Stories from the Field

January 9, 2005
Jakarta, Indonesia

It is a privilege, a real privilege to be part of history. How ironic, a natural disaster of biblical proportions shook the sea and united a planet. How remarkable that a sea monster that ate the planet and its people is impotent to the power of love.

0415
We pack up our things and drive to the airport to catch a plane to Sumatra, one of 17,508 islands that make up Indonesia. Hundreds of people scammer for a place on the last plane to Aceh this week. The plane is filled to the brim with people and packages; not an inch of spare space is left for anything additional. The next flight to the island of Sumatra is in seven days. What are all these people going to do? Aid organizations from around the world flood the scene as the tsunami did. How will this natural disaster unfold and will the humanitarian agencies work together or apart, cooperate or become territorial in the field, as is often the case?

Indonesia’s capital, Jakarta, to Banda Aceh is approximately 1500 miles. Once airborne, we are dazzled by lush tropical greens spanning the entire length of the island of Sumatra. In no time, we find ourselves flying over areas that appear to be decimated by the tsunami. A palpable hush seizes the aircraft as the passengers become spectators. There is an unspoken reverence that takes hold of the entire cabin to honor those who died and those who now suffer. We have not yet arrived and remain airborne hundreds of miles away from our final destination, but our hearts have all been pierced by a jagged reality of massive loss and the fall of generations. Clouds obstruct our view, but we feel what awaits us and what we feel renders an impression that is more vivid than what could ever be seen with the naked eye.

The passenger next to me reeks of fear and self-doubt for making this journey. He is from the protected enclave of Laguna Beach, California where the sun shines and where the desert has lost its nature to man who dressed it in a robe of royal blue and paraded it down Sunset Boulevard. He and his wife were in Bali when the tsunami hit. Moved to tears seeing images of floating corpses and homeless survivors, they appealed to friends for donations to procure medication and water filters for communities in need. Finding out that I was part of a medical mission with a humanitarian organization, the remarkable couple asks me if I can take responsibility of their care package. I gladly accept the honor and assure them I would find the neediest homes for their offerings. I smile on the inside because I was supposed to purchase antibiotics in Jakarta before departure, but for a number of reasons was unable to do. Now, the antibiotics are hand-delivered to me by good-deed doers on a plane.  I’m reassured that I am exactly where I’m supposed to be, doing exactly what I’m supposed to be doing.

Touchdown…

There is pandemonium as there should be in a crisis like this. We are shuffled off to a United Nations daily update of the current situation. Security, education, medical services, water and sanitation, logistics and some other topics are covered in their report. On the educational front, 400 schools were damaged and internally displaced people (IDP’s) occupy the damaged structures preventing schools from opening. On the logistics front, the tented camps set up to house people who lost their homes are disastrous with people living gutter rats. The people’s basics are covered. They have food donated by the World Food Program (WFP), potable water is being trucked in and plastic sheeting is being supplied by the UN. On the sanitation front, there must be meticulous management to prevent disease outbreak given the massive numbers of people living in close quarters. The agencies responsible for waste management and hygiene are well-versed and competent to tackle the issue. Missing in the management of this crisis are trained counselors, social workers and psychologists to provide trauma support. The survivors of this disaster have sustained personal losses that are greater than any heart can endure. Most of the people in Aceh were financially comfortable living in multi-generational households. They have now lost their families, homes, businesses, and livelihoods. In some cases, people have even lost their land which has been permanently reclaimed by the sea. At this point, they have nothing left and are dependent on the kindness of strangers. Living off charity, and receiving handouts and hand-me-downs, is clearly disturbing and degrading for these people. But what choice do they have? The people need time to heal. They need sympathetic ears to listen to them and prayer to keep them connected.

January 10, 2005

I sit next to life and watch it unveil its mysteries. Finding sense in it doesn’t make it to my to-do list today and probably not tomorrow either. There are more pressing needs to attend to at the moment. Making sense out of life may come later on, but not now. No time. And what difference does it make because whatever happened happened and whatever is destined to happen will happen regardless if we understand why or not.

