Planning Medical Assistance to Tsunami-Hit Areas
By Dr Mohammad Afzal

Dr. and Mrs. Mohammad Afzal Arain

Since the day tsunami struck and caused devastation, I started to find a possible connection in Indonesia. I contacted Indonesia Embassy, Red Cross, and doctors without borders, doctors world wide. I called many other organizations also.
Mr. Waseem Baloch founder of Hidaya foundation in San Jose California contacted me and we started to communicate regularly. Dr Waheed Akbar of Michigan who is past president of APPNA and member of APPNA disaster management and social welfare committee was willing to go with me. We actively started to look for means of making a fruitful trip to Indonesia. Hidaya foundation was able to contact Mr. Mustafa Kamal who had studied at Stanford University and had gone back to Indonesia. Mustafa is fluent in English and Indonesian language and is an engineer by profession. After several teleconferences we decided that we will go to Indonesia. Dr Waheed Akbar could not join me due to his personal and family engagements so Hidaya Foundation’s Mr. Quazi Shamim to accompany me. He has already been to Sri Lanka and had surveyed and helped the suffering humanity.
We left by Singapore airline from San Francisco on the 12th February. Since we had purchased the ticket at a short notice before our journey at San Francisco Airport even our vaulets were checked by security. Airport security guard did not seem to be in hurry and seemed to be enjoying going through our personal objects. . Our flight went through Hong Kong to Singapore. From Singapore we went to Jakarta. At Jakarta Singapore Airline agent received us to facilitate our visa. Mustafa was waiting at the airport to receive us. At Jakarta airport we paid $20 for the visa. When they found out that we were there to help them our money was withdrawn from the bank and returned to us. Immigration officer commented that “you have come here to help us. We cannot charge you the fee. Thanks for coming to our help”.

The Baiturrahman Mosque that survived the tsunami onslaught

Mustafa took us to Indonesian Red Crescent head quarters. We had to travel through massive traffic jams and it took us almost two hours to get to Red Crescent head office. We had a meeting with Dr Basuki who is an orthopedic surgeon and has been to many parts of the world to serve humanity. We found him a very knowledgeable and devoted person. He shared with us the situation at Banda Aceh. He showed us the maps, albums and a documentary. He showed us the plan of the future hospital in Banda Aceh. They have rented a multistory building and already have a 40-bed functioning hospital with operation room and needed subsidiaries.
Estimated cost to make this hospital fully functional was 0.5 million US dollars. They have already received $ 25,000 from a Middle East agency as down payment for hospital property. They also had received two ambulances which were fully furnished and were purchased at the cost of $ 22,000 each. Indonesian air force was going to fly them to Banda Aceh. We had dinner with chicken and rice wrapped in banana leaf and a paper. There were small sealed glasses of clean water. We stayed at a Jakarta hotel. It was no less than a 4 star hotel but cost only $ 40 for the night.
Next morning we were joined by the Chairperson of Islamic Relief Malaysia and flew from Jakarta to Medan where we had to take Adam Airline to go to Banda Aceh. We went to Banda Aceh which is about 30 Km from Iskandar Moda airport. Islamic Relief of Malaysia arranged our transportation from airport to Banda Aceh city. We visited the makeshift hospital of Red Crescent. It is a three-story building with clinic, X-ray, lab and operation room on the ground floor. There were about twenty patients on the second floor which were mainly trauma patients. Most of them had infected wounds.
We found out that most of the foreign medical teams were very liberal with amputations. Not realizing that the artificial limbs were scarce in Indonesia and amputees will have to live a handicapped life. We also had glimpse of devastation of the area by air and also we drove by to see the famous land mark of the area “Masjid Abdul Rahman” lone building in ten mile area of massive devastation. I could not sleep till late that night. I kept thinking about all the people who disappeared and what the tsunami left behind. I kept thinking how best we can help these unfortunate people. Even though the people have faced a major disaster, they were very polite, hospitable and appreciative. Some local people told us that some missionary people have purchased local land by proxy and are making small gated areas with Christian names and were heavily preaching Christianity. They felt very uncomfortable because of what appeared as conditional support. Because they were on the receiving end they took it quietly. They have substantial Christian population and get along well with each other.

