Introduction
To get a complete picture of the Permanente physician, it is important to highlight life outside the normal work environment. Possibly nothing demonstrates the compassionate heart of Permanente better than the amazing response to the December 2004 tsunami disaster.
Approximately three weeks after the tsunami struck the northern Sumatra province of Indonesia, I joined a medical-surgical team of volunteers from Baltimore. Although I have been on numerous short-term missions to developing countries, I was not prepared for the devastation. I was not alone; many other Kaiser Permanente (KP) volunteers joined the relief effort. You will see from their stories that they also had life-changing experiences.
To give the Journal reader a glimpse of what these physicians and other clinicians experienced during their volunteer work in Sri Lanka and Indonesia, we have prepared this edited compilation of writings from some of these relief workers. Writing their stories is important not only for sharing experiences with others but also for these physicians to gain perspective and insight into their own personal experience. Writing deepens empathy. The testimonies and pictures are only the tip of the iceberg–—many others in KP contributed.
— Lee Jacobs, MD, Section Editor
Banda Aceh, Indonesia
Physicians take many paths to finding meaning in medicine. For the doctors of the TPMG International Tsunami Disaster Relief Team, humanitarian medical work in South Asia provided meaning and much more.
In the following collection of essays, you will read of these experiences and of the lessons learned. Teams confronted rare diseases and complicated medical cases with minimal resources. They developed large-scale public health programs as part of a collaborative international team. As medical volunteers in areas ravaged by both civil war and tsunami, teams were challenged to be resilient and flexible, to maintain an open mind, and to improvise. We were reminded of the tremendous wealth of our communities, the value of our own skills, and the personal rewards of serving where the need is so great. Both our international colleagues and our patients inspired us to maintain our hope and idealism in the face of immense tragedy and sorrow. Above all, we shared with our colleagues, our staff, and even with our patients, a tremendous sense of pride and gratitude as we watched KP set the standard for corporate compassion and responsibility.
However, the most important stories are about the people we served. Bearing witness to their experiences and learning first hand of their lives was not always easy. As Brian Hertz, MD, our Team Lead, recently explained upon accepting the American Red Cross, Bay Area Region, International Humanitarian Hero Award, “Humanitarian work requires that one struggle to be present and stand in close proximity to those who are suffering.” Supporting this work, he says, “… allows us, as relief workers, the opportunity to continue to expand the boundaries of human consciousness. This is a consciousness that says that humanity in its highest form does not willingly leave its wounded to suffer alone on the road. It is through these actions that we truly make our lives richer.”
December 26, 2004 Banda Aceh, Indonesia
Banda Aceh was a city of approximately 450,000 people located at the northern tip of Indonesia. The epicenter of the 9.0 earthquake (one of the largest on record) was approximately 150 miles off the coast of Sumatra at the boundary of the India and Burma tectonic plates in the Andaman-Sumatran subduction zone. It has been reported that one of these plates suddenly dropped 100 feet creating a plunger-like effect resulting in the tsunami. Satellite photography suggests that the waves traveled up to 200 mph until they approached Indonesia. The first waves struck northern Indonesian shores within 15 minutes, at approximately 9:00 am on December 26th. Gigantic waves continued to strike the shores throughout the Indian Ocean over the next 4–5 hours. The countries most severely affected were Indonesia and Sri Lanka.
The people of Banda Aceh did not have a chance. The destruction was not just the coastal villages, but also included the city's flat, highly populated area that extended up to two miles inland from the shore. As of January 26th, the dead and lost in northern Indonesia approached 230,000 with 2000 bodies found that first day.
The devastation in and around Banda Aceh was indescribable. Miles and miles of cement slabs were all that was left. The scene from an atom bomb could hardly be any different. I was reminded that large numbers of people had lived here when I passed by the many mass graves.
— Lee Jacobs, MD
