Tsunami Revisited

Run aground
Feb 13, 2007 10:17 AM
Lynda Redwood-Campbell
Special to The Star

Two years after she spent several months in tsunami-ravaged Aceh province in Indonesia, Burlington physician Dr. Lynda Redwood-Campbell, who also teaches in the Department of Family Medicine at McMaster University, has returned for a visit.

Arrival

Here, I am 25 months after the tsunami, back to the place that was so devastated.

I wonder what has happened in terms of development. As we drive by the previous site for the International Red Cross tent hospital, I see that the fields have been replaced with temporary housing. Children laugh and splash in puddles as the rain continues to pound down.

Week One
Days 1-2: We passed by the site where only one house was left standing after the tsunami. It is now refurbished, beautifully painted. The area that was just debris is becoming a community again.

Run aground Before the tsunami hit, the ship seen in this story -- the PLT Dapung -- was moored off-shore and used as a power generating station. The waves carried the ship around five kilometres "inland" and dumped it in the middle of this village, where it obviously destroyed everything that had been located where the steel giant now sits. Dr. Lynda Redwood-Campbell reports that the tanker has been re-painted as a memorial. Dr. Redwood-Campbell's photos show the Dapung just after the December 2004 tsunami (at the top of the page) and two years later (middle of the page).

After such a disaster, how does a government provide fair distribution of housing? A Rotarian is working on the database in an attempt to help to formally identify affected people. A very large task and it is expected that over 100,000 families will be on the list. There are probably more.

The medical students [we are working with] are half women and men. All have been affected by the tsunami in one way or another. I was most impressed with the women. They were mature and asked good challenging questions. They were getting on with their lives.

The students are having a tutorial using problem-based learning. This is a new model of teaching in Indonesia. Eleven students in a small group, men and women.

The topic is Islam and abortion and contraception. The students have not yet seen a real patient, as they are in their pre-clinical years. The discussion is interesting, as they are only 17 years old.

Wouldn’t it be interesting if we could one day video conference and have students from Canada join them? Imagine the learning for both sides.

Days 3-4: Today we drove to one of the worst affected areas.

I have a bitter feeling as I think about the devastation I saw soon after the tsunami.

It is pouring again. As we get closer to the shore, I see many new houses, many new developments. Men busy hammering and cutting wood in workshops set up every few kilometers.

My friend is driving and explaining the sights. We arrived at a bridge but could not go over it. The road was not good enough, worsened with all the recent rain. I wonder if this weather must be slowing down the building process. Through another direction, the newly build homes are still empty.
The December, 2004 tsunami drove this tanker five kilometres inland and deposited it in the middle of a village. Two years later it is now a memorial.

We pass along through busy neighborhoods, and then, we saw the ship. In the middle of the neighborhood, there stood an oil tanker, five kilometers inland from where it took before the wave engulfed it. It has been re-painted as a memorial.

Most of the destruction is gone, and it is actually very difficult to believe that the tsunami was as destructive as it really was. My Acehnese friend says that people cope by just moving on The shops around it are bustling and bright, the road that was once rubble is now busy.

Days 5-7: It poured again all night last night. The streets were flooded and many people were not able to leave their homes.

Last night we met a man who has been living in Indonesia for almost 30 years. He is an engineer and has been working on a housing project. He is frustrated because he believes that too many of the new homes are not earthquake proof and the next quake will bring them all down again.

I asked about the Canadian efforts. He said the Canadian Red Cross was constructing houses very well. I sighed great relief.

Perhaps the most impressive thing to me is the sense of hope that appears to be here.

Aceh has been an area of political conflict for many decades.

Since the tsunami, a peace accord has been signed. The first democratic election has been held and the new governor will take office in February.

My friend tells me that people are happy for a change. People just need to let him "do his job."

Week Two
Day 5-7: Reuniting is always special. I found a friend. Two years ago, she lost her husband, her parents, family and home. She was stuck on the roof of her house for more than 24 hours watching neighbours get washed up onto the roof and grieving others who didn’t make it. She is re-married and she is expecting her second child.

