By Pamela Davie, Canadian Red Cross
Standing on the dusty roadside, the arrivals of ExpoAir flight 771 wait silently in the still heat of mid-morning for their luggage. I feel a sharp sense of recognition and sobriety when the white land cruiser of the International Committee of the Red Cross (ICRC), a red cross emblazoned on its hood, pulls up on the other side of the barbed wire barrier and engine off, waits patiently with the dozen airline passengers to begin its journey from the Jaffna military airport.
The ICRC has been present in Sri Lanka since 1989 and has a well established relationship with local authorities in order to assist the population affected by conflict in the north and north east. A ceasefire between the Sri Lankan government and the Liberation Tigers of Tamil Eelam (LTTE) has been in effect since 2002.
As mandated by the Geneva Conventions, the Red Cross protects civilians, prisoners of war and detainees by facilitating authorities' adherence to their international obligations under the Conventions. In Sri Lanka, this includes assisting with civilian's movements between the lines that divide government and LTTE controlled areas. During the recent relief efforts the Red Cross worked with local authorities on both sides of the lines in order to facilitate the transport of all relief items flowing into the north, including 700 trucks of ICRC relief items.
This week, I plan to meet with Canadian Red Cross relief workers (delegates) working in the region who were instrumental in those first weeks of the relief efforts and to learn about the current situation for the tsunami-affected population living in the north and north east of Sri Lanka.
I am accompanied on this journey by members of the Canadian Red Cross assessment team: Judi Fairholm, director of the Canadian Red Cross violence and abuse prevention program, RespectED, who is addressing the psycho-social needs of survivors; and Lily Montano, a Canadian health delegate who has been working in the north since January 2004.
Our first appointment is with Fred Robarts, the Head of the ICRC operation in Jaffna. The British expatriate explains how profound this disaster has been psychologically for the population, of which 90% already have suffered the turmoil of displacement due to the conflict at least once prior to the tsunami.
"People directly impacted by the tsunami lived by the sea and thought they knew it. They had felt the effects of conflict but discovered they are not safe from nature either. They now are asking, what is left?"
In terms of psychological and physical health, some of the significant issues now threatening the communities of the north in the aftermath of the tsunami are an increase in depression, sleeping disorders, suicide and alcoholism.
Women and children constituted a large number of those killed and in many cases men witnessed their demise, helpless to save them. In a society where gender roles are clearly defined, men now find themselves confronting a double burden as heads of single parent households. Their personal loss, combined with the destruction of their boats and livelihoods, leaves them at greater risk of suffering from the psychological impact of the disaster.
Dr. Daya Somasundaram of Jaffna University confirms that psycho-social assistance is a priority need for people impacted by the tsunami. He notes that children and youth are also suffering, as shown by nightmares, fears and heightened emotions. But the Head of the Psychology department for the faculty of medicine stresses that well meaning organizations must take into account the type of psychological assistance required as well as the cultural context in which it is delivered.
According to Dr. Somasundaram, less than 10% of people suffering from depression or trauma following the tsunami require professional help, rather they need community based interventions such as befriending, listening and sharing activities. "Survivors struggle with guilt, replaying the event. There is a need for support groups, and an understanding of stress and tension and how to relieve it." He also recommends rituals and remembrance events in order to help the mourning process.
Dr. Somasundaram heads the coordination body for psycho-social assistance in the north east, North East Secretariat for Human Rights (NESHR), and has developed training for community health workers to intervene and assist people suffering from the psychological impact of war. He has adapted the program to the needs of the same population now affected by natural disaster. "This was a significant blow but people here have faced a lot in the past and they are hardy."
I notice my colleague Judi nodding in agreement. Throughout the rest of our journey, she will point out three men standing on rocks fishing in a river, music blaring from inside a small shop surrounded by debris, and road crews applying fresh paint on a newly repaired bridge. "People are incredibly resilient," she repeats.
