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By: Robin Lim, March 4th,
2005
The Indian Ocean off the
West Coast of Sama Tiga Aceh is the exact
temperature of tears. We put our feet in the
water. Kelly Dunn, Canadian midwife, found a
child’s rubber slipper there on the beach. She
made it an altar, with shells, rusty wire, stones
and broken plastic. Ari Tueku wrote poems on the
shore, and let the gentle waves take them away,
just as the Tsunami had taken away his
grandmother, closest cousin, and nearly 70 dear
family members.
The earthquake that struck just
offshore of Northwest Sumatra on December 26 and
subsequent tsunami has changed our planet both
physically and emotionally forever. Geologists
speak of a rise in the underground water table, as
far away as Florida. Spiritual leaders tell us it
is an opportunity to open our hearts, as so many
people, all around the world have been effected.
An accurate accounting of the loss of life can
never be achieved. In Aceh, Indonesia alone
experts began to conservatively estimate 800,000
homeless survivors, and well over a quarter of a
million souls lost. The remains of the dead
continue to be unearthed by search and rescue
workers, at an alarming rate, everyday, even two
months after the disaster. The only thing that
has become clear is that we will never fully
understand the extent of the devastation.
I am to write a report of the Yayasan
Bumi Sehat (Healthy Mother Earth Foundation)
relief efforts there. I am having trouble doing
this. There are just too many faces of anguish,
the sleepless guilt lines a mother wears, because
her baby was torn from her arms, the tsunami was
just too violent. The fierce strength of
mother’s love was not enough to keep the children
alive. A man comes to cry for his daughter, also
torn from his arms, his wife still missing, and he
has no photos of them. No home, no spoon, nor
tool nor bed mat. His skin is covered with
scabies and there are festering wounds, now weeks
old, from the debris he swam in on December 26th.
We arrived in Medan a busy Sumatran
city, not hit by the giant waves. We were able to
make contact and meet informally with World Food
Bank staff, to discuss the problem of infant
formula distribution, which could undermine
breastfeeding, with devastating results. They
agreed with our recommendation to only give infant
formula if the mother had actually died. We also
met with International Medical Corps, UNICEF, IRC/
CHRDI, Catholic Relief Services, and Global
Relief.
Also during our whirlwind two days in Medan, with
the help of Yayasan WALHI (Friends of the Earth-
Indonesia) (huge thanks to Lenny, Monang, Herwin
and the WALHI staff) we purchased a huge truckload
of cacang hijau and cagang tannah, (mung beans and
peanuts). We choose protein for a population who
for over four weeks has survived on coconuts,
white rice and dry packaged noodle soup sent from
relief organizations. Those who had already seen
relief, were fortunate. We were to learn that
there are still pockets of survivors in places so
remote that medical and food relief had not
reached them.
We also loaded the truck with school
supplies donated by Yayasan Ibu Puduli (Mothers
Who Care non profit foundation) of Bali. We
organized kitchen buckets for families who had
lost everything, in the hope of making a step
toward the restoration of ‘normal life’. We were
to learn that ‘normal life’ must be redefined
forever for Aceh. Loaded up onto the truck were
baby sets, in little plastic baby bathtubs.
Small, small clothing, blankets, a little hope for
a new post-tsunami generation. We had big plastic
boxes filled with precious medicines. A hundred
jilbabs, so the Muslim women who lost their
necessary head covering could come out. We were
given bras to distribute, because that apparently
is what women had asked for along with underpants,
and prayer books, salt, kitchen knives, mosquito
repellant, candles, matches and other essential
survival items.. We loaded the truck until it
seemed it would burst, and then we loaded up three
generators, tools, drums of fuel. The truck and
the rental car went over land, with Benny, Ari and
Ida, traveling over 16 hours, through dangerous
mountain checkpoints, military and rebel tension
zones, to the far northern province of Aceh. The
rest of the team, Thoreau, Wil, Deja, Oded, Kelly
and Robin would catch a free Red Cross – Red
Cresent flight to Meulaboh. (Thanks to IRCRC
director Phil, a true angel)
In Meulaboh we found a city more than half
destroyed. While the ‘Search and Rescue’ teams
were still packaging bodies and parts of people,
the remains of a market was open. Oranges and
selak fruit for sale, even some fish, though there
are nearly no fishermen or boats left. We were
blessed to find, thanks to Ari and Benny, Ibu
Rosni, Ibu Dosni, Elly and Ibu Makbid of Yayasan
Anisa. Anisa means woman in Arabic, Yayasan means
nonprofit organization. This grassroots
organization had lost its office during the
Tsunami, Anisa staff had lost family, but they
kept working. These brave women were the first to
give relief to the tsunami survivors in Meulaboh.
