Friday, July 01, 2005

On my way to Rwanda

So I have an official departure date: July 18th. I'll be leaving from Boston and flying to Kigali, Rwanda via Amsterdam and Kenya. Thank you everyone for all of your support. Please do click on the comments area to leave me messages...

Tamalia's Thank you from the Indonesian People April 2005

This is a speech from Tamalia - one of the translators aboard the USNS Mercy as the second wave of Project Hope Volunteers were departing, March 2005. She works as a curator for the Indonesian National Museum in Jakarta.

"I think that it was Sir Arthur Chesterfield who said something along the lines that the human species is happiest when it is of service to others. Well, I do not think that I shall ever be on a happier ship than this one.

You, doctors and nurses who have worked on this ship treating the wounded Acehnese tsunami survivors are extremely special people with an enormous compassion and empathy for others, especially for those who are suffering. You are truly good people - if you were not you would never have volunteered to be on this ship and I think that when a large group of truly good and caring people are collected together in one place like this - it creates a certain energy of its own which has far reaching effects.

I do not know if you are aware of it but when I left Jakarta to join the Mercy the front page article of one the newspapers in Jakarta was about how Indonesian public opinion towards America was taking a major turn. This happened after Indonesians started reading about and watching via the television the thousands of mercy missions flown by the helicopters of the USNS Abraham Lincoln off the coast of Aceh. Daily the helicopters dropped food, water and medical supplies to the survivors of the tsunami whom my government would never have been able to reach in time after the enormous destruction of roads, bridges and communications by the tsunami.

And later Indonesians witnessed the compassion of the doctors and nurses of the USNS Mercy as they treated over 19,500 Acehnese patients and performed over 250 operations. I do not think that any other government in the world would have been able to provide such an enormous quantity of aid so rapidly because no other government is equipped with the enormous war machine that the United States has and what happened is that in the last three months we have watched that great war machine being used for something totally different and in a way that was completely foreign to us. It was being used to save and heal thousands of lives and quite frankly, at first we Indonesians watched with suspicion and then in puzzlement but finally with gratitude and fondness.

During the last days before the departure of the ship many of the patients were returned to shore to finish their final recuperation at Indonesian hospitals many of which are just starting to fully function again. It was a very emotional time for me as I have had to translate for many of the patients and doctors and nurses as they bid each other farewell. Over and over again this is what the patients have been saying, "I do not know how to thank you. I cannot repay you for what you have done. I have nothing with which to repay you. It is only God who will be able to repay you for what you have done..."

It is one thing to heal people and to give them medical aid but I think that there is another element in all this that you may not be aware of. These people that you have been treating are the poorest of the poor. They eat chicken or meat perhaps once a year. If they eat fish twice a week that is already good. Normally, their meal will be a plate of rice with some chilly peppers and a bit of swamp spinach or other vegetable. There has been an insurgency going on here for many years. The military comes and extorts money out of them and burns their houses. Then the separatists come and kidnap them, extort money out of them and burn their houses.

They are frequently caught in the cross-fire between the military and the separatists and it doesn't matter because they are just garbage - people of no value. If they go to a hospital for help they are not kept waiting for hours - they are sometimes kept waiting for days and they are treated with arrogance and without care. Indifference is often the best they can expect. And then they came here. Here you not only healed their bodies but you treated them with such gentleness, such compassion and such great courtesy. For the first time in their lives they were treated as human beings who have worth. You see a man who has lost an arm, a patient who has lost a leg and yet when they leave the ship they are all smiling.

The joy in them is overwhelming. They are perhaps happier than they have ever been in their lives because for the first time they are aware of their worth as people - that their thoughts and feelings and lives count. When they leave here they know that they are valuable. They leave with self-esteem. This is something very special and very rare that you have given them.

In Indonesia the words for "thank you" are "terima kasih" which if you translate them literally mean "accept love" for what is it to give someone thanks other than to gave them a part of your love? So allow me on behalf of my country and my people to express to you our gratitude and to give you our love."

Reflections on coming home from Indonesia March 3, 2005 "Homecoming"

I already miss the smell of the ocean and the thick heavy humidity of southeast Asia. It's something that hadn't happened to me before - this not being able to write or even describe a place or experience while I was there. I know I promised up-to-date emails of my activities but found myself at a complete loss for words every time I sat in front of monitor and keyboard.

Where to start now that the icy blue of the New England sky and the snow on the ground tell me irrefutably that I am home.

