Batticaloa, Friday, 7th January.
Twelve days after the tsunami and the city is still buzzing with medical vans and doctors all rushing in different directions. I've arranged to see the Divisional Deputy Director for Health Services at the Government building this morning. We meet at 9am and I spend twenty minutes outlining what I've seen in the field - the neglect, the disorganization, the massive gap in getting services to those who need them the most. I suggest that he takes a lead in coordinating the array of international agencies in town. They need vehicles, they need translators, they need local guides. The director shrugs. He says there are 63 different international organizations in town right now (down from eighty-one last week) and they do not fall into his jurisdiction. He says it is up to the foreign medics to come and check in with him, it is not for him to go to them. I point out that he could call at least one meeting so that the heads of the different groups can meet and form a coherent plan of action, if only between themselves. He says that it is not his responsibility. I point out that with the overcrowding and malnutrition in the makeshift shelters, there's an epidemic just waiting to happen. I ask him when, if ever, the government feels that it can take responsibility for this. He says he is waiting to hear from the capital. I start describing what I have seen in the towns and villages still waiting for medical assistance when he cuts me off. He is Tamil and it seems his family is from Kallar as well and that he knows about the situation there.
I realize we are getting nowhere. Decades of ethnic warfare have left few Tamils in government health services. Those who still work there fear for their jobs, and sometimes their lives, in making the simplest administrative decisions. An hour after entering the government offices, I leave without even a promise of help.
10 a.m. I check back into the TRO office. One of the clerks calls contacts in the local camps to see what medical help they need. There are four of us, all Tamil Sri Lankans returned from the West. There is a surgeon from America and a couple of doctors from the UK. We spend the next two hours waiting for transport. While we wait one of the other British doctors (a psychiatrist) gives our small team emergency training in trauma evaluation. We have our lunch in the waiting room (more packed parcels of rice and curry) and head out at noon on the first available van.
12.30 p.m. The first camp that we visit (Koddamunai Kanesda Vidyalya) currently holds 2,553 people. We spend the next hour or two assessing those exhibiting the most severe mental distress. Of the ten patients I see, two of the men have lost every member of their entire extended family.
2.30 p.m. Another makeshift camp in a high school (Maha Jana Vidyalaya). Camp volunteers are just getting ready to distribute food and the 1,612 camp dwellers are all standing in line for food as we arrive. In the interests of efficiency, we decide to leave them for the time being and press on to the next camp, phoning in to TRO headquarters to send another team later in the afternoon.
2:50 p.m. Batticaloa Central College. There are 1,252 refugees stationed here and I spend the rest of the afternoon seeing 40 cases. The team psychiatrist treats 19 cases that are in deep shock. While we work a team of parliamentary members from the northern Tamil city of Jaffna arrive and inspect the camp but we have no time to talk to them or even find out the latest news.
5:30 p.m. On our way back to headquarters we ask the driver to detour through Navalady, one of the villages that was hit directly by the tsunami. It is the first chance we have, since arriving in Sri Lanka, to take a break from tending the human casualties of the storm and to go and see its impact on the land itself. When we get to Navalady, there is nothing there. The sea has receded but where there was once a thriving, bustling village there not single building left standing. The site is full of broken concrete blocks and mutilated timbers. The sea has even thrown up her own refuse and we see the shells of broken ships and impossibly large metal pipes scattered across the fields in a surreal landscape. Here and there, there are bedraggled people, picking through the ruins of their homes, looking for clothes and food, hoping they will find their missing children still safe, somehow, under the rubble. The emergency services gave up a long time ago.
Dr. Sundaralingam
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