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Doctors face more than physical tragedy

Doctors have come from around the world, ready to deliver medicine and to mend broken bones. But how do you heal a nation like Sri Lanka,  filled with patients who have lost spouses, children, homes, an entire way of life?
/ Source: Dateline NBC

As unforgiving as the tsunami was, the wave of despair that has followed is just as relentless. Doctors have come from around the world, ready to deliver medicine and to mend broken bones. But how do you heal a nation filled with patients who have lost spouses, children, homes, an entire way of life? That is the challenge doctors are facing.

Ann Curry: “How deep is the wound in the heart of Sri Lanka?”

Amalie De Silva: “You really can't say how deep it is really because, the acute situation has gone away, but still the suffering is there.”

The enormity of the suffering drew 27-year-old Dr. Amalie Da Silva, a pediatrician, from  the nation's capital to her grandmother's village, to help care for the crush of refugees who came after the tsunami swallowed the coast.

De Silva: “There was this gentleman, he has lost all his family members, his wife, his kids, everybody. Now he says he wants to commit suicide.”

Everyone is so sad, their stories so tragic, the doctor struggles to find ways to console them.

De Silva: “Sometimes you are at a loss of words what to say to them, really.”

Days after the disaster claimed homes and loved ones, the survivors are haunted by the unspeakably painful images. A group of schoolgirls dragged away by the water as it cascaded back to the sea. A man confronting another to prevent him from stealing jewelry off the body of a drowned woman. The horrendous sight of bodies arriving at southern Sri Lanka's largest hospital immediately after the tsunami struck.  

Wave after wave of people rushed into the hospital, more than 800 injured, overwhelming doctors and nurses scrambling to keep up.

Most of all, there was the unbearable sight of the children, so many children lost.

Sri Lanka suffered the highest death rate per capita of any country hit by the tsunami; 30,000 people killed in minutes, and the tragedy wasn’t confined to a single area . More than 70 percent of the island nation's coast was slammed by the deadly waves.

Dazed survivors stare at pictures of the dead day after day, half-hoping to recognize a missing relative and also hoping not to. Like two sisters searching for their younger brother, the bread-winner of the family. Another brings a photo of his own of a friend who was riding this doomed train on a church trip.

So many deaