February 14, 2005

Dear friends,

I started to write this when I was honored to be one of the play therapists selected by the Association for Play Therapy and OperationUSA to go to Sri Lanka after the Tsunami to play with children. It was one of the most amazing experiences of my life, and I want to thank you for all the support you gave me. I continued to write in Sri Lanka, and then, back home, fueled by jet lag (which I think was really 'soul lag') I kept writing. And writing. And I may have written too much, so feel free to skip around, or just look at the pictures.

This is my thank you to all of you for your support and donations, for the stickers, band-aids and crayons, for the drawings the children did here, for the children in Sri Lanka; and to the amazing teams I worked with (from APT: Janine, David, Joe, Prabha, Jodi, Sharolyn, Valerie, Maria; from OpUSA: Nimmi, Carinne, Ravi and Anita) and my gratitude to the incredible "animators" of  Sri Lanka, who taught me so much; and to Reverend J. and Selvie-Amah, and all the children at St. John's orphanage. Most certainly and most especially my eternal gratitude to all the wonderful children and adults of Sri Lanka who, having survived the war and the Tsunami, opened their hearts to me.

Thank you forever,

Kate

Kate Amatruda

 

Tsunami

A visit to Sri Lanka
A humanitarian mission sponsored by the Association for Play Therapy and OperationUSA
by
Kate Amatruda, LMFT, CST-T, BCETS

 


I look on the map and see that Sri Lanka is a teardrop off the coast of India.

I have not slept through the night since I returned from Sri Lanka five days ago. It is the eyes that haunt me; the eyes of the father whose daughter was ripped out of his arms, the eyes of the grandmother who saw her children and grandchildren swept away. A generation lost in a heartbeat. I see shock on the faces of the survivors, and am reminded yet again of how everything can change in an instant. Whether it is an earthquake, a Tsunami, a tornado, or planes hitting towers, life is so fragile. Everything can be gone in the blink of an eye; we are so little, nature and war are so big. Yet we have this illusion, at least in the West, that we are in control. So I look, and look again, compelled to try to discern how people do it. How do you go on when your village, your home, your family, is destroyed? I see the faces of those who I met in the refugee camps, and it is the eyes that capture me. And it is the eyes of the children that haunt me, and make me unable to sleep through the night.

The number of people believed killed in December's Tsunami disaster rose to 285,993 on Saturday, February 12, 2005. Every day the death toll rises. The number of children orphaned is still unknown. Sri Lanka's death toll now stands at 43,832. (Reuters)


The earthquake hit on Sunday, December 26, 2004 at 7:58:53 AM = local time at epicenter
For us in California, it was on Christmas afternoon,
Saturday, December 25, 2004 at 04:58:53 PM (PST)
Location 3.307° N 95.947° E
Depth 30 km (18.6 miles) set by location program
Region OFF THE WEST COAST OF NORTHERN SUMATRA.
It was a 9.0 earthquake, the fourth biggest since 1900.

(This should be animated to show the Tsunami. If it is not, try passing your mouse over the map.
If it does not animate, the non-animated map below shows the course of the Tsunami.)



I am remembering the Northern California Loma Prieta earthquake in 1989. The Indian
Rim "Boxing Day" 9.0 earthquake makes our 6.9 magnitude pale in comparison, as each Richter logarithmically increases the size on an earthquake, yet the Loma Prieta was strong enough to break the Bay Bridge.   Scientists from Pasadena explain, "It has since been shown to be proportional to the energy released in the earthquake but the energy goes up with magnitude faster than the ground velocity, by a factor of 32. Thus, a magnitude 6 earthquake has 32 times more energy than a magnitude 5 and almost 1,000 times more energy than a magnitude 4 earthquake."

"The massive earthquake off the west coast of Indonesia on December 26, 2004, registered a magnitude of nine on the new "moment" scale (modified Richter scale) that indicates the size of earthquakes. It was the fourth largest earthquake in one hundred years and largest since the 1964 Prince William Sound, Alaska earthquake.

The devastating mega thrust earthquake occurred as a result of the India and Burma plates coming together. It was caused by the release of stresses that developed as the India plate slid beneath the overriding Burma plate. The fault dislocation, or earthquake, consisted of a downward sliding of one plate relative to the overlying plate. The net effect was a slightly more compact Earth. The India plate began its descent into the mantle at the Sunda trench that lies west of the earthquake's epicenter.

For information and images on the Web, visit:
http://www.nasa.gov/vision/earth/lookingatearth/indonesia_quake.html
For the details on the Sumatra, Indonesia Earthquake, visit the USGS Internet site:
http://neic.usgs.gov/neis/bulletin/neic_slav_ts.html
http://www.nasa.gov/home/hqnews/2005/jan/HQ_05011_earthquake.html

Question: How much energy was released by this earthquake?
Answer: Es 20X10^17 Joules, or 475,000 kilotons (475 megatons) of TNT, or the equivalent of 23,000 Hiroshima bombs

.

When I get home, I read:

Sumatra Earthquake Three Times Larger Than Originally Thought

EVANSTON, Ill. --- Northwestern University seismologists have determined that the Dec. 26 Sumatra earthquake that set off a deadly Tsunami throughout the Indian Ocean was three times larger than originally thought, making it the second largest earthquake ever instrumentally recorded and explaining why the Tsunami was so destructive.

By analyzing seismograms from the earthquake, Seth Stein and Emile Okal, both professors of geological sciences in Northwestern's Weinberg College of Arts and Sciences, calculated that the earthquake's magnitude measured 9.3, not 9.0, and thus was three times larger. These results have implications for why Sri Lanka suffered such a great impact and also indicate that the chances of similar large tsumanis occurring in the same area are reduced.

"The rupture zone was much larger than previously thought," said Stein. "The initial calculations that it was a 9.0 earthquake did not take into account what we call slow slip, where the fault, delineated by aftershocks, shifted more slowly. The additional energy released by slow slip along the 1,200-kilometer long fault played a key role in generating the devastating Tsunami.
http://www.sciencedaily.com/releases/2005/02/050211094339.htm

 

Satellite Imagery


This image acquired on 28 December 2004 by the MERIS (Medium Resolution Imaging Spectrometer) on board ESA's Envisat Earth observation satellite shows the northeast coast of Sri Lanka and the southern coasts of India. Sediment (light brown & green colour) left after the Tsunami can be seen along the coast. (Credit: ESA)

(http://www.disasterscharter.org/disasters/CALLID_078_e.html)

Tsunamis


When thrust-faulting earthquakes happen under the ocean, the earthquake can push large blocks of ocean floor up. When the ocean floor moves up, the water that was in that spot has to go somewhere else. That somewhere else is into a large wave called a Tsunami.
http://pasadena.wr.usgs.gov/ABC/pt.html

I keep feeling there is a "disturbance on the field"; that something is very wrong.


NASA Details Earthquake Effects on the Earth
NASA scientists using data from the Indonesian earthquake calculated it affected Earth's rotation, decreased the length of day, slightly changed the planet's shape, and shifted the North Pole by centimeters. The earthquake that created the huge Tsunami also changed the Earth's rotation.
http://www.nasa.gov/home/hqnews/2005/jan/HQ_05011_earthquake.html

 

 

Children in the Bay Area of San Francisco, where I live, are anxious about a Tsunami hitting here. The San Francisco Chronicle has an article about it, so I am able to reassure my son, as well as myself, that we would be in no danger. We live on the Petaluma River, but find out that we would be protected by the deep channel through the Golden Gate Bridge. Deep harbors are more able to absorb the shock of a Tsunami than shallow waters.

I received an e-mail from the Association for Play Therapy calling for a team of volunteers "to participate in a US delegation to Sri Lanka to provide play activities (but not psychotherapy) to children in orphanages and community centers."

I quickly faxed and mailed off my application, hoping to be selected. I was so honored when when Dr. Janine Shelby, the Association for Play Therapy Foundation President, and a brilliant clinician, called to invite me to join the project.  I learned later that only 14 play therapists from across the country have been selected to go. We will be working with OperationUSA, an NGO that was the co-recipient of the 1997 Nobel Peace Prize for its work banning land mines. Their mission is based upon Mahatma Gandhi's belief that "You must be the change you wish to see in the world".

After the initial elation, panic sets in. What am I going to do there? I don't speak the language, nor know the culture. I madly research techniques for working with children after a disaster, and find very little. There is a need for Dr. Shelby's project, which will be to bring specific cognitive-behavioral protocols, in the form of games, to the field.

I find that the Save the Children guidelines are:

1.Apply a long-term perspective that incorporates psychosocial well being of children.
2.Adopt a community-based approach that encourages self-help and builds on local culture, realities and perceptions of child development.
3.Promote normal family and everyday life so as to reinforce a child’s natural resilience.
4.Focus on primary care and prevention of further harm in the healing of children’s psychological wounds.
5.Provide support as well as training for personnel who care for children.
6.Ensure clarity on ethical issues in order to protect children.
7.Advocate children’s rights.

I have ten days notice in which to prepare. I have to tell my patients, and work through their feelings about me going so soon after the holiday break. One mother sums it up, "Well, while I am glad for all those children that you will help, I am not happy for my daughter who you will be leaving!" Shots - I rush to the doctor to get Hepatitis A and B vaccines, Typhoid, tetanus and diphtheria shots, and malarial prophylactic pills. After the shots, I cannot raise my arms for days. I have to pack; we are told to wear long sleeved shirts (with high cut necklines) and pants. I go to Target and buy loose fitting cotton outfits in the pajama department. I will not be a fashion plate this trip, that's for sure. I spent hundreds of dollars on over-the-counter stuff: mosquito repellant, sunscreen, tea tree oil, antacids, anti-diarrhea pills, Advil, Tylenol, anti-itch cream and pills, wipes, toilet paper, hand sanitizer, etc. I feel like a walking pharmacy.

My sister, Elizabeth Howell, tells me that one her colleagues and dearest friends at Calvin College, where they both teach, is from Sri Lanka. His name is Kumar Sinniah; he is an Associate Professor in the Department of Chemistry & Biochemistry. He is wonderful, e-mailing me information, and offering to hook me up with his five sisters in Sri Lanka. I get helpful e-mails from his sisters Sharmini, who is working with the Christian Blind Mission,  and Melanie. My one regret was that I was unable to call with them or meet them when I was in Sri Lanka. When I had a few minutes, finally, on our last day in Colombo, my laptop, with their phone numbers, went on a little jaunt through Colombo on its own. Fortunately, it returned intact and in time for the plane.

