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Dear Turbo,
Your energy unites people to serve those in need, while keeping the music alive in our hearts. The world needs more people like you, who have a dream and make it come true. Thank you so much.... Peace, Ibu Robin
Report from the Field - Samatiga, Aceh, Tsunami Clinic Nov 2005…. Robin Lim
My first night "home" in Aceh was particularly heartwarming, as the Bumi Sehat and IDEP staff had moved us to the new clinic site, just down the road in Gampung Cot. We have more than twice the space, and this wooden building, built from trees felled by the tsunami, is beautiful beyond description. There is still a pressing need for more facilities, so that we can separate the birthing women from the very sick patients. The staff continues to sleep on the clinic floor, which is crowded. Peter, Rene, Ida, and Jan had organized the medicines in the treatment rooms, a gargantuan task. Ade, Christine, Sam, Hendra, Hanafi, Cut Rachman and many Acehnese workers had labored for months to make this space a reality. We tear up when we pass our old clinic-shack, where the conservative estimate is that over 12,000 people were treated, over an 8 month period. How I wish that every IDEP and Bumi Sehat donor could walk across those wobbly floors, lean on the crumbling walls, under the leaky palm leaf roof, and look into the eyes of just one patient, who sought and found healing there after the tsunami.
The road is again impassible due to repairs being done on the bridges. With each rain it flash floods, to the point that trucks and cars get stuck, and the passengers must wade out. And it is the rainy season now.
It was Halloween night, "All Souls Day" and I settled in with my book under the mozzie net, enjoying the quiet. No sooner had I dozed off when an ambulance pulled up. Bidan (midwife) Elly from Calang, had set out at 1:30 in the afternoon, transporting a mom in labor, hemorrhaging with a placenta previa. It was already 8:30 pm. Rene changed the IV, "Marlinda" the young mom was dehydrated, tachycardic and needed to pee. Fortunately she was contracting gently, and the bleeding was not life threatening, yet. Clearly the ambulance could not cross the flooded riverbed. As miracles do happen, our transport vehicle was stuck on the far side of the river. Ida and Hendra were about to abandon it and wade home. A huge truck was nose down in the water, blocking the remains of the road. We brought the ambulance to one bank. Christine and Ade had gone ahead to move the traffic. Six strong men hefted Marlinda on her stretcher, over the water, slipping and nearly dropping her in the dunk. Ida, Midwife Elly and I held hands, rolled up our pants and braved the thigh deep, icy, rushing water. Hendra got us to the hospital in Meulaboh, which was only the beginning of the evening's adventure.
The Meulaboh hospital midwives were sorry to say that no surgeon would come until morning. This could mean that our young mother would bleed to death in the night. At the very least it would further compromise the baby, who was coming early as it was.
Without a cesarean birth things looked grim. Ida called a surgeon Dr. Cahyo, whose number she happened to have in her hand phone. He agreed to come and at least evaluate. Once he saw the situation, he doubted that he could get a surgical team together before morning. We prayed, the doctor made desperate calls. Finally, a team was organized. Ida negotiated for most of the IV fluids and medication to be donated. One more glitch, surgery could not be done with out blood to replace Marlinda's loss. Marlinda had type B+ blood. All of us there that night were O+. Marlinda was the soul tsunami survivor of her blood relatives, so getting blood via family was not possible. Once again, Ida/miracle worker, made some calls. She contacted Eddie and Mr. Wong from Mercy Relief. Middle of the night, and he hunted up a donor, and delivered the needed rare and precious blood right to us in the hospital parking lot!
Marlinda and her tiny 1 kilo 700 gram baby girl are alive and well. To add to the sadness of the story, only a week earlier the baby's father had died of complications of TB and Filariasis (Elephantiasis). It was nearly 2 a.m. when Ida, Henda, Midwife Elly and I made the long trip back to our beautiful new clinic. We had to park on the South side of the rushing water - and wade across. Ade and Hanafi were waiting to shuttle us the rest of the way home by motorbike. After drying off we all slept well, deliciously.
In the morning we learned the Midwife Elly had lost all three of her small children in the Tsunami. She was stationed in Calang, while her husband was far North in Banda Aceh. She was distressed, and shared that they had planned to try to make a baby at Idul Fitri, the end of the Ramadan month of fasting. She had been given a few days off to return home to her man. Sadly, the saving of Marlinda's life meant her planned honeymoon was cut short, in fact there would not be time, as the bus trip from Meulaboh would be nearly two days long, even if the roads were open. I called Mike at the UN, and shared Elly's story. He put her on a Un flight that very day, reuniting Elly and her husband for the first time in many months.