Let’s begin the day. It starts at 5:15 AM and 51 seconds. The house shakes violently, the ground shakes, too, as well as my bed. It is like a ride at an amusement park. It is surprisingly not frightening, but fun. It happened too quickly to feel fear. So it actually was exhilarating like on a roller coaster ride that comes with that sense of elation.

Moments after the Earth dance, the mosque across the way blares Muslim prayers over the loud speaker. The roosters then do their duty and crow an intrusive cacophonous cock-a-doodle, which obligates me to start my morning.

Driving down the city’s main road, the devastation looks like something out of a lunar walk with unrecognizable terrain. The land resembles something out of this world, as if the Earth skin needs some serious attention. Blemishes, pimples, warts, crevices and pockmarks mar Mother Earth’s complexion and she needs some serious reconstructive surgery to face the public again. Strewn to the right and to the left are pieces of things that are no longer recognizable. Mud and filth, wood, metal and scraps of whatever look like regurgitated gastric contents that Mother haphazardly expulsed.  Men wear masks to quell the stench of rotting rot and long overdue unburied and bloated corpses. They sift through the muck and rubble looking for bodies. They find three of them and wrap them in blue plastic sheeting, the kind aid agencies give to people to cover their temporary shelter. They lay the bodies on the side of the road away from everyone’s way as they continue the clean up process. The bodies have been decomposing since December 26th at 8 am when the tsunami made its way here. Today is January 10, 2005. I can’t imagine the stench or the appearance of these people. We drove by in an air-conditioned jeep as the locals toil the soil outside. I wonder how they feel unearthing one of Allah’s children. We drive by, but the image of those three once-upon-a-time people leaves a noticeable blemish in my heart. The last tally of dead was 225,000 according to a French report I saw. Now I know it is actually 225,003.

We proceed to the camps for internally displaced people. When we arrive, we are met with sincere warmth and affection. The joy in the hearts of the people is remarkable. A family invites us inside their house, which isn’t even a tent. Metal rods barely balance that familiar blue plastic sheeting…the same material used to wrap the bodies just down the road. The rods and plastic housed a lovely family of seven which fortunately includes mom and dad and their five boys. They don’t complain and ask us for nothing more than what they have, which is essentially nothing. They have each other and nothing else matters. They lost their house and their business, but they have their generator and their lives, of course. Prior to the tsunami, these people were relatively affluent and enjoyed more than basic comforts of life. They were privileged, educated and had opportunities afforded to few people here in Indonesia. After the tsunami, they joined ranks with the homeless and the bagmen. They now live under blue donated plastic sheeting.

When the people smile and have brilliantly white teeth. Out of curiosity, I check the children’s gums and teeth. They are immaculate.

“Did you use to brush your teeth when you had a home?” I ask.

“Yes,” mom answers.

“Do you have toothbrushes and toothpaste now,” I continue to inquire.

“No,” she replies.

“And what about soap. Do you have soup?”

“They gave us a bar for thirty people,” she adds without a peep of disappointment.

Donors would be happy to buy them soap. “What do you need and how can we help you?” I ask the woman of the house.

She hesitates and speaks half words, struggling to tell me her wish list.

“Female things, things females use,” she mumbles uncomfortably.

She wants a bra, some underwear and some hygienic napkins, essential items the international community forgot to include in the daily rations given to the tsunami victims. I think donors would be happy to include these things for the women. I will see what can be organized.

We leave the family parting ways with handshakes and smiles. No renovation of these souls is needed.

There is such gleam in their smiles and resolve in their souls, I leave encouraged and hope-filled. They have each other and are still together in spite of the problems that now beset them. Later, they will join their cousins, aunties and friends. They are all in this together. It is easy to laugh and smile when you have you all that is important and all that you need: family, friends and love. What more do you need in life? I will bring them toothbrushes and toothpaste, soap and female things. And in this way, they will have it all.

