Bumi Sehat Clinic sees both grief and relief

Bumi Sehat Clinic sees both grief and relief

Catherine Wheeler, Contributor, Ubud

This account by Robin Lim was prepared by Catherine Wheeler, Robin is the
the midwife who founded
the Bumi Sehat health clinic in Ubud, Bali. Lim and a team of
volunteers went to Aceh as part of a relief project. The team has
established a walk-in clinic in Cot Seulamot near Meulaboh on the
west coast of Aceh.

The Indian Ocean off the West Coast of Sama Tiga Aceh is the
exact temperature of tears.

The Bumi Sehat free walk in clinic in Cot Seulamat, Sama Tiga,
Aceh, serves an average of 70 patients per day. It rains
endlessly. There are earthquakes. And there are tears -- lots of
them.

The rolling staff consists of volunteers from all over the
world, based out of Bali. The Aceh staff is growing and will give
solidity to our dream of sustainability. This clinic is a neutral
place where tsunami victims, host families, military personnel
and the most marginalized peoples feel comfortable coming for
help.

Some of them are very sick or have infected injuries. There
is an increasing number of malaria victims. Most of the people we
saw were malnourished, and 100 percent were traumatized.

Informal counseling was part of our work. There are many faces
of anguish. A mother wears sleepless guilt lines because she
lacked the physical strength to prevent her baby being torn from
her arms by the violent tsunami. A man comes to cry for his
daughter. His wife is also missing, and he has no photos of them.

His skin is covered with festering wounds, now two months old,
from the debris-choked waters he swam in on December 26th. Most
of the schools we saw were either destroyed or filled with mud
and debris. A school teacher in his early forties came to the
clinic to ask for help sleeping.

"I had 116 students before the tsunami, only nine survive,"
Pak Abdul said before he broke down. He cried for a long time,
then softly began to say the names of his beautiful students. We
gave him homeopathy remedies to take before bedtime, and we
listened. Two days later he returned, looking much better.
"Thank you," he said, "for hearing their names. I am now
sleeping a little."

Kelly and I taught a day-long workshop for midwives in
Meulaboh. We were amazed when 41 midwives attended. Most of
these women had lost families and homes. One midwife walked for
three days to attend. She had lost her husband, child and home,
and was 30 weeks pregnant. This workshop was an opportunity to
get back on her feet, so she could continue to help people.

All of the midwives attending the workshop had lost their
equipment and birth kits. We invited Scott Whoolery, the medical
director of UNICEF Indonesia, to attend our meeting. He was
thrilled to meet so many of the women who are delivering primary
healthcare to the citizens of Aceh, and arranged that each
midwife would receive a UNICEF midwife kit.

Sadly, we found a high rate of infant demise due to tetanus in
Aceh. Vaccination will not solve the problem; the tetanus toxoid
vaccine requires refrigeration, which is rare in rural Aceh.

The traditional birth attendants of Aceh lack dependable water
resources and the means to keep instruments sterile. Many
midwives' cord-cutting instruments were swept away by the
tsunami. We taught these birth attendants how to safely burn the
umbilical cord.

This method eliminates the danger of tetanus or other
bacterial transmission from non-sterile instruments. The midwives
were delighted. They came away from the workshop feeling like
they had learned a desperately-needed skill.

We were also able to encourage them to get free medicines from
Ober Berkat Foundation, as well as seeking help from Medecines
Sans Frontiers and Global Relief.

We shared a camp in Cot Seulamat with the WALHI/IDEP clean
water and sanitation crew. [WALHI is a non-governmental
organization that campaigns mainly on environmental matters,
while IDEP is a Bali-based, social welfare charitable
foundation.]

About 70 patients a day appeared at our free, walk-in clinic
made of bamboo draped with tarpaulins for rain protection.

We found that nearly every mother had lost children within two
to three days after birth, long before the tsunami washed over
their lives. Chronic malnutrition adds to the maternal and
infant mortality rate.

Early one morning, we were rushed to the home of a mother who
had just given birth. The traditional midwife had already cut the
baby's umbilical cord with old, blunt school scissors and pulled
the cord off the placenta. The baby appeared fine but the mother
was hemorrhaging and her placenta was retained.

I gloved up quickly, and manually peeled the placenta off the
wall of the uterus centimeter by centimeter. Roswita and her baby
survived but I learned that just 8 months earlier her sister-in-
law had not been as lucky. She'd also retained her placenta, and
died on the way to Meulaboh hospital, 45 minutes to an hour away
by swamp road.

This near fatal complication turned out to be one of the many
blessings along our way in Aceh. The midwife's trust was
essential if we were to serve these communities of hard-hit
tsunami victims. She later did a birth with the Bumi Sehat
midwives of team II, Jenny and Indah.

They burned the cord and the traditional midwife is now sold
on this much safer protocol. No doubt this alone will save
countless neonatal lives.

While we operated the clinic, our support team worked with the
WALHI Bali crew to help the surviving villagers of Pucuk Leung
and Lhok Bubon to resettle. We gave them generators and strung
out electric street lamps.

Though the homes were completely destroyed, Oded and Christine
networked with Mercy Corps to obtain tents and kerosene cooking
stoves for the families. Oded organized the people into work
crews to fix the Mosque roof, and make a rain catch system for
wash water.

Oxfam brought in a 10,000 liter bladder for drinking water,
which they deliver every day or two. Mentor donated malaria
rapid test kits and medication for both children and adults with
P. falciparum malaria.

The survivors of this village are mostly men, who were far out
to sea fishing when the tsunami hit. When they returned home that
evening, they found their wives, children, parents, friends and
homes had disappeared. The only building left standing was the
mosque, with 70 people marooned on top. Catholic Relief services
paid for a new roof for the osque of Lhok Bubon.

We left Meulaboh on the International Red Cross Red Crescent
plane, flying low and slow all along the West Coast of Sumatra.
From high above, it looks hopeless. Busy cities have been
leveled. Huge barges rest five kilometers inland. The beaches
are strewn with broken toys and broken dreams.

But the wounds of December 26 are scarring over. I felt no
ghosts in the night at Aceh. There is a peace, a sweetness
between people, and a prayer for healing.