Should I start at the end with the last heartbreaking story of a month of numbing tragedies recounted for us - that of the 5 yo girl we put on the Indonesian military C-130 plane to Jakarta just as we were boarding our own US Marine C-130 to Singapore? How she lost her mother and siblings the day of the wave torn away from them and washed up on a mosque's steps a mile inland, brought to a hospital with a severe aspiration pneumonia - somehow found by her father who had been out of town - the two of them all each other had left in the world. How she was treated in three different hospitals, getting through skin grafts and the pneumonia how they finally were discharged from the 3rd hospital to an IDP camp nearly 6 weeks later to slowly begin their lives together again. She had a seizure and never regained full consciousness the day after her discharge and her father rushed her back to the hospital. How we found her on land in that decimated pediatric ward of the formerly proud Banda Aceh University Hospital in a corner crib unresponsive her father holding hand. Helicoptering her to our ship the might of America poured into a tertiary care floating hospital complete with CT scanner, Operating Rooms and ICUs. How the glimmer of hope in her father's eyes slipped back into despair as we discussed the CT and test findings with him. Massive hydrocephalus - from tuberculosis. The TB we could treat but we didn't have a neurosurgeon to relieve the hydrocephalus. So to Jakarta she was going as we were going home - her chances of survival and meaningful recovery meager - her father with the only thing he had left in the world still holding onto her hand as she continued to lay unresponsive on the stretcher. Still he pulled me close to him in a tight hug as we were leaving - thanking me in the only way he could - our differences in culture and religion shattered by love of this little girl. I will forever be haunted by the look in his eyes.

There are happier stories - particularly from Ward 1 our makeshift "family" ward which functioned as the social center of the ship. Colorful origami figures hung from the ceiling and former strangers clung to each other for support. A large crowd gathered as we would round each day - as opposed to the fierce American need for privacy the Aceh people desired community in a way that is foreign to our discrete disjointed western lives. The day's triumphs and setbacks made their way in murmurings throughout the ward on each patient - when asked if a patient wanted privacy for some delicate test result the answer would always be a quizzical expression as if the question was too absurd for a straight answer. I never became fully comfortable in the month of daily rounding with the crowds we would gather as we moved from one patient to another.

The benefit of the open bays - designed to house recovering wounded "subacute" soldiers, marines and sailors in a bygone era was that of dispersion of horror and grief. All had their own tragedy and for a short while on Ward one - no one had to go through it alone. The older women left without a family to care for took on the nurturing role for the young mother whose baby was recovering from extreme dehydration and electrolyte imbalance. A 15 year old girl whose arm was amputated because of an aggressive tumor took turns coloring with a 9 year old boy with a large mediastinal mass.

The play room - lined with drawings first of coffins and waves which made way to happier themes - was not just inhabited by the children - the adults were often found lounging on the cushions, deep in discussions. If ever a ward itself could be responsible for healing - Ward 1 had a power of transformation deeper than anything I can explain.

Elisa manifested this perhaps the best - she was our profoundly sad and withdrawn 17 yo girl with pneumonia and brain abscesses, paralyzed on her right side - having lost her mother and siblings in the tsunami - emerging from her cocooned grief to the warmth of Ward 1 and finally full of smiles as she found her voice again. The day of her transfer back to the ICRC field hospital when she was finally able to move her right leg for the first time in a month (the powerful IV antibiotics finally penetrating the abscesses in her brain) she burst out in giggles so loud that we couldn't believe they had come from her.

Flying in a helicopter over Aceh the dead brown earth where the saltwater had reached sometimes miles inland killing everything it touched was in stark contrast to the tropical greenness juxtaposed against all the death. Someone had described it to me as if a giant hand had come and scooped everything away in its path. Looking on it the first time the rendering was accurate. I couldn't stop myself from snapping pictures despite the determination not to fall prey to "disaster tourism." The magnitude of destruction was uncapturable in pictures however. Arriving on the scene nearly 5 weeks after the event, dead bodies were still being pulled from the mud. A school we visited was lined with flags in the schoolyard - each marking the spot a dead body had been found. The director of the university hospital had lost his wife and children and came back the same day to start digging out patients from the hospital. The heat and acridity of the air on land was accentuated because we were used to the clear saltwater breezes on the decks of our hospital.

There is so much more to tell - the Navy culture - the amazing doctors and nurses I was lucky beyond measure to have met and worked with, football on the flight deck, seeing the southern cross in the sky and the 4 moons of Jupiter - but this is my best attempt for a start. Thank you so much for your thoughts and prayers as I was gone - I'm looking forward to catching up with everyone in person.

much love,