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Rebuilding Hope - Nurses Rush Relief to Tsunami Survivors

medicalTriagemedicalTriageHeather Jeavons remembers exactly when she first heard about the Dec. 26 tsunami in Asia. "I was on the Stairmaster at my gym," she says, "watching the news on TV." She thought, "I have skills that can be used there, and here I am in my insulated world watching it on a little box. This is not right."

By early January, Jeavons, a nurse practitioner experienced in disaster-relief medical work and 2002 master's graduate of the UW School of Nursing, was on her way to Sri Lanka with Northwest Medical Teams. Traveling in the same group was UW Bothell nursing student Katie Sundt, employed as a charge nurse and preceptor at Harborview Medical Center, working in acute neurosurgery.

Sundt, who had done international medical work before but had never worked in a disaster zone, says she felt compelled to go help as soon as she heard of the devastation. Her family, friends, employer and coworkers-who covered her shifts during her monthlong absence-all helped to make her four-week trip possible. The UW Bothell Nursing Program also supported her work, she says, by integrating the trip into her academic program. (Her e-mail correspondence from Sri Lanka is posted online athttp://www.uwb.edu/chancellor/tsunami.html.)

Meanwhile, Gail Pyper, a School of Nursing research nurse and study coordinator in psychiatry and behavioral sciences, was preparing to go to Thailand. The tsunami occurred less than a month after Pyper, a frequent volunteer, got home from a medical mission in Ecuador. For Pyper, who pays her own way as a volunteer, the decision was challenging: she lacked funds for another trip so soon. But the generosity of friends, family, her church and complete strangers eased the way. Once she put the word out about her trip, she received $7,500 from 80 donors, including many at the School of Nursing. After travel costs, the extra money supplied children's vitamins, a propane stove, pots and pans for a refugee camp, and $2,000 to help rebuild a children's center.

All three volunteers discovered that the ravaged communities they served needed them to expand their definition of nursing. As Sundt wrote in one of her e-mails home, "In the third world, you work with what you have." In the turmoil of makeshift refugee camps and devastated communities, amid long, hard days, they adapted their services to meet local needs. Jeavons, whose team was one of the first medical relief groups to arrive in Sri Lanka, says that the most urgent needs were for "really basic things-obvious things. Food. A toilet. Water." She quickly learned about the importance of flexible leadership in a disaster zone, she says. "We went assuming we'd be doing medical clinics all day. We learned that medical needs weren't as bad as we thought-there wasn't cholera, there weren't epidemics," she recalls.

Some days they spent in clinics, bandaging wounds, treating respiratory infections, giving antibiotics when needed and addressing lots of musculoskeletal and psychosomatic complaints. Other days they toured refugee camps, asking people what they needed, working to coordinate care with government and other relief agencies, and delivering prenatal vitamins, tool kits and school supplies.

Survivors also had psychological needs. Sundt reported in an e-mail from Sri Lanka that, in addition to treating physical injuries, she attended to "broken hearts." And misinformation about health problems was widespread, she noted. For example, many Sri Lankans had heard a rumor that children who had swallowed sea water would die on the three-month anniversary of the tsunami. "A little reassurance and education can go a long way," she noted.

Jeavons first assumed that it would be respectful not to ask survivors to talk about what they'd been through. Instead, she says, "I found that people really wanted and, I think, needed to tell their stories; they needed someone to witness what they had been through. In some ways, listening was the only way to help."

Pyper, too, found that her experience in Thailand deepened her understanding of nursing as a vocation. "The art of nursing is translatable to other cultures, countries, languages," she says. "People know when they are being listened to. There is a connection that happens.

"Nurses make a difference in the lives of people," Pyper says. "It matters that people know they are not alone in their suffering."

The resiliency of the Sri Lankans she went to help impressed Sundt, and she learned from them something about how to face hardship gracefully. "The trip made me a better person," she says. "It impressed upon me that a person's spirit can endure more than I ever thought. All the medical technology in the world cannot save someone who has given up spiritually. Thankfully for the people in Sri Lanka, this did not happen. I have carried this sense of spirit back to Harborview with me, and since have had daily reminders of the strength of the human spirit, despite facing great adversity." Jeavons says that her trip to Sri Lanka taught her a great deal about how to cooperate with other agencies to provide sensitive, culturally-appropriate care. Jeavons stresses the importance of engaging respectfully in a mutual dialogue with the people you want to help, because learning about local needs-material and emotional-is key to crafting the most effective response.

Jeavons notes that coordinating relief efforts with other international aid groups in Sri Lanka was extremely challenging because there were so many helpers arriving in such a short time, inevitably adding to the post-disaster confusion.

"If you're not careful, the relief effort could be like another tsunami," she says, as relief workers place heavy demand on scarce local resources and create a fragile, temporary economy set up to serve visitors' needs. The arrival of thousands of volunteers has an inevitable impact, she points out. "The only question is, will it be positive or negative?"

All three volunteers emphasize that recovery from the tsunami will take many years. Jeavons recommends that those who want to help should look for long-term projects to support, not just "band-aid approaches." Based on her experience in Sri Lanka, she notes that now the most urgent health care projects include building hospitals, replenishing medical supplies, or helping displaced families rebuild their homes and livelihoods. "It's all health care," she says.

CREDIT:  Heather Jeavons, second from right, performs medical triage at a makeshift clinic in the Ampara region of Sri Lanka. During their monthlong stay, Jeavons and nursing student Katie Sundt provided care in dozens of refugee camps in the region.