Planning Medical Assistance
to Tsunami-Hit Areas
By Dr Mohammad Afzal
Dr. and Mrs. Mohammad Afzal Arain
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them our money was withdrawn from the bank and returned to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
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
Ships swept by the waves are strewn all over the coast
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
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 $
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.