We visited her temporary home. Her own home is still in rubble: no front wall; debris on the floor; the kitchen is barely recognizable. Her 8-year-old son showed his room where he hopes to be again one day. It was just an empty shell – no bed, nothing. She hopes to have government compensation soon to rebuild her home. In the interim, the three of them live in a small room in a house. She does not know where the baby will be born. It is expensive to go to hospital. I quietly worry about her. Maternal mortality is high in Indonesia, something that we take for granted.

Day 8-9: Yesterday we visited the main general hospital. The fist time I saw it, it was full of debris and bodies 6 feet high. Over the next weeks and months, the hospital was cleaned and slowly started to function again. I see the hospital now. The bodies and mud outside have been replaced with green grass, fuchsia bougainvillea flowers, new gardens and fresh paint. The mosque in the centre of the hospital complex has been rebuilt. It is hard to believe that this is the same place where so many people died a sudden death. Progress is happening but the hospital still does not have the same capacity as before. The beds are there but too many nurses died and still have not been replaced.

The traffic is crazy and unsafe. It’s a problem in many developing countries. Families of three and four on one motorcycle, no helmets. A woman lay on the road, unconscious after she fell off her motorbike today. The tsunami and earthquakes are not preventable, but these injuries are. The public health students were with us today. I encouraged the students to seriously consider doing a project to try to reduce head injuries in their community. They smiled. I hope that they do think seriously about it.

Day 10: We visited a grandmother in her home in a village today. Her typical Achenese home is built on stilts, made of wood and is more than a century old. She was as old as her house, we were told. This lovely 100-year-old woman lay comfortably in her bed. Her’s is a simple life in the village. She never had a birth certificate so her age was estimated. Without a birth certificate you have no identity. Without identify one cannot access many services. Midwives now are being trained to try to get birth certificates completed for all the new babies born. Seemingly small things to us but a basic human right.

A thought that a colleague reflected on today is that the tsunami brought together all sorts of people who would not normally interact together. Doctors and store owners, teachers and villagers. I wonder if they will stay friends because of the experience that they had together or in time go back to interacting with their old ways. Time will tell.

Departure: As I reflect on Aceh two years after the tsunami, I do feel hopeful. I feel better than I did two years ago. I feel like progress is happening, albeit sometimes slower than expected. Life must move on. In many areas of the city there is little physical memory of the event. I still can not really begin to imagine what it was like when the tsunami wave roared through the city taking everything in its path. I still cannot imagine the pain of losing so much in just 15 minutes. The sea of mud and debris out my plane window in now replaced with green, lush areas and scatterings of new communities and houses. There is a sense of peace. Let’s hope and pray that this is the beginning of rebuilding of a province that has been rife with conflict and disaster for decades.

Departure – December 1, 2005

As I start my return journey home, I reflect on my time here. I think about all the suffering, the stories, and all the very sick people. I always feel torn when it is time to leave. Of course, it is time to go home, but at the same time, there is still work and aid that needs to be continued. Over the next month and with time, more organizations will leave, but there will still be humanitarian workers there to continue to provide shelter, food and medical care.

The freshly fallen snow in the mountains exemplifies the utmost in beauty. The mountains look grand and majestic. The irony is that it also means more hardship for thousands and thousands of people. Every day of colder weather means more difficult delivery of much needed supplies. It is estimated that thousands of people will descend to lower altitudes over the next month. I wonder how many will actually make it.

We did see illness and injury related to the earthquake. Fractures, old infected wounds and vague physical symptoms related to the stress and mental health trauma. All this as a result of just 45 seconds. Yes, just 45 seconds. Women and children were mostly affected. Unfortunately, we also saw the inevi

table. All the illnesses that are related to and are caused by poverty. Malnourished children, measles, diarrhea, pneumonias causing death and many more. We couldn't prevent the earthquake but we can prevent many diseases and we can better address the issues of poverty. Why is only 10% of the global health research budget allocated to 90% of the global burden of disease? I ponder.

As I arrive at the stopover in Manchester, I enter the airport and hear Christmas songs and see vibrant Christmas decorations galore. I wonder if this is the same world as the one I just left? Improving health can never be approached in a silo. The global implications of understanding and responding appropriately to disease, illness, poverty and disasters are more compelling than ever.

