February 2006 in Aceh

At the Banda Aceh Public Hospital. "ZainNoel Abudin" - Ernawati and her son Iskandar (with Robin) breastfeeding for the first time - The UN Medi Vac saved this mom and baby.  Bumi Sehat's capacity to work with the larger NGOs like UNHAS in Aceh is largely due to Team IDEP --- Thank you we love you!   Thanks Reihan for the photo.
 
Bumi Sehat ~ Aceh Field Report January to mid Feb. 2006
 
January began with the Staff of Bumi Sehat Bali singing dancing and celebrating at The Flava Lounge.  We are also proud to announce the marriage of Sandi and Tini, two of our most devoted members of staff.  Midwife and Bali clinic manager, Ibu Budi, is expecting.  So you see, Bumi Sehat is not all work.
         Brahma Kumaris Foundation sponsored Lee James to come to Ubud, and give a trauma workshop.  Much of our volunteer staff has been so inspired by his wisdom. Thanks BK, Pak Frank and Lee!   
         The Bumi Sehat Aceh clinic has a new and amazing field manager, Rosita.  "Sita" smoothes the way everyday for the medical staff to focus on patient care.  On site harmony and happiness has been just wonderful since Sita joined us.  Our total incidence of patient care for January was 1478 (some patients presented with more than one ailment).  That is an average of 47.6 incidents of patient care per day!  
         Thank heaven Atlas Logistics has been providing us with another vehicle.  Finding Atlas and convincing them to help us was the work of Matias and Thor.  We have been swamped with home visits and transports. Besides our routine postpartum and breastfeeding support, Waihidi, our paralyzed patient's bedsores get better and then worse like the weather.  Sadly, I don’t foresee a time when we won't be treating him.  We had several serious burn patients, who required daily care.  One woman with suspected leprosy, complicated by diabetes, and a very infected foot, is much improved.  A young man with filiarasis (elephantiasis caused by nematode infection of superficial and deep lymphatics) is on the mend after suffering for over two years.    
         Obor Berkat blesses us the help of a doctor and a nurse five mornings and one evening per week.  Twice a week they provide a dentist.  Without these gifted, young doctors and nurses help, our heavy patient load would surely tax our sanity.
         The Ethos Team, Renita, Will and Matias have been raising funds and running the ship from the wings.  They have secured a promise from Mercy Relief to build us three prefab buildings to our specifications.  The land site wraps around our existing clinic.  (Paula… this is what we are using your gift of funds for, THANK YOU.)  This addition of buildings and property will make our Samatiga, Aceh clinic and community center one of the most complete human resource centers in Indonesia. Rotary New York, S.E. Asia, and Ubud have kept us afloat all this time.  IDEP has also continued to support us in all the ways they can. We have been so blessed.   
         Sita and I answered a middle of the night call to the side of Yanti, a 19 year old girl with the worst rebound abdominal pain I had ever seen.  The family was reluctant to transport to the hospital, until I explained the severity of the condition their niece was in.  Yanti did get transported and had an emergency appendectomy.  Her family was unable to take her back to the hospital for post surgery follow up.  Over three weeks later she managed to bring herself to our clinic.  We removed the stitches and are now treating her for fever and infection.  Fortunately she is on the mend.      
         On the Muslim holiday, "Idul Adha," Dewi Michelle and I,  received a baby boy in the barracks at Reusak.  It was a tender birth punctuated with the mother's tenderness due to the loss of her first baby in the tsunami water. They named their new son Haji.
         Two baby girls were born at the Bumi Sehat clinic during my stay.  Dewi and Nilam, our brand-new-out-of-school midwives provide thorough and loving care for the pregnant and laboring women.  We are so happy to welcome them to the permanent Bumi field team.  Sam of team IDEP helped with Ibu Yani's birth. Sam was later called upon, by our beautiful cat, Salju, to act as midwife when she delivered two kittens in Sam and Christine's bedroom.
         Just when I thought my six week stay would prove to be busy but drama free, I was called to the tent city in Reusak, Ernawati had been in labor two days.  The traditional birth attendant, Ibu Kajika was concerned for this first time mom. As the tent was the temperature of an oven, and the laboring mom was dehydrated, I asked her to move to the Bumi Sehat clinic.  She found the clinic a cooler and much nicer place to labor.  Ibu Kajika and the family came along.  Ernawati finished out the day laboring and then all the night, with no progress. Her contractions were plenty strong, but the baby's head would not come down and dilate the cervix.  So we transported to the Meulaboh hospital.