 

To further prepare, especially emotionally, I go to the Center for Disease Control, the National Center for Post Traumatic Stress Disorder, and the  National Center for Child Traumatic Stress. (The following articles are in the public domain. Feel free to skip them if you just want to read about my journey.)

Disaster Rescue and Response Workers
A National Center for PTSD Fact Sheet

The terrorist attacks on New York and Washington are, together, the greatest man-made disaster in America since the Civil War. Lessons learned from natural and human-caused disasters can help us understand the unique stressors faced by rescue workers such as police and firefighters, National Guard members, emergency medical technicians, and volunteers. Past experience may also help us recognize how these stressors may affect response workers. Rescue workers face the danger of death or physical injury, the potential loss of their coworkers and friends, and devastating effects on their communities. In addition to physical danger, rescue workers are at risk for behavioral and emotional readjustment problems.

What psychological problems can result from disaster experiences?

The psychological problems that may result from disaster experiences include:

What severe stress symptoms can result from disasters?

Most disaster rescue workers only experience mild, normal stress reactions, and disaster experiences may even promote personal growth and strengthen relationships. However, as many as one out of every three rescue workers experience some or all of the following severe stress symptoms, which may lead to lasting Posttraumatic Stress Disorder (PTSD), anxiety disorders, or depression:

Who is at greatest risk for severe stress symptoms?

Rescue workers who directly experience or witness any of the following during or after the disaster are at greatest risk for severe stress symptoms and lasting readjustment problems:

Studies also show that some individuals are at a higher than typical risk for severe stress symptoms and lasting PTSD if they have a history of:

Disaster stress may revive memories of prior trauma and may intensify preexisting social, economic, spiritual, psychological, or medical problems.

How can you manage stress during a disaster operation?

Here are some ways to manage stress during a disaster operation:

Develop a "buddy" system with a coworker.

Encourage and support your coworkers.

Take care of yourself physically by exercising regularly and eating small quantities of food frequently.

Take a break when you feel your stamina, coordination, or tolerance for irritation diminishing.

Stay in touch with family and friends.

Defuse briefly whenever you experience troubling incidents and after each work shift.

How can you manage stress after the disaster?

After the disaster:

How can you manage stress after returning home?

After returning home:

Taking each day one at a time is essential in disaster's wake. Each day provides a new opportunity to FILL-UP:

* Focus Inwardly on what's most important to you and your family today;

* Look and Listen to learn what you and your significant others are experiencing, so you'll remember what is important and let go of what's not;

* Understand Personally what these experiences mean to you, so that you will feel able to go on with your life and even grow personally.

______________________________________________________________________________

Psychological Impact of the Tsunami Across the Indian Rim

National Child Traumatic Stress Network
www.NCTSNet.org

The massively destructive Tsunami that struck across the Indian Rim caused extensive loss of life and injury as well as devastation to property and community resources. The combination of life-threatening personal experiences, loss of loved ones and property, massive disruption of routines and expectations of daily life, pervasive post-disaster adversities, and enormous economic impact on families and entire nations pose an extreme psychological challenge to the recovery of children and families in the affected areas. This brief information sheet provides an overview of expected psychological and physical responses among survivors. The key concepts include:

o Reactions to Danger
o Posttraumatic Stress Reactions
o Grief Reactions o Traumatic Grief o Depression
o Physical Symptoms o Trauma and Loss Reminders
o Post-disaster Adversity/Disruption

Appreciating the psychological implications of such an overwhelming event on the lives of the survivors plays a crucial role in considering specific efforts that will be of greatest help to the affected communities. The following issues may be helpful to consider in efforts to respond to disaster victims:

Reactions to Danger

It is important to recognize the difference between a sense of danger and reactions to traumatic events. Danger refers to the sense that events or activities have the potential to cause harm. In the wake of the recent disaster, people and communities have greater appreciation for the enormous danger of a Tsunami and the need for an effective early warning system. There are likely to be widespread fears of recurrence that are increased by misinformation and rumors. Danger always increases the need and desire to be close to others, making separation from family members and friends more difficult.

Posttraumatic Stress Reactions

These reactions are common, understandable, and expectable, but are nevertheless serious and can lead to many difficulties in daily life. There are three types of posttraumatic stress reactions. Intrusive Reactions are ways the traumatic experience comes back to mind.

These include:

o recurrent upsetting thoughts or images that occur while awake or dreaming
o strong emotional or physical reactions to reminders of the Tsunami
o feelings and behavior as if something as terrible as the Tsunami is happening again

Avoidance and Withdrawal Reactions include:
o avoiding talking, thinking, or having feelings about the Tsunami
o avoiding places and people connected to the event
o feeling emotionally numb, detached or estranged from others o losing interest in usually pleasurable activities


Physical Arousal Reactions are physical changes that make the body react as if danger is still present.

These include:
o constantly being “on the lookout” for danger
o being startled easily or being jumpy or nervous
o feeling ongoing irritability or having outbursts of anger
o having difficulty falling or staying asleep or having restless, easily disturbed sleep
o having difficulty concentrating or paying attention

Children may show some of these reactions through their play or drawing. They may have bad dreams that are not specific to the Tsunami. In addition to increased irritability, children may also have physical complaints (headaches, stomachaches, vague aches and pains). Sometimes these are difficult to distinguish from true medical concerns.

Grief Reactions

Those who survived the Tsunami have suffered many types of losses – including loss of loved ones, home, possessions, and community. Loss may lead to:

o feelings of sadness and anger
o guilt or regret over the loss
o missing or longing for the deceased
o dreams of seeing the person again

These grief reactions are normal, vary from person to person, and can last for many years after the loss. There is no single “correct” course of grieving. Personal, family, religious and cultural factors affect the course of grief. Although grief reactions may be painful to experience, especially at first, they are healthy reactions and reflect the ongoing significance of the loss. Over time, grief reactions tend to include more pleasant thoughts and activities, such as positive reminiscing or finding positive ways to memorialize or remember a loved one. One of the many untoward results of the Tsunami is that some family members’ bodies have not been found. This, unfortunately, has prevented the normal use of religious, and cultural burial and mourning rituals, and has put the experience of grief on hold. Whereas trauma is more restricted to personal experience of the Tsunami, loss and grief extend well beyond the impacted areas, indeed across the world.

Traumatic Grief

People who have suffered the traumatic loss of a loved one often find grieving more difficult. Their minds stay on the circumstances of the death, including preoccupations with how the loss could have been prevented, what the last moments were like, and issues of accountability. These reactions include:
o intrusive, disturbing images of the manner of death that interfere with positive remembering and reminiscing
o delay in the onset of healthy grief reactions
o retreat from close relationships with family and friends, and avoidance of usual activities because they are reminders of the traumatic loss

Traumatic grief changes the course of mourning, putting individuals on a different time course than is usually expected by other family members, religious rituals, and cultural norms that offer support and comfort.

Depression

Over time, the risk of depression after the Tsunami is an additional major concern. Depression is associated with prolonged grief and strongly related to the accumulation of post-Tsunami adversities. Symptoms include:
o persistent depressed or irritable mood
o loss of appetite
o sleep disturbance, often early morning awakening
o greatly diminished interest or pleasure in life activities
o fatigue or loss of energy
o feelings of worthlessness or guilt
o feelings of hopelessness, and sometimes thoughts about suicide

Demoralization is a common response to acutely unfulfilled expectations about improvement in post-disaster adversities, and resignation to adverse changes in life circumstances.

Physical Symptoms Survivors of the Tsunami may experience physical symptoms, even in the absence of any underlying physical injury or illness. These symptoms include:
o headaches, dizziness
o stomachaches, muscle aches
o rapid heart beating
o tightness in the chest
o loss of appetite
o bowel problems

In particular, near-drowning experiences can lead to panic reactions, especially in response to reminders. Panic often is expressed by cardiac, respiratory, and other physical symptoms. More general anxiety reactions are also to be expected. Physical symptoms often accompany posttraumatic grief and depressive reactions. More generally, they may signal elevated levels of life stress.

Trauma and Loss Reminders

Posttraumatic stress reactions are often evoked by trauma reminders. Many people continue to encounter places, people, sights, sounds, smells, and inner feelings that remind them of the Tsunami experience. The ocean has become a powerful reminder. Additionally, the tide simply going out or even the wave in a bathtub while bathing a child can act as a disturbing reminder. Because the Tsunami was accompanied by a loud roar and the crashing of waves, loud noises can be strong reminders. Reminders can happen unexpectedly, and it can take quite a while to calm down afterward. Adults and children are often not aware that they are responding to a reminder, and the reason for their change in mood or behavior may go unrecognized. The day of the week, the time of day, and the anniversary date are common reminders. Television and radio news coverage can easily serve as unwelcome reminders. It is particularly difficult when family members have been together during a traumatic experience, because afterward they can serve as trauma reminders to each other, leading to unrecognized disturbances in family relationships.

Grief reactions are often evoked by loss reminders. Those who have lost loved ones continue to encounter situations and circumstances that remind them of the absence of their loved one. These reminders can bring on feelings of sadness, emptiness in the survivor's life, and missing or longing for the loved one's presence.

There are several types of loss reminders: Empty situations occur when one would be used to being with a loved one and they are no longer there, for example at the dinner table, during activities usually done together, and on special occasions, like birthdays and holidays. Children, adolescents, and adults also are reminded by the everyday changes in their lives, especially hardships that result from the loss. Examples include temporary or changed caretakers, decreases in family income, depression and grief reactions in other family members, disruptions in family functioning, increased family responsibilities, lost opportunities (for example, sports, education, and other activities), and the loss of a sense of protection and security.

