total of 227,898 people died. Measured in lives lost, this is one of the ten worst earthquakes in recorded history, as well as the single worst tsunami in history. Indonesia was the worst affected area, with most death toll estimates at around 170,000. An initial report by Siti Fadilah Supari, the Indonesian Minister of Health at the time, estimated the death total to be as high as 220,000 in Indonesia alone, giving a total of 280,000 fatalities. However, the estimated number of dead and missing in Indonesia were later reduced by over 50,000. In their report, the Tsunami Evaluation Coalition stated, "It should be remembered that all such data are subject to error, as data on missing persons especially are not always as good as one might wish". A much higher number of deaths has been suggested for Myanmar based on reports from Thailand. The tsunami caused severe damage and deaths as far as the east coast of Africa, with the furthest recorded fatality directly attributed to the tsunami at Rooi-Els, close to Cape Town, from the epicentre. Relief agencies reported that one third of the dead appeared to be children. This was a result of the high proportion of children in the populations of many of the affected regions and because children were the least able to resist being overcome by the surging waters. Oxfam went on to report that as many as four times more women than men were killed in some regions because they were waiting on the beach for the fishers to return and looking after their children in the houses. States of emergency were declared in Sri Lanka, Indonesia, and the Maldives. The United Nations estimated at the outset that the relief operation would be the costliest in human history. Then-UN Secretary-General Kofi Annan stated that reconstruction would probably take between five and ten years. Governments and non-governmental organizations feared that the final death toll might double as a result of diseases, prompting a massive humanitarian response. In addition to a large number of local residents, up to 9,000 foreign tourists (mostly Europeans) enjoying the peak holiday travel season were among the dead or missing, especially people from the Nordic countries. Sweden was the European country most severely affected both in absolute numbers, and by a wide margin when considered in relation to the country's population, with a death toll of 543. Germany was close