In Sri Lanka after the tsunami
Authors: S. Pasu
Journal: Journal of the Royal Society of Medicine (2005)

After the tsunami had hit, I sat at home watching the death toll rise and hearing about the chaos. Being of Sri Lankan origin I was especially concerned, and four days later I was on a flight to Colombo with three other medical students, a nurse and a chaperone. Only during the 9-hour flight did I begin to ask myself what a fourth-year medical student could possibly offer amidst the devastation caused by the tsunami. I then realized that this journey was precisely why I entered medical school: I was on my way to help people who were in need.

Once in Sri Lanka we decided to focus on getting ourselves and the medical supplies to Amparai, on the eastern side of the island. This area felt the full force of the tsunami and a great number of lives were lost here. Our trek across the island took us three exhausting days, because many of the roads were flooded by heavy rain. Amparai had been flattened, a creepy ghost town, and the only help the people were getting was from the LTTE (Liberation Tigers of Tamil Eelam) and the Sri Lankan TRO (Tamil Rehabilitation Organisation)—no international aid, nothing from the Sri Lankan government.

Reinforced by two doctors we had picked up in Colombo, our team visited five refugee camps altogether. We split into three groups of two, while the nurse became the pharmacist and dealt with minor wounds. The people queued up and my partner and I experienced further self-doubt as we greeted our first patient. Somehow we took a history, came up with a diagnosis, and sent him on his way with a prescription (thanks to the trusty BNF). There was no time for sighs of relief, because the orderly queue had now turned into a mass of people firing questions. Many of them sought treatment for diarrhoea, fever and vomiting or upper respiratory tract infection. In one camp there was a heavy and inexplicable demand for tapeworm medication. In almost every consultation we heard how people had narrowly escaped death only to discover that all their possessions were gone. But there was some laughter as well as pain. Although I understand Tamil, my ability to speak it is questionable. Whether people were laughing at my jokes or at my Tamil was far from clear, but either way they were laughing. We were thankful to hear that an international group of forty Tamil doctors had arrived in Amparai and was starting to visit the camps.

We also visited Killinochi district hospital and Jaffna hospital to see how they were coping. This was my first time in a hospital outside the UK and I was struck speechless by the conditions therein. In the male general medical ward, the sicker patients were on the beds, the less sick lying on the floor under the beds. The patients had much the same stories as those in the camps but seemed far worse affected psychologically, perhaps because in hospital they had had more time to think. The doctors explained that, as in much of Asia, psychological care is provided by the immediate and extended family—and many of these people had no family left. There was no professional counselling, though volunteers came in regularly to offer some sort of social support. What these communities need is help in rebuilding their lives. When in due course I revisit the warm and loving people of Amparai, I hope to find that international assistance has done its part in helping them to emerge from this calamity.