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Mobile Doctors Work to Prevent Disease

Survivors of the tsunami begin life anew in camps.

Meredith Billman-Mani lives in Herndon and is a reporter for The McLean and Great Falls Connections. She is a frequent visitor to India and went there in December to finalize the adoption of her daughter, Priyanka. This is the second in a series of stories on the tsunami and its aftermath.

<bt>Friday, Jan. 14, marks the Tamilian festival of Pogal - the New Year. Relief efforts for the villagers of Chennai who were displaced by the tsunami that hit India the day after Christmas are well under way and starting to have an impact on the people who need assistance rebuilding their lives.

People all over the world have donated funds and equipment to give aid to the tsunami victims in all the affected countries, but India has been able to mobilize its own resources and professionals to begin repairing the damage inflicted by the massive wave of sea water that hit parts of Asia.

In Chennai, within the state of Tamil Nadu, the southern region was the hardest hit, with entire fishing villages being wiped out and the wooden boats that enable the villagers to ply their trade largely destroyed. Hundreds of lives were lost, and many more victims were physically and psychologically damaged.

Several bootstrap organizations sprang into action almost immediately to deliver food, supplies and medical assistance to those in need. Sri Ramakrishma Math ("Math" being roughly translatable into "Order") is one such organization operating on the shores of the Bay of Bengal. Each day more than a dozen volunteers -- doctors, nurses, translators and aid workers -- pile into a bus and visit four or five camps in the vicinity. They stay only for a few hours at each camp because the need for help is so great they must push on.

"BECAUSE OF THE CALAMITY we are taking over to give the people the help. Daily we are seeing around 100, 120 people at each camp," said relief organizer Indrama Ragupati.

"We are treating all sort of diseases. We give them tablet[s], injection[s], and biscuits," explained relief coordinator Radha Krishnan.

Much of what they can offer people is a sympathetic ear. "Many people want to talk about what has happened to them. They have lost everything, and now they are here in the camps. They do not know what will happen next to them, so they wait here only," said Ragupati.

Krishnan said the group was able to mobilize so quickly and work directly in the camps because of private donations from Indians both in-country and living abroad. "We are getting donations from all over India. People are sending money from all over to help. We can then come here and do this work with the villagers," said Krishnan. "But we need more help. There is more to be done. More needs to be done to help these people," he added.

The traveling makeshift medical clinic is the perfect foil for the camp environment. Once they arrive in a camp, plastic lawn chairs and a folding table are brought down from the roof of the bus. Boxes of biscuits (that's "cookie" in American English) stay strapped to the bus until the children come clamoring for food in sufficient numbers for one of the aid workers to climb up and unlash a box or two.

THREE DOCTORS ROUTINELY travel on the bus to the camps. The camps are impromptu tents set up in the sand within feet of each other, with no running water or proper sanitation. Cooking, bathing and cleaning are all done in the open and often en masse. The "better" camps have tents made out of oily-looking royal-blue plastic sheeting. The poorest of the camps have fashioned tents out of the used, donated saris sent from around the country.

These camps Ragupati refers to as "real slums." Young and old in these slums have horror stories to tell. Seventy-year-old Raja Bai carries herself with a quiet dignity as she approaches Ragupati to discuss her symptoms before seeing a doctor. Bai complains that her eyes hurt, and she quickly dissolves into silent tears, explaining that she has lost everything and everyone to the tsunami and does not know what she will do now. She doesn't appear to be looking for answers -- only wanting to be heard.

The doctors at Sri Ramakrishma Math have no more eye drops by the time they reach her rugged camp. Instead she is looked at by a doctor and then given some pills by a nurse who dispenses prescriptions through a window in the van. Bai can't read and returns to Ragupati asking what to do with the medications. She then stands with the crowd of people around the bus and waits. She has nowhere else to go.

Krishnan said one of their biggest challenges is to listen to the villagers' plight and then offer advice. Though age and gender were not factors in who was swept into the sea by the tsunami, they do have enormous impact on those who lost loved ones. Elderly women who lost their daughters now find themselves taking care of their grandchildren. Women who have lost their husbands are left wondering how they will make a living and feed their children. Husbands who were unable to save family members from the waves' grip deal with shame and remorse.

SOME CHILDREN, survivors of ione of the largest age groups killed in the tsunami, have largely begun to return to shades of normalcy. They play simple games to occupy their time in the camps. Boys can be seen roughhousing and climbing trees as deftly as monkeys. Girls, more accustomed to domestic work at an early age here, sit quietly together playing house with rag dolls. But even this innocence keeps an eye to the sea and probably always will.