Post-disaster Adversities/Disruption

Successfully addressing the multitude of post-disaster adversities not only saves lives, protects health, and restores community function, but constitutes an important mental health intervention. Contending with adversities such as lack of shelter, food and other resources, and disruption of daily routines can significantly deplete coping and emotional resources and, in turn, interfere with recovery from posttraumatic stress, traumatic grief, and depressive reactions. Post-disaster medical treatment and ongoing physical rehabilitation can be another source of post-disaster stress. New or additional traumatic experiences and losses after the initial experience are known to exacerbate distress and interfere with recovery. Likewise, distress associated with prior traumatic experiences or losses can be renewed by the experience of the Tsunami.

Children’s recovery is put in jeopardy without proper caretaking, reunification with family members, and restoration of normal daily routines – for example, schooling. Some adversities require large-scale responses, while others can be addressed, in part, by personal and family problem solving.

What Are the Consequences of These Reactions?

Post-disaster reactions can be extremely distressing and may significantly interfere with daily activities. For adults, posttraumatic stress, grief, and depressive reactions can impair effective decision-making, so vital in adapting to the recovery environment. They also compromise parenting. For children and adolescents, intrusive images and reactivity to reminders can seriously interfere with learning and school performance. Worries and fears may make it difficult for young children to return to school or to venture any distance from parents or caregivers.

Avoidance of reminders can lead adolescents to place restrictions on important activities, relationships, interests and plans for the future. Irritability can interfere with getting along with family members and friends. Trauma-related sleep disturbance is often overlooked, but can be especially persistent and affect daytime functioning. Adolescents and adults may respond to a sense of emotional numbness or estrangement by using alcohol or drugs. They may engage in reckless behavior. Adolescents may become inconsistent in their behavior, as they respond to reminders with withdrawal and avoidance or overly aggressive behavior. Over time, there may be increases in marital discord and domestic violence.

Depressive reactions can become quite serious, leading to a major decline in school or occupational performance and learning, social isolation, loss of interest in normal activities, self-medication with alcohol or drugs, acting-out behavior to try to mask the depression, and, most seriously, attempts at suicide.

Traumatic grief can lead to the inability to mourn, reminisce and remember, fear a similar fate or the sudden loss of other loved ones, and to difficulties in establishing or maintaining new relationships. Adolescents may respond to traumatic losses by trying to become too self-sufficient and independent from parents and other adults, or by becoming more dependent and taking less initiative.

Coping after Disaster

In addition to meeting peoples basic needs for food, water, shelter, clothing and medicine, there are several ways to enhance people’s coping. Physical: Stress can be reduced with proper nutrition, exercise and sleep. People may need to be reminded that they should take care of themselves physically to be of help to families and communities. Emotional: People need to be reminded that their emotional reactions are normal and expected, and will decrease over time. However, if their reactions are too extreme or do not diminish over time, there are professionals who can be of help. Social: Communication with, and support from, family members, friends, religious institutions and the community are very helpful in coping after a disaster. People should be encouraged to communicate with others, and to seek and use this support where available.

Daily Routines: For children especially, it is important to restore normal routines, including mealtimes, bedtime) as much as possible. Children feel more safe and secure with structure and routine. Meeting basic survival needs, restoring a sense of safety and security, and providing opportunities for normal development within the social, family and community context are important steps to the recovery of children and adolescents.

source: http://www.nctsnet.org/nccts/asset.do?id=603
This project was funded by the Substance Abuse and Mental Health Services Administration (SAMHSA), US Department of Health and Human Services (HHS). The views, policies, and opinions expressed are those of the authors and do not necessarily reflect those of SAMHSA or HHS.

My preparation to go to Sri Lanka was aided by a visit to Leland "Skip" and Aew Whitney, Mill Valley residents who arrived in Colombo just after the Tsunami. Synchronistically, Skip is on the board of OperationUSA; I read about his family's journey in the local paper and then called him. He and his wife graciously invited me to their home to tell me about what had happened to them.

Mill Valley man helps in Tsunami zone
Jason Walsh, IJ reporter
Wednesday, January 19, 2005
- As a fund-raising board member of the international relief foundation OperationUSA, Skip Whitney is used to helping disaster victims from a distance.
But when fate placed the Mill Valley real estate developer at the center of the Sri Lankan Tsunami devastation, Whitney found himself offering relief in ways he never would have imagined. Whitney, his wife, Aew, and their two daughters were vacationing in Southeast Asia during the holidays and were due to fly from Bangkok to Colombo, Sri Lanka on Christmas Day. But, because of a miscalculated departure time, the Whitneys missed their flight - as well as the earth-shattering waves that rocked the island the next day. "I have no doubt in my mind that if we had arrived on schedule, we would be dead," Whitney said. Having heard only vague rumors of a tidal wave and unaware of the full extent of the catastrophe, the Whitneys caught the next flight to Colombo, arriving hours after the Tsunami swept away the lives and homes of thousands of Sri Lankans. (The full story is at http://opusa.org/press/marin_ind.htm)


As I prepare to go to Sri Lanka, I also solicit donations from friends and the local schools. It is so hard to ask for money that instead I ask for crayons, paper, scissors, stickers, and children's band-aids. People are wonderful. Especially moving are the letters and drawings done by children here to give to children in Sri Lanka. People I did not know were coming up to me, offering me crayons, blessings, good wishes, and respect.  It is the admiration that throws me, as I feel this is something I have to do; a call I must answer.

 


Friday, January 28, 2005

Today is my flight, and at 4:00 a.m., I am still awake. The alarm is set for 5:00 a.m. to begin the journey. Yet here I am, packing and racing around, fueled by adrenaline, anxiety and pressure to get everything into one small bag. I am shocked by my lack of preparation; why am I just now starting to pack? It was hard, I had only known for a week and one half that I was going to Sri Lanka, and only found out yesterday I will be in the group going to Batticaloa, affectionately known as “Batti”. I hear many jokes from my son Colety that “Mom is going Batty!”, which feels very true at the moment. We are allowed two bags, up to 70 lbs each, so my husband Roy and son Colety packed the big suitcase with things for the children: stickers, paper, letters and drawings from children here, zillions of children’s band-aids, scissors, paper punches and balloons. 69 pounds, all donated. Colety handed me a roll of money; between bake sales and spare change jars, the Novato Charter School had collected $200 for the children of Sri Lanka.

 

7:09 am
Now the journey really begins. I missed the Airporter bus, so Roy had to race me to the Larkspur terminal to catch another bus. Kate Chaos! I do get a little tired of my frenzy at times, wishing for some of Roy's composure and serenity. Finally, I am on the Airporter bus, heading to SFO. From there, I catch a plane to LA, switch airlines and terminals, meet with the group, and then we fly to Colombo, via Tokyo and Singapore.

Our team met in boarding area of Singapore Airlines, we range in age from 26 (our leader, David) to the geriatric one among us; me, age 50. We bring a wide range of experience to the project. We will find out more of what we will be doing in Singapore; there will be training. The interventions are specific, and directive. We cannot bring anything aquatic, including in the stickers. I would like to know more about this; it seems a paradox to be directive, but avoid talking about the thing that caused the trauma. Kind of the "you-know-who" Lord Voldemort thing in Harry Potter.


We had received an e-mail from the Association for Play Therapy; our team is:

Janine Shelby, Ph.D., B.C.E.T.S., RPT-S is a licensed psychologist and a clinical faculty member in the department of Psychiatry at UCLA. When she returns from Sri Lanka, she will assume the position of Chief Psychologist in the Child Crisis Center, Department of Pediatrics, Harbor-UCLA Medical Center. She is a frequent consultant for OperationUSA and other NGOs, a consultant for the National Center for Child Traumatic Stress, and a long-term American Red Cross volunteer. She appears on the National Red Cross mental health training video. Dr. Shelby has lectured in and provided relief to survivors in more than a dozen countries including those in the former Yugoslavia, Russia, Western Europe, Asia, and Latin America. Her articles and book chapters focus on posttraumatic interventions for traumatized children. She is the President of the Foundation for the APT and in that capacity, worked with OperationUSA, the Foundation Board, APT staff to design the project in which we are participating.

Our leader, David Bond MSW, has been collaborating with the National Center for Child Traumatic Stress for the last nine months on Psychological First Aid, an early response intervention protocol to be used in the immediate aftermath of terrorist attacks and natural disaster. He works full time as a psychotherapist at St. Francis Medical Center in Lynwood, CA. David is a member of APT and has completed the requirements for the RPT credential, for which he will apply upon obtaining his LCSW in March '05. He is currently co-authoring a chapter on mental health practitioners' involvement in post-disaster relief work.

Kate Amatruda, MA, LMFT, Novato, CA: UC Berkeley Adjunct Faculty, Certified Sandplay Therapist-Teacher, relief work during Loma Prieta Earthquake, 9/11 work in schools, ARC Disaster Mental Health Member, CAMFT Trauma Response Network Responder, Author of "Trauma, Terror and Treatment: PTSD in Children and Adults".

Sharolyn Wallace Bowman, Ph.D. (Social Work), Tulsa, OK: Professor at Tulsa Community College, 18 experience in the childhood grief field, past experiences working in Russian orphanages doing related work, RPT-S (Registered Play Therapist-Supervisor), Officer for OK Branch of the APT

Valerie Hearst, LGSW, Brunswick, OH: Provided work to orphanage in Mexico and Standing Rock Reservation, lived and studied in Mexico, social justice trip to Puerto Rico and Dominican Republic, backpacked in Thailand, Mexico, Guatemala, and Belize

Maria Parreno, Psy.D., Psychologist, Mission Viejo, CA: Experience with relief work after Hurricane Iniki, volunteer work in orphanages in Mexico, studied in Israel during war, background growing up in Philippines with missionary parents

Prabha Sankaranarayan, MS (Child Development), Pittsburgh, PA: Therapist and Mediator, Snyder & Sankar Associates, 20 years experience working with children, lived in India for 20 years, speaks Tamil (one of the Sri Lankan languages), NOVA training, currently writing PA plan for victims of a terrorist attack

Jodi Smith, LCSW, Claremont, CA: social worker at Children’s Hospital LA in ER and long-term wards for crisis and trauma victims, Red Cross Volunteer, provided recreational activities for orphans in Mexico

Joseph Wehrman, Ph.D. (Counselor Education), Aberdeen, SD: Many years experience working in early childhood, former member of US Army where he provided on-site medical care to remote villages in Honduras, lived and worked in Iraq providing medical care to civilians and soldiers, worked 5 years in early childhood development, former Hall Director for international students.

clockwise: Kate, Joe, Prabha, Jodi, Sharolyn, David, Valerie, Janine and Maria

The flights are endless. We left LA at 1:00 pm, went to Tokyo for a refueling. In Tokyo, even though the layover was less than an hour, everyone had to get off the plane, exit, go through security again, wait in a long line, and get back on the plane. The security guards, the ones who run your things through the x-ray machines, are all young women, wearing red hats, red skirts and vests, with white blouses. They wear high heels, as does every Japanese woman we see who works in the airport. All the people I encounter on the plane, in the airports, even at the security screening areas are so touched that I am going to Sri Lanka, that they thank me. I accept their gratitude, knowing it is soul food that will sustain me during the hard times.

