Doctors revisit horror of Aceh
Standing before thousands of people physically and emotionally devastated by the Boxing Day tsunami, WA doctors with Professor Rene Zellweger had a stream of decisions to make.
One ultimate dilemma was whether to operate on one person for five hours or on five people for one hour each.
"You need to choose the five lives against the one life," Professor Zellweger said.
"Whether it's correct or not, whether it's logical, it's difficult to say but these are the decisions that will stay with you."
The journey from Perth to Banda Aceh started early on December 27, 2004.
Royal Perth Hospital orthopaedic surgeon Professor Zellweger, trauma surgeon Sudhakar Rao, emergency department nurse Terry Jongen and public health physician Paul Van Buynder were part of the team ready to fly within four hours of the call for volunteers.
Mr Jongen vividly remembers the destruction as they circled Aceh's only runway.
"I just saw this swampy sea of grey and I thought, what have I got myself in for," he said.
The medics were among the first teams to reach Aceh and were confronted by what the island had lost by shifting 17 tonnes of supplies off the plane without mechanical help.
With few transport options, the doctors bartered what they could, including their services, to get equipment to anything that resembled a hospital.
The injuries there were horrific. Dr Rao said by the time they had arrived, people badly hurt were already dead.
They set about doing their best with incredibly limited and basic resources. Amputations were common and a constant source of conflicts for the predominantly Muslim population with many refusing surgery on religious grounds.
"These people who beg you on their knees a day or two days later to reconsider (when close to death) but it's too late because the patient is so bad they are going to die," Professor Zellweger said.
The fear of not being "whole" left Mr Jongen searching through waste for an amputated leg for one distraught family.
A woman with septic leg wounds died in theatre and the family asked for just one thing: her leg back.
"I found the leg and they carried her out in a body bag," Mr Jongen said. "We not only cared for the physical aspects but their emotional and psychological needs as well."
The emotional toll was evident in most patients.
When not treating infections, disease, lack of equipment and sanitation, aftershocks took their toll.
Dr Rao said one half-naked patient ran from his examination when she noticed a slightest movement in a drip stand.
Dr Van Buynder divided his time between the hospital and makeshift camps.
The main camp with about 3000 people was at a mosque around which everything else was destroyed. "They took it as a sign Allah was protecting the mosque," he said.
The camps were an example of the resilience of the people, in particular children who played together and did not appear to understand the magnitude of the disaster.
"One of the striking things was the children could still find a way to be happy," he said.
