Surgeons provide aid to tsunami victims

Several medical groups responded with volunteer services and financial assistance.

The tsunami that struck Southeast Asia in December, leaving more than 200,000 people dead and thousands missing, also left many more people needing medical care for injuries they received as they sought shelter.

Entire villages were wiped off the map in Thailand and neighboring countries, leaving thousands injured and/or homeless. Courtesy of Richard P. Whittaker

To treat survivors of the worst natural disaster to strike Asia in recent history, several groups volunteered their services during the weeks that followed.

One such group, the World Surgical Foundation, sent a nine-surgeon team to Thailand to care for survivors. One physician, Richard P. Whittaker, MD, an orthopaedic surgeon in Pottstown, U.S.A., spent nearly two weeks in south Thailand at the end of January and early February, working at two hospitals that treated tsunami survivors.

The only orthopaedic surgeon in the group, Whittaker worked closely with physicians from Germany, Belgium, Switzerland and Australia during his mission. He said the devastation caused by the earthquake and flooding was overwhelming.

“It was amazing to see how much damage could occur in such a short time,” he told Orthopaedics Today.

The Thai Army gave Whittaker and his colleagues a ride on an army helicopter up the coast, where they witnessed the carnage from a different vantage point.

Did not discriminate

“I have aerial pictures of these five-star resort areas that were just devastated, as well as some of the local fishing villages that were also destroyed. It hit the rich and the poor equally. It didn’t discriminate,” he said.

Whittaker, who has used his medical skills in other volunteer efforts, said he felt prepared to tackle the challenges of the tsunami. With 38 years’ experience in the U.S. Army Reserve, he visited Nicaragua in 1972 literally within hours after an earthquake hit the region.

“We provided a lot of acute care for the patients there for three days. That was quite dramatic; we were in a tent hospital treating patients while the ground was still shaking,” said Whittaker, who published findings from that experience in the Journal of Trauma in 1973.

In 1974, he spent a month and a half in Santa Domingo under the auspices of Orthopaedics Overseas. Several years later, Whittaker served as the program director of a project in Uganda. He continued his worldwide volunteer efforts in Guatemala in 2000 with the group Hands for Peacemaking, and has also volunteered for efforts in Panama.

Local donations

Prior to the Thailand trip, residents of his hometown donated about USD 2000, and the local hospital provided medicines, which Whittaker and his World Surgical Foundation colleagues used on their effort.

They arrived three weeks after the disaster and worked in two hospitals: the Patong Beach Hospital, located near one of the beaches struck by the storm, and a 400-bed city-based hospital in nearby Phuket.

“When we got to these patients, most were in a healing or subacute stage,” he said. “We had some patients who were tossed around by the waves and got banged up a bit. It wasn’t so much the waves that did the damage, though; it was all the debris that got picked up like cars, buses, trucks and building materials that was getting tossed around with these people. That’s where they received most of their injuries.”

The first hospital only had rudimentary surgical equipment, and all of the beds were lined in makeshift rows. “The beach hospital was a small place – maybe 50 beds – with a lot of interns mainly, and I worked with them in the emergency room. We dealt with mostly general cases and only few surgical cases.”

More surgical cases

Puskesmas Kopelma Darussalam hospital in Banda Aceh, Indonesia, was a large general health practice that served as a training center for young physicians. It was severely damaged in the tsunami. Courtesy of Tahija SG

In the Phuket hospital, Whittaker worked alongside seven orthopaedic surgeons. “In that situation, you’re volunteering to help out in whatever capacity they need help with,” he said. “We had a lot of general fracture cases there, including one woman who was hit by a car in the panic that occurred [when the storm struck], and everyone was kind of running around looking for cover. She had an open fracture of the tibia.”

Although most of the cases he saw were not emergency cases, Whittaker feels that the care he and his colleagues provided was much appreciated.

“The interns and other physicians we worked with at both hospitals were very hospitable. We felt a little bit like celebrities,” he said. “I think we learned as much from them as they did from us.”

Ongoing work

The rehabilitation of affected areas will require long-term devotion and the concerted effort of many groups to help survivors reclaim their lives.

In the Banda Aceh and North Sumatra provinces of Indonesia, where the World Health Organization (WHO) estimates that 150,000 people died, more than 50% of the health care workers were killed or reported missing.

“In the aftermath, health care was nonexistent,” said Sjakon G. Tahija, MD, a vitreoretinal surgeon at the Klinik Mata Nusantara in Jakarta, Indonesia, and a founding member of The Tahija Foundation, a social organization that has provided outreach services to tsunami-affected areas.

He said that many health care workers died in Banda Aceh, the hardest hit area in Indonesia.

Long-term rehabilitation

Immediately after the tsunami, government officials and international nongovernmental organizations (NGOs) knew that providing survivors with immediate necessities was key, but beyond that need, the rehabilitation of damaged health care systems was vital.

Orthopaedic surgeon Richard P. Whittaker, at right, assists an intern in Thailand during his visit there after the tsunami. Courtesy of Richard P. Whittaker

“We must look beyond immediate relief to rebuild lives, livelihoods and systems,” said David Nabarro, MD, executive director of the WHO’s sustainable development and healthy environments division, in a statement. The focus of many NGOs such as the WHO has since hinged on planning for long-term restoration of health care systems.

“A key challenge is the re-establishment of the health system at all levels,” said Colin J. Davies, project coordinator of The Tahija Foundation’s Aceh Project, an “Assist a Village” program that was established after the tsunami to help rebuild two Banda Aceh districts.

The Tahija Foundation’s “Assist a Village” program is focused on restoring health care facilities on the coast of Indonesia that were damaged by the tsunami.

“We are rehabilitating two clinics in Banda Aceh that were demolished by the waters,” Tahija said. One clinic, the Puskesmas BLKM in Baiturrahman, was a large general health practice that served as a training center for young physicians.

“It was severely damaged and filled with mud after the tsunami,” Tahija said. When aid workers entered the clinic to begin draining the mud, he said, they discovered 15 bodies.

Doctors of the World

Doctors of the World, another international medical volunteer organization with affiliate offices in 11 countries, also treated tsunami victims. Thomas Dougherty, executive director of Doctors of the World-USA, said the organization provided emergency medical relief and materials to alleviate or prevent health crises.

Doctors of the World teams were dispatched to the most heavily affected areas of Sri Lanka and Indonesia, focusing on improving public health and the water supply.

“They established clinics and refugee shelter settlements and have brought tons of supplies in terms of medicine, chlorination kits, water and food,” Dougherty said. “They’re also making an assessment for further rebuilding of the health care system there.

“Our approach is not only to deliver emergency relief, but also to stay for an extended period of time and help in the reconstruction of health systems.”

Anthony J. Kozlowski, executive director of the Seva Foundation, an NGO that is raising tsunami relief funds through the Internet, said the restoration will take time.

“In places like Aceh in Indonesia or several parts of Sri Lanka, where people’s lives were decimated and communities wiped away, it’s going to take years before some sense of normalcy is restored to these places,” he said.

Correspondent Nicole Nader and corresponding editor David W. Mullin also contributed to this article.