Kerstin Jeska-Thorwart (left) talks with a nurse at the Mahamodara Teaching Hospital in Galle, Sri Lanka.
Photo Credit: Rotary International / Alyce Henson

From the April 2016 issue of The Rotarian
 
ers is the silence. No birds chirping, no dogs barking, no car engines revving. Nothing. “I’ve never heard such a silence before, and never since,” she says. “I knew something must have happened.”

It was 9:35 the morning after Christmas 2004, and in Sri Lanka, it was a Poya Day, a Buddhist public holiday held every full moon. Jeska-Thorwart, a lawyer from Germany, was on vacation in Hikkaduwa, on the island’s southwestern coast. Any other morning of her holiday she and her husband would have been on the beach, but today they stayed back at their vacation home, up a small hill about a half-mile from the water’s edge, to clean and prepare for guests.

After a few minutes, sound returned, as though it had been switched on. Now she heard people running, crying. She went down the main road to see what had happened. She saw people in swimming suits, shoeless, covered in blood.

They told her there was a big wave.

The tsunami, as she later learned, was caused when an earthquake with the estimated force of 23,000 atomic bombs rattled the floor of the Indian Ocean. The seabed rose 10 feet, displacing 7 cubic miles of water. A wall of water, in some places up to 100 feet high, slammed into countries throughout Southeast Asia and as far away as Africa. All told, more than 230,000 people died in 14 countries, and 1.7 million were left homeless. More than half of the dead were in Indonesia, followed by Sri Lanka, where 35,000 people were killed.

Sri Lanka was hit by several waves that day. They knocked out cellphone service, land lines, electricity, television, radio. Jeska-Thorwart, then governor of District 1950 (Germany), opened up the house as a makeshift first aid clinic. Four days later, when the situation had stabilized, she and her husband, the late Carl-Otto Thorwart – himself a member of the Rotary Club of Nürnberg-Sigena – together with some Sri Lankan friends, drove down the coast looking for clues to the extent of the damage. “We had no information about what had happened,” she says. “Was it only Hikkaduwa that was hit, or other towns too?”

The first city they came to was Galle, about 12 miles south. Conquered by the Portuguese in the 16th century and fortified by the Dutch in the 17th, the city had long served as the main port between Europe and the East. The tsunami killed 4,000 people in the city and damaged 12,000 houses. “Every minute that went by,” Jeska-Thorwart says of her Sri Lankan companions, “they were more and more silent. They were completely shocked. They realized their country was destroyed.”

On the edge of the city, directly across the road from the beach, the group arrived at a hospital. It was Mahamodara Teaching Hospital, the primary maternity hospital in the province of 2.5 million people. “It was totally empty,” Jeska-Thorwart recalls. One of the women in the car had delivered four children there, and when she saw the devastation, she cried out: “Where are the babies?”

When the first wave of the tsunami slammed into the hospital, deliveries had been underway. Although the 10-foot wall around the hospital could not stop the wave, it buffered its force, so the water was only 4 feet high by the time it reached the prenatal ward that faced the sea. The power failed, the backup generator failed, the water supply and sewer systems failed. Patients’ mattresses were soaked with foul-smelling water. The 349 patients were evacuated, first to a nearby temple, then to the Karapitiya Teaching Hospital, a couple of miles inland. By the time the subsequent waves hit Mahamodara, no patients or staff remained on site. One baby had died.

Upon learning that the patients and staff had been moved, Jeska-Thorwart and her companions went to check on them. Only the most urgent cases had been transferred – others were sent home – and the maternity hospital had been squeezed into 70 beds in the male neurology wing and portions of two other wards at Karapitiya. Jeska-Thorwart saw pregnant women sitting outside in the rain. They lay in beds to deliver and moved to the floor to recover. There were not enough toilets; there was nowhere to eat or drink. “It was a horrible situation,” she says. She asked to speak to a doctor.

Her first words to him were: “Don’t worry. We will help you.”

“Excuse me, may I know your name?” asked Malik Goonewardene, the head of the obstetrics and gynecology department at the University of Ruhuna in Galle and a consultant at Mahamodara Teaching Hospital. He eyed Jeska-Thorwart, who was dressed in a T-shirt and shorts, like a tourist.

“I’m from Rotary. I want to help you.”

Goonewardene invited her into a meeting where the Mahamodara doctors were gathered. Jeska-Thorwart explained who she was and asked the doctors to compile a list of everything they needed. (She still has it.)