The camps have the basics, but the basics are lacking the basics. There is only one latrine for 3500 people. The contents of the latrine slosh about in the receptacle that people are supposed to sit above. Do your dump and you are bound to be sprayed and spoiled with urine and or excrement in the receptacle. The smell is too much. I’m told, the people prefer to go to the river and do the needful. The problem is that they get their water from the same place. While there are no landmines in the area, mixing human waste in people’s primary water source is another kind of landmine that can potentially be more lethal. Contaminating a public water source is the perfect storm for the perfect health crisis. Disease will match the fury of the tsunami and be its rival. We brace for the inevitable. There needs to be better communication with camp’s residents. There needs to be better coordination with the agencies responsible for public hygiene in these populated residential settings. There needs to be sound leadership and clear protocols for people to respect and follow to change the course of the next tragedy.

The rains bring the mosquitoes. The mosquitoes will bring death. The trash will bring pestilence. The pestilence will bring death. The contaminated rivers will bring cholera and amebiasis and giardia and gastrointestinal nightmares that will dehydrate and demystify death itself.

Death will become commonplace in a place already under siege if no action is taken. Death will bring people together and tear them apart at the same time if no action is taken. Plastic sheeting used for roofs might as well be used to wrap the few who survived the tsunami and then ironically succumbed to the aftermath. Am I psychic? Do I know the future? No, but I know 1 + 1 = 2.  Throw a ball up and it will come down. Let the people poop and pee in the public waters and line more roads with blue plastic.

We visit another camp. They are running out of medicines while another camp across the road is bulging at the seams with them. Neither camp communicates with the other. And so the story goes.

JANUARY 16, 2005

Life after Life

The tsunami was a natural disaster that took the lives of hundreds of thousands of people, destroyed millions of people’s lives and left entire regions devastated for decades to come. We all know that. And now what we know for the near future is the possibility of disease playing havoc on all the people who survived. Not only do they have to contend with the tragedy of losing their families and friends, they fight for their lives face-to-face with diseases that wreak more human suffering. For non-medical people, I will explain what is now happening in this phase of the recovery effort.

The tsunami decimated villages and the island’s infrastructures. Water supplies have been polluted by debris and human carcasses. Refuse collection has been disrupted and human sewage systems have collapsed. Human waste is running into the potable water system and conditions for the perfect storm for disease and continued human destruction are rife. In addition, the rainy season is in full swing causing pools of water to form throughout the island to the delight of mosquitoes that use these as breeding sites. Indonesia’s mosquitoes carry falciparum, which is the most lethal form of malaria. Aid workers can protect themselves with repellents, mosquito nets and prophylactic medications, but the thousands of people living outside in tents don’t have these basics and are therefore at greatest risk of being infected. Fortunately, the World Health Organization and the other aid agencies have organized an anti-malarial campaign, acquired rapid testing kits, established a treatment protocol, and started insecticide spraying. My plan this week is to find local partners in the community to begin spraying houses. This mosquito mitigation strategy can keep the mosquito population down and hopefully prevent disease.

It is important to act proactively to prevent problems from spiraling out of control. If you throw a ball up, it will come down. This is the law of gravity. If you do nothing here, nothing will become something, something deadly. This is the law of commonsense. Act, don’t react.

JANUARY 17, 2005

One Plus One Equals Two

As the tsunami relief work continues there is an amazing community spirit among the Indonesian people. Local volunteers from around the country have mobilized their resources to assist their neighbors and many of the hundreds of thousands of people without homes have been taken in by people in the villages who were not affected. I’ve heard reports that some families have opened their houses and hearts to as many as 24 people. Barriers that once separated people now are no longer separating but uniting. Food distribution has been going exceptionally well and all people from what I can ascertain receive rations. Soap, clothing, toiletries and other essentials are also being distributed. Mental health professionals have been mobilized and they are beginning to work with the people suffering from post traumatic stress problems. Some camps have event organized makeshift schools to continue educating the children. Overall the situation is improving day by day.

The international humanitarian community is phenomenal as well. Aid organizations from around the world have come and engage rigorously in all activities needed. Currently on the ground, there are dozens of different nationalities who have come to offer their support. At today’s UN meeting, teams from Russia, Albania, Sweden, Norway, Holland, Belgium, England, The USA, Spain, the Philippines, Korea, Singapore, Ireland, Hungary, and Germany were present and this only represents a portion of the people who are here.

