An interesting question is why did we not see disease epidemics in Indonesia, following the devastating tsunami disaster of December 2004? Could rapid public health intervention be credited with minimizing spread of disease? In the case of Aceh Province, many communities reported diarrhea as the main cause of illness (in 85% of children <5 years of age), but no increases in deaths were reported, and no outbreaks of cholera or other potentially epidemic diseases occurred (27) . Given the massive scale of the disaster, was this likely? In some towns, more than two thirds of the population died at the time of impact, almost 100% of homes were destroyed, and 100% of the population lacked access to clean water and sanitation (27) . To a large extent, the Australian army and other groups are to be credited with rapidly deploying environmental health teams to swiftly implement public health measures, including provision of safe drinking water, proper sanitary facilities, and mosquito control measures (28) . Widespread fecal pollution of the surface waters was shown, yet the saltiness of the potable water supply after the disaster made much of the water unpalatable. Wells were vulnerable, perhaps to other etiologic agents of fecal origin including viruses and Shigella spp., with greater probability of infection than Vibrio spp., thus leading to the widespread diarrhea.