As my plane lands in Canada, I think about that little girl who looked up to me with the eyes of pain, sorrow and utter trust. Her eyes said, “please don't forget about us, and all those around the world who also suffer from all preventable causes.” I shed a little tear. “OK,” I said, aloud, as I stepped off the plane, we owe it to you.

November 28, 2005

We are hearing reports now of hypothermia and more respiratory illnesses. A refugee camp will be moving to a ‘better location' 10 km from the city.

This particular camp had an outbreak of acute watery diarrhea, which is now controlled. This camp was not set up in a planned way so moving it ensures a better camp layout, including the better la

yout of latrines. Public health is paramount in the situations. But what about the people who have to move 10 km away from the town? How will they get to town? What if they are fortunate to have a job right now? How will they get to and from their jobs? Disaster situations are very difficult, always harboring a challenge to every decision that is made.

November 27, 2005

Today the rain fell hard in the valley. It was the first rain here in a few weeks. The helicopters were grounded for the day. This means that a day of much needed relief supplies was halted. The morning was greeted with more snow in the distance, a sign that winter is closing in and time is once again, of the essence. It is likely that in the next few weeks, more people in need will descend into the valleys and towns in need of relief.

November 26, 2005

There are long lines of men lined up in some of the northern affected cities. They are lined up in hope that they are eligible for financial assistance from the government. Their homes have been destroyed, their families killed or displaced, their livelihood remains uncertain.

A young boy came to the hospital with his mother. He had multiple fractures of his femur and tibia/fibula. He couldn't stay in this hospital though. As it turns out, his mother died in the earthquake, his father is 200 km away and his aunt, who is with him, needs to go back to her home, to be with her five children. He has nobody else.

Many people talk about why the earthquake has happened. Why did it happen to them? Why did it destroy so much? Why are they having so much suffering? A said today, ‘It is obvious. We deserved it. We have sinned and not followed our faith as we should have.'

November 25, 2005

Imagine this. Your house was shaken down in 45 seconds. Most of your family is now dead. Your injuries are life-threatening so you are transferred to an unknown hospital. You are hearing foreign languages that you don't understand. You are transferred from one hospital to another to get better care. Now, you must put all your trust and faith in total strangers. Decisions about your health, your care and your future. Their eyes gaze at you with that full trust and faith, hoping and praying that things will all be ok.

After a disaster, life still must go on. Although many stores were destroyed, there are still stores that have opened in unstable and half fallen buildings. A man tries to sell his goods in a store that is surrounded by dangling wires, precarious pieces of hanging roof and doors that are only half standing. In Balakot, a man looks through the debris to find his barber chair. He pulls it out, dusts it off, and in the middle of a pile of rubble, offers barber services again.

November 23, 2005

I heard some stories today.

A team reached a very remote area and found a young woman with a very badly crushed foot. It was almost falling off. The team explained that she would need to come to the hospital and that, unfortunately, she needed to have an amputation. Her family refused because an amputation would mean that she would never be “beautiful” again. The alternative was that she would die of septicemia. It took a lot of discussion and the family reluctantly agreed to send her to the hospital. These situations are always very difficult, and they always begs the question, “Who was right?”

We also have heard stories about people trying to steal children, across the borders. Heart-breaking. Glad to hear that the rules are clamping down to decrease the chance of children being mistreated.

It seems that after the tsunami in Aceh, the majority of patients in the hospital were men. Here in Pakistan, it is mostly women and children. To see a child smile when they receive a little toy (donated by a Canadian) is heartwarming.

A snow coyote attacked a child yesterday. Rare and unusual things happen after an earthquake.

Last night, there was an earthquake in the middle of the night. Very traumatic for those who survived the last one. All the patients in the middle of the night ran outside the hospital. Parents frantically ran outside leaving their children inside. Is it survival of the fittest or just sheer terror? The latter, I think.

The disaster is now in the subacute and early rehabilitation phase. It appears that the biggest need now here is for rehabilitation specialists, physiotherapists and prosthetic specialists.