It was the Anisa staff that organized and
distributed the precious kitchen and baby buckets
for us. They told of the dilemma of host
families, who had not lost their homes, but were
housing many, sometimes 20 or more victims, and
feeding them on a family budget that was
inadequate before the tsunami struck. We were
able to report this to World Food Bank, who
immediately acknowledged that displaced peoples
outside the tent camps were not getting food
relief, and they promised to address the problem
immediately.
Ibu Rosni and the Anisa staff hosted Kelly and I
to teach a day long workshop for midwives. We
were amazed to find that 41 Bidans (midwives)
attended. Most of these women had lost family and
home. One midwife, walked three days to attend.
She had lost her husband, child and home, and was
30 weeks pregnant. For her this workshop was an
opportunity to get back on her feet, so she could
continue to help people.
All of the midwives attending the workshop
reported that they had lost their equipment and
birthkits. We were able to convince the medical
director of UNICEF Indonesia, Scott Whoolery, to
attend our meeting. He was thrilled to be meeting
so many of the women who are actually out there,
doing the primary healthcare for the citizens of
Aceh. He promised that each midwife would receive
a UNICEF midwife kit. Scott will be using the
network of Yayasan Anisa to be certain that the
birthkits are delivered to each midwife in her
home village.
Sadly we found a high rate of infant demise due to
tetanus. Because most of Aceh has no
refrigeration, (the TT vaccine requires
refrigeration) it is not reasonable to believe
that a tetanus toxiod vaccine campaign could solve
this problem. One must also consider the fact the
midwives and ‘dukun bayi,’ (traditional birth
attendants) who are attending the lion’s share of
births in Ache, do not have a dependable source of
water and means to keep instruments sterile.
(Plus remember that most of the midwives’ cord
cutting instruments were swept away by the
tsunami.) Kelly and I taught these 41 birth
attendants how to safely burn the cord. This
method eliminates the danger of tetanus or other
bacterial transmission from non-sterile
instruments. The midwives were thrilled. They
came away from the workshop feeling like they had
learned a skill which they desperately needed. We
were also able to encourage them to get medicines
free from Ober Berkat Foundation. As well as
seeking help from Medecines Sans Frontiers and
Global Relief.
Meanwhile at the camp we shared with the WALHI/
IDEP clean water and sanitation crew, staffed by
16 hard working Balinese men, an American
dedicated to testing wells for salinity, a Mexican
doctor and run by Nuragh and Christine, a clinic
was being built for us. We barely arrived in camp
and we started seeing between 30 and 70 patients
per day, in a bamboo structure with blue tarps for
rain protection. (Oh yes it rained and rained, and
yes, we had earthquakes!) While pumping the salt
water from wells, and making pit toilets for the
people of the 15 or more villages surrounding the
community of Cot Seulamat, the Balinese crew
turned trees felled by the tsunami into lumber and
built a beautiful clinic.
At the clinic we found that nearly every mother
had lost children, within 2 to 3 days after birth,
long before the tsunami washed over their lives.
Over thirty years of civil war has deeply
compromised the people’s nutrition, adding to the
maternal and infant mortality rate.
One morning, early we were rushed to the home of a
mother who had just given birth. We found Ibu
Bulan,(Ibu means mother, Bulan means moon) a
traditional midwife in attendance. She had
already cut the baby’s umbilical cord with old,
blunt school scissors. The baby appeared fine,
though small, about two kilos. The new mother,
Roswita, a thirty five year old woman, having just
birthed her fourth baby of which two had already
died, most likely of tetanus, was not in good
condition.
Roswita was hemorrhaging, her placenta was
retained and Ibu Bulan had done cord traction, and
pulled the cord off of the placenta. I gloved up
quickly, and manually peeled the placenta,
centimeter by centimeter off of the inside wall of
the mother’s uterus. This was painful for Roswita,
and doubly difficult as culturally she was not
comfortable opening her legs, even to save her
life. Kelly talked me through the intense
procedure, while Ibu Bulan spoke soothing words to
Roswita. When finally the placenta, the most
unhealthy looking one any of us had ever seen, was
born, Ibu Bulan fell sobbing into my arms. “Thank
you, thank you, this has never happened to me
before, I was terrified, I did not want my
friend’s daughter to die.” I learned that just 8
months earlier Roswita’s sister in law birthed in
the same home, with the help of Ibu Bulan’s
daughter, also a traditional midwife. That young
woman was not as lucky. She also retained her
placenta, and died in transport to Meulaboh
hospital, which is 45 minutes to one hour away, by
swamp road.