 Field hospitals have been established with x-ray and laboratory capacities, ICU and surgical departments. Infectious disease surveillance is aggressively underway and systems are in place to handle any potential epidemics. Toilets are being built, hygiene teams are in place to manage the camps, reconstruction of schools and clinics are underway and with the will of the world magic continues.

I’ve been in other world tragedies, but for some reason this one has captured the attention and affection of the entire global community. The donations that people around the world have made enable this massive effort to perform expeditiously and magnanimously. Everyone’s support and goodwill makes this all possible and it is something phenomenal to witness.

Today I went from camp to camp and talked directly with the people living in the “tented villages.” They are strong-willed and resilient people and wish to begin their lives again. Their needs are enormous, but with the coordination of all the aid agencies in place, new lives can be made stronger and the sadness we all feel together as a world community can motivate us and strengthen our resolve. This catastrophe has given mankind a chance to work together and help one another as one people. This tragedy has the capacity to mark a new beginning, one of love and cooperation among all of us.

 

JANUARY 21, 2005

Rachmid’s Shack

Today is a Muslim holiday. People gather at the mosques, pray and share a sacrificed cow among the community. Family and friends gather together and visit one another from house to house as they share bountiful arrays of different foods. Our neighbors invited us to celebrate with them. It’s amazing how much conversation can be exchanged with hands, facial expressions, charades and heart.

The people here are so lovely. Everyone smiles greets me with such affection and respect. This area has not been taken by tourism because of political conflicts over the past decade so the people find us foreigners novel and intriguing. When I first came, I thought perhaps they would be biased against me for being American, but actually, they hold Americans in high esteem. They know that people from around the world have come to help them and they are hopeful that we will work together with them to rebuild their lives.

I went for a walk today, just somewhere, anywhere around the neighborhood for the first time since my arrival. The tropics are beautiful, but come with an oppressive sun that heats, singes and melts anything daring to walk beneath it. The area where I live, about 5 miles from the sea, wasn’t affected at all by the tsunami. Impressive houses line these residential streets. As I wandered about, I was particularly curious about a small shack that was nestled in between grandiose mansions of the obvious more privileged. As I stood before the shack a young woman came out and invited me inside. I thought she was hurt and needed some assistance. To my surprise she wasn’t hurt, needed no assistance and wanted nothing from me. In fact, it was the opposite. She invited me inside to serve me a plate of food.

 The little shack was home to her and her husband, their three children and another boy they called “tsunami.” His real name was Rachmid. Though no one spoke English, we managed to have an entire dialogue using a pen and paper and again the charades with trusty hands and facial expressions. I came to know that she and her husband were very concerned about the welfare of the people hurt by the tsunami. So after the wave hit, they went to a local group and asked to adopt a child. Rachmid, 9 years old, had lost his mother and father and siblings. Actually, he had lost all 30 members of his family and was left alone without anyone in his little life. These people living in this little shack took him as part of their family. Not impressive? Well, the Mr. makes three dollars a day as a driver. They live in a house with one light bulb, one bedroom and a front room, no kitchen, no refrigerator, no bathroom, no nothing, but they did have a radio.

We all sat together in the front room and continued our charades. When I asked them how they could consider taking in another child when they didn’t have enough for themselves with a salary of three dollars a day, they simply said they had to help this child who suffered so much. I asked if they had toothbrushes and they showed me three with bristles going horizontally. I asked if they had soap and I was shown a pill-sized piece that was shared among them all.

I excused myself momentarily and went to the corner shop and bought toothbrushes of every color, toothpaste, peanuts, pens and paper, soap and detergent. Because of the holiday, all other shops were closed so truly speaking Santa couldn’t do his thing…yet. But rest assured, these people will be touched by the hand of whoever or whatever is in charge. Some people gave me money in Hong Kong before I left on this mission. When I asked what I should use it for, they told me to use my judgment. I can’t imagine anything higher than to help these people help Rachmid. But it isn’t about Rachmid; it’s about the poorest of the poor stepping forward and having the opportunity to serve another person in need.

