At dusk, a team of jet-weary volunteer medical professionals from Tzu Chi in Taiwan filed out of the small plane that had just touched down at Yogyakarta, Indonesia. The first thing they saw was the damaged airport, while the drone of military rescue aircraft filled their ears.

The volunteers went straight from the airport to the RS Senopati Hospital in the severely ravaged city of Bantul. The scene there was troubling: there were piles of rubble everywhere, and soldiers crisscrossed the premises moving the wounded. Lying in the long corridors and under outdoor tents, more than a hundred patients, literally in pain, anxiously awaited surgery.

It was the last day of May, five days after a magnitude 6.2 earthquake struck the Indonesian island of Java.


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AFTER THE QUAKE, many foreign medical rescue teams came to Yogyakarta to help. Because of a severe shortage of surgical equipment at local hospitals, some of the teams went home without accomplishing much of what they had hoped for. Luckily the Tzu Chi team was well prepared, having brought surgical gear from Taiwan and the Tzu Chi Free Clinic in Jakarta. Since the team was thus ready to perform surgeries, a local hospital designated an operating room for their use. In the history of Tzu Chi's international disaster relief work, this was the first time that Tzu Chi medical volunteers performed surgeries for disaster victims.

The volunteers quickly unpacked, set up, and started performing operations even though they were tired after a very long trip. "Time is the most formidable and cruel opponent in any disaster rescue mission. Delayed treatment could leave a patient disabled for life," said Dr. Chien Sou-hsin (簡守信), deputy superintendent of the Dalin Tzu Chi General Hospital and head of this medical delegation. "The sooner operations are performed, the better."

On the day of their arrival, they operated on patients from nine in the evening to three the following morning. Then arrangements were made with two local hospitals. At the RS Senopati Hospital, the Tzu Chi team manned the eight-hour shift that started at four in the afternoon. At the RS Jogyakarta Hospital, the Tzu Chi team was able to perform operations at any time of day.

"I noticed a marked and swift shift in the attitude of local people toward us," Dr. Lin Da-wen (林大聞) reflected. "On the day of our arrival, we could hardly get anything or any help from the locals. On day two, they would respond to our requests immediately. On day three, they were highly cooperative and helpful. They even sought our medical advice. The availability of the hospital's operating rooms to the Tzu Chi team also went up accordingly." He felt that when the team did a good job, the recipients of its services would soon put down their guard and come to trust and even rely on the team.

Immediately after the quake, there were about 8,000 injured victims who badly needed surgery. Five thousand of them were still waiting by the time the Tzu Chi team arrived five days after the disaster. Guo Zai-yuan (郭再源), deputy CEO of the Tzu Chi Indonesia branch, lamented that even some of the most gravely injured were not operated on promptly, not to mention those less severely hurt. He was very concerned about the situation there.

A woman in her seventies suffered from a broken left thigh bone that had been crushed by a fallen roof. Only some cotton balls and two pieces of plywood were tied around her thigh in a forlorn attempt to secure the injury. She did not dare to make the slightest move lest the jagged edges of the broken bone should prick the surrounding tissues and cause excruciating pain. So this old woman lay still for several days--so still, in fact, that ants built nests in the primitive cotton rolls covering her wounds.

"When we removed the plywood, ants ran out of the dressing. Having been bedridden, especially so motionlessly, for several days, the poor woman had bedsores on her buttocks. You can imagine the pain that she must have endured," said Dr. Su Quan-fa (蘇泉發), chief of neurosurgery at the Hualien Tzu Chi Medical Center. The team quickly operated on her and fixed her broken bone with stainless steel plates.

A woman in her forties also had a broken thigh bone. She was similarly reluctant to move so she would not aggravate the excruciating pain. She even refrained from going to the lady's room to relieve herself. "As we prepared her for operation, a palpate examination of her abdomen indicated an extremely distended bladder. So we put in a urinary catheter and got out more than 1,000 c.c. of urine," Dr. Su said. Usually 500 c.c. or more of urine in the bladder will increase the risk of infection and uremia.

Located just a 15-minute drive from the center of Yogyakarta, the government-owned RS Jogyakarta Hospital is registered with 125 beds. At the peak of the post-quake chaos, however, more than 600 patients poured in that day, and 63 of them perished by the end of the day. Since there were more patients than available beds, many overflow beds were placed in the hallways or under big tents set up by the military.

The beds were tightly spaced. As male and female patients were not put in different quarters, there was no privacy to speak of. Family members who came to care for their loved ones simply sat or lay by the sides of the beds. Many people used much of the open space in the hospital to dry their laundry. The hospital became quite a colorful and hustling place. Doctors held medical records in their hands as they patrolled the hospital grounds looking for their patients.

Ny Samribut, 60, was injured by a collapsed roof. A fallen beam landed squarely on the instep of her left foot, breaking four big bones, three small bones, and two phalanges--just about all the bones in that foot. Totally overwhelmed by the patients flooding in after the quake, the hospital did not have the manpower to fix her broken foot. Instead, doctors just sewed her wounds up and put her in a plaster cast. No further care was given to her for ten days.