This near fatal complication turned out to be one
of the many blessings along our way in Aceh. Ibu
Bulan’s trust was essential if we were to serve
these communities of hard-hit tsunami victims.
She later did a birth with the Bumi Sehat midwives
of team II, Jenny and Indah. They burned the cord
and Ibu bulan is now sold on this much safer
protocol. No doubt this alone will save countless
neonatal lives.
Oded from our Bumi Sehat team, along with the
WALHI Bali crew, was busy helping the surviving
villagers of Pucuk Ulung and Lhok Bubon to
resettle. We gave them generators and strung
electric street lamps, to help the people conquer
their fear of the night. Though the homes were
completely destroyed Oded and Christine networked
with Mercy Corps to get the families tents and
kerosene cooking stoves. He organized the people
into work crews to fix the Mosque roof, and make a
rain catch system for wash water. Oxfam brought
in a 10,000 liter bladder for drinking water,
which they deliver every day or two.
Catholic Relief services paid for a
new roof for the Mosque of Lhok Bubon. The
survivors of this village are mostly men, who were
far out to sea fishing when the tsunami hit. When
they returned home that evening, they found their
wives, children, old people, friends and homes,
were all totally gone. The only building standing
was the Mosque, where 70 people were marooned on
top.
One of the women clinging to that roof
was Sarjani. Sarjani had lost her two daughters in
the deluge that day. Deep in the water, nearly
unconscious she resigned herself to death. A
caribou (water buffalo) nudged her with a huge
horn, and Sarjani grasped it. She was huge with
child and could not swim, the gentle animal took
her to the surface and deposited her beside the
roof of the Mosque. As the sunset, that evening
and the tsunami waters receded, and the men of
Lhok Bubon came home to a nightmare of
devastation, Sarjani went into hard labor. Also
among the survivors on that roof was a midwife.
“Alhamdulilah, (all glory to Allah) as the Muslim
people of Aceh say when they’ve been blessed.
The resettlement of these villages is
essential to the physical and emotional survival
of the people. Those people who do not go home to
their destroyed villages, to attempt to rebuild
their lives on ancestral soil, face generations of
displacement. Many will live in tent cities,
surviving upon relief foods, or in military
barracks’ where five to eight people will be
housed in rooms with one small window, and
hundreds will share toilet facilities. Those
people going “home” face other hardships.
Citizens of villages close to the sea may find
themselves permanently displaced, as the
Indonesian government has delineated a
conservation zone, disallowing any resettlement
within 500 meters of the sea. For this reason the
small fishing communities are rushing to return
home, before they are stopped. The resettlement
of Lhok Bubon and Pucuk Ulung, facilitated by our
IDEP/ WALHI team and Oded from Bumi Sehat, was not
in our budget. Going there late at night to do
medical relief, in a tent, and sharing their meal
of the mung beans and peanuts we donated… was a
beautiful feeling. I heard rumor that Oded bough
them a volley ball set, also not in the budget!
Oh dear.
Other heroic deeds include, the WALHI
Bali staff pumping wells, testing and mapping
wells for salinity, building the clinic, and to
finding the time to build a bridge, connecting
Lhok Bubon to the rest of the world. What these
guys can do with some dead trees, a chain saw and
a lot of cooperation is an ongoing miracle. We
are hoping IDEP can continue to fund Christine and
Nuragh’s amazing crew, so that they may continue
their clean water and sanitation efforts. Graham
of Catholic Relief Services is planning to work
with the WALHI Bali Crew and with Bumi Sehat in
“livelyhood” efforts. One request from the
resettled villagers was for baby fruit trees.
Thanks to Nils of Mentor (and to the
tireless efforts of Midwife Kelly and Dr. Dario)
we were able to get malaria Rapid test kits and
medication for both children and adults with P.
falciparum malaria. Team II from Bumi Sehat is in
the field now, and recently found a small girl
with falciparum malaria, they were blessed to be
able to diagnose and treat her in time. A
volunteer from Bali died this morning of hepatitis
and what seemed to be complications of malaria he
contacted while doing relief work in Sama Tiga
Aceh. The Bumi Sehat team is taking preventative
medications for malaria, which is only 30%
effective, so light a candle for us.
The orphans we met, there were many,
were being cared for by relatives. This is the
traditional way of caring in Aceh. Rizky, a
well-fed eight year old boy survives his mother,
father, sister and several cousins who were
spending the night in Meulaboh with his family.
There is a nearly healed gash across his left
cheek. He quietly told me that the piece of sheet
metal that glanced off of his face, took off his
father’s head. He and his six year old brother
live with their maternal uncle, whose own son was
carried out to sea floating on a couch, never to
be seen again. Rizky worries about his thirteen
year old sister, “She may be alive. Neighbors saw
men from a large boat taking teenage girls away
the next morning after the tsunami. She may have
been kidnapped, and now living as a slave. My
uncle is always trying to find information, but we
have no way of finding who these men are.”