The LA to Tokyo flight was 11h 40m long. Tokyo to Singapore is 7h 30m long. Singapore to Colombo 3h 35m. 22 hours and 45 minutes in airplanes! Are we there yet?

Back on the plane, seven+ more hours in the air until Singapore. I am getting a bit squirrelly. It would be nice to go outside, breathe fresh air. In Singapore, we stagger out of the airport, having been stamped through immigration (I was so happy to get a stamp in my new passport) and through the “nothing to declare” line in customs. We get off the plane, into the night, and realize we have no way of getting to the hotel. David arranges for a van, and we get to the hotel at 3:00 a.m., but which day I have no idea.


Sunday
Hotel, shower, sleep. In the morning, David tells us “The Protocol”, a series of exercises designed by Janine Shelby and her team to help children master trauma. They are cognitive behavioral, with specific objectives and techniques. Each game has the objective, such as to:

*Normalize reactions ("Yes, you are having a 'normal' reaction to an 'abnormal' situation; whatever you are experiencing; sleep difficulties, crying, anger, etc. is OK and normal."   In my work in the States, this is the  stage when I usually reassure a person that they are NOT crazy, but in Sri Lanka I don't know the cultural context for craziness.)
*Assess current coping mechanisms (and reinforce healthy ones),
*Assess and modify misattributions and cognitive distortions (such as if the child feels that he or she did something to cause the Tsunami)
*Decrease hyperarousal and panic symptoms (We hear that at one camp, people feared that another Tsunami was coming. Some children were hurt in the stampede.)
*Increase self-soothing (breathe! breathe!)
*Identify and change intrusive re-experiencing, such as flashbacks
*Decrease isolation and withdrawal and reinforce the ability to seek helpful social support (ask for a hug, find someone to talk to, tell a grown-up)
*Decrease regressive behaviors by focusing on strengths and resources
*Identify loss reminders (water images, perhaps the aquatic stickers?) and trauma triggers (such as loud noises, big waves, whatever you were doing at the time at the disaster)
*Finally, to leave the child with a sense of hope.
(Adapted from "Enhancing Coping Among Young Tsunami Survivors: Culturally Approved Interventions 1/24/05 © Shelby, Bond, Hall & Hsu, 2004)

I am worried that our attempts to help will come to nothing; that we are offering a band-aid for a gaping wound. A disaster that has killed so many cannot be quickly overcome, particularly after so much war trauma. The Tsunami is a holocaust that will affect Sri Lanka, the Indian Rim nations, and the world for generations. And no technique will work if the hierarchy of needs is not met; if the child is still in danger, hungry, or without shelter. The first step in trauma work is to establish that the danger is over, that the child is safe now.

Child Trauma Intervention Model

Click here for a power point presentation published by The National Resource Center for Child Traumatic Stress, and adapted from: Pynoos RS, Goenjian AK, Steinberg AM: (1998) A public mental health approach to the post-disaster treatment of children and adolescents. Psychiatric Clinics of North America 7:195-210.

                                                                 Psychological First Aid

Click here for a power point presentation published by The National Resource Center for Child Traumatic Stress, and adapted from: Pynoos RS, Nader K: (1988) Psychological first aid and treatment approach to children exposed to community violence: Research implications. Journal of Traumatic Stress 1: 445-473.  These ideas are the basis of the techniques we used in Sri Lanka.


Why do we go to play, and teach play techniques, in a cataclysm? As we get closer to Sri Lanka, my mind struggles to hold the number who died. September 11 was about 3000, the Tsunami was around 150,000 when I left.  By the time I returned home the death toll was 285,000; the count rises each day. I think we go to play with children because play is the first language, before children can verbalize, they play. Play allows for the expression and healing of trauma. And we go because we, as humans, want to do something for other humans who are suffering.


After working all day in Singapore, we have a few hours off. Prabha, Valerie and I jump into a cab and go to Chinatown. We walk through crowded streets; Chinese New year is almost here, so it is very festive. Great shopping; I keep thinking I could make a killing on EBay if I had enough time and money, connections, and could carry everything. This must be how people make money; they buy things very cheaply, sell high. What an alien concept for a therapist! Not this lifetime! We check out of the hotel and then leave for the airport to head to Colombo, the biggest city in Sri Lanka. We had arrived at the hotel at 2:00 a.m., and we leaving at 8:00 p.m. the same day...how many hours is that? 18 hours, most of it spent in training.

We get to Colombo, where there is a strong military presence. The Army is everywhere, running checkpoints and randomly pulling over cars. We are pulled over and the soldiers shine a flashlight into the car, mostly focusing on Valerie. She is scared, keeps asking, “Should I open the door?” Everyone yells out, “No! No!” Later we find out we were stopped because some of the women in our group have short hair.  The women fighters of the Liberation Tigers of Tamil Eelam (LTTE), or Tamil Tigers, are the only women in this country to have short hair.  We get to the hotel very late, it is 3:00 a.m. I am still awake, wondering what is to come.


Monday

The next day is Monday, and we have another meeting, this time with Nimmi Gowrinathan, an OperationUSA worker, a tall, brilliant and gorgeous Tamil woman who grew up in Los Angeles, and is getting a Ph.D. in Political Science from UCLA. She embodies her quote, "Leadership is the capacity to translate vision into reality." Nimmi orients us to the political and social structure of the country. We learn about the years of warfare, the riots, the discrimination that the Tamil have felt at the hands of the Singhalese. (For more on this conflict, please go to: Sri Lanka: Ethnic Conflict & Civil War.)

There is now a cease-fire in the war. We learn that three days after we left Batticaloa that Kousalyan, the head of the Liberation Tigers' political division for the Batticaloa-Amparai district, was killed in an ambush on the highway to Batticaloa Monday night February 7 around 7:45. Three people who were traveling with him were killed and four were injured. [source: TamilNet, February 07, 2005 16:08 GMT]

I wonder how this will affect the survivors of the Tsunami...how can they begin to feel safe if the war comes again? I cannot help but feel we left just in time, and, after viewing the devastation wrought by nature, I would like to bring the leaders of every country to view it, to tell them to stop all wars.  To help rebuild the planet. To stop senseless killing.  To use resources to end human suffering, not to increase it. (Of course, I do keep all these sentiments to myself. One of the requirements of disaster response is to be non-political, non-denominational and nondiscriminatory. We offer aid by need, not religion, ethnicity, political affiliation, etc.)  

We have two teams, one headed to the South, the area that is primarily Buddhist and Singhalese. My team's destination is Batticaloa, ground zero of the Tsunami, and the place where there have been the least services provided. The East is primarily Tamil, with the major religions being Hindu and Muslim. There also seem to be pockets of Christianity throughout the country, and the Eastern team will be staying at an orphanage started by Christian Missionaries.


We learn about the social customs; that women tie their hair up or back at all times, that dress is modest, with most of the body covered. Women and girls wear earrings, and we hear tales that if a woman has a hole in her ear, without an earring in it, that the Sri Lankan women will come up and try to put an earring in the piercing. Irreverently we joke that is a way to get more earrings. The henna paintings on hands, toe rings and lovely sandals make sense if a woman's body is mostly covered; for where else can she show her beauty?


We then briefly meet Janine Shelby, the play therapist who has masterminded this project. She is very busy in Colombo, doing many trainings. David asks her some clarification questions and then she ends by giving us some lovely words of encouragement for our mission. We race upstairs to pack up the toys, and we are off to Batti, while the southern team heads toward Galle.


To Batticaloa is a long drive, at least 8 hours through the center of the island. The roads are winding, the countryside incredibly beautiful. We see elephants and monkeys, and go by some huge statutes of the Buddha, towering over the town and countryside.

We are regretting the ‘typical Sri Lankan breakfast’ of very spicy curry we had this morning, as it is raising havoc with our Western tummies. For bathrooms, we stop at “rest houses”, which have little cafés with bathroom facilities. Almost all have ‘English toilets’, but not all. The alternative is a hole in the ground over which one squats. You stand on little wooden steps, pull your pants down and to the front, and squat down low, trying not to splash yourself. There is a bucket of water nearby that you fill and dump in quickly, hoping to flush. We carry our own toilet paper, as few rest houses have any.

We are almost there when our driver, Ravi, pulls over. The van has a flat tire. Out comes most of the luggage (and we are not traveling light; with clothing and supplies for the entire 10 day trip, as well as toys and art materials). We pile ourselves and our luggage out of the car, and wait while Ravi tries to find the jack to raise the car. He finds most of it, missing however the crucial piece that is the crossbar, with the socket end to remove the nuts that hold the tire on. Fortunately, we have stopped in a well-lit place by the university, and Ravi is able to borrow the cross piece of the jack. We stand around swatting at mosquitoes until Nimmi’s father, Roger, suggests that we put mosquito repellant. We find later that the mosquitoes are very resilient in Sri Lanka, finding the tiniest area of skin not covered with DEET. Poor Valerie awakens one morning with swollen eyelids; it had not occurred to her to put the repellant on her eyelids. “DEET UP” becomes a clarion call of the group, morning and evening.


