1. Hassmiller, Susan PhD, RN, FAAN
  2. Simanjuntak, Hotli


A nurse's observations two years out.


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On December 26, 2004, a massive earthquake, measuring at least 9.0 on the Richter scale, set off a series of waves that decimated coastal areas around the Indian Ocean rim. More than a dozen countries were affected by the tsunami, including Indonesia, Sri Lanka, the Maldives, and India. The area hit hardest was Banda Aceh, Indonesia. On February 22, 2005, provided figures from Indonesia's Ministry of Health: 122,232 dead in Banda Aceh and 113,937 still missing and presumed dead. Alarmingly 80% of Aceh's health care workers were killed, according to International Medical Corps figures. Many people lived in low-lying areas in Banda Aceh; there were no refuge buildings or early warning system, nor did the people know how to recognize the coming tsunami.


Within hours of the disaster, the American Red Cross began responding to what would turn out to be one of the largest disasters in recent history. The American Red Cross worked alongside partners in the International Red Cross and Red Crescent Movement, including some 40 Red Cross and Red Crescent national societies worldwide. During the relief phase, the American Red Cross and World Food Program worked together to provide emergency food and water to 1.2 million people in Indonesia. Providing the basics, such as food, water, and shelter, was paramount. Additionally, mass vaccination campaigns and large-scale training efforts in psychosocial counseling for teachers, nurses, and community leaders were crucial to helping these populations survive, physically and emotionally. The Norwegian Red Cross, responding to the loss of thousands of Indonesian nurses who perished in the disaster, built a school of nursing northwest of Sumatra, on the small volcanic island of Pulau Weh.


As a member of the American Red Cross National Board of Governors, I visited Banda Aceh and the surrounding region recently to see how the recovery effort was going. I spent nearly a week there in November 2006 and was amazed by the amount of devastation that's still apparent (despite having seen many photographs just after the disaster occurred), but was equally amazed by the progress that's been made.

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Figure. These scenes... - Click to enlarge in new windowFigure. These scenes of schoolchildren singing and drumming were from programs designed by the American Red Cross to help survivors overcome the emotional trauma. In the village of Lam Dingin, hundreds of people were lost in the tsunami. Parents in the audience had lost many of their children, and many of the children performing did not have their own parents there to watch them.
Figure. In the villa... - Click to enlarge in new windowFigure. In the village of Calang, where 70% of the population was lost, disaster preparedness became a major goal. While I was there, the entire community engaged in its first-ever full-scale disaster drill, organized by the American Red Cross, using uniforms and a couple of ambulances donated by Taiwan. This realistic event stirred terrible memories of the disaster, and some villagers were seen crying and comforting each other. Nevertheless, the drill helped to demonstrate the importance of disaster preparedness for this vulnerable community.

(To read more highlights of Dr. Hassmiller's trip to Indonesia, see the daily blog she kept for

Figure. This young f... - Click to enlarge in new windowFigure. This young father and his children, inhabitants of Pulau Weh, Indonesia, could not speak English-and I could not speak Acehnese. I'd like to think their smiles reflected their thanks for the help provided to their country. I saw smiles like this in every place I visited in Indonesia.
Figure. The waves ne... - Click to enlarge in new windowFigure. The waves near Banda Aceh were strong enough to thrust this boat weighing 1,000 metric tons inland over several homes. The ship is too large to move, so local citizens have turned it into a regional electric generator.
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Figure. The American... - Click to enlarge in new windowFigure. The American Red Cross is supporting Community Habitat and Finance International in building a number of "healthy markets" across Banda Aceh. The idea is to provide structurally sound buildings with enough square footage to allow for the separation of fresh fruits and vegetables from poultry and fish. Additionally, space is being allocated in each of the markets for a nurse-run clinic, with support from the Indonesian Ministry of Health.
Figure. The first da... - Click to enlarge in new windowFigure. The first day I arrived, I was struck by the vast number of transitional shelters that dot the landscape. They are made of wood and have the same three rooms, but each is decorated according to the tastes of the residents. They are certainly a big improvement over the tents in which people had previously lived. These shelters will be their homes until permanent houses can be established.
Figure. Getting fres... - Click to enlarge in new windowFigure. Getting fresh water is a priority. Most of the water supply in Aceh was contaminated by sewage and salt from the ocean, and basic plumbing was demolished by the force of the waves and debris. In some areas, temporary systems are still necessary and will be until permanent housing is built. This water tank will provide a sustainable source of water for communities.
Figure. This grave s... - Click to enlarge in new windowFigure. This grave site, one of several mass graves, holds around 14,000 people. The adults' bodies are buried to the left of the central walkway, and children's are to the right. An archway leading into the cemetery gives praise to Allah, but other than that, the only memorials are two crumbling buildings that serve as reminders of what happened that day.