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December 27th 2004 our U.S. Trauma Team was ordered by the president to aid in the aftermath of the tsunami in the surrounding countries of the Indian Ocean.

All three teams were called.
Our teams usually include:
• 3 Trauma Physicians
• 2 Trauma Surgeons
• 1 Neurosurgeon
• 3 Orthopedic Surgeons
• 4 Anesthesiologists
• 15 Trauma Critical Care Nurses
• 5 Respiratory Therapists
• 3 Radiology Technologists
• 3 Lab/Blood Bank Technicians
• 4 Surgery Teams
• A Physician’s Assistant for each surgeon
• Religious Life Staff, Chaplains, Social Workers skilled in handling orphans of disasters and when needed -- translators.

We took a flight from Nashville to Ft. Hood AFB in Texas the converge point for all three U.S. Trauma Teams. There was no time for a briefing. We only knew we would be set down in one of the countries hardest hit. Tibet, of course, refused all aid. We made the entire trip in a monstrous cargo plane. I had the keys to the drug cabinet even now plastered against the walls of the plane by thick rope netting. Other huge crates sat in slots on the open floor. This was before we had prefab buildings so huge neatly squared green canvas tents were also held by the netting.

I had learned if I didn’t wish to end up flailing my arms throughout the plane and be 'saved' by an amused soldier, I had better wind my arms through the webbing. I envied the soldiers, The Special Forces men and women who could walk from cockpit to tail without stumbling, even during the turbulence the plane appeared to fly into every ten minutes. It was a relief when we felt the plane climb and things settled. Perhaps it’s like sailors developed sea legs after you’ve been on the ocean so long; soldiers develop air legs.

We made three more stops for I assume was refueling, that is the time when you ran for the bathroom and back to secure yourself before takeoff. Our second stop we loaded more supplies and soldiers. The third we picked up a group with DWB who hitched a ride though they were going onward to Sri Lanka.

It is so loud inside these monsters you cannot hear anyone speak nor try to use earphones to block out the noise. The best thing to do is plug your ears for the duration or else feel once we land you will feel like your hearing is underwater for several days.

We spent roughly twenty two hours in the air.

I had heard one soldier during our last stop say we were going to Indonesia which explained why they gave us the influenza vaccine before we departed. They had recently had an outbreak of bird flu and an increase in Yellow Fever and Malaria.

I pulled out my journal checking to be certain I was vaccinated for everything we might run up against.

Influenza, Dengue Fever, TB, Hepatitis alphabet, Japanese encephalitis (I hope the regular vaccine covered that), rabies vaccine, Typhoid Fever, Yellow Fever, and Malaria(we had pills to take every day for that). As the dead were not recovered fast enough, the water supply would become a breeding ground for cholera, which is why two nurses were not allowed to come with us as their shots were not up to date and you can't just take it and go. Besides the golf ball size knot on your arm, you have flu-like symptoms for seven to ten days.

We landed on a broken landing strip that thankfully our pilot was extremely skilled in handling, for we rolled to a bumpy stop. Intact the big plane gave a final shudder. The back of the plane was lowered. It was my responsibility to remain with the drug cart. Another nurse, Mary had the antibiotics and IV fluids and yet another, Kathy was responsible for all other medication and medical supplies.

Because of looters being shot on sight and rebels taking shots at anyone who moved we made camp around and inside the plane. Since I had the narcotics I had my own Army Special Op. protecting me and it. Antibiotics were just like gold here so Mary had her own protection, too.

In the morning we traveled by army trucks to higher ground. The plane left us, which always leaves me with a doomed feeling as my only means of getting away from danger flies off into the wide blue yonder.

A place was cleared and tents were erected. I found another nurse and we counted narcotics, this is done at the beginning and ending of each shift.

We were just set up when the deluge of human casualties bombarded us; men, women, children, and infants. At that time I worked only as a trauma nurse not as a P.A. I assisted the trauma doctor prepare patients for surgery or for admittance to the makeshift hospital.

The first two days we saw mostly injuries. Gashes, items you’d never think could be impaled in the human body, and sever traumas. One man had a palm frond stabbed through his abdomen leafy side out. One had both shoulders dislocated with tendon damage. One had a child’s wooden toy embedded in his head. And on they came. Injuries with massive blood loss which we could only admit and make comfortable until they passed. We rarely took breaks, a run the latrine or to grab a power bar and a bottle of water then return to work.

When we could finally take breaks it was always with an escort, bless the U.S. soldiers of all branches, they were there for us.

We only see the aftermath of these disasters, the sea had sent three story waves crashing over the land and then with unbelievable force ripped things back into the sea. There if floated until waterlogged it sank. The beaches were littered with debris and waves shoved more onto the beach and carried other out to sea.

Everywhere you looked was devastation. This once was a beautiful resort city with vacationers from all over the world had climbed high into the buildings to escape only to have the ground erode and the entire resort fall into the greedy waves and be dragged out to the sea. Some were lucky, most were not. We heard that in Sri Lanka a train of 800 people was hit and swept into the sea all were lost.

One the third day we began to see the diseases take hold of the injured. They came to us with injuries with rashes and red whelps, they now had croupy coughs and uncontrollable diarrhea. Yellow fever and Malaria were diagnosed.

The fourth day we had our first Dengue Fever presented. Gangrene reared it’s ugly head in wounds that had remained untreated, where people could just not reach us or any of the other countries trauma centers and had been found and rescued by the dog teams.