Returning to the shack, I asked some neighbors living in fancy houses with cars, shops and gold ornaments, if they also adopted a Rachmid. They said that they didn’t have enough money to meet their own needs let alone adopt a tsunami child. I asked them how it was possible that their neighbors living in the shack down the road adopted Rachmid and the people living in mansions didn’t have enough to do the same. No one answered my rhetorical question. A shack that would not be inhabitable in the West now houses six people proudly. They will have a fan to squelch the sweltering heat and I will buy them some mattresses and some more household supplies. I will do what I can to honor these people who have so selflessly touched a little boy’s life.

 

JANUARY 26, 2005

Sealed in my Air-Conditioned Car

When I think that I’ve got things under control and I feel firmly comfortable and confident, I suddenly stumble across a crack in the road that sends me into a funk and contraction. Driving down the same roads day after day you’d expect to find monotony in the scenery of the insane. But there is nothing monotonous about buildings hanging by a hinge from the earthquake, caved in foundations as if built in quick sand, roofs corrugated at the seams and debris bound up like a gorilla’s bowel movement… stenchy, mushy and mucky. The mud and solid soot from the bowels of the sea come together yielding something like an oil spill that suffocates all inanimate and once animate now inanimate debris. Dead bodies are recovered but new ones come to replace them. They  line the road dressed in different colored plastic body bags. The stench of their rotting flesh is hardly masked by facial masks that the custodial workers wear. I drive by it all in a sealed air-conditioned car watching with disbelief through the window. I don’t need to smell the smells. I don’t need memories of this stench. When I leave here, let it be gone and done with. Let me be effective now and give the most possible, but then leave it when I leave. I don’t need to carry this home with me.

What is so remarkable is the shear scope of the devastation. Hundreds of miles of shoreline are gone, sunken in the sea, swallowed by it leaving nothing but ruin in its path. Some villages are without a single dwelling. Ninety per cent of the population has been killed in some areas.

Today, I explored affected areas on the outskirts of the city. To date, most of the clean up has been focused on the city center. What I saw cannot possibly be described. Villagers pick meticulously through the wreckage looking for perhaps trinkets, but there is nothing resembling anything useable in any way, shape or form. Nothing is salvageable.

In spite of unfathomable misery, today was a great day? How could anything be great in any way here and now? Well, it’s a feeling. I see such tremendous moments that touch profoundly the fabric of the soul itself. And when I’m able to do something that matters to just one person, I have a great day. For example, an old woman, frail and sinewy schleps along on the street under an obsessively oppressive hot sun. I stop my driver and give her some money. Then a bit farther down the road another little fellow clearly need some help to follow, so I gave him some money, too. Let them have a respite from a hard life for a while.

While walking around one of the camps for displaced people, my driver spotted someone he knew from his village. He sat with her and they talked about their ordeals. They went systematically through the events of their recent lives and identified who had been lost or killed by the tsunami. They were comforted by each other’s stories of loss. It fascinated me to watch them together. Neither could do anything for the other, but having company to deal with the pain is very healing.

 Later it the day, I went to a mobile clinic that we are supporting. They needed everything and then some so I scoured the city in search of medical supplies. I found the obvious sources and then went into the nooks and crannies looking for more. The city is still severely crippled with most shops closed or destroyed. The ones that have managed to reopen have practically nothing of interest or value to sell; something like the Eastern block countries during communism. There is nothing to buy and when something is there it is usually so unappealing that it’s best to keep looking for something else down the road.

The Danish emergency rescue team has set up a hospital for orthopedics where perhaps the best orthopedic surgeon on the planet serves. He is a man with a heart of a saint and cares for his patients beyond what one would consider normal in any way. He holds people’s attention through his profound affection and love, and shows great respect for all people. He inspires me.

The Danish hospital has a 40-bed reserved for people with fractures, amputations and infected wounds. I was told about one in-house patient who lost his leg and was profoundly depressed because of it. He could no longer find a reason to live. He lost everything and everything minus everything didn’t leave him much to hold onto for the future. So, why stick around? I approached his bed and with the help of a translator I worked hard to find a way inside and give him some hope. I promised that he would have a new leg and that he would walk, and no one would even know that he was without leg. His battered face was still swollen weeks after his accident and his hip was pinned to the intact appendage to the left.

 “You will have a leg, I promise. If no organization will give you one, I will. I will buy you a leg myself.”

 The man smiled, but did not believe me.