Catalog

Trauma: The Invisible Pain
ADB Review [ April 2005 ]

Tsunami survivors in Aceh continue to be haunted by memories of the day the killer wave struck

By Ian Gill, (igill@adb.org)
Principal External Relations Specialist

DESTRUCTION Dr. Marwan explains how the tsunami blew out a back wall of the clinic

MEULABOH, INDONESIA

Midwife Fitriana, aged 31, says she was holding her baby girl when the water “came at us from the front and struck like a cobra.” She holds up her hands to illustrate the point. The impact knocked her over, forcing her to relinquish hold of her daughter, Alfia, whom she never saw again.

On the verandah of an Asian Development Bank (ADB)-supported puskesmas (health clinic) in Johan Pahlawan subdistrict, Fitriana tells her story with apparent calm, but two women listeners are soon in tears.

STILL HOPING Searching for names of missing loved ones at Meulaboh General Hospital

A surviving daughter, 6-year-old Talita, is still traumatized and would not leave the upstairs part of a house for weeks, continues Fitriana. Talita cries whenever it rains or the sky becomes cloudy.

Stress is also evident in the faces of those who crowd around the lists of survivors posted on the walls of Meulaboh General Hospital—along with bleaker notices, usually with photographs, put up by families searching for their missing. Most people arrive with hope, but leave without closure.

One couple, Noraimah and Manwa, are looking for a girl and a boy, but their grim faces reflect the result.

IN THE FIELD ADB staffers Yukihiro Shiroishi (center) and Ayun Sundari (far right) in Meulaboh

An ADB health mission, headed by Yukihiro Shiroishi, visited Meulaboh—a formerly thriving west coast city that was badly damaged by the tsunami—to help ascertain the priority needs of affected hospitals and clinics.

More than a third of Aceh Province’s 240 health centers were wholly or partially damaged, says Dr. Susono, another mission member who is an advisor to the Ministry of Health. Total damage is estimated at $82 million.

“We have an ongoing ADB-supported decentralized health services project in Aceh Province, targeting the poor and vulnerable, especially children and women, and we identified funds of $13 million, such as loan savings, that can quickly be used to help tsunami-affected areas,” says Mr. Shiroishi.

ADB is also discussing with the Government the provision of substantial new grant funds under its recently created Asian Tsunami Fund to rehabilitate the health sector.

Damaged roads and bridges north of Meulaboh also restricted aid agencies’ access to the city after the disaster.

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Patients Flee in Terror

Dr. Haris Suputra, chief of Meulaboh General Hospital, recalls the pandemonium that followed the tsunami.

“As soon as I felt the earthquake, I rushed to the office,” he recalls.

Fitriana says she was holding her baby girl when the water “came at us from the front and struck like a cobra.” The impact knocked her over, forcing her to relinquish hold of her daughter, Alfia, whom she never saw again

“The hospital is near a major intersection and people began running in the streets and screaming, ‘Water is coming!’ This caused panic in the hospital, and some patients fled while I was treating them. Others left in wheelchairs and some in beds pushed by their families,” says Dr. Haris. The doctor scarcely left the hospital as the influx of patients soared fivefold to 500 a day. Moreover, he had to cope with a staff reduced by 80% through deaths and homelessness—and with limited medication.

Foreign and Indonesian teams helped stem fears of an outbreak of diarrhea, acute respiratory infections, measles, or malaria through vaccination and “fogging” (spraying with disinfectants or insecticide) programs and by providing essential drugs and oral rehydration salts.

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Healing Hidden Wounds

But the experts say the greater long-term problem—and one less treated—is the trauma associated with calamity.

“Some of our assistance is expected to go toward providing counseling therapy,” says Mr. Shiroishi. “But the bulk will go toward repairing or reconstructing health facilities; providing equipment, transport, and management support; and capacity building.”

Some health centers are already returning to operations. The Johan Pahliawan clinic reopened on 2 February after a French Red Cross team helped clean up the debris.

The clinic head, Dr. Marwan, stands in front of a wall that was largely destroyed by the tsunami.

“Six of our staff of 66 died, and others have gone to Medan and other places,” he says. “This makes my job difficult, but I cannot put pressure on my staff, who lost family and homes, and who need counseling.”

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