Most of the schools we saw were either destroyed
or filled with mud and debris. A man in his early
forties came to the clinic to ask for help, as he
could not sleep. He was a school teacher. “I had
116 students before the tsunami, I am left with
nine surviving.” Pak Abdul broke down and cried.
He cried a long time, then he softly began to say
the names of his beautiful students. We gave him
homeopathy to take before bedtime, and we
listened. Two days later he came back, looking
much better. “Thank you,” he said, “for hearing
their names. I am now sleeping a little.”
The Bumi Sehat free walk in clinic in
Cot Seulamat, Sama Tiga, Aceh, serves an average
of 70 patients per day. The rolling staff
consists of volunteers from all over the world,
based out of Bali. The Aceh staff is growing and
will give solidity to our dream of
sustainability. This clinic is a neutral place
where tsunami victims, host families, military
personel, and the most marginalized peoples feel
comfortable coming for help. Some of them are
very sick, or have infected injuries. There are
an increasing number of malaria victims. Others
are pregnant, most all the people we saw were
malnourished. 100% were traumatized. For many
just telling their story, saying the names of
their dead children and wives, brothers, sisters,
mothers, uncles, gave enough comfort to allow them
a night’s sleep, finally. I am still not sure
what we dreamed our goals could be in going out to
Aceh. We were asked to go, helped by the donors
to IDEP Aid for Aceh, and many others. I hope we
did a good job for our donors and the people of
Aceh. We got a Clinic going and must try to keep
it staffed. We bridged many Indonesian Aid
organizations and care providers with the big
International NGOs. We made some beautiful
friends in Aceh.
Huge thank you to our ground team in
Bali, particularly Josh, Nita, Ibu Sundari, and
Melanie, who take care of us so we can take care
of others. The gang at IDEP, Petra, Frank, Rhoda,
David, Mary, Endang, Made, Peter, Samantha, Chakra,
Rebecca, Cat and all of you… My graphics team who
developed the “Clean, Safe, Calm Birth book for
Aceh, Josh, Lakota, Zhouie, and Ibu Brenda who did
the writing. Zion, the Bumi Sehat team t-shirt
rocks. The Bumi Sehat Staff, Sandi, Harvest, Ibu
Budi, Ibu Susanti, Dr. Bobbi, Suastini, Kadek,
Ketut, Pastika, Kadek Kick, Pak Tunjung, Iloh, Ibu
Putu, you are so wonderful. Special hugs to my
household staff, IbuWayan, Tini, Liwati, Made and
Sandi, for putting up with this crazy lifestyle of
SEVA (service). My family, Husband Wil, who
joined the Team with son Thor and daughter Deja
bringing media support and nursing skills (By
helping Search and Rescue bring bodies home to the
families for proper burial, you built trust and
showed great courage.) Ari, Benny, Ibu Rosni,
Isnyati and Ibu Aysha, thank you for being our
Angels in Aceh. Oded, Ida, Christine, Nuragh, Pak
Made, Tyak, all the Bali crew, huge thanks and so
much love. Agustian, Noel and Zion for joining
team II, even though that really is gunfire you
hear at night in the woods behind the clinic. I
know testing and mapping well salinity, driving
around, and supporting the midwives, collecting
medication, translating, digging the WC, moving
the water tower, and constant clean up, are pretty
thankless jobs… you are so great to be doing all
this and more. Kelly, you and your family have
given a thousand percent. Plus you took the
hardest patients on, with smiles. Team II
midwives, Indah, Jenny, Cheryl and Louise, I pray
you are finding joy in the tremendous job you are
currently doing out there in Aceh right now.
Harvest, Carolyn and the Team III members yet to
be named, thank you advance. I’ll be back in Aceh
around the first of April, God-in-all-of-us
willing.
From the perspective of our goodbye
flight on the International Red Cross Red Crescent
plane, flying low and slow all along the West
Coast of Sumatra, it looks quite hopeless. There
are big, once busy Asian cities leveled. Huge
barges four or five kilometers inland. The road
North of Meulaboh is hopelessly ruined. The
beaches are littered with broken toys and broken
dreams. My midwife friend Shirley Tidy once said,
“Maybe we can’t change the world, but we can give
it a go!” This has become my mantra. The wounds
of December 26 are scaring over. I felt no
ghosts in the night at Aceh, there is a peace, a
sweetness between people, and a prayer for
healing.
Om
Shanti, Ibu Robin
Lim
March, 2005, Bali, Indonesia
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