By coincidence, Ibrahim was in the region conducting assessments for future projects in south Thailand and Indonesia, and was in Jakarta at the time. Within 72 hours, once permission had been received for MSF to enter the closed Banda Aceh province, Ibrahim arrived with a team of 12 national staff members and 3.5 tonnes of emergency aid materials.
"We arrived on December 28 in the evening and the next day we had two mobile clinics in Banda Aceh visiting the areas to provide medical care where the largest numbers of people were gathering," Ibrahim said.
"There were 108 displaced camps by then. People were gathering anywhere there was an empty building where they could find shelter. Schools, factories everywhere. There were between 50 families and 2,000 families in each of the camps. Other members of the MSF team were looking into logistical issues and other needs. In Banda Aceh, the entire northern region has been flooded and demolished and the water had washed in deep into the city. There are still bodies buried in the debris and mud. The bodies were more concentrated in the centre of the city where the water reached the furthest and pushed everything inland. The water then fell back and left the debris and bodies behind.
By December 30 MSF had dispatched more staff to the disaster zone and the initial team was able to increase the scope of their work and reach out to more remote areas, in particular the devastated western coast of the province.
By December 31, we had a helicopter and we did a flight down the west coast to assess the damages. The flight stayed just 300 or 400 feet above the ground so we could see clearly the scope of damage. The entire west coast had been swept away as far inland as three kilometers. It was gone. All gone. You could see pockets of people, maybe 20 or 25 people each time, and many had moved to other villages inland, sometimes 10kms away.
On our first flyover, we only landed twice. In one location, they had a medical person so we left some drugs. In the other we left BP5 (biscuits). On the second day, we flew in mobile teams as well as non-food items and some rice. The helicopter visits initially were rapid visits. We would land and keep the motor running and ask them five basic questions. Did they have a health centre? Was there a medical person? Did they have any food? Were there any injured? Anyone who had to be transported back to a hospital? On the same day, or the next day, we would return with more goods and staff to care for them. In the first visits, we stayed only for a day because of security concerns. The staff were staying for a few days and we were reinforcing the supplies. For the first week, we were concentrating our efforts on the west coast and only by helicopter. And we were working as far along the coast as Meulaboh. Just 20kms further along, there was no more devastation and the crisis zone ended.
Initially to get to Meulaboh, we had gone on the east coast to Sigli and then headed south to visit Meulaboh. But the first two times we could not land because the rains were so heavy. Visibility was only ten meters in the rain and we could not land. Finally established, Meulaboh was reinforced by sea, using the Greenpeace flagship, Rainbow Warrior II. Today we have four bases where we concentrate MSF staff and supplies. Banda Aceh at the northern tip. Then Sigli on the east coast. Lamno and Meulaboh on the west coast. And we have about seven or eight points on the east coast where we visit frequently.
We have seen light and heavy injuries and some surgery needs. But also mental health work is needed as people are very traumatised. There are many unaccompanied children and the destruction of health facilities as well as the death of many of the medical staff and a lack of resources and infrastructure. Primary health care was already malfunctioning before the tsunami but now many of the health staff are dead and the health centres are gone.
Now, one month later, basic health care and mental health work is the priority but the psychiatric facility in Banda Aceh was destroyed and there is no referral facility. The mental health issues are being cared for in whatever health centres are available. And now there are overwhelming needs in the out-patients departments."