CHILDREN'S CLINIC, MAWELLA CAMP, SRI LANKA

February 11, 2005
By Dr. Martina Fuchs

Arriving in the early morning of February 5 via Taiwan and Singapore, it took me a couple of days to get an overview over the medical situation here in southern Sri Lanka.

We are in the district of Hambantota which consists of four provinces. The tsunami death toll in this area was about 20,000 people. This number might be even higher since many people are still missing. About 10,000 people were injured, many of them badly. The medical situation now is that the local hospitals are unable to meet the needs of the people, tsunami-affected or otherwise, since there are more than 1,000 people to be taken care of daily and most of the hospitals cannot handle more than 200. So there are still very basic medical needs that are not covered.

Our focus is on helping several villages along the southern coast of Sri Lanka, about 1,000 families, 100 of which are living in a camp, since there is nothing left of their houses. The first time I went through the ghost towns that were formerly flourishing fishermen's villages, I felt like being in a horrible movie. I am not sure if it is possible to fully comprehend that for these families, everything is gone.

Since the immediate catastrophe needs have been taken care of, the challenge now is to cover the basic needs of the people we are committed to help. For the medical part, the ministry of fishery allowed us to use a small two-room house that was flooded by the tsunami but was basically not destroyed, as a clinic.

With the generous help of the Sri Lankan Navy, our clinic has been painted, electricity has been installed, etc.

Our goal is to establish a new database for the families and to get an overview regarding their basic medical condition and health needs. We want to make sure that everybody will have a medical record, i.e. basic check-up, vitals, vaccination schedules for the children. I am in touch with the closest local hospital, in Tangalle, which was in desperate need even before the tsunami, and we are coordinating our efforts. Within the last month alone, 15 patients have died from simple things like blood loss from a broken leg because medical supplies and staff are simply not available.

There is a person from Great Britain, Nick Buckingham, who started to raise money for the hospital and is very hands-on himself; fixing the rooms, painting, buying mattresses, preparing for an operating room, etc. Real Medicine plans to coordinate with Nick in widening the network for medical support and supplies from the US and Europe.

Our villagers here need help with very basic and immediate things, i.e. one man who is short-sighted lost his glasses in the tsunami with no money to replace them, a little girl who needs daily medication lost all her medication for the next several months; and the list goes on and on. And actually, one more thing: all the toys are gone, little Ranashiri just told me a few days ago that she doesn't have a single doll anymore, Tamasiri lost his teddy bear, and this, of course, is the case for all the other girls and boys, too. So, we will work on raising more funds in the US and Europe - with all of your generous help - to take care of the needs of these people who have literally only the clothes left they were wearing.

A lot of people from all over Hambantota were at the Sunday market in Tangalle on December 26, 2004, and were killed in the tsunami. So, loss of loved ones and often the loss of the breadwinner is a reality for many, many families here in the area. We distributed children's clothes and about 40 mothers showed up with their babies, we gave towels and bed sheets to them and taught them how to use the milk powder we had received in big quantities. They were so grateful, it was absolutely heartbreaking.

February 20, 2005

Our little clinic is up and running and I couldn't be more proud.

I am proud to present two of my patients:

The Sri Lankan Navy helped us to install electricity, we have light, and we have two fans (thank you, Commander Jagath Mutubandara, for making it all possible!).

Volunteers Jonathan and Orrin from England built our examination table and all the furniture:

Wasana, a woman from the camp, sewed curtains for us:

We will get a sink; a water tower is already prepared in a nearby tree. Patients are lining up as soon as our clinic opens, and it is everybody, infants and children and their parents of course, but also adults of all ages, pregnant women. I have seen about 70 patients in two days. Right now, we have an infection going around in our camp; a lot of children are suffering from really high fever. And what I am seeing a lot, too, are patients who had swallowed water when the tsunami happened and need reassurance that they are okay. At this point, I want to thank the pediatric surgery division of the Kinderkrankenhaus St. Marien in Landshut, Germany, and their chief, my brother, Dr. Oliver Fuchs, from the bottom of my heart. The seven large boxes of medical supplies that you have provided and sent to us are absolutely invaluable. We would not be able to work without them. We are absolutely impressed by your generosity.