When the Tzu Chi medical team arrived, Samribut became a patient of Dr. Pan Yong-qian (潘永謙), superintendent of the Guanshan Tzu Chi Hospital. He noticed that her wounds were severely inflamed. He immediately cleaned the wounds and fixed the five largest broken bones with pins. Dr. Ye Tian-hao (葉添浩) followed up with a graft implantation procedure, which lasted four hours. Dr. Ye is a plastic surgeon associated with a Tzu Chi International Medical Association (TIMA) branch in southern Taiwan. Like the other members, he used his own time and money to join this Tzu Chi relief delegation. Lacking a specialized implantation instrument, Ye had to use an old-fashioned razor to perform the skin graft for Samribut the following day.

"It was much too late by the time we saw her, intervened, and operated on her. The tissues in and around her wounds had deteriorated to the point that the implanted graft might not take root. And she might still face..."--Dr. Ye's voice trailed off, and then he continued--"...amputation. But as long as there is still a ray of hope, I'll do my best to avoid it."

While the surgeons and orthopedic specialists of the Tzu Chi team worked in the operating rooms, the rest of the team carried medicine and gear out to the countryside to find and treat injured victims who needed medical care.

Bawuran was among the most severely damaged areas. About 90 percent of the houses in Bawuran had collapsed and more than 70 people had died. The Tzu Chi medical volunteers found and obtained permission to use a slightly damaged but still safe house. They emptied the rooms and converted them into a makeshift clinic. Many people complained about headaches, insomnia, loss of appetite, and racing heartbeats. Dr. Lin Qiao-xiang (林喬祥), head of general psychiatry at the Hualien Tzu Chi Medical Center, commented, "These are all acute stress reactions to shock, distress, and grief in the wake of the earthquake."

Dr. Lin talked with victims through an interpreter. He was so absorbed in listening to some victims' stories that occasionally he reflexively uttered some Chinese words. The people acknowledged his comments all the same, and the conversation went on uninterrupted. Reflecting on such cross-cultural communication, Dr. Lin came to realize that a sincere facial expression of a physician is itself a wonderful remedy. He now understands that love and care can transcend differences in language, culture, and ethnicity to more easily and fully reach a doctor's patients.

In the meantime, day after day, some Tzu Chi volunteers went out to remote villages to seek out those who were hurting at home but were unable or unwilling to get out of the house to obtain medical assistance. When volunteers found anyone who needed help, they would examine and treat them or give them medicine right on the spot.

Villagers had rarely had a chance to receive medical care in the past. Many of them were initially dubious, and they just watched from a distance to see what the Tzu Chi team was up to. Gradually and hesitantly, a few of them came out to be treated. Good results spoke for themselves. Eventually, so many villagers came to ask for treatments that the doctors had to work into the night by candlelight to care for all of them.

A pregnant woman with fractured bones looked particularly emaciated and sickly. After examining the woman, Dr. Zhu Shao-ying (朱紹盈), a physician in the department of pediatrics at the Hualien Tzu Chi Medical Center, suggested to the woman's family that they give her some yogurt, one egg, and a glass of milk each day to help her recover. The family just wryly smiled at her suggestion. It then quickly dawned on Dr. Zhu, in light of the post-quake scarcity of most daily essentials, how difficult her suggestion would be to carry out. She became more grateful for the abundance that she enjoyed in Taiwan.

Musiman was a pious Muslim. He showed the Tzu Chi team the village mosque where he preached every Friday. Bright sunlight filled the clean interior of the mosque, which had been only slightly damaged by the quake. Many holy books surrounded the altar where Musiman stood. "Since the quake, I have worshipped five times per day in the hospital worship hall. And that will not be disrupted." When asked what he prayed for, he replied humbly, "I pray to Allah to spare the world of any severe earthquakes in the future." He also hoped that his wife would make a speedy recovery so that he could resume his job of pulling a pedicab.

The Tzu Chi medical team concluded its mission after eight days, during which they had served about 3,000 patients. The doctors bid farewell to their patients after examining them for the last time. Wang Si-hui (王思惠), a Tzu Chi registered nurse, patiently explained one more time to family members of patients who would be bedridden how to massage their loved ones. "Follow-up visits and treatments are as important as the initial surgery," Dr. Pan Yong-qian said as he filled out some referral forms for his patients. His thoughts were clearly fraught with his concerns for his patients. "After we leave, will the patients know how to continue doing physical therapy? If their condition worsens, can they be transferred to another medical facility? These things really worry me." [see Editor's prologue] Volunteers at the Tzu Chi Indonesia branch promised him that they would take over and follow up with the patients.

The Tzu Chi medical team left amidst countless cries of "Terima kasih (thank you)" from grateful and tearful patients who came to say good-bye.