The search and recuse and cadaver dogs with their handlers travel on special flights to keep the dogs calm. No cargo planes for them, but they do a hell of a job in very dangerous situations.

On the fourth day a mother was brought in with three children. Her husband had been swept away by force of a wave as he pushed the last child to a roof of safety. The mother fell onto the debris below as she climbed down in the aftermath and pulled out the objects that had penetrated her body so they bled, insects feasted on them while she got all her children from the roof of the building. It took her two days to walk the family with bare feet over debris fields to the trauma center and one hour to die after she arrived. Blood poisoning and Yellow Fever along with a wound to her liver took her life.

The eighteen month old girl had a broken ulna, the bone from the elbow to thumb that we casted. The three year old boy had drank some stagnant water and was battling cholera, the oldest was five, he was the last pushed onto the roof and had almost been swept away. His mother pulled him to safety but not before he had inhaled some of the tidal water.

We were doing what we could for his lungs, Respiratory worked with him, but if he survived he would in all likelihood have asthma for life. By the time I pushed the three into the orphan’s tent’s there were hundred’s -- like six or seven hundred children already inside many injured.

I talked with one of the harried social workers who was doing her best by satellite phone to find homes for as many children as possible all over the world. She told me the two youngest I brought should be easy placements but the asthmatic boy might be harder to find a home. She also said soldiers had been here to harass the children as they searched out the Seventh Day Adventist. Indonesia was a country in the middle of a religious war.

She said at first she allowed them to take these children when told they had families for them, but later she discovered these children had just disappeared. The tsunami gave those in power the ability to do a little religious cleansing. Afterwards she requested an armed show of force in the tent and the hunts stopped. The head social worker was the bridge for the Team to the Presidency of the country.

The children clung to me and cried as I had to leave them to go back to my post, the social worker seduced them away with lollipops.

This is why I can’t work Pediatrics. Every time children like this leave a bruise on my heart. I went back to work.

The fifth night I worked we were attacked by a rebel force that wanted all our antibiotics. No staff was injured for our Special Op soldiers put an end to six of them before the others fled back up into the darkness. We were warned never to go outside our perimeter due to the danger of kidnapping and one of the nurses from another camp had been caught out and raped by five local men. The local police force was mostly nonexistent and their soldiers just sneered as if she deserved it.

By day six most of what we were seeing was wounds with infectious diseases and those who we called the walking dead. They made it after walking no telling how many miles only to die shortly after arrival. No medical treatment could save them. A bed and morphine was all we could do for them.

Several islands connections had been destroyed. So on day seven a group of volunteers, myself included gathered medical supplies to go to some outlying of these outlying islands. I think this may have been the most terrifying part of this disaster. We pulled up by boat onto island maybe five miles wide and six mile long only to find
. . . nothing. It was as if Mother Nature decided these people and their belongings who had inhabited this island for over a thousand years should be wiped out of existence. Only vegetation remained. We walked the island checking palm trees and no one found any sign of humans, animals or their existence. The sea had sent a wave over the island taking everyone and everything and reclaiming much of the land.

We checked seven islands, found survivors on some but most of the islands were bare. I didn’t volunteer to go on the next mission the next day. I had enough to by creeped out about right where I was in trauma triage.

The U. S. Trauma Team does not delve into politics of the countries we aid. Some countries refuse us, some reluctantly accept, not for their people but for the monetary aid sent that line the leader’s pockets no matter what they promise to do with it. Aid given to Indonesia for the 2004 tsunami still had people living in tents when the 2006 tsunami came.

I worked with an immigrant from Indonesia who was a nurse. Joe brought his family to America to escape the persecution of Seventh Day Adventist. We had heard rumors that the government soldiers were shooting them and calling them looters, but I don’t know if it was true. I do know the Seventh Day communities in the U.S. when notified of the orphans; adopted every single child whose parents were Seventh Day Adventist. Other Americans and Europeans came forward and adopted hundreds of others.

I did go back to check on my three little ones, but they were gone. The social worker I talked with tried but could never tell me what happened to them. There were just so many placed and so many more to place. She was their bridge to the world to find them homes and a safe place to live.

I hope they found a home that accepted all three children. Being so young they were not quite as susceptible to the big three after a disaster — PTSD, severe depression and severe anxiety.

We were recalled home after two weeks, it seems the country’s president did not think he needed an armed presence of Americans in his country any longer. So we returned home and left thousands still untreated.

There were 130,000 dead, 37,000 missing, and 500,000 homeless and uncounted still injured just in Indonesia but their president didn’t want us there.

I don’t understand the leaders of these countries. Do they not care for their people? Are we called just so they can receive financial aid?

Sometimes it’s difficult doing this job when politicians get in the way. We aren’t there to begin a coup, just to treat their injured, the sick and dying.

At least they didn’t take us hostage and try to ransom us back to the U.S. That’s happened once, since then we never go anywhere without a military presence.

Earthquakes, volcanoes, floods, fires, famine, tornadoes, hurricanes, mudslides, and an avalanche that covered a resort; I have seen the aftermath of them all. And its always the children alone, hurt, and lost that break your heart.

I could not disclose the exact location or go into further details of things we encountered due to nondisclosure documents we sign in debriefing. Names were changed. Each time I get the call so am I.

My poor sick harried partner who did warn me of the possiblity she would be late. Since Gary allowed her to stay and I think her entry is pretty great go HERE to read it.
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