Marlinda's baby dropped in weight from 1 kilo 700 grams to 1 k 300 g. We continued to visit them in the hospital, She named her baby Muliasafitri, after her deceased husband, Mulia. The last time we visited they had been released and had gone home to Calang, the baby, tiny, weak, but alive.
The next morning we were visited by the family of Mohamed Thori, born at Bumi Sehat the month before into the loving hands of Anna Rawling. He is healthy and growing. Malaria patients keep coming in. It is raining part of nearly every day and night now. The tent dwellers have scavenged what they can to build shacks around their tents. There are houses of brick going up in our area, thanks to many international NGOs but construction is slow due to the rain and poor road conditions.
Dr. Anne Entus (PHD psychology) is here treating Bumi Sehat patients for trauma, believe me she is busy. We have seen her help so many people with high blood pressure, sleep and eating disorders. One night a 25 year old deaf and dumb patient was brought in, in a catatonic stupor. All his vitals were normal, he was cold and stiff as a board, as if in a trance. After 20 minutes in therapy with Anne he walked out of the clinic, to resume his life. Late the next night, a patient was brought in by his family, with a suspected "acute asthma attack". Upon examining him I found he just had a terrible case of hiccups, which had begun 10 hours earlier! Again, Dr. Anne to the rescue, the patient left without the painful hiccups and with a smile.
Alulia, a two year old girl was brought in having fallen from her uncle's motorbike. She suffered two deep gashes in her head. Ida calmed her while I sutured. She is just fine now. Today she will be coming in to have her sutures removed.
We had thought that moving the clinic would mean that attendance would drop drastically. Well, we are averaging 45 to 60 patients per day, unless it rains all day and all night. There are an increasing number of pregnant women, including many who had come in for fertility counseling months ago, to achieve pregnancy. We continue to need vitamins. UNICEF has provided micro nutrient powder for all the children. John Fawcett Foundation gave us combantrin, and I am worming everyone who has symptoms.
The mosquitoes are savage out here in Gampong Cot, where the new clinic sits, between two graveyards, swamp to the East, Ocean just West. We struggle with the high price of gasoline to run the generator. Our prayer is to find the financing to get set up with solar power, as the electric lines will not be reaching us out here anytime soon. The clinic staff is enjoying a heap of harmony. The food is, well, not so good. Ade went out and caught a jungle foul, roasted it for us, that was the week's culinary highlight. Bang Hanafi goes fishing. The cooks bring food from Meulaboh, but they are widows, and their depression is evident in the flavor of their cooking. Seems the only really delicious food that comes our way these days is a result of the male staff getting hungry enough to go out and kill something, roast it on a fire, and feed it to us!
Dr. Anne Entus suffered the near rupturing of her hernia. Thanks to cooperation between doctors from several NOGs, coordinated by Samantha from IDEP, and the Meulaboh hospital, Anne received surgery just in time. The UN plane then airlifted her to Medan. She is on the mend now, home in Bali.
Dr Frank and Nicole arrived toward the end of November, to donate a week of their time. Frank, a Dr. of Traditional Chinese Medicine treated dozens of patients, with great success. He is already missed. One life Dr. Frank saved was that of a young man stung by a scorpion. His foot was bright red, hot, swollen. A red line was traveling up his leg, and he had extreme pain. Frank applied a Chinese medicine almost never used, toad venom, to the wound. Then he and Ade drove the patient to the hospital in Meulaboh, to get serum/anti venom. Because the poison was moving fast, they were worried that the long trip on our impossibly bad road, would get them there too late, unless the toad venom worked. Well, when they arrived at the hospital, the patient's foot looked normal. The red line was gone. The swelling was also gone. Pain, nearly gone. Serum was administered 'just in case', but the patient was clearly saved. Sometime around 2 a.m. Ade called to say that a truck had fallen off of the last bridge on the road home to the clinic. I woke Bang Hanafi, to go get them. Hanafi took the patient home by motorbike. Then he finally brought Frank back to the clinic. Ade stayed with the car, and helped get the truck out of the way so he and some friends from the village could fix the bridge. About 5 a.m. Ade came home, feeling very good about the night's events.
