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| Friday, 28 January 2005 |
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US doctors come to grips with tsunami's tragic fallout
A team of doctors and students from the Yale School of Medicine was in Sri Lanka for two-weeks assisting the tsunami relief effort by providing medical care. Travelling through camps in the Eastern and Southern areas of the country, Joanne Cossitt EPH '05, Ramin Ahmadi EPH '97, Sherwin Nuland MED '55, Padmini Ranasinghe EPH '05, Majid Sadigh and Monique Tello treated patients with medical problems ranging from respiratory infections and malaria to depression and chronic pain. Although the team treated ailments directly resulting from the tsunami, most illnesses the doctors treated were related to poverty, medical school surgeon and professor Nuland said. Nuland, who authored the award-winning book, "How We Die," said the trip was an emotional experience because he had never seen such extreme poverty. A native of Sri Lanka and resident at Griffin Hospital in Derby, Conn., Ranasinghe said more money is needed to provide shelter, rebuild hospitals and help Sri Lankans regain occupational resources than for more medical teams. She said while the team did not see signs of any serious epidemics, the doctors encountered many patients with psychological conditions from the disaster. "I saw a couple of patients who had to run away to escape the disaster," Ranasinghe said. "Many had post-traumatic stress and flashbacks," she said the doctors had to take personal precautions against malaria, contaminated water and patients' bacterial and viral infections, but none of the physicians have fallen seriously ill. Ranasinghe said she admires efforts by Sri Lankan leaders to keep diseases under control and maintain an operating healthcare system, despite the tsunami. Medical School Dean Robert Alpern said the school does not have any immediate plans to send doctors to Sri Lanka or other parts of South Asia affected by the tsunami but is prepared to do so if a serious epidemic arises. "As a medical school, we then might coordinate something," Alpern said. "For now, we think it is best to sit and watch." Alpern said the school is concerned that an insufficient supply of clean water might make the outbreak of disease more likely in coming weeks. Dr. Ramin Ahmadi is assembling another team of physicians and healthcare professionals for a second mission to tsunami-ravaged Sri Lanka to assess survivors' mental health and begin treatment of what he calls a fragile populace overwhelmed by the disaster. "To leave them alone and to treat them with silence invites years of trouble down the road," Ahmadi, Griffin Hospital's director of internal medicine residency and co-director of internal medicine/preventive medicine residency, told a gathering of about 30 of his co-workers in a review of his team's work on the island from January 2 to 15. "Early intervention is the name of the game." The next team will leave Derby on February 1. Among their tasks will be to train Sri Lankan nurses in how to assess the mental health needs of their countrymen. The effusive physician told harrowingly of the scenes the team faced after it landed in Colombo on January 2, having left Connecticut on December 31 and losing New Year's Day in the air. "I believe that there was nothing I have seen in my life before to this extent and this devastating," he said. "What you see in reality is far more graphic than what you see on TV," he stated later, "railroads, buildings, roads, cars and human bodies melted into one another." The odour of garbage and human remains burned together hung in the air for miles during the team's 10-hour trip northward from Colombo, then east across the island and south to Batticaloa, a district capital in the middle of the island's east coast, he said. Joanne Cossitt, director of the Griffin Centre for Health and Human Rights and a public health specialist who was on the Sri Lanka team, said the team found far more health issues in their five days in Batticaloa than in their four days afterward in the Matara District, on the island's southern end. Over the nine days in the field, the team visited nine camps from 190 to more than 300 people each and treated 900 patients, Cossitt said. In Batticaloa and the Matara District, they found people who needed immediate care of everything from wounds to respiratory illnesses brought on by exposure to water and weather, symptoms of cholera and dysentery, and latent anaemia and malnutrition. The Sri Lankan government, she said, "did a fantastic job in light of the increased need for infrastructure," including ensuring the safety of water supplies. The patients, Ahmadi said, gave the team the knowledge that its presence was important, "that we came all this way there, from Griffin Hospital in Derby, Conn., to tell them they are not alone." Some gave the physicians hugs, some cried, and some could not look up at their caregivers. But the team also began to see people who complained of "overall body ache" - a tipoff to mental illness. Cossitt said some patients showed anxiety or giddiness; others told of inability to sleep, fear of another tsunami or of ghosts, the loss of their families, or their personal economic destruction. "I can rebuild my house, but how can I deal with the fact that I'm a fisherman and I'm afraid of the sea," she paraphrased. Ahmadi said it became apparent that more care was needed, "to take small steps in dealing with the capacity of the problem." He said it is his goal to provide treatment to the point that "these people can get back to some sense of normalcy." Cossitt and Ahmadi said the Sri Lankans, torn by separatist hostilities with the Tamil people since the mid-1980s, are alternately numbed by their experiences but euphoric with the external support and dedication to their recovery. They also accede that the nation faces great needs - to grow the government, create jobs, build a future, Ahmadi said. Before they departed for America, Ahmadi said, the team met briefly with Prime Minister Mahinda Rajapakse, to have tea but also to talk about the patients they'd seen, the nation's plans and what the team could do to help them bear fruit. Griffin resident Dr. Padmini Ranasinghe, a native of the island who left four years ago and returned as a team member, also attended the gathering. Ahmadi playfully chided her at the start, introducing her by saying, "Dr. Ranasinghe will never complain again about the patient population here." At the podium later, she quietly reflected upon her first sights of the destruction, and conceded that the psychological effect on her is huge. "It's a part of my life," she said. "Emotionally, I was very unstable to handle that." Nonetheless, she said, "I have a satisfaction that I did something for the country." (Source: Daily Yale) |
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