Several government and private organizations have stepped up to announce their intentions to help the orphans of the tsunami. Group homes are being enlarged and expanded to accommodate the children left without parents or relatives to care for them. Americans can adopt Indian children, though the process is lengthy and preference is given to NRIs (nonresident Indians).

Dr. Aygaswamy has been with the group since they starting giving aid the day after the tsunami came ashore. "The medicines we have were all donated. They were given to us by doctors from all over India. They donate their samples to us, and we bring them to the villagers," said Dr. Aygaswamy.

INDIANS ARE EXTREMELY PROUD of the fact that they do not need the world's charity to aid the victims within their borders. Though the country is a growing power economically, is a technology leader and has the largest English-speaking population and workforce in Asia , the images put out by the mainstream media reinforce the Third World stereotype of thin, brown-skinned men wearing a cloth and pulling a rickshaw like a beast of burden. These days members of the growing middle class in India are prosperous and as visual about their success as any European or American. Mammoth shopping malls cropping up in every town, in every state, attest to the disposable income available and the thriving economy.

"The other places need help. We do not need help in India. Would the United States of America take help from other countries? No, we do not ask for help in this," said Chennai resident Gomati Balajisan.

In addition to money, Indians with an applicable skill during an emergency situation such as this (doctors, nurses, engineers, chemists) have taken time out of their lives to travel to the most affected areas and apply themselves directly. Professionals from New Delhi are working side by side with Tamilian doctors in the camps. NRI's are also sending money and returning personally to give aid.

The water supply to the camps around Chennai has been adequate to stave off the diseases emerging in other countries and regions. Water is trucked in daily to the camps and dispensed to the village women, who bring colorful plastic containers resembling spittoons to hold the water. Once the jugs are filled, the women balance them on their heads or on their hips like a child and carry them back to their tents, where the water is used for everything from cooking rice and dal (the staple meal at the camps, as the combination of rice and the dried legume creates a complex protein) to washing hands.

"There is a problem here with water, but we teach them, educate them, on how to make it safe," said Ragupati. This includes advice to boil water and to cover it to prevent insects from bringing diseases or breeding in the water.

Mosquitoes have become an issue since the disaster. Although it is currently wintertime in Chennai (with temperatures in the daytime around 80 degrees), the mosquitoes have flourished in the conditions created by the tsunami. Large ponds of water were trapped inland, creating hospitable breeding pools for the insects, which can carry malaria and cause skin problems.

"We see a lot of insect bites. In these conditions they are living in, there are many," said Dr. Nanjunda Roa. "We treat them as best as we can. We tell them the precautions, and we treat them with what we have available here," Roa said.

EVEN WITH AID GOING DIRECTLY to the people, from the people, grumblings can be heard wherever you go in Chennai. It's widely believed that higher-ups in the government are likely to profit the most from the donations coming in, that the money will line their pockets before it ever gets to the villagers. Dr. Aygaswamy said, "The biggest problem is politics and politicians."

Not that the villagers are exempt from profiteering, if rumors are to be listened to. It is believed that the local fishermen's families each received between 50,000 and 100,000 rupees in the days after the tsunami.

Even Dr. Aygaswamy complained that some villagers were using the medical camp to diagnose and treat ailments they should have sought help for ages ago. "These people make lots of money, but they do not see a doctor even though they can. They just don't want to spend the money unless they have to," said Dr. Aygaswamy.

The doctor only shook his head from side to side and threw up his hands when asked why, if that were the case, these people chose to live in grass huts on public land. This type of belief, that somehow everyone is getting one over on everyone else, permeates Indian society.

Many residents of Tamil Nadu expressed disbelief and resignation when the government asked people to stop donating used clothes because the villagers have pride, and in this situation their wishes (at this moment apparently for new clothes) should be heeded.

SO, WHERE DOES the truth lie? Facts point toward more aid being needed to help the villagers rebuild their lives. Houses must be rebuilt quickly, and the need for new fishing boats is immediate. These two things will return the villagers' economic situation to where it was before the tsunami.

Slowly but surely these will occur. A scheme has already been initiated to rebuild houses (out of asbestos, but still, it's a house) at a cost of 8,000 rupees each. And, the aid money going directly to the villagers will first be spent on new boats. The New Year holds the promise of re-establishing life for the villagers along Chennai's coast.