Our Faculty at the frontline of tsunami relief
Many doctors and associated health professionals throughout the country, in the days following Boxing Day 2004, were called to arms, not for emergency cover in their ‘day job’, but to assist with the health, medical and forensic needs of our nearest neighbours.
Amongst the many health professionals doing their bit were several member of the Faculty of Medicine. We’d like here to acknowledge the work of some of the members of the Faculty of Medicine who responded to the needs of the tsunami victims.
above right: Our staff at the frontline of tsunami relief.
Dr Peter Ellis
Peter, Forensic Pathologist and Director of Forensic Medicine at Westmead,
went into Thailand as part of the Australian Federal Police team responsible for initiating the handling of the ‘non-Thai’ victims and supervising the construction of a temporary mortuary. Peter arrived in Phuket two days after the disaster and participated in the development of the early phase of the Disaster Victim Identification (DVI) program in Khao Lak, Phuket and Takua Pa that subsequently involved teams from many countries.
Despite having undertaken forensic work in Kosovo and in the aftermath of the Bali bombing, Peter considered his work in Thailand, “the most intense and exhausting 2½ weeks of my career, but it has also been the most rewarding. This has been, and continues to be the largest DVI program ever undertaken and it has been an overwhelming experience in which to participate.”
“With the amazing industriousness and cooperation of the Thai people, an air-conditioned mortuary was operational by 2nd January (4 days after arrival).
After developing the mortuary systems together with forensic dentists from Sydney and Canberra, autopsies commenced. By this stage, forensic teams from over 15 countries had arrived and commenced work in the mortuary. Using this and two other facilities constructed nearby, over 1200 bodies were examined in just over 3 weeks”, Peter commented.
Dr Greg Hollis
Canberra Hospital emergency specialist Dr Greg Hollis and colleagues got the call to join a medical emergency team with just half an hour and a half to pack before the plane left. Once on the ground in Thailand’s Phang Nga area, the team was struck by the devastation but impressed by the medical response.
“The Thais had done a spectacular job in the first two days...patients for the most part were getting adequate care. But the system was under enormous strain, “Dr Hollis said.
[The Canberra team] visited up to 11 hospitals searching for injured Australians. Their brief was to locate, assess and provide advice on the treatment required and if necessary arrange for transfer to Australia or elsewhere.
“This was difficult because in the chaos of those first few days many patients had been misidentified as Austrian instead of Australian and Australian when they were Austrian.”
Dr Greg Hollis was interviewed by Lara Cole for the 14th January 2005 edition of The Medical Observer.
Dr Dominic Dwyer
Westmead Hospital Infectious Diseases Physician, Dominic Dwyer, joined the team sent to the Maldives as part of the Australian Government emergency response to the tsunami. The group included emergency, public health and primary care experts, and was asked by the Maldivian Government to provide assessments, public health and disease control advice, and provide primary care where needed.
The team divided into small groups on arriving in the Maldives, and went out by hospital boat to the affected remote atolls and small communities. “The Maldives depends primarily on fishing and tourism, and the infrastructure that supports these activities and the local inhabitants was severely affected. The damage was patchy, depending on which direction the islands faced, but the psychological impact of the wave was dramatic as the whole country lies only about one metre above the water surface”, said Dominic.
“The salt water not only damaged buildings and caused some loss of life, but also has contaminated the small water table on the islands, meaning loss of the breadfruit, guava and banana trees that supply nutrition. Clinics were held on islands that had no medical services, “but fortunately outbreaks of gastroenteritis or respiratory disease were thankfully uncommon”, commented Dominic.
The tyranny of distance was evident in the Maldives, with transport of people, food, water and other supplies all undertaken by boat. “But, by the same token”, commented Dominic, “the close-knit small communities that characterise the Maldives, precisely because of their isolation, assisted greatly in the management of displaced persons and cleaning up of affected communities.”
Dr James Branley
James is infectious diseases physician and clinical microbiologist at Nepean Hospital and Clinical Lecturer at the University of Sydney.
