Zainoel Abidin -- a hospital run by coalition of concerned doctors

Andi Hajramurni The Jakarta Post/Banda Aceh

In the pediatrics unit, Belgian and Spanish are spoken besides Bahasa Indonesia. Over in the surgery unit it's English with an Australian accent and German. In the high care unit, it's Singlish with a hint of Malay.

Elsewhere in Zainoel Abidin General Hospital, they speak French, Chinese, and even Vietnamese. And there are also an assortment of local languages like Batak, Riau-Melayu, Makassar and Betawi used by Jakartans.

Welcome to what is probably the most international hospital in the world today. Around 500 doctors and medical staff, some in the uniform of their respective countries, have been working side by side to treat victims of the magnitude-9 earthquake and tsunami that hit Aceh on Dec. 26.

In spite of the multicultural environment and language differences, everyone in this hospital seems to know their place and what is expected of them. Coordination, or lack of it, which seems to be the chief complaint in the ongoing massive international relief operations to help victims of the disaster, seems to be the least of the problems in this hospital.

The activity of the hospital, however, does not conceal the fact that it is located in the center of the town and was badly damaged by the quake and tsunami. The hospital lost many of its patients and more than half of its staff.

Many of its patients were moved to "safety" in the open field outside the hospital when the quake rocked the building that fateful Sunday morning. When the walls of black water from the sea swept through the city, they had no chance at all.

Reminders of that disaster are still visible even as the hospital is now working around the clock treating patients that seem to keep coming every day.

While parts of the building have been cleaned and restored, allowing the hospital to resume operation as of Jan. 8, other sections remained closed because they are beyond repair.

The pile of mud cleared from inside the buildings has also not been fully removed; a reminder to visitors of how difficult it must have been for soldiers and volunteers to clean the place up and allow the hospital to function.

And the tents housing the foreign medical staff outside the hospital building tell us that this international hospital cannot be anything but temporary.

It all seems just too good to last. It begs the question how long will this go on?

Rus Munandar, head of the medical services, fears that the hospital will be closed once the international and national teams leave town.

"This hospital is running because of outside help. Once they are gone, there is not much we can do really. All our equipment was destroyed, sunk in thick mud and saltwater," he told The Jakarta Post in his office on Wednesday.

Around 220 hospital workers, including many doctors, have not reported back for duty. Their fate, like the tens of thousands missing across Aceh, is unknown.

Work to clean the place up only began in the second week after the disaster. All roads to the hospital were then impassable, filled with debris, mud and bodies.

Indonesian and foreign soldiers, worked side by side to clean up parts of the hospital that could be salvaged. When it reopened, it had an emergency ward, an intensive care unit, a high care unit, and last but not least, a ward for children.

Initially, some of the work had to be done in the field hospital set up by Australia and Germany. Surgery, for example, had to be performed in tents.

The hospital formerly could accommodate 400 patients. Now it only has 110 beds. "We are trying to add more rooms and beds. The number of patients is just growing every day," Munandar said.

On Wednesday, the hospital was treating 60 in-patients with complaints ranging from tetanus, upper lung infection, and diarrhea. It has also received an average of 200 outpatients every day since it reopened.

The foreign teams came not only with medical staff, but also with their own equipment and medicine. Helping to coordinate their work are administrators from the Wahidin Sudirohusodo Hospital in Makassar.

"There has not been any problem with coordination so far," Munandar says.

"The foreign doctors are all working along side our doctors. We decide their function according to their respective skills. The Belgians and Spanish are assigned to the pediatrician unit because they have the doctors. The Australians and Germans are doing the surgery because they have the equipment."

The plan is for these doctors to stay here until the end of March.

Munandar is uncertain whether the foreign teams will donate the equipment and leave it behind. "If they don't then this hospital may as well close down."

But the equipment is only half of the problem. The other half is in recruiting new staff to run the hospital, a process that will also take a long time, and lots of funds. And there is also the need to rebuild and restore the hospital building.

Munandar estimates that the total costs would reach Rp 100 billion ($11 million). "It's the kind of money that can only come from the central government," he said.