Rebuilding after the tsunami: reflections on medical experiences in Banda Aceh.

I met Yusni in June 2006, late in the afternoon on a busy day in the orthopedic outpatient clinic at Zainoel Abidin Hospital in Banda Aceh, Indonesia. A year and a half earlier, Yusni’s village on the west coast of Aceh province was swept away by the infamous Indian Ocean Boxing Day tsunami. He lost his home and 2 of his younger siblings, yet Yusni somehow managed to survive, although he did suffer a posterior hip dislocation. He was 15 years old at the time. Yusni had been taken to see a traditional bonesetter who was unable to treat him properly and who did not reduce the dislocation. Over time, scar tissue formed around the joint such that he was able to put partial weight on his leg and walk with great difficulty. However, he remained unable to fish or do many of the things that he’d previously done to help support his family. Months later, a family friend suggested that the doctors at the hospital in the provincial capital might be able to help. Yusni borrowed money to pay for his lengthy trip and finally ended up in our busy outpatient clinic. What was tragic about Yusni’s story was that it was anything but unique. So many of the patients I saw in Banda Aceh had similarly neglected traumatic injuries and equally unfortunate stories. Having finished medical school, I was there as a medical observer for the Surgical Implant Generation Network, a non-profit orthopedic organization. I spent my time on the orthopedic floor in Zainoel Abidin Hospital, which was filled with cases like Yusni’s. Nearly half of the patients seen there in 2005 were injured during the tsunami and, of those patients, less than half had presented acutely. The vast majority were under the age of 25.