James was part of the first relief team, a group of 28 Doctors nurses, paramedics and firemen, sent to Aceh leaving Australia on December 29 and arriving on December 30th, four days after the Boxing Day earthquake and tsunami. The team consisted of members from NSW, Queensland, Western Australia, and Victoria.
“We were completely self-sufficient carrying all our own food, water, bedding as well as medicines and equipment”, said James, but this was no camping holiday. “December 31 saw us commence work at the Fakinah Hospital, a small private hospital which, although deserted after the tsunami, was relatively unscathed by the earthquake.”
James and team set to work. “Over the next week and a half over 100 operations were performed at this and a second hospital in Banda Aceh as well as a small number in Sigli. My colleagues were involved in running a basic emergency department and I assisted in management of infections amongst the 70 patients in the ward. Unfortunately, most of those patients with head, chest and abdominal trauma had already died, and we found ourselves managing limb trauma, fractures and lacerations and aspiration pneumonia as well as eye and ear infections,” James said.
“Particularly prevalent were cases of tetanus and prevention of these cases using vaccination was critical. Our public health colleagues also liaised with other organisations and refugees.”
James and team remained working until their supplies ran out and until they were replaced by others.
The experience had a powerful impact on James and the team, “we felt so much for the people of Aceh and what they had gone through, we were all so impressed with their dignity amongst such devastation.”
Dr Andrew Ellis
As an Army Reserve surgeon, Lieutenant-Colonel Andrew Ellis has often answered the call for duty. A veteran of operations in East Timor, Bougainville and the Solomon Islands, he was recently called to serve in Indonesia onboard HMAS Kanimbla. In civilian life, Lieutenant-Colonel Ellis is an orthopaedic trauma surgeon at the Royal North Shore Hospital and a senior lecturer in orthopaedic trauma at the University of Sydney.
The Navy team was tasked with providing medical facilities for Defence personnel who may become sick or injured during Operation Sumatra Assist, allowing the Army's field hospital in Banda Aceh to focus on its humanitarian aid task.
The workload for the ship-bound surgeons was thankfully fairly light, so when the opportunity arose for Lieutenant-Colonel Ellis to go ashore and help at the ANZAC Field Hospital for a few days he leapt at the chance.
Despite his considerable operational service, Lieutenant-Colonel Ellis found the situation in Banda Aceh totally unlike anything he had seen before.
"The scale of devastation was amazing. I feel very sympathetic to what the people of Banda Aceh have gone through," he said. "To lose such a significant amount of life is beyond my experience and imagination."
Working at the field hospital also gave him a chance to see the good work the Australian and New Zealand soldiers had done to make the ruined Banda Aceh Hospital operational again.
“The soldiers were doing a fantastic job," he said. "They were continuously working hard in very poor circumstances. The amount of work they did along with Indonesian Armed Forces personnel to refurbish the hospital, to get the surgical facility running and care for the very sick patients required them to work long hours. Quite frankly, I'm amazed at what has been achieved here - it's a great tribute to the ANZAC Field Hospital."
Andrew Ellis was interviewed by Corporal Cameron Jamieson for the Australian Defence Forces website.
Professor Beverley Raphael
The destruction caused by the Asian tsunami has also had a mental health impact. In order to establish and coordinate Australia’s response to the mental health needs and to ensure its activities are in line with best practice, the National Mental Health Taskforce for Disaster Response has been established with Professor Beverley Raphael as Chair. Professor Raphael is an Adjunct Professor of the Faculty and the Director of the Centre for Mental Health, NSW Health Department.
“The taskforce, has drawn together internationally recognised Australian experts and state and territory mental health leaders, said Professor Raphael. “This model of national collaboration has proved to be invaluable and will be a major ongoing contribution to future disaster response.”
The taskforce has developed guidelines for those Australians directly affected by the tsunami and for the public on coping with its impact. It has also developed advice for general practitioners and agreed principles for response within Australia and these guidelines have also been translated into multiple community languages.
In addition the taskforce has provided expert advice to a range of national, international and state and territory agencies responsible the coordination of relief and recovery teams.