         At the hospital we found there were zero surgeons, all having been called away to a conference on menopause in Jakarta - ok no comment. Ernawati's baby's heart was already showing signs of stress, she would be forced to go overland, by ambulance to the city of Banda Aceh, about a 24 hour trip on a road that may not even be passable.  I called Nurse Wun at Malteser.  She and Dr. Russel came right away to meet us at the hospital.  They agreed with me, that overland transport would endanger the lives of both Ernawati and her baby.  We notified UN Human Services - those angels, Mike Poole and Steve Ray.  It was already sunset, so medi vac by plane would need to wait until dawn.  Wun and I calmed Ernawati down enough to get her through the night.  Before dawn we were loading her into the Malteser ambulance.  At first light Ernawati, her husband, Anwar, and I were on our own private UN flight to Banda Aceh.  Dendy Montgomery, our Banda liaison, and Ari met us with a commandeered ambulance.  The staff, of the ZainNoel Abidin hospital, were amazing.  While we prepped Ernawati for surgery I helped the student midwives receive a quickly born baby girl.
         At the medical center in Banda Aceh the medicines and supplies donated from all over the world are finished.  Anwar and I were forced to run between three pharmacies to buy what was needed while the surgeon was on standby for the emergency surgery. Last but not least I had to run across the busy highway,  buy the sterile gloves, so that surgery could proceed.
         Once the incision was made we found that thick scaring from tsunami wounds across Ernawati's abdomen were keeping the baby's head from descending into the pelvis. T. Iskandar, a healthy 3.600kg boy was safely delivered.  The surgery was beautiful.  
         Five days later Hordur of UN Human Services working with our own Renita, moved mountains to get clearance for the new baby boy to board the UN flight home with his parents.  It was a beautiful successful medi vac, accomplished because many people and NGOs worked together to preserve life.
         A lovely side story… Ernawati and her husband had met in the tsunami water.  Anwar helped rescue Ernawati, and her two nephews from drowning.  In the days following the tsunami they fell in love, and by January 2005 were married.
         On the morning of Feb. 7th Nursima who lives in the tents at Luk Bubon, arrived in labor.  She told me that gentle labor had begun the night before, but that soon after that she had not felt the baby move or kick.  I could not find heart tones.  Nursima's blood pressure was 150/120.  We decided to deliver at the hospital and transported. Ade had to search for Nur's husband, who was fishing out at sea.  
         Even with pitocin induction Nursima's labor went all day, through the night and it was not until 4:30 the next afternoon that she was ready to birth.  The hospital midwives were gentle and compassionate and could see Nur's attachment to me. They allowed me to handle the birth along with her cousin, Dewi Fitri, a dear friend of the Yayasan.   
         Nursima's lifeless son was beautiful. The birth did not feel like a tragic event, it felt rather like all was as it was meant to be.  Nur and her husband were able to snuggle and kiss their baby, hello and good bye, before the father and I, with Ade and Sam's help, took the baby home for burial.  Sam helped me tenderly wash and dress the small fragile body. I had searched his perfect body, placenta, cord and found no irregularities, except one; the baby's palm creases looked like Islamic stars! As we squatted by this baby's back yard grave, in the dark praying together, it begun to rain.  With our hands cupped in front of our faces, I felt more blessed than ever to be a part of this project in Aceh.   
         Special thanks to Dewi Fitri, Ade and Sam if IDEP staff, Rosita, Dewi and Nilam, our new midwives.  To Ida and Thor and Matias, who were leaving as I arrived on site. Incoming team members include… "Ambo" Mark Wallace, midwives, Cheryl, and Louise from Australia (returning to us after nearly a year) plus Coner from the U.S. Nia, our young translator has also returned. Hendra our driver is still barely coping with his grief, but continues to serve.  Biggest Thanks to my family… Wil, Dèjà, Noel, Zhòu, Lakota, Zion, Thor, Hanoman and Cucu, for supporting me every minute everyday in Bali and in Aceh.  
         The day after Nursima's baby was stillborn, I received a baby for a young first-time mom living in the barracks.  Her 3.700kg baby boy was born healthy and alive.  I am reminded that life is stubborn, and babies keep being born.  That just over a year ago death had visited Aceh in a huge way. Yet, family-by-family, homes are being built.  Wells are being dug. Tsumani wounds are healing. Our clinic vegetable garden is just beginning to feed us.  Yusmi, who suffered the loss of her infant daughter and Tsunami wounds that festered for nine months, and required daily dressings, has healed. Just this week she came in to the clinic and has a positive pregnancy test.
         Bumi Sehat has now been in Aceh doing Tsunami relief work for over a year.  Looking back over this year I have learned to stretch my concept of 'safety' to include this geologically unstable, conflict zone and malaria swamp.  Yes - I have allowed my own children to work and live in Aceh.  Many, many of our volunteers have been between the ages of 14 and 24. These multi-lingual "kids" not only worked hard they taught us how to heal, by making a joyful noise and smiling into the face of trauma.  
         The Tsunami survivors have taught us that at the end of each of our lives what really remains is, love.  If those people who we leave behind on Earth feel we loved and appreciated them, they will be just fine.      
Heartfelt thanks to all our supporters all over the planet…
Om Shanti, Blessings & Alhamdulillah! ~~~ Ibu Robin Lim