We drive further, and are ‘almost there’ when the lights go out on the van. This is very dangerous, as the road is narrow and the people drive like maniacs. (It doesn't help my sense of mastery that Sri Lanka has right hand drive; I keep being surprised by trucks and busses roaring toward us on the right.) I feel as if I am in one of my son’s video games, in which driving on a road means taking your life into your hands. We find out later that traffic fatalities are the leading cause of death in Sri Lanka, followed by snakebites. We scrounge around in our luggage and find flashlights, and Nimmi hold a flashlight through the windshield as Ravi drives. We are grateful for Ravi’s driving skills, as in the morning we see that he has successfully navigated between the sea on one side and the sewer trench on the other. There are cows and goats to be avoided as well; somehow, Ravi got us safely to the orphanage. Later we draft Ravi into our team to work with the children; he knows how to play cricket!


We finally find our destination, St, John’s, an “American Ceylon” mission that is an orphanage and school for children whose families have died in the war. The children run out to greet Nimmi, who has visited before.   Jeff Greenwald   wrote in his Field Journals: A Journey Through the East
January 19, 2005:
"At the St. John’s Tsunami Relief and Rehabilitation Center in Batticaloa, an Episcopal Reverend known as “Father J” (short for Jeyanesan) is spearheading a multi-level effort that includes orphanages, feeding centers, vocational training, and emergency relief supplies. (The popular Reverend was already immersed in refugee work, providing for families displaced by the civil war, when the Tsunami struck. Trained at the Hebrew University in Jerusalem, Father J’s commitment to spiritual integration is immediately obvious; St. John’s is the first church I’ve seen with a Jewish mezuzah on its doorway.)"

We stumble upstairs to a large airy room and have dinner. This dinner, to be repeated every night we are here, consists of cold rice noodles, a sauce of coconut milk with a yellow spice in it, a curry with chucks of meat and bone, cut up and steamed carrots and green beans. We see there are no utensils, so we follow Nimmi and Prabha’s lead as we eat with our hands. One never touches food with the left hand, ever, as that hand is used for cleaning oneself. Joe, who is left handed, has to sit on his left hand in order not to use it. I find that I cannot bring myself to eat any fish here, fearing, as the villagers do, that the fish might have eaten the dead. There are charts in the papers to show what fish feed on, to reassure us that the fish are safe to eat, but I can't make myself do it.

The room upstairs is large and airy, and we think it will be a good place to sleep. We find out, however, that only the men will sleep there. The women go down to beds in the girl’s dormitory, bunk beds. The girls flock to us, touching, talking in Tamil. They are very curious about us, and call us “Auntie’, which is a sign of respect given to an older woman. They quickly find something to tease us about; for Valerie it is her long nose (which to my Western aesthetic seems on the short side), for me it is my lack of earrings, as I have removed my earrings due to sore piercings. They tug at their earrings and then reach for my sore and inflamed ear lobes. I am determined to find earrings that are not as heavy as the ones I was wearing, and put antibiotic ointment on my earlobes before bed.


Getting ready for bed is a challenge. The girls are very modest, and so I take my clothes with me to the shower. What shower? Bathing take place in a large red bucket, with a smaller pitcher. You use the pitcher to pour water over you, then soap down, and rinse again with water from the pitcher. There is no hot water, and by the end of our stay there, I am in agreement with the ‘what do you need hot water for in the tropics anyway?’ school of thought. Right now, it is a shock, and I just cannot deal with it.


After the plane trips, the long ride from Colombo, dinner eaten with my hands, I confess to a moment of Western princessness; I want a real shower and a room of my own! Not. Instead of braving the shower, the big red bucket, I use wipes to clean myself, and try to change into sleeping clothes without getting them wet, as there is water everywhere in the floor. I do a little dance of rolling up my pants leg, getting my feet in and out of my flip-flops, getting my legs through the pants, without getting them wet. I am not quite successful, so spend the first night with pants wet around the ankle. At least it is water from the bath, and not the toilet!

                        


All ready for bed, and I cannot sleep. I wander out and run into Selvie, the lovely 30-year-old woman who is in charge of all the girls at the orphanage. Selvie speaks some English, and we find ourselves sitting on a bench, talking. She is “amah” or mother to 175 girls! I compliment her, and say that I an amah to only three children , and I cannot imagine how she does it. The girls call her “Selvie-amah”. I tell her that I will be a grandmother in July, so my name becomes ‘Amahmah”, or grandmother. Soon all the children call me “Amahmah”. Selvie and I talk a bit, but every minute a girl comes up to her for something; she is mother, nurse, soother, everything to 175 girls. She also supervises the wardens, or young women who serve as house mothers. They get to go home each night if they have one, while Selvie-amah lives at the orphanage with the girls.

Things have become complicated lately, as the Tamil Tigers, as a gesture of good will, released their child soldiers to Unicef. Unicef turned the children over to the orphanages, the place where they would be safest. Selvie has to integrate adolescent girls who were soldiers into the community of proper Christian-schooled girls. The child soldiers are the ones with short hair, and they stick together. The culture of the army and the culture of the orphanage are quite different, and I wonder how long, if ever, it will take for the soldiers to blend in with the cloistered girls. Finally, I am sleepy enough to try to go to bed; so I find my bunk in the dormitory and sleep.  Our team begins to joke about the the Southern team; we call them the 'resort humanitarians', because they are eating in restaurants and staying in hotels. (We find out later they visited 10 refugee camps; hardly the 'resort' life we had fantasized for them!) What we lack in comfort at the orphanage, however, is more than compensated for by the warmth with which we are embraced by the children and staff at St. John's.


Tuesday

I awake at 4:30 a.m. to the chatter and laughter of girls, the sounds of sweeping and mopping. Bathing is done by seniority, so if the younger girls want to bathe, they must get up very early to complete their chores before the ‘showers’ are taken over by the older girls. I try to get back to sleep, but my body has no idea of the day or the time. We have breakfast, a cold fried egg with bread and dried coconut flakes, very spicy and good. We are eating with our hands, but cold egg defeats us, until we see that Prabha has made an egg sandwich. We have tiny bananas that grow in Sri Lanka; if the bananas in the States tasted this good I would eat them every day. They grow in bunches and are sweet and creamy. We also meet up with OperationUSA's water team, who are giving people small hand pumps to filter water from their wells. Carinne Meyer's report is online at http://www.operationusa.org/sri%20Lanka/field%20report.htm.


We get into the van to go meet the people who have arranged the training. En route, we see houses damaged, and ask it is from the Tsunami. “No, it is from the war. Fighting was here; this house was damaged by a bomb, here you see bullet holes.” We realize, that, other than flooded rice fields (a huge concern, as the fields were inundated with salt water and sewage…how will there be enough rice to feed the people?) we have yet to see Tsunami damage.


We are greeted by Father Paul Satkunayagam, Director and Co-founder of the “Butterfly Peace Garden”. Children traumatized by the war can come here to begin healing, and groups are run to promote understanding and peace. I fall in love with The Butterfly Peace Garden, and its mission:

The Butterfly Peace Garden is located in the Batticaloa district of Sri Lanka, a region where many lives and communities have been profoundly affected by a long-running civil war. For seven years now the Garden has provided a sanctuary where thousands of children from villages and towns throughout eastern Sri Lanka have come to play, cultivate the soil, care for animals, practice arts such as music, painting, sculpture, ceramics, theatre and learn basic elements of yoga, qigong and other body wisdom exercises. Most importantly, the Butterfly Peace Garden is a place where children have the opportunity to simply be kids again. As they make and mend in the Garden, the children who pass through its gates become healers in their communities, their nation and their world.

The Butterfly Peace Garden opened its gates on September 11, 1996, and since then it has been bringing together artists, peace-workers, ritual healers and counselors with children from Batticaloa's various ethnic and religious groups - Tamil, Muslim, Hindu, Christian - in an oasis of peace amid the devastation of a civil war that has raged for two decades. The children of the Butterfly Peace Garden are a remarkable tribe of magicians who provide living testimony of the power of play as a tool in the lost art of making peace."
(source: http://www.thestupidschool.ca/bpg/index2.html)

"Children from six to sixteen years of age attend the Butterfly Garden for nine months, one day a week, in groups of fifty drawn from the local Tamil and Muslim populations. Many of them have endured profound family loss and witnessed great horror: they are the children of terror. In the Butterfly Garden these children are slowly restored to themselves and to the world through play and storytelling, music and drama, the arts of painting and puppetry and participation in the life of a garden. Reconstructed rituals of genogram-making (The Mother-Father Journey) allow them to begin telling the story of their families and their villages; group storytelling allows them to find the narrative and dramatic power to represent new worlds of their own making. Many of the Butterfly Garden staff were themselves child victims of the war, and working there is for them a process of healing and recovery. The work of the Butterfly Garden extends to the villages in the countryside through a program of outreach and by means of the Butterfly Garden Bus, which was a gift from the World University Services of Canada."(source: Geist No. 33, 1999

We are met here by a group of several men, called MEESAN (Modern Economics Education and Social Affairs Network) who want to hear about what we intend to do, and to make sure it is culturally sensitive. Too many Westerners have come in to work and apparently, they either leave the children a wreck (we hear of someone who came to do EMDR with the children, and left them all sobbing and unglued as she or he caught a flight back to the States) or just come in and lecture the workers about what the children need. We are determined to be different. We decide the best use of our time and talents is to ‘train the trainers’, and so a group of 18 people who work with children are invited to come to our trainings. David explains the exercises and play activities to the group.


The men also review our exercises, cognitive behavioral puppet shows and games that are geared toward mastery of trauma, and agree that they will not disrupt the culture. Where we are, in the East, most of the children are Hindu or Muslim. The team in the South is dealing with Buddhist children. Each team finds quickly that we need to modify certain elements of our games.


That afternoon we meet with the trainers to find out their needs, teach them our techniques, and get to know each other. I become the designated icebreaker, and while the rest of the team sets up, I offer each person a cinnamon Altoids, and then go around and put a butterfly sticker on each person's hand. I make eye contact when I do, and see incredible wisdom and pain in their eyes. They are called “animators” (no one seemed to know why) and they work with the children. Until the Tsunami, their role was to help the children with war trauma.