Ships swept by the waves are strewn all over the coast

Next day we again saw several patients and visited more devastated areas. Local doctors told us that some aid groups had been using Banda Aceh disaster as their training ground. They had brought physician assistants, nurses and medical students and let them practice on the injured. There was no accountability and many patients were mismanaged. Many patients got amputations for the wounds which could have been treated conservatively. I saw a patient with hernia operation with groin and scrotal incisions. He had skin staples at the scrotum for over three weeks with pus pouring out of the incision. Dr Basuki stated that he tried to attend some of the medical planning meetings and tried to have local physicians observe the patient care skills but they were denied to attend any meetings or observe anything to improve their skills. They were very thankful to all who took time and came to help them.
We also went to see some more devastated areas. What we saw was beyond imagination. Buildings completely washed away with only floor left. A school building had only steps left. We saw mass graves with over fifty thousand dead buried in each grave.
I saw dead bodies wrapped in yellow plastic bags lying on the roadside to be picked up by disposal trucks. I have been through wars but this destruction of human life and property was beyond imagination.
We saw a huge ship which was five stories high and weighed 200,000 tons which was lifted by tsunami waves 5 KM deep into the heart of the city. This was the powerhouse for the city and was undamaged. This was sitting cross ways on the road. There were buildings intact between the ship and the ocean. Most of the people who stayed on the ship survived. It looked like a genie carefully picked the ship over the houses and placed in the heart of the city.
I also saw multiple ships washed away and lying next to mountains. Many places had boats lying in the front yards of the houses. I also saw a large ship turned upside down.
I visited several clinics which were seeing up to two hundred patients a day. Many places refugees had built small shops on stands and were selling basic necessities.
Next morning we visited all the hospitals inthe area. Zainul Abidin Hospital was a 400-bed university hospital with 900 medical staff. Only one-third has been accounted for. Numerous patients and hospital supplies were washed away. The hospital was still under five feet of stinking tsunami mud. Most of the surviving patients were suffering from mud pneumonia and injuries. They were still finding dead bodies in the mud. Australian and German teams were trying to rehabilitate the hospital. We saw major hospital equipment buried and damaged in the mud.
The Military Hospital was clean and in working order, but lacked basic equipment. They did not have an ultrasound machine. Instruments were washed and being packed on the floor. They treat 20% military personnel and 80% civilians. Due to struggle for freedom in the area people and military were not comfortable working with each other but the Hospital commander was willing to provide all the services needed if we were to take a team of specialists to provided service to the local population.
The Fakina hospital was a110-bed hospital and appeared to be in good shape and had almost all the rooms occupied by patients. This was a private hospital and was well maintained. Almost all of the 200 hundred doctors had vanished in the tsunami and the owner had almost abandoned the place. Local police doctors were running the place till 26 March. Hospital had 110 employees and all could be kept on the job with mere $15,000 per month.
Permata Hati was totally destroyed by tsunami. It was the only cement structure standing with major holes in the wall and all patients and providers becoming victims of tsunami.
Indonesian Red Crescent hospital was a leased building and was a newly built place. It had a nice surgery room and had about 40 in-patients. There were three full-time doctors - general practioner, psychiatrist, pathologist and a visiting orthopedic surgeon. This hospital could be completely furnished and can be a big asset to the community. It will cost $ 0.5 million and doctors from Jakarta can be hired for about $ 600/month.
We also visited refugee camps. There were miles and miles of refugee camps with different NGO’s waving their own flags. Most of the refugee camps appeared to have adequate necessary supplies. All the refugees were keen to get back to work and rebuild their lives.
Next we went to visit boys and girls orphanage. It was a very sad experience. We took candies drinks and milk for them. The orphans were between two years to 17 years of age. Some of them would come and hug and would not let you go. Some of them clearly remembered how they lost their loved ones and how they were saved. They had become very close to each other but looking into their eyes you could sense the loneliness and uncertainty of future.
The Banda Aceh area is somewhat warm and humid. There were no fans or air conditioners in the orphanages. Electric fans could be purchased for about $30.00. It was warm and humid and very uncomfortable. I could not think of anything else and donated $ 400.00 to each place to purchase fans. It was difficult to hold back tears after seeing these little angels who were left in this world with an uncertain future with no one to love and provide them comfort.
Before leaving Banda Aceh I visited many NGO’s and discussed the need for opening a hospital. Clinics were easy to set up and easy to maintain and every body was concentrating to make a clinic. Islamic Relief was very receptive and they had raised over 20 million euros and were actively working to provide assistance to the victims of tsunami. Housing, food, clean water, provision of jobs and psychiatric support were the priorities. One boat cost about $ 4,000. and provided livelihood to four families.
On 22 February we left Banda Aceh and went to Jakarta. We had a final meeting with Chairman of Indonesian Red Crescent. We had a very detailed meeting with Dr Basuki. He gave us plans of the new hospital with details of all the needed supplies. He promised that if any doctors wanted to go and help his people, they will be provided transportation, accommodation, meals and working environment. We also discussed taking specialty teams and have camps for few weeks every six months or as needed. Dr Basuki was open to any suggestions and anything which could help alleviate the pain and suffering of his people.
What next? I am going to request my APPNA friends for their support for this noble cause. We will collect medical and surgical supplies and provide medical specialists in different fields. We will try to coordinate rotation of medical students and residents to have a rotation at Banda Aceh. Hidaya Foundation has promised to provide funds for shipping all the supplies we could collect. They will pay all the shipping costs and provide further assistance if needed.

 

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