of dust that cling to everything, from the ankles to the sweat-slicked faces of passersby. This pervasive dust is directly inhaled by many who lack masks, contributing to respiratory issues in the already vulnerable population.
Further compounding the environmental distress, flood-swept mud, now mixed with refuse, has hardened into formidable mounds of clay. While some piles of garbage are being burned, others are left to fester, swarming with flies. This grim panorama is commonplace along numerous roads in Sibolga City and Tapanuli Tengah Regency, observed on Saturday, December 6. Both regions had previously been identified by the National Disaster Management Agency (BNPB) as areas requiring “serious attention.” Ten days after the devastating floods and landslides claimed over 150 lives, these areas remain far from recovery.
Rekson Charles Pardede and Rismawati Samosir, a married couple, are deeply anxious about the health of their 11-month-old child. Directly in front of their home lies a one-meter-high mountain of trash, originating from nearby houses. “We had some trash here before, but since the flood, there’s just so much. From when the flood hit until today, none of it has been collected,” Rekson told BBC News Indonesia reporter Muhammad Irham.
Beyond being an unsightly nuisance, these accumulating piles of waste are a potent breeding ground for disease. “We’re worried. All this trash definitely affects our baby’s health. My child even had a fever for two days,” Rismawati shared. The couple has implored the local government to promptly remove the waste, yet the post-flood and landslide garbage problem is proving to be far more complex than it appears.
See also:
- Waves of disease threaten Sumatra flood child victims amid very low basic immunization coverage
- Sumatra flood victims face clean water crisis; can rainwater and rivers be consumed?
A few kilometers from Rekson and Risma’s residence, a small group of women, their faces covered with makeshift cloth masks, diligently load trash into trucks. Aditya Wardana Cambak, a sanitation field supervisor from the Tapanuli Tengah Environmental Agency, admits his team is severely understaffed for the monumental task of waste removal. “Some of our members haven’t come in; they were affected by the disaster. Only a fraction of us are here, only those who can work on the trash in Tapteng,” he explained.
Amidst these significant personnel limitations, Aditya and his team are in a desperate race against time to mitigate the potential for disease outbreaks stemming from the post-disaster waste. Beyond the challenge of waste management, another critical source of illness that frequently emerges after floods is the pervasive crisis of clean water.
In Tapanuli Tengah, many residents are compelled to use ditch water for washing clothes and household items caked in mud. Disturbingly, even kitchen utensils, dining ware, and drinking containers are rinsed in this same ditch water. The particular ditch encountered by BBC News Indonesia in Pandan District, Tapteng, originally served as a household wastewater drain. Following the flood, this two-meter-deep ditch became choked with mud. Over it flows brown, foul-smelling water sourced directly from a nearby river.
Jasman Mendropa, a local resident, described Pandan District as “quite severely” impacted by the floods and landslides. “Because there’s truly a water crisis, the PAM water (tap water) system isn’t active yet and is still undergoing repairs, the community is temporarily using ditch water for washing,” he elaborated. For drinking and other daily clean water needs, residents must trek two kilometers to collect it from mountain springs or purchase it from local mountain water providers. “For daily needs, we have to travel two kilometers, collecting water from the mountain’s edge where there’s a clean flow. So, we collect it using jerrycans,” he stated.
What are the conditions like in the shelters?
At the Pandan Sports Hall (GOR), now a temporary evacuation center, Novita Tiara, who is five months pregnant, reported that many children, including her eldest daughter, are suffering from coughs. “My child is coughing, the child next to us is also coughing, so much so they can’t sleep,” she lamented. Novita also complained about the strong, unbearable odor emanating from the bathrooms, located a mere five meters from her sleeping mat.
“It’s just smelly here because there’s no water. People from up here [the stands area] try to get water to bring up, and then the water runs out. People are also too tired to clean,” explained Novita, who has been displaced for over a week after her home was flattened. The crowded conditions at this relief post also frequently lead to arguments among evacuees, sometimes escalating into conflict even over a simple fan. “When the fan was turned off, it caused a commotion. There was a big argument earlier,” she recalled. While Novita had been offered a designated sleeping area for pregnant women or mothers with babies, she declined, stating, “Because my husband won’t visit often then.”
What are the post-flood threats?
The World Health Organization (WHO) has long highlighted the critical issues of clean water, waste management, and overcrowded shelters in the aftermath of disasters. Waterborne diarrheal disease outbreaks are a common consequence of contaminated water sources post-catastrophe. During the 2004 Aceh tsunami, for instance, eight out of ten displaced individuals reportedly contracted diarrhea after two weeks of consuming unsterile well water.
Beyond diarrhea, the crisis of clean water also raises the risk of Hepatitis A and E, as well as leptospirosis. The WHO also points to the increased risk of measles transmission in crowded displacement settings. “The risk of measles transmission in a disaster-affected population depends on the level of basic vaccination coverage among the affected population, particularly among children under 15 years of age,” a WHO report states.
Moreover, meningitis and Acute Respiratory Infections (ARIs) are common disease risks in crowded shelters. “ARIs are a major cause of morbidity and mortality among displaced populations, especially children under 5 years of age,” the report emphasized. Historically, ARI cases surged fourfold in Nicaragua within 30 days following Hurricane Mitch in 1998. The WHO has also identified ARIs as a leading cause of illness and death among tsunami evacuees in Aceh (2004) and earthquake victims in Pakistan (2005). Other potential health risks include malaria, various fevers, and tetanus.
What are the conditions of post-flood healthcare services?
The Tapanuli Tengah Health Agency reported an astounding 400% increase in patients presenting with “cough, flu, fever, and itching” compared to pre-disaster levels. “By December 5, we had already seen 6,700 patients, up from 1,300-1,500 previously,” stated Lina Panjaitan, Head of the Tapteng Health Agency, on Saturday, December 5. This figure clearly demonstrates the dramatic 400% surge.
Lina reported that Tapteng has 25 community health centers (puskesmas); 22 were unaffected, while three were impacted by floods and landslides. She claims all facilities have been operational since the fifth day following the disaster. “We are also establishing health service posts in each sub-district, and we remain optimistic about providing healthcare services even in hard-to-reach areas,” she added. “As of December 5, we have mobilized 69 such posts, and today, medical teams are en route to isolated areas to deliver healthcare.”
Nevertheless, the availability of healthcare services often represents merely the last line of defense in addressing the profound health challenges faced by residents. Novita Tiara, the pregnant mother in the evacuation camp, simply yearns for her region’s infrastructure to recover swiftly. Her deepest hope is to receive government-assisted housing before her baby’s birth. “My hope is that our house will be rebuilt soon, so we don’t have to stay here anymore; I can’t stand the smell of the bathroom,” Novita pleaded.
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Summary
A severe health crisis is emerging in flood and landslide-affected regions of Aceh, North Sumatra, and West Sumatra, with a significant surge in infectious diseases like fever, diarrhea, and Acute Respiratory Infections. This grave threat is exacerbated by critical issues such as a severe clean water crisis, compelling residents to use contaminated ditch water for daily needs. Furthermore, widespread uncollected garbage forms extensive breeding grounds for disease, while sanitation teams grapple with severe understaffing.
Overcrowded displacement camps, like the Pandan Sports Hall, face poor sanitation, strong odors, and increased risks of disease transmission, with many children suffering from coughs. The World Health Organization highlights that contaminated water sources, poor waste management, and crowded shelters are primary drivers for outbreaks of diarrheal diseases, Hepatitis, measles, and ARIs post-disaster. While healthcare services are being mobilized, the immediate restoration of clean water, proper sanitation, and safe living conditions remains crucial for preventing further health crises.