As I hand out the stickers, they tell me that a butterfly is called “Vannathupoochi” in Tamil, and I try to say it to each person. When I get toward the end of the group, someone started singing a song about “Vannathupoochi” in Tamil, which amazingly, goes to the tune of “Frère Jacques”. I try to sing along, bringing gales of laughter from the people. This song becomes my theme, and somehow, by osmosis, the children at the orphanage start singing it to me as well. It is perfect, and when I tell the trainers how the butterfly motif has appeared spontaneously in the psyches of children with whom I have worked that are facing death, they nod in agreement. I tell them of the children in the concentration camps who had carved butterflies with their fingernails in the wood, and again they nod "yes". They know firsthand the grave loss and despair that seems to summon the butterfly.


Sri Lankan nodding “yes” is like that of a dancer; somehow, the head goes back and forth, and the neck moves sideways. When I try it, I feel like I do when I try to show children how an owl can look backwards; my neck muscles cannot do this at all! More gales of laughter when we try to nod ‘yes’ to the trainers. This learning to nod becomes David’s theme with the trainers; they tease him as he good humoredly tried to do it. We learn there is a subtle difference between nodding ‘yes’ and ‘I don’t know” and “no”; I think I would have to stay for years to understand the nodding, much less master it.

The men and women animators are amazing; they have such a depth of compassion for the children. We start by asking them what they want from us. They are exhausted, and need some new ideas, specific to the Tsunami. We learn later that two of the women who are working with the children are also refugees; they have lost everything, and are living in tents side by side with the children. We realize that these workers are suffering from ‘compassion fatigue’, so part of our plan is to help them refuel, to play with them, and give them an opportunity to tell us what it is like for them. We know, however, not to push, but to hold the space so that if they feel safe enough, they may tell us what they are going through. I am in awe of these animators, who have been on the front lines of trauma for years: first the war, and now the Tsunami; yet still, they smile. One of the animators, Shanty, shows us a drawing and story by a girl who was rescued by a helicopter; she was in the water from the time of the Tsunami at 8:00 a.m. to her rescue after 3:00 p.m. Her story shows the progression from the trauma to the rescue, showing great resilience. Shanty tells us the girl is only 11 years old; she is living in the refugee camp now.


I ask the man sitting near me if he could please translate, as our Tamil speakers are elsewhere. He graciously agrees, and I find out later (with embarrassment!) he is Mr. Sornalingam, of the Sri Lanka Centre for Development Facilitation (SLCDF), and a very important man. Again and again, I see great humility in the people here, and incredible beauty. I can hardly imagine what their lives must be like - 20 years of civil war, and now the Tsunami. One woman said it so eloquently to Prabha, “We lost so many in 20 years of fighting, and then we lost more in 20 minutes of the Tsunami.” I have such respect for these trainers, and know that they will teach me more than I could possibly teach them. They have been to hell and back, and survived, still their faces shine, and they smile through tear-filled eyes. We adapt some of our exercises based upon their feedback; “Go fish” becomes “Go choose” until we realize that card games of any type are taboo, due to the association with gambling. Our game of "fishing”; using a pole with a magnet on it to pick up a felt fish with a coping method written on it, becomes instead "bobbing for apples". We don’t want the fish aspect to be a ‘trauma trigger’ but instead want the children to concentrate on the coping methods. “Stone soup” becomes “Tsunami Samba”, samba being a type of stew.

 

We then drive to the beach to see the damage first hand. We are shocked, speechless, horrified. There are no words.

 


We are stunned into silence. The devastation is immense. Cement foundations are cracked, walls torn off houses and temples. One beautiful Hindu temple was halved; we speak to the priest, who was inside praying at the time of the Tsunami. He was safe in the inner sanctum of the temple; it is considered a miracle. The back of the temple is torn off, the front still intact.

                            

We see a beach that was covered with fishing shacks; this beach looks empty, there is no sign that any homes had once been there. But on the beach where we are now, there were hotels, and houses made of cement and stone. All is demolished. Coconut trees are downed. Some of the trees have saris still caught in them. These are the saddest, because these trees had women clinging to them, women who were then torn out of their clothes, out of the trees, to their deaths. We see an occasional shoe, a flip-flop, a dress in the debris.

 

A few people are working, trying to remove debris from where their homes were. They are carrying away broken boards, bricks and chunks of cement by hand, and in baskets. There is no sign of any heavy equipment.

 

In the East, Tamil country, people believe that all the resources are going to the South, to the Singhalese. We hear later, from our Southern team, that the people in the South believed all of the help is going to the East. We wonder where the billions of dollars of aid are going; certainly not to clearing the beaches of rubble, should people decide to rebuild. This is more than one month after the Tsunami, yet very little clean-up appears to have been done. We see white flags of mourning, and a grave, or memorial marker, surrounded by red flags. So much is lost.


People are also disturbed by a plan in which they must go 1,000 km inland to rebuild, yet the hotels can rebuild on the beach. It seems so unfair to the people; in this land of bicycles, how would a fisherman get to his boat? Get his catch home? Yet many are also unsure if they ever want to see the sea again. How could you ever feel safe again in a place that has destroyed your family, decimated your home? No one believes he or she would ever sleep through the night living by the sea, yet no one wants to be forced to move.


We hear from people that after the Tsunami, there were hundreds of bodies on this beach. It is impossible to imagine such devastation looking at the sea today, which is calm and brilliantly blue.

We hear that snakes caused the Tsunami. In fact, two days before the Tsunami, blue water snakes curled around a nearby bridge. People were frightened, and believed that it meant war was returning. Later speculation was that the snakes somehow sensed the heat generated by the ensuing earthquake, so fled to the bridge. We drive over that bridge; the snakes are gone now.

We heard repeatedly of the animals; that shortly before the Tsunami hit, the animals all fled to higher ground. Many people died, while few of the animals did. Reuters reported on December 29, 2004, "The strange thing is we haven't recorded any dead animals," H.D. Ratnayake, deputy director of the national Wildlife Department, told Reuters on Wednesday. "No elephants are dead, not even a dead hare or rabbit," he added. "I think animals can sense disaster. They have a sixth sense. They know when things are happening."


Another story was that a statue of the Buddha floated over from Thailand, and caused the Tsunami upon hitting the Sri Lankan shore. We heard of two temples to different deities that were too close together; the gods of these temples warred, and caused the Tsunami. We hear that UFOs were sighted before the Tsunami hit. Another rumor swirling around was that underground nuclear testing that caused the Tsunami.


Walking on the beach, we see few people. Those that are there look absolutely haunted. The ones who want to talk come up to us and tell their stories. Through translation, we hear again and again stories of death and destruction. “The first wave took my house, the second wave my children, and the third wave my wife. What do I have to live for?” “My baby was ripped out of my arms.” We are near Kalmunai, where the famous "Baby 81"; the eighty-first person admitted to the hospital, was found. So far, eight heartbroken and desperate couples have claimed this baby as their lost child. “I lost my 5 year old son, my 10 year old son.” “Lost, lost, all is lost.”

We are sobered, going back to the orphanage. Here the children talk with us, some are studying English. They all want us to know their names and ages. One girl tells me about the “bomb” that killed her mother, her father, and her brother during the war. The little house was left for her was destroyed during the Tsunami. "Bomb" and "Gone" are her English words. The children are full of sorrow and joy, reflecting both in their wise eyes. They have lived through things we in America have no inkling of; civil war and then the Tsunami. I am grateful for the orphanages, knowing the huge amount of child trafficking and prostitution that occurs to orphans. My heart breaks again and again.


The girls see my butterfly sticker, and repeat “Vannathupoochi”. I hum a few bars of ‘Frère Jacques’ and the girls sing the butterfly song to the same tune. They try to teach me the words, giggling at my Tamil pronunciation. Later, every time they see me, they call out, “Amahmah, Grandma, Vannathupoochi” and start to sing the sound, with accompanying arms gestures as butterfly wings.


Vannat-hu-poo-chi
Vannat-hu-poo-chi

Parakkuthu Par
Parakkuthu Par

Ailagana Chettai
Ailagana Chettai

Adikkuthu Par
Adikkuthu Par

(very rough translation...if anyone knows the correct spelling and meaning, please e-mail me!
Here's the tune, courtesy of Mickey Gentle at Laura's Midi Heaven)

Butterfly
Butterfly

Wings we see
Wings we see

Beautiful Wings
Beautiful Wings

See the flight
See the flight


We have dinner, and the team talks about the day, what worked, what didn't, what we want to do tomorrow. We share our sadness and shock about being on the beach, when the full horror of the Tsunami hit us. Daily debriefing became very important to us, as we needed to help each other deal with the torrent of loss and pain we were facing and feeling. The name for this phenomenon is “vicarious traumatization”; it describes how a person can feel holding so much of another’s pain. We needed each other, and the laughter of the children at the orphanage helped as well.

That night I braved the shower. Sri Lanka is very humid, and I felt so sweaty and sticky that the idea of dumping a pitcher of water over my head was quite appealing. Bracing myself, I poured cold water over my head, then I soaped down and rinsed off. It felt wonderful! My hair was more problematic, as it hangs to my waist and tends to snarl. Finally, in order to rinse out the shampoo, I just stuck my head under the faucet. I had to be careful not to take even a sip of the water. As it would have been scandalous to go upstairs to the open room, with its cool breezes, because the men were there, I had to stay in the girl’s dorm (hot, airless, humid...AAARGH!)to untangle my hair. I also resisted the girl’s attempts to help brush and fix my hair, as I did not want to get head lice. I used ‘tea tree oil’ to ward off the lice, so I smelled somewhat like a tree. Any mention of lice would start my scalp itching like crazy. In fact, if someone had offered me an opportunity to go to Sri Lanka, to a land of malaria-bearing mosquitoes, snakes, head lice, humidity, showers that were buckets of cold water, unmentionable toilets, winding, dangerous roads, I would have said they were insane. I would have declined, even if they had paid me to go. Yet here I was, volunteering, having paid my own way, and truly loving it. Go figure…I think it is the people who made the difference, as they are so warm and wonderful, and perhaps the hope that I could help even a little bit.


