TSUNAMI CAMP

Yesterday we went to one of the tsunami camps - a small place with dirt floors and concrete store rooms where people set up makeshift camps. Many of these people have been here since the tsunami in 2004. We took a three wheeled motor cart from Dehiwalla CCS headquarters to the camp a good 20 minute drive through traffic away off the coast. I was accompanied by a nurse and another staff member, and armed with a small array of OTC drugs, skin creams, and a few bandaging supplies. When we pulled into the camp, we made our way to a prepared area: a small plastic table and 3 chairs. We unloaded our boxes, and as we did, people emerged from every corner of the camp. A half circle quickly formed around us as people shuffled to sit in the chair. The first woman sat down with her naked child in her lap, "wheezing, fever." The nurse translated, starting each sentence with, "Dr. Ben." As I put my stethoscope against the moist skin of the 1 year old child, I had to usher flies out of the way to avoid squishing one on her back. She had loud wheezing, and was using a lot of effort to breath. My first instinct was to admit this kid and observe her over night with breathing treatments. Not an option. In fact, there was no way this kid was setting foot in a hospital unless they were a lot worse - no money, no medications, no resources. We gave the kid some paracetamol for the fever and discomfort and asked the mother to bring the kid to CCS regularly so we could keep an eye on her. We also educated her to keep wood fires for cooking out of the home where this girl was sleeping. Next patient. A boy had been bitten by bugs and small animals during the night in their uncovered shelter. The wounds were now superinfected with surrounding cellulitis. He had a slight fever and was complaining that it was uncomfortable to walk. Again I thought to myself, close outpatient management with responsible parents for cellulitis. The best I could do was examine the child, give paracetamol, and write down the name of an antibiotic they could get from the pharmacist at CCS the next day. I stopped to look at the growing crowd of patients behind me. The blaring sun caused beads of sweat to constant drip down my face. Flies surrounded us in small clouds. At the end of the morning, I saw 43 patients in all. I wanted to take more pictures - especially of the angelic Lankan children, but there was quite frankly no time. Once everyone had been seen, they dispersed back to the tents from which they came. Time for us to have tea.