Stop all the clocks

People ask me why I became an activist after studying medicine. The answer is simple: to make a difference. In a city clinic I can treat maybe 40 people a day. Out in the field I can help thousands push for their rights to life’s basic needs.

My eyes were first opened 20 years ago. As a medical student in India I volunteered to help in Bhopal when a toxic gas leak from the Union Carbide chemical plant killed 7,000 people. I didn’t practise any medicine but I held people’s hands, listened to them and helped them get compensation. People are still fighting for their rights there; people are still dying.

What I realised then has not changed today: the poor suffer when disasters strike because they are often last in the queue once help arrives. I believe the best way to help disaster victims is to make sure people are not passive recipients of aid. They must not be beggars. They must have the power to help themselves.

When the Indian Ocean tsunamis struck Asia on December 26 I was returning from a project in Haiti run by Action Aid. I wanted time off to visit my ailing mother in south India. But I rushed first to India’s tsunami-hit southern coast, then to Sri Lanka, where I am now. I don’t want to sound like a storm-chaser, but relief groups must deploy quickly.

In Sri Lanka, the death toll kept rising. More than 20,000 people had died by the time we got there. We did not want to duplicate relief efforts that were being set up. So I visited towns in the island’s south, north and east to see where we could help.

In an overcrowded hospital in Jaffna, a town on the island’s northern tip, I held the hand of a 12-year-old girl who was crying. She had been treated for a bone fracture but the doctors would not discharge her because her parents had died and she had nowhere to go. There were so many other children like her.

My spirits brightened when I visited a well-organised refugee camp for 6,000 tsunami survivors. It was run mainly by the Tamils Rehabilitation Organisation, a humanitarian group linked to Sri Lanka’s Tamil Tiger guerrillas. I don’t want to glorify life in the camp but it was unusual, one week after the disaster, to see survivors helping to manage it. One teenager was cooking rice and sambar, a spicy lentil soup. Children played. I can’t say if this was happening elsewhere but it showed that people were not dependent on roadside charity. They were not passive.

I agree with those who say that school is the best medicine for this tsunami generation of children. It gives them something to focus on. But many adults are finding it hard to cope. One thing we have decided to do is to try to help adults deal with psychological trauma.

By offering basic psycho-social services we are trying to help survivors regather themselves. Many are fishermen who say “the sea was boiling” in the tsunami. They are afraid to go out on the water. But the sea is their livelihood. The initial instinct is to give them boats. I think it would be good for some if they rebuilt the boats themselves. It gives them work and money and helps them come to terms with their loss.

Here and in India we have been giving local volunteers crash courses to help survivors cope with trauma. I wouldn’t call it psychiatric counselling. We say to people: “It’s normal to feel numb, it’s OK to cry in these times. But still get involved in ceremonies and celebrations that are coming up.”

We also check to see if their shelter is OK, and if the children have enough toys and crayons. We are training teachers and trying to start up local employment schemes.

This kind of humanitarian work needs a lot of effort. I worry that this disaster has put the development clock back by a generation. The government says reconstruction work will take six months. But that’s just bricks and mortar. Rebuilding lives will take much longer.

Some critics of humanitarian work say rich countries give money to aid groups like ours to salve their conscience. Still, I have hope in humanity. For me, it felt good to learn of the generous promises of aid from the global community.

But we know from experience in Afghanistan and East Timor that promises don’t always translate into action. Once the smell and the heat and the blood disappears, and the television cameras move on, the public memory starts to fade. These become unkept promises.

Dr P.V. Unnikrishnan is a doctor with Action Aid, a development charity. He is working in Sri Lanka co-ordinating psycho-social care for tsunami survivors