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John Key last night voiced fears that the death toll in tsunami stricken Samoa could rise even higher with the outbreak of disease.
Speaking to the Herald on Sunday in the village of Lalomanu, worst hit by the disaster, Key said infectious disease medics would be sent from New Zealand today after the Samoan Government asked for more help.
He said the New Zealand and Samoan Governments would need to look at the adequacy of the island nation's tsunami alert system, which failed to kick into action despite drills earlier this year.
An earthquake of magnitude 8.3 followed by four large waves hit Samoa, American Samoa and Tonga on Wednesday.
Public and environmental health teams are working on the ground to prevent the spread of infection, but Key said the specialist unit would target potentially lethal cases of tetanus.
"If there was an outbreak, New Zealand holds enough vaccine for the entire population to be vaccinated," he promised.
Efforts to rebuild the devastated Pacific Island nation - which Key estimated would cost more than $100 million - would need to first concentrate on water and sanitation, to keep people healthy.
The news was welcomed by Dr Limbo Fiu, the clinical manager for the National Health Services in Samoa.
He has worked tirelessly to save lives - the death toll stands at 149 in Samoa, with another 31 in American Samoa and nine in Tonga - but Fiu said a second wave of deaths was inevitable.
Many survivors were coming into hospital to be treated for wounds with skin infections, which could cause lethal blood poisoning.
Fiu said there had not been any cases of tetanus yet.
"Also in a few weeks, we will see many people sick with gastroenteritis and diarrhoea. That will affect the young and the elderly. Deaths are inevitable."
Key was reluctant to put a dollar figure on the aid to be given by New Zealand on top of the $1 million pledged, but said it would be significant. "It's important that New Zealand steps up."
The Prime Minister had spent the afternoon travelling along the south-east coast including Poutasi, where he embraced New Zealander Joe Annandale, whose wife Tui was killed. Key had met the couple when he visited the village in July.
"I'm heartbroken that he's lost his wife," he said. "It was supposed to be their 40th wedding anniversary yesterday."
Key became the first National Prime Minister to be honoured with the chiefly title of tuasavili by the people of Poutasi.
The Prime Minister also remembered time spent in Lalomanu, when he was Leader of the Opposition in 2007. "It's gone from being an idyllic part of the world to Ground Zero."
The 14 officers in the New Zealand police search teams will today scour Lalomanu with two "cadaver dogs" to find those still missing.
Back in New Zealand, Ron Dunham, chief operating officer for the Counties Manukau DHB, is coordinating 400 medical volunteers to help counterparts in Samoa.
Last night 14 volunteers, mainly from the Waikato, flew by Air Force Hercules to Apia to help with the injured. The team included orthopaedic surgeons, a general surgeon, two anaesthetists and theatre and trauma nurses.
- ADDITIONAL REPORTING: Anna Rushworth
How you can help
Pacific Cooperation Foundation
Deposits can be made at at any Westpac branch. All the money raised will go to the Samoan Government
Red Cross
- Make a secure online donation at redcross.org.nz
- Send cheques to the Samoan Red Cross Fund, PO Box 12140, Thorndon, Wellington 6144
- Call 0900 31 100 to make an automatic $20 donation
- Make a donation at any NZ Red Cross office
ANZ bank
Make a donation at any ANZ bank branch, or donate directly to the ANZ appeal account: 01 1839 0143546 00
Oxfam
- Make a secure online donation at
Oxfam.org.nz
- Phone 0800 400 666 or make an automatic $20 donation by calling 0900 600 20