The 23rd of November I was called with Nia, my assistant, to a birth in the barracks in Reusak. Suardani gave birth to a healthy 3 kilo girl. Her first child, a four year old boy, had been taken by the Tsunami. That birth, in the run down barracks, where the laboring woman had to wade out over toilet seat covers laid out to make a path to the outhouse, was a beautiful event. We could hear the happy sounds of Federation Red Cross, Red Crescent food packets being distributed. We could smell the fish drying on huge plastic tarps. We could hear the radio of the people 1/8 inch of plywood away, in the room next door. They could hear us, laughing and crying.
The next day I went to see Wahuidi, the young man paralyzed in a motorbike accident. His younger brother Farizal is taking such good care of his bedsores that they are healing beautifully. Matias is bringing him books to read. Handicapped International has provided him with a rolling bed, proper mattress, and gel pillow. His spirits are good. Our translator and 'get anything and everything done' girl, Ida… has given him hope for a quality of life that he knows will be entirely up to him. Wahuidi is so positive - we believe he overcome the obstacle of not ever being able to move around on his own.
I had wanted November 24th, my 49th birthday to be quiet. I was terribly lonely for my family, and wished just to catch up with Wahuidi and see my friend, Ibu Elysa. Elysa and Pak Usman had two living daughters. Yenni, and Wulan. Bella and Indah, the two youngest, a toddler and a baby, had been torn from Yenni and Elysa's arms by the tsunami. Now, nearly a year after the tsunami, Elysa was expecting any minute. I was a bit concerned as her fundus was huge and I felt baby parts all over the place. I found two heartbeats, but said only, "Pak Usman, how many babies did your plant in your wife?" I was not certain, and I wanted to wait to see what they next prenatal visit proved. Since there is no ultrasound available in Muelaboh, I did not refer them.
Well, I showed up at Elysa's house, which they share with four families. She was feeling badly, had mild pain. I felt her pulses and her belly and assured her that this was most likely, early labor. I told her I would come back in about an hour, as I had to do a few errands for the clinic, and asked her to call my hand phone should anything come up. Well, less than an hour later Elysa called to say her waters had released. I had just gotten through to the clinic to have my birthkit sent out. I had my basic prenatal kit, and dashed into Medicens Sans Frontiers to ask for some sterile gloves. Hendra got me to Elysa's side in record time. Ade, back at the clinic in Samatiga sent Eti, our accountant and Nicole off at top speed on the motorbike, with the birthkit. They arrived 9 minutes before the first baby came.
Baby number one was born 8 minutes before number two. Both girls were born head-first. It would have been a stress free delivery for me, but for the fact that I could get no heart tones at all on baby number one. The birth was moving too fast to transport. Imagine my relief when a perfectly healthy alive baby emerged. The girls are identical, shared one placenta, separate amniotic sacs. Baby number two was born in the caul at 2 kilos, 800 grams. Her elder sister was 3 kilograms exactly. Considering the size that her uterus had to stretch to accommodate the twins, Elysa did not bleed that much, though I would consider it a hemorrhage, and I did administer pitocin. I watched her carefully. Baby number two needed some suctioning as her airways were blocked by thick mucous, and she had some chest retractions, which cleared up within 9 or 10 minutes. Both girls went enthusiastically to the breast.
For Nicole this was her first time to assist at birth. What a beautiful introduction to midwifery! I am so grateful for her assistance. At one point I am sure we each had four arms.
We are now getting help from the Obor Berkat doctors from Java several days per week. I was sad to find two patients with Leprosy. We are currently seeking medication for them. It is a grave concern of mine whenever I find yet another contagious disease in Samatiga. The people in the tents and barracks are immune depressed from grief, minimal sanitation, and malnutrition. They don't need leprosy.
This year as you celebrate the birth of Christ, the tsunami survivors will be remembering that one year ago on December 26th 2004, most of their loved ones died. One year ago they became homeless. As the New Year dawned the tsunami survivors slept in the rain, and wore mud to cover their bodies. Their eyes searched the sky for help, in the way of boxes of dry noodles dropped from helicopters. Today, a year later, they live in rotting tents and barracks buildings with sagging floors. They survive by the kindness of donors all over the world. They are having babies if they can. They are happy as the tiny houses are beginning to go up.
Together, we are building bridges in the rain.
With very special thanks to Rotary, Zimmerman Foundation, Sakthi Foundation, as well as all the ANGELS behind the scenes who are keeping the Bumi Sehat Tsunami Relief clinic open. Your hearts move our hands to heal.
With love and gratitude, Ibu Robin Lim
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