My colleagues Judi and Lily are already familiar with Dr. Somasudaram's program and arrange for him to train a team of 50 Red Cross community health workers this month, from a program which Canadian Red Cross has managed in the region since 1998. The health workers are located throughout the north and were mobilized to deliver first aid immediately following the tsunami. They now work in the transit camps to deliver psycho-social assistance, first aid and hygiene awareness to the displaced.
We continue on our assessment mission further south to Puthukudiyiruppu, located approximately 15 kilometres from the north eastern coast and home to the district's hospital. The ICRC and the German Red Cross have been supporting the hospital since the tsunami and Canadian Red Cross is contributing to the effort by providing delegate Marg Lachmuth, a nurse from Calgary.
While my colleagues review the hospital operations and needs, I join Marg on her rounds. She reports that she recently treated two girls, ages 11 and 16, who were experiencing seizures, apparently as a result of the trauma of losing family and witnessing the aftermath of the tsunami "One elderly woman came to the hospital and when I asked her what was wrong she said 'I'm so tired. I just want to rest.' People have had so much happen in their lives, but they keep going."
From the hospital we travel to Mullaitivu on the coast, from where the first patients arrived following the tsunami. On the way, we pass a transit camp, where the ICRC is providing shelter and water and sanitation facilities. This is one of several camps supported by the ICRC throughout the north and east of the island.
Arriving at the beach front of the devastated town we meet a fisherman pulling tiny fish from his tangled net. Naghingam Thiruchchavam has repaired his boat and is back at sea. Of the 2000 fishing boats that lined this shore, his was only one of two boats that remained intact. While his boat survived, his four children and home did not. He is living in a welfare centre.
The Red Cross is working with authorities to move people from government welfare centres, often located in schools and temples, into medium-term transit camps where shelter, clean water and sanitation facilities are provided.
We continue several hundred kilometres south until we reach the lines between north and south Sri Lanka at Vavuniya. Driving through the 500 metres of no mans land between the lines, I spot Robin Creelman, a native of Truro, Nova Scotia, who facilitates the movement of civilians and goods between the two areas.
Robin seems pleased to see us and after serving us coffee in the thatch-roofed hut that is the permanent ICRC booth in the middle of no man's land, he describes those first days following the disaster. "On the 26th, trucks started arriving in the early afternoon carrying badly injured people, trying to get to the closest hospital in the south. At first we didn't know what was happening. But the authorities on both sides responded quickly, relaxing the official hours for crossing the lines. They were open 24 hours and the injured and relief goods moved both ways across the lines." Robin continues to facilitate aid reaching the north.
Managing the ICRC operations in the area was another Canadian, Catherine Godin of Montreal. The head of sub-delegation in Vavuniya describes a similar scene.
"On the 26th, we realized something was happening at the lines. When I arrived there were injured people arriving from the north by the busload. I mobilized the Red Cross cars and we helped to transport people to the hospital. Those first hours we had little idea about the scale of what was happening. We just kept running to meet the needs."
While located inland, Vavuniya sits on the A9, the transit route that represents the economic backbone of the country. It was Catherine's role to mobilize immediate relief in those first hours and days and later to oversee the transport of 78 truck loads of relief into the north.
The last leg of our five day journey is to Batticaloa, a badly affected area on the north east coast. There I meet with a Sri Lankan Red Cross volunteer tracing team. Their efforts continue as they show me the stack of hundreds of photos taken of recovered bodies, which they are attempting to match with living relatives.
People need to know what happened to their family to help them move on," says Rajaseelvan, the tracing coordinator. I later discover that he is speaking from personal experience. The 23-year-old describes how he lost his mother and 11-year-old sister from the tree they had climbed together with his father. "It was the second wave," he says. "We found their bodies the same day. I want to help others to know as well."
At that moment I am overwhelmed by this young man's strength, his ability to help others in the face of his own loss. Canadians are helping the thousands affected by the tsunami but it is people's own resilience that will contribute most to their recovery.