Lamno

Writing from my fifth day in Lamno, a small town on the West Coast. The helicopter ride down the coast was spectacular. Strapped in my seat looking out the window of the chopper, listening to Echo and the Bunnymen (my iPod earbuds snug inside the protective earphones our UN pilot told me to put on), I could see all along the coastline the ruin that the rush of water brought. Miles and miles of wasteland, decay and lifelessness, for up to five miles inland. Patches of resettlement camps amidst sprawling mudflats, bits of road, chunks of boats, and tangles of trees, with lush hills splayed out in the distance.

The town of Lamno has a main street with a busy marketplace, where hawkers sell colorful cotton shirts, fruit drinks, shrimp, traditional batik fabrics, tiny cups of steaming Sumatran coffee, pineapple, plasticware, and car parts. At the end of the main street is the small one-story hospital where NWMT has been working since January with no working plumbing, and electricity only at night. The other night at midnight we rushed from our house on the other side of the market to the hospital to see a baby who had been born not breathing well, and our pediatrician saved its life with simple tools we brought with us. The mother lay exhausted and sweating on the bed, and blood pools lay on the floor, but when we put the baby in her arms, she smiled and held him to her breast.

The mountains on three sides of Lamno are a vivid green, and to the West of us lay the devastation that the tsunami left: scattered tree branches, stumps of houses, clumps of tin and twisted toys, puddles of mud, a trace of a road here, a red flag indicating a body that still needs to be buried there. In the midst of the rubble and emptiness, small structures are sprouting up where survivors are returning to start rebuilding their lives and livelihoods. They walk for miles from refugee camps in the burning sun, collecting scraps of wood, and somehow patch together something resembling a house standing nearly alone on a barren plane. Grass shoots are just starting to sprout up through the mud, and palm fronds on the trees that survived are sporting new green leaves. The people often have only the clothes on their backs, and the memories of many family members lost, but they want to get on with their lives and begin anew. People who survived ran uphill, happened to be far away, were very lucky, or had fast, strong legs. Interviews with them net stories of children swept away, wives missing, grandmothers drowned.

Our team also visits different IDP camps (“internally displaced persons”) – i.e., refugee camps – to attend to patients there. Our translators help the patients tell our doctors and nurses what ails them. Sometimes we need two translators, one from English to Indonesian, and one from Indonesian to Acehnese, the local language. We bring toys and day-glo barrettes for the children in the camps, and mark the hands of those who have received a gift so that they don’t hoard and leave none for others. The cases our staff sees include coughs, worms, scabies, hernias, advanced stages of untreated breast cancer, bloody diarrhea, severely infected cuts, lower back pain, upper respiratory infections (from the smoke of the burning trash), burns (from the kerosene cooking stoves), and depression. Lots of cases of depression and listlessness, loss of appetite, sleeplessness, etc. People line up eagerly to see the American doctors and collect medication from our pharmacy. One of our translators took us to the open soggy field that used to be her village. One lone wooden frame stood for as far as we could see on the horizon: it was her family’s house being rebuilt, with the money she was making working for us.

Mostly I’ve been observing operations and trying to assess the impact of our programs and looking for gaps in services in the community – in other words, are we effective at what we’re doing, and could we be more effective elsewhere? Lamno is a bit oversaturated at the moment with foreign medical personnel, so there’s actually been some turfwars over who was going to run the hospital in the longrun for the government. Despite the fact that our site coordinator Dr. David, his wife and the other NWMT volunteers have been throwing their blood, sweat and tears into taking care of the patients for the last two months, our organization doesn’t have the muscle and the political connections to get the long-term contract with the Ministry of Health, so it looks like we’re being pushed out of the hospital. A French organization managed to broker a deal with the hospital management to refurbish and fully staff up the facility starting ASAP, and they don’t want to share duties with us. So be it. It seems that if this organization can do it better than we can and devote the resources to the hospital that we can’t, then it’s in the best interests of the community. There are other projects we can and will do.

I made the executive decision of sending Dr. Dave and his wife Nancy away this weekend so they could get a mental health break on Sabang Island, a snorkeling and scuba diving island off of Banda Aceh. They’ve been working like mad, staffing and planning and developing and organizing the programs with no logistical support, on top of trying to practice medicine alongside all the volunteer doctors and nurses. Our doctors and nurses are great, and it’s a small group with pretty good camaraderie. We’re tightly crammed into a little house, so if the programs continue in Lamno, we’ll have to get a bigger house.

The calls from the mosque across the street wake us up at dawn every day, and the roosters begin crowing almost simultaneously. Some mornings we go on walks down the dirt road as far as the river, where we find children bathing, women washing clothes, and water buffalo napping. On the walk home, little girls in white school uniforms and white head coverings smile shyly as we walk past, and shoeless boys run past yelling “Hello missis!” I mist myself with bugspray at dusk (“eau de mosquito”, as I call it). At night the teenager across the street strums his guitar on his porch singing Indonesian ballads, while our security guards sit chatting and smoking. People are very happy to have us here, and recognize what we are doing in the community. The food our cook prepares for us OK, but we are really getting bored with rice. The one time we didn’t have rice, our translators complained that their stomachs hurt because they didn’t have rice with that meal. Guess we’re stuck with rice.

The international community, which is very small here, is getting nervous about the March 26th deadline, simply because we don’t know if that date is just a bluff or if things will actually change then. The rumors were originally that the government wanted all foreigners out by then, and later they clarified to say that they meant foreign military. Now we’re not sure if they will stop reissuing visas, or simply kick everyone out. Pessimists are saying that the government will make the foreigners leave and then the military will launch an assault on the GAM (Free Aceh Movement, the separatists who have been fighting for Acehnese independence, mostly because they feel that Indonesia is stealing their natural resources). There are still skirmishes between the Indonesian army (TNI) and GAM in Aceh province, but the international presence is to a large extent what’s kept the whole thing from blowing up into a full-scale war. I personally don’t think the government would be stupid enough to forgo all the Western dollars that we’re bringing in here, even if the cost is not being able to terrorize and murder separatist sympathizers. It would be a tragedy if the people victimized by the tsunami were denied aid because the government wanted to keep control over the population. Anyway, we’ve all got our evacuation plans ready just in case.

Going back to Banda Aceh next week. I’ll try to upload this posting to the blog from the compound of another NGO (non-governmental organization, i.e., aid group), since they have wireless internet and we have non internet.