By Rainer Lang

Padang, Indonesia

The old man is trying to smile, although he must be suffering great pain. He has bruises and cuts all over his thin body.  The 80 year old was covered up to his neck in rubble when his house collapsed after the strong earthquake that hit Sumatra last week. The man lives in the severely-affected rural area north of Padang.  In the villages, most of the houses are destroyed or severely damaged. Although hardly any help reached the victims in the first five days after the earthquake, ACT International was the first organisation to bring help to some villages in Pariaman district.      

Five days after the earthquake, Pendi Mandailink has finally brought his father on his motorbike to the ACT International medical post that was established along the main road at one of the many points where people report deaths and losses. It is also a place where victims go to sleep. Here in Singailimau sub-district, it is a market place with a roof which gives some shelter.

"It is a rough road and transporting a sick person is rather difficult," the son explains while doctor Prem Kumar examines Minik Mandailink. Dr Kumar then transfers the old man to the next hospital. "His wounds have to be treated with needles and stitches. We cannot do this here," he says. He points also out that the old man, who seems to feel uncomfortable and disorientated, is also severely traumatised.

But there is no capacity for psychological problems in the emergency situation because all the doctors are concentrating on the physical wounds. In the first days after the disaster Dr Kumar had to treat 300 patients a day. Most of the illnesses - typical for catastrophes - he could treat easily: skin diseases, bruises, infection of the lungs or severe headaches. "The people are undergoing a very difficult time at the moment," is how the doctor explains the high number of people with headache.

But there are still severely wounded people in the villages. They were injured by falling rubble. There was for example the elderly woman, Pik Itam, in the village of Sibaruas who was found by one of ACT's mobile medical teams. For five days Pik Itam lay on the ground in front of her destroyed home.  The mother of eleven could not move at all but the family did not know what to do or how to transport her to the clinic. Dr Witono Poerwo Laksano diagnosed a lumbar fracture and referred the 65 year old to the clinic. She had been hit by a falling wall when she tried to escape from the house, her husband says looking desperately at his wife. But it took Arshinta, who is coordinating some of ACT's emergency actions, two hours to get an ambulance to the village.

"Some hospitals are hesitant to send out ambulances although they have the car and the personnel," Arshinta says. "The reason is the price of fuel, which skyrocketed after the earthquake.  There was a severe shortage of fuel going along with a high demand for fuel. The hospitals simply can not afford this," she adds, pointing out that more medical teams would be needed. It is important to treat all the wounds because of the danger of severe infections, the doctors say. And there are still many people in the villages with wounds to the arms or head.

The three medical teams of one doctor and two nurses each have encountered an unexpectedly high scale of devastation. In many of the villages, 90 percent of houses are destroyed. Also, the infrastructure was badly hit.  Another ACT member in Indonesia is going to deliver water bladders and temporary toilets to eight villages in Pariaman district.   

In many cases only the rubble of a house is left with the iron roof still on top. Being looked at from the air, the house seems to be intact. The inhabitants are searching the rubble for belongings while trying to set up life under the open sky. Official figures say that in total nearly 90,000 houses have been damaged. Compared to that, the number of dead is relatively low. At that time of the earthquake, most people were outside the houses and not working, Arshinta explains. Looking at it from that perspective, Indonesia could have experienced a massive tragedy.

Rainer Lang spent the day with ACT International member, Yakkum Emergency Unit.

ACT International is supported by gifts from One Great Hour of Sharing, United Church of Christ.