Seven physicians at Kaiser Permanente Northern California are leaving as early as today for Indonesia and Sri Lanka in the first phase of a coordinated relief effort that will take area medical experts to tsunami-ravaged regions over the next year.
The doctors who have either disaster-relief experience or familiarity to South Asia will set up clinics and help combat infectious diseases for the thousands of survivors.
"Our primary goal is not to go there to treat casualties," said Dr. David Witt, an infectious-disease specialist at Kaiser South San Francisco. "It's to get the public health infrastructure up and running."
The physicians are organized into two teams. Witt is one of three doctors going to Banda Aceh, a northern province of the Indonesian island of Sumatra that was devastated by the tsunami. More than 105,000 people in Indonesia, largely in Sumatra, died in the disaster.
The physicians two infectious-disease experts and one family practitioner will spend a month in Banda Aceh working in coordination with the Britain-based Mentor Initiative, a program that trains local people how to reduce cases of malaria and other diseases.
Both teams will bring medical supplies, satellite phones, computers and pharmaceuticals with them. The conditions will no doubt be harsh, and like the people they help, the doctors may not have adequate access
"This is an unprecedented disaster, and there is no way we can expect to prepare ourselves," said Dr. Scott Smith of Kaiser-Redwood City who is on the Banda Aceh team.
Dr. Katherine McNally, a family practitioner at Kaiser Petaluma, is returning to South Asia 20 years after serving in the Peace Corps in Thailand.
She said the need to prevent vectorborne diseases in Banda Aceh is urgent, with drainage ditches destroyed, pools of standing water everywhere and the springtime monsoon season fast approaching. Three million people die from malaria worldwide each year.
"Salt and fresh water together create brackish water, which is a perfect breeding ground for mosquitoes," McNally said.
Relief work could be interrupted, as a longstanding conflict between the Indonesian military and separatists had caused the government to require military escorts for foreigners traveling in more remote areas of Aceh.
Witt said the group would pull out if any dangers arise. "We're all willing to take a little risk in our lives but this isn't a suicide mission," he said.
The second team, with four members bound for Sri Lanka, will focus on setting up clinics to treat patients and help stabilize the local health care system.
Dr. Vaji Dharmasena, an OB/GYN at Kaiser San Jose, is a native of Sri Lanka and is leaving today for two and a half weeks. The clinic could treat between 300 to 600 patients a day. "We are expecting a lot of uncertainty," she said.
One unknown is where to set up the clinics, as some areas have received supplies and medical help while others are still without aid. The team plans to focus in the country's south and southeast areas, and perhaps move to more isolated areas in the east as needed.
Dr. Sara Beekley, a pediatrician at Kaiser Redwood City who is on the Sri Lanka team, said children who survived the disaster are particularly vulnerable. About 2.2 million people, mostly children under age 5, die each year worldwide from diarrhea from a lack of clean drinking water and sanitation.
"As a pediatrician you can take care of the primary infection but organizing prevention efforts is the most important," Beekley said.
Among the tools the group will bring are water filters, water purification tablets and rehydration salts.
Beekley said another priority is mental health care for children.
"The emotional devastation is catastrophic," she said.
More than 300 Kaiser medical staff volunteered to go to South Asia to help with the relief efforts. Two to four doctors at a time will follow the initial teams, while others will help by caring for the patients of those chosen to go overseas.
"It's very easy these days to be skeptical and cynical and see medical care as a business," said Dr. Robert Pearl, CEO of Kaiser's medical group. "I think this is inspirational."