It was quite late after my hair was finally unsnarled and properly braided by Prabha, so I went out and found my friend, the housemother, Selvie-amah. She has such a gentle way about her. As we talked, she told me she had lost two of her brothers in the war. I asked her how she takes care of herself. It seemed a hard concept for her, and for many of the workers I met. Taking care of oneself was an alien idea. Here, when I work with people, I use the metaphor of what flight attendants say when they are going over the safety features on the airlines, “In the event of an emergency, if the oxygen masks come down, and you are sitting with a child or someone who is incapable of taking care of themselves, put YOUR mask on first, then take care of them." This image would not work in Sri Lanka, because most people had not been on an airplane. Not only was my metaphor a dud, but the whole idea of taking care of oneself seemed self-centered, against the grain of the culture. Finally, Selvie-amah told me that she loves to listen to Christian music, and starts and ends each day with that. I laughed, telling her of my Sunday morning ritual of listening to KDFC’s (San Francisco’s classical music station) Sacred Music concert on the radio, in spite of my husband and son moaning about it.

I go to bed, wishing I had known our lodging arrangements prior to leaving home, as mosquito netting would have made a huge difference in my comfort level. I tried to read a bit in bed, but soon fall asleep. I was a bit nervous that my childhood and young adulthood nightmare of a huge wave, black with fury, would recur in the land where the Tsunami had hit, but it did not. I was surprised, though, at how much my dream Tsunami matched that of the survivors' descriptions. I never knew consciously that tidal waves were black, yet my nightmare wave always was. Again and again we heard of the big black wave that took everything.

Wednesday
After our egg breakfast, we go to a new space, the Mangrove Center, to continue to train the trainers. It is raining outside, and we cannot turn on the fan, due to a leak in the roof, water was in the fan motor. Every person who joins us late starts to turn on the fan, and we yell out "No!", acting out an electric shock. The room is very hot and humid; sweat is pouring off me, which I hate. Once again, I open with the cinnamon Altoids, the butterfly stickers, and the “Vannathupoochi” song. This time, because the team is not quite ready, I go around again with flower stickers. They teach me the word for flower is “poo”, and I try to repeat the colors. Everyone is laughing by the time the team is ready. Our translator is Anita Nesiah, a brilliant woman with two master's degrees, and a Ph.D., who taught at Harvard when she lived in the States. Prabha, speaking Tamil with Anita, teaches the puppet show to the trainers. Prabha is so full of life and energy - everyone loves her. I wish I could speak Tamil, as she does, to not to have to rely on a translator.


We teach the animators our games and exercises, and then, when the rain clears, go outside to show them a version of "Follow the Leader”. This is Valerie’s contribution, and she is wonderful - very animated and joyful. She includes some yoga. My favorite exercise is when she has us “reach for the stars” grab them, then, “Whoosh” bring them down to earth. She is the leader in "Follow the Leader”, and then, having learned the the Tamil word for leader, points to someone else in the group, designating him or her as the leader, and we all follow. Soon we are jumping, hopping, and laughing.

An older woman wanders in to the yard in which we are playing. Two young girls accompany her. We invite them all to join us. They do, and then suddenly the woman starts sobbing and keening. I go over to her, and I hold her and rub her back as sobs pour out of her. She wails with pain, her cries almost a song. She somehow communicates to me that she has lost 41 members if her family in the Tsunami. 41! I cannot even begin to imagine her pain. A world of pain. Sometimes there is nothing to do except hold someone, rock with them in their pain. Show up. Be as human, and humble as you can, because you certainly cannot fix it, or heal it, or make it go away, or even comprehend this level of loss. She gestures, and somehow I know she has lost children and grandchildren. She makes a slashing gesture around her neck, and I am concerned that she is suicidal. Sri Lanka has one of the highest suicide rates in the world, and I am very worried about this woman. I call Anita over, and describing the woman’s gesture, ask her to find out what it means. Anita listens for a while, and tells me the woman is referring to her husband, to the necklaces she wore when she was married. She was gesturing that she had lost her husband in the Tsunami, not that she was suicidal. She had been in the hospital when the Tsunami hit, killing most of her family. The two little girls with her are the two grandchildren who survived, and they look like they are in shock. One of our workers plays with them as I try to console the woman; knowing that consolation is impossible. So I witness her pain, rocking with her. When she looks into my eyes, she sees my tears, mutely reflecting her excruciating pain. The little girls keep looking at their grandmother, not knowing what to do. They look very scared, they too have lost almost everything and everybody. One of the trainers comes up and agrees to help the grandmother find the resources she needs.  My heart breaks; this woman's unbearable loss stays with me.


We finish the morning training session, have a quick lunch in town, and then head to a refugee camp. This camp, Valaichenai, is housed at the Pentecostal Church, Karuwakerni mission building; it is a huge open two-story building. Shanty and her co-workers, Thaya and Mansulla greet us. Shanty takes me inside and shows me a young boy who is lying on a mat. She explains that he has lost his two brothers, one age 5, one age 10. His mother sits up, looking at us with tear-rimmed eyes. His father is also lying down. Shanty says the boy hardly moves, ever. She is very worried about him. Looking at him, I realize that my project for the day, drawing, should be done in the shelter, because children like this boy will not come to another space.

Our team decides who will do what; Prabha and David will do the puppet show, and Valerie (with Ravi's help) will do active, outdoor activities, like cricket, volleyball, and follow the leader, while Joe will make “support necklaces”. In this activity, a child makes a necklace out of colorful pieces of foam, putting on the foam the names of people they can count on to be there for them. Joe has a very calm manner, and the children flock to him. I will do art, hoping to do a sequence of drawings with the children (and maybe some parents, who knows?) in which they can draw whatever they want. If they draw the Tsunami, my task is to lead them through a series of questions, “What happened next?” to the realization of where they are now, and that they were relatively safe. It is very hard to do trauma work in a refugee camp, because of the hierarchy of needs; food and shelter come before anything else. Yet play and drawing are the first languages of children, and we could see how depressed the children and adults were. It was eerily silent; later we learned there were hundreds of children in the camp, with no toys, no supplies, nothing. And this is more than one month after the Tsunami. Government reports of January 11 state there were 416 families, a total of 1,263 people, housed in this camp alone.


I go to get the art supplies, generously donated by some of my local schools: The Mountain School, Good Shepherd School, and Novato Charter School. They have also given me letters and drawings from the children, ranging from poignant ones from kindergartners, who did water colors, and said, "We love you", to those from the seventh graders, who did beautiful drawings.  I wanted the children in Sri Lanka to know that there were children from far away who cared about them.

Trudging across a field to get the art materials, I see that the camp leaders have brought a huge group of children to an area to see the puppet show. But, alas, no David and Prabha, as they are furiously working to get the dialogue translated into Tamil. The children are starting to fidget and fight. I went to them, and asked someone to translate for me. I tell them there once was a caterpillar. Then I asked what happens to caterpillars, and the children answered ‘cocoon’ (I am not even going to try that in Tamil!). “And then what happens?” I asked. “Vannathupoochi” and so began a round of “Vannathupoochi”, sung to the tune of Frère Jacques. I kept looking for the puppeteers to appear, abut no such luck! Some of the children came to the front of the group and sang solos, ending when one tiny child came to the front.( She was the size of an American three year old, but probably was about seven years old. We were invariably wrong when we tried to estimate children’s ages, off by years. Whether it was child nutrition, or genetics, the people of Sri Lanka are much smaller than Americans. Sometimes, at 5’3”, I felt like a giant.) She sang “Vannathupoochi” beautifully, then segued into “Frère Jacques”, ending with the English version, “Brother John”.


Still no puppeteers, so the children and I made up a story. I asked the children what “Vannathupoochi” did. “He flew” they answered, so we all flapped our wings. “And what did he see?” and the children yelled out various things, until their voices were drowned out by the sound of a train. The workers tried in vain to get the children to stay seated, but of course, they wanted to see the train. Knowing from years of experience that to resist is sometimes fruitless, in the story, Vannathupoochi sees a train. The train came and went; the trees mostly hid it. One child quipped that “Vannathupoochi” did not see the train, and everyone laughed. The story continued with “Vannathupoochi” hearing the train, and continuing his journey. Finally, the puppet crew came, so the butterfly landed on a flower and I said good-bye. I grabbed art supplies and headed to the shelter.

My goal was simple: to try to engage some of the children and parents in an art/play activity. The lethargy in the camp was palpable; many children and adults just lay on mats, depressed. People were surrounded by their belongings; pitifully small amounts that they were able to salvage, or had been given to them. I imagine for a minute if everything I had was lost; if all I had were a few items of donated clothing, maybe a few mats on which to put on the concrete floor. Yet, that would pale if I had lost my family. I keep remembering the woman at the Mangrove Center who had lost 41 members of her family. How do you go on after that?

I went to a clear space on the floor and started to sit down. Before I knew it, mats were appearing. I sat on a mat and put out some brightly colored paper, markers, and crayons, thinking perhaps a few children would come, and then maybe I could engage their parents.  Within minutes, children and adults surrounded me. I was handing out paper and crayons like mad. This was not going to be a small group exercise, leading people through the "what happened next?" scenario; this was free-form chaos. Adults as well as children wanted to draw, mostly pictures of the Tsunami. I gave no direction, they sat and drew, and drew. Children and adults approached, showing me their drawings. Almost everyone wanted their picture taken with their drawing.

Once people were settled into drawing, I walked around the shelter, giving out paper and crayons to the ones who had not come forward. These were the people I was most concerned about, the children and adults so overcome with depression that they lay on their mats on the concrete floor. The first family group I gave art supplies to is that of the little boy who Shanty had pointed out, the one who hardly moved. I wandered through the camp, handing out markers, crayons, and paper. There are so many children here! I could only give a few crayons to each child; I wished for the abundance of being able to give each child a whole pack of crayons, so that he or she could have all the colors from which to choose.

Returning to the main group, I see the drawings range from depictions of the Tsunami to lotuses and doves. Some of the people have included a chronology in the drawings; you can see a whole sequence of events portrayed. These people had discovered the "what happens next?" technique on their own.

               

It is hard to say good-bye to the children. Joe shows the children their images from the back of his digital camera; like all children, they love to see themselves.

 

I think we are all feeling inadequate to the task, overwhelmed by the numbers of children and adults. I wish I could have a year just to work with the people at this one shelter.

 

As we leave, I am pleased to see the boy who had been lying on his mat, so depressed, had joined the circle of children drawing.