March 5, 2005

The little clinic found its place in the camp, the village of Mawella and the adjacent villages, and it is always busy. I am happy to say that we don't have any epidemics yet, which is a big success considering the very cramped conditions our families have to live in.

Here it is:

This is my assistant, Suranga Baduge. He has been essential in translating (Singhalese into English and back), documenting the examination results and transferring the medical histories into our newly designed and established computer database (thank you to Debbie and Elaine for manifesting what at the beginning has only been an idea):

I am proud to say that - out of nothing - we have actually created and established a model for basic medical care that now is easily transferable into any area that needs medical care. All our furniture, i.e. shelves, examination table, etc. have been built by Jonathan, Orrin and Susanthe. Orrin's last deed before he went back to Great Britain was the clinic sink, thank you!! Here it is, with a water tank in an adjacent tree (it works!! ... and, depending on the time of the day, the water even gets really hot!):

Our villagers brought this altar to us to bless the clinic:

And now, as you can see, the clinic is firmly in the hands of the children:

Sometimes, the lines get really long:

But once, you get into the waiting room, you are almost there:

As I had mentioned before, one of the things that have been very important to me, is to have a psychiatrist taking care of our families and the post-tsunami pain and unbelievable suffering they have to deal with. Dr. Sunietha Galappaththi came for one afternoon, and one of the things, Real Medicine is committed to, is to make sure these visits will happen on an ongoing basis.

In this one afternoon, Dr. Sunietha and I saw eight mothers who had lost one or more or all of their children. The pain is beyond comprehension and their stories are harrowing. I am not sure if it will ever be possible to fathom that this tragedy has happened to thousands and thousands of mothers and fathers and children in one single day.

One of the mothers we saw had lost her 3-year-old girl. She came initially because her 8-year-old boy, who had survived, had started to sleepwalk. That afternoon, she, for the first time since the tsunami had happened, was able to express her pain about how guilty she felt that she wasn't able to save her younger child. This is what many of the mothers expressed, in addition to the pain of the loss, the guilt of: if I only... So, we tried to tell her that she in this situation did the best she could. She expressed, too, that if the 8-year-old would have climbed on a palm tree by himself, she could have saved the little girl. All this while the boy, who is only eight years old himself, was listening without any expression. So, we tried to tell her that the boy now needs her love since he had lost a sibling and was mourning, too. Since I felt so helpless, I asked him, if he could paint a picture of the tsunami for us. About two hours later, he came back with a painting, all blue, with 18 human heads pointing in different directions in the water. He smiled for the first time when he proudly handed his painting to us as the one that started the gallery. I don't think it is possible to imagine what this little boy had to go through on December 26, 2004. We put his picture up on the wall in the clinic and had him sign his name:

Seeing the difference just one painting could make for a child, Suranga and I told all the kids in the camp that if they would paint a picture of the tsunami for us, they would be part of the clinic gallery and would get a tennis ball. We got dozens and dozens of paintings, and I am very happy that every child that wanted to, is represented with his or her picture in the clinic. Here are some more examples:

I bought and gave out more than ninety tennis balls. For one afternoon, everybody in the camp seemed to be playing with these tennis balls:

This actually made the clinic become something of a social meeting place. There are always people hanging out in the waiting room area; kids and adults, patients and non-patients, checking in on the patients or just chat. And often, the curtain is being pulled aside a little bit because someone is curious about what's going on in the examination area.

I had reported about the Tangalle hospital before. Nick Buckingham has made astounding progress renovating and upgrading the hospital. And he and his team actually found time as well to give the little clinic a beauty treatment. They came out early one morning, planting a garden in front of the clinic, setting up a fence, putting up a table in the examination room complete with tablecloth and flowers, chairs in the waiting area - thank you, guys, this was a beautiful surprise!!

One of my goals was that our clinic would be long-term, and integrated and accepted into the daily lives of our villagers. Thank you so much to Nick Buckingham who helped us find Dr. Ranjith, the wonderful doctor who will take care of the clinic and our patients when I have to return to Los Angeles. It is beautiful to know that it will be in such good hands!

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