A few days later, she drove to Colombo, which – because of its location on the island’s western coast – had not been damaged as severely. She asked local Rotarians to email the list to her office in Germany. By the time she returned home on 6 January, her office was jammed with medical equipment, and by 10 January, German Rotarians had shipped the doctors 2 tons of supplies, including scalpels, drapes, arm slings, gloves, three ultrasound scanners, and 1,360 diapers. Less than a month later, they shipped another 7 tons.

And that was only the beginning.

A decade later, Mahamodara Teaching Hospital’s only ward that has not been replaced or refurbished after the tsunami stands empty. Inside, pieces of plaster are falling off the walls. A couple of old bed frames are stacked in a corner, and wires hang from the ceilings. The building dates to the 1800s, when the hospital was built to quarantine South Indian immigrants arriving to work on Sri Lanka’s plantations and vaccinate them against smallpox.

In contrast are the bright and airy new buildings designed by Lakshman Alwis, an architect and a member of the Rotary Club of Colombo. Inside one, lofted ceilings with vents allow the tropical heat to rise, so the building stays comfortable without air conditioning. Large windows illuminate a room filled with beds where women rest, waiting to deliver. Since patients come from all over the province, many arrive before their due date so they don’t have to travel while in labor. The hospital serves the entire socioeconomic spectrum; the wife of its deputy director delivered her baby here.

Within a few weeks of the tsunami, more than 6,000 German Rotarians had donated €1.3 million, and in 2008, The Rotary Foundation supported the project. Other partners included German-headquartered global corporations such as Siemens, Trumpf, and Ejot, as well as a foundation set up by former German Chancellor Helmut Kohl, who had been vacationing at a coastal resort southeast of Galle when the tsunami hit.

In the past 11 years, this funding has helped renovate or build 10 departments and wards, and provided equipment worth more than €1 million. The Rotary Club of Colombo, which partnered with District 1950 on the Foundation grant, managed much of the construction. Since work started, 160,000 babies have been born and more than 2.5 million women have received gynecological care. In 2014, a year the hospital saw more than 12,000 births, not one mother died – a statistic many Western hospitals would covet. “That speaks volumes about what we have been able to achieve here,” says RI President K.R. Ravindran, a member of the Rotary Club of Colombo.

“When this hospital got damaged and we had to evacuate, it was an absolute calamity. We didn’t know what to do,” says Goonewardene. “Without our donors, including Rotary, who came to our aid from the start, I don’t know how we would have managed.”

The project has included many steps over the years: first, operating rooms and intensive care units for mothers and babies; then the prenatal wards; and, finally, training. Jeska-Thorwart, whom Rotary honored as a Global Woman of Action at the United Nations in November, says they plan to celebrate the completion of the project in January 2017.

Since 2010, a team of doctors, midwives, and nurses has traveled once a year from Sri Lanka to Germany, and another from Germany to Sri Lanka, for training. At the biggest hospital in Nuremberg, where Jeska-Thorwart lives, only a couple of babies are born each day. In contrast, the Mahamodara Teaching Hospital delivers 70 babies daily. Because of the number of births in Sri Lanka, the German doctors get more experience in the neonatal intensive care unit dealing with birth complications. Meanwhile, Sri Lankan doctors get experience on state-of-the-art equipment in Germany.

The neonatal intensive care unit, one of the few air-conditioned buildings at the hospital, is a world of beeps and scrubs and needles. A 19-day-old infant lies in an incubator, connected to a neonatal CPAP machine to support her breathing, donated by Rotary, which equipped the entire unit. The newborn, who arrived two months premature, was transferred here because the hospital has some of the most advanced equipment in the country. “When I started here, I was amazed,” says Selvi Rupasinghe, the chief neonatologist. “Rotary’s contributions have made a tremendous change to neonatal care.”

Outside the unit, a woman holds a sleepy toddler in her arms. The child’s eyes are closed and her head droops as her mother, a dance teacher, smiles and hugs her daughter tight. The child, now 21 months old, was born premature, weighing only 2 pounds. She spent a month in the neonatal intensive care unit and today loves to dance, like many girls her age. “Without all of this equipment, she would not have been able to survive,” says Sumith Manathunga, the hospital’s deputy director.

English isn’t the mother’s first language, but she does know four words: “Thank you very much.”

By Diana Schoberg
The Rotarian
1-Apr-2016