           

 

After our visit to the camp, our translator, Anita, suggests that we go to the beach in Batticaloa where the people we had just seen in the shelter had lived. She tells us she used to go a hotel there; all is gone. Nothing is left. Again, it is seeing the saris caught on the ruins and in the trees that make my heart clutch. Were women torn out of them by the Tsunami?

 

 

Thursday

Again, we are up and out the door. I am finding it difficult to have so little time and solitude. I have not been alone since boarding the Airporter bus in San Francisco. Technology is defeating me; it is difficult to use the laptop to write, and downloading photographs is impossible. In Batticaloa, there are intermittent power outages, and the system to charge a battery-operated device, such as a camera or laptop, takes all of Joe's knowledge and wizardry.  My adaptors and transformers don't work at all.

Thursday morning we return to the Butterfly Peace Garden to meet with the trainers, and again I greet them with cinnamon Altoids, butterfly and flower stickers, and the now famous (or infamous) butterfly song. Valerie has threatened me with death, because she can't get the butterfly song out of her head. When one of the workers comments that I am a "little crazy" about butterflies, I laugh, and agree. How do I explain the synchronicity of the stickers, the song, the butterfly peace garden? I think butterflies picked us, we did not choose them.

We again start the session asking the animators what they need, and, after teaching a few more protocols, they begin to speak of their experiences. Shanty tells us her sister lost both of her children in the Tsunami. Fajriya and Rifaya are refugees, living in the camp in which they work. Everyone speaks of loss, of burnout. They have no more creative energy to come up with ideas - every cell in their bodies is saturated with pain and trauma; they are exhausted. We hold them as a group; hoping our containment and caring can at least let them know that we care. It would be arrogant to say that 'we know', because, how could we? Our group has developed such respect for these workers, and such humility. As always, they have taught us much more than we have taught them; given us more than they have given us. They humble us.

Thursday afternoon, the group returns to the Butterfly Peace Garden. Learning from the chaos of our visit to the camp, and the difficulty of working with so many children at once, has led us to the idea of creating 'stations'; Joe, Prabha, Valerie and David each take an activity, and working with one of the Sri Lankan trainers, play with a group of children. The children rotate through the stations, so, instead of all the children doing an activity at once, only a quarter of them do. 

I stay back at the orphanage to do an exercise with the younger children. As we call them, more and more children come, so at the end there seem to be over 100 young children. Their housemothers help me, and we make “Vannathupoochis”,folding a piece of paper in half, and drawing one side of a butterfly on the paper. Cutting it out, when you open the paper, there is a full butterfly. The children then use crayons and stickers to decorate the butterflies. They are beautiful; each child wants me to admire her “Vannathupoochi”.

                                

We end by singing the Butterfly song
.

 

That evening, our last night at the orphanage, the children have arranged a dance for us. Dancing barefoot is the best compassion fatigue exercise in which I have ever participated.  Some of the animators we have been training came to the dance. I inadvertently ended up having a showdown with one of the girls released by the Tamil Tigers. She came up to me and started dancing. Reminiscent of "West Side Story"; the dance got more and more aggressive as we postured and imitated each other. I was so hot I had to leave midway to dump cold water on my head. When I returned, the dance floor cleared, as the two of us danced. The women were cheering us on. As the music ended, I bumped out my hip and her headband went flying. Everyone clapped. I was deemed the winner, but I think it might have been a tie, because she didn't need to leave to cool down. (Hot flashes in the tropics are a drag!) By the end of the evening, we were all glowing with sweat and joy.

 

Friday

This was our last morning at the orphanage and camps before we began the long journey home. None of us wanted to leave; we wanted to go North to Jaffna, to work with the people there. Saying good-bye to the children and staff at the orphanage was very difficult; I know I was sad to leave, in spite of mosquitoes, showers from a bucket, hand-washing laundry in a pail, head lice, the unspeakable toilets, and the 4:30 a.m. wake-up. The people were so warm and gracious; they will stay in my heart.

 

We went back to the Butterfly Peace Garden for a good-bye session and feedback from the trainers. They most appreciated our playfulness; that we, as adults, would play with them, and with the children. They said they were now playing more. Saying good-bye to these dedicated workers was very difficult. We then went to a Muslim camp, Firthous Refugee Camp, Kattankudy.  We are greeted by Fajriya and Rifaya and people from Meesan. Conditions were dismal there; people were living in tents with no floors. I heard later that the temperature inside the tents could reach 110°.

                

 

We began to hear reports that many elders perished in the Tsunami; that the most vulnerable, the children and the elders, were the least able to escape the devastation. In fact, we see only a few older people at the refugee camps.

We have only a little time here, so we go to the classroom to meet the children. Here we find out that the children are school-aversive; an unusual thing in Sri Lankan society. The children are very dedicated to school; literacy rates are extremely high, education is seen as the only way out of poverty. Generally the children wake up early to do chores and study, then go to school, then have an hour for chores and play time. At 4:30 homework starts. (I am going to try this schedule with my son when I get home...right!) We are amazed at how well behaved the children are - they listen to the adults, they sit quietly, and are so well socialized that I agree when Joe says, "Actually, we could learn a lot about how to raise children from the people here."

The children in the camp are avoiding school; we don't know if it is that they are reluctant to leave their parents (or are the parents reluctant to have their surviving children out of their sight?) or is it because the school faces the sea? I know that if I had sustained the losses these people had, I would never let go of my surviving children, never let them out of my sight. At first the children appear very serious and sad; as we leave they are smiling.  We have given them letters and drawings done by children from all over the world, and, or course, stickers. They sing “Vannathupoochi” with me, singing more verses than I ever imagined existed. Valerie did her magic with "Follow the Leader", and David, as our leader, was honored by having his hands painted with henna. The woman who did the henna never once touched his hand; indeed, men surrounded her as she worked to make sure that did not happen.   

          

 

 

After we saw the children we walked on the beach, this time with the people who had lost their homes. Children would come up to me and say, pointing to a pile of rubble, "This is my house."  My broken heart surely broke a million more times that day. We reluctantly said good-bye to begin the long journey home.

 

 

 

 

Re-entry

Re-entry is hard!  I nearly burst into tears at the grocery store, overwhelmed in the shampoo section by how many types and brands there are. I want to pack off everything in the store and send it to Sri Lanka, to the people in the camps and the children in the orphanages. I am not sleeping very well; I do not think it is jet lag, but rather "soul lag". I wake up in the middle of the night and start to write. How can I be here when so much of my heart is there?

I keep thinking, "What next?" What can we, as humans, do, for other humans who are suffering? I don't know the answer, other than the feeling that we, who have so much, are not doing enough for those who have lost everything.

It is still the eyes that haunt me; the eyes of the woman who lost 41 people in her family, of her two shell-shocked granddaughters, of the mother whose children were swept away, of the man whose wife and children's bodies have not been found. It is the eyes of the listless children at the refugee camps, and the eyes of the children who sadly point out where they used to live. My heart goes out to these people, who have seen war, and death and destruction. I see pain, shock, and loss on the faces of the survivors - everything can change in a nanosecond. Life is fragile and precious. How do you go on when your village, your home, your family, is destroyed? I see the faces of those who I met in the refugee camps, and it is the eyes that capture me. And it is the eyes of the children that haunt me, and make me unable to sleep through the night.

Tsunami Journal - A visit to Sri Lanka by Kate Amatruda, LMFT, CST-T, BCETS

Thank you!

My heart is touched forever ~ thank you for letting me share my journey with you. Thank you to my wonderful team: Joe, Prabha, Jodi, Sharolyn, David, Valerie, and Maria, and to Janine Shelby, Bill Burns and the crew at APT, and everyone at OperationUSA: Nimmi, Carinne, Ravi, Anita and Skip. Thank you to everyone who donated to the Foundation at APT. Thank you to Barbara Amatruda for your kind donation, to the Novato Charter School, especially to George Bevins' 7th grade class and to principal Rachel Bishop, to the Mountain School and Good Shepherd School for sending supplies and your artwork to the children of Sri Lanka. Thank you Catherine Craig, for balloons, paper and crayons. Thank you Kevan Rosenberg for sharing your bar mitzvah money, and to your mom, Karen, for her last minute run to Costco. Thank you, Anne at Mrs. Grossman's for the stickers, and CuradUSA for overnight shipping two cases of Clifford Band-Aids, and to everyone else who contributed to this journey. I feel as if I took the spirit of my friend, the late Mary Murray, with me. Thank you Kim for running www.psychceu.com and always to Roy and Colety for all of your love and support, and to the kittens for getting on the phone the few times I could manage to call home. Most certainly and most especially my eternal gratitude to all the wonderful children and adults of Sri Lanka who opened their hearts to me.

 

With gratitude and love,

Kate

Kate Amatruda, LMFT, CST-T, BCETS
45 Hillside Terrace
Novato CA 94945

February 14, 2005

Kate Amatruda, LMFT, CST-T, BCETS, is a Licensed Marriage and Family Therapist, Board Certified Expert in Traumatic Stress - Diplomat, American Academy of Experts in Traumatic Stress, and a teaching member of the International Society for Sandplay Therapy. She is a Disaster Service Mental Health volunteer with the Red Cross, and has responded to the Hurricane Katrina disaster, as well as to local fires and floods with the Disaster Action Team. She went to Sri Lanka with the Association for Play Therapy and OperationUSA. She has lectured internationally and teaches in the Extended Education departments at U.C. Berkeley and Sonoma State University. She is the author of A Field Guide to Disaster Mental Health: Providing Psychological First Aid,  HIV: The Storm, Psyche & Soma, Trauma, Terror and Treatment, and Painted Ponies: Bipolar Disorder in Children, Adolescents and Adults. Her work with trauma is featured in the DVD Trauma Treatment - September 11 - One Year Later, an hour interview with Frontiers.TV in Brooklyn, NY, and her work with children with cancer is shown in the DVD Sandplay Therapy and the Liminal World. She is the co-author of Sandplay, The Sacred Healing: A Guide to Symbolic Process, Reweaving the Web: The Treatment of Substance Abuse, The Safe Harbor Ethics Series and The Witch and The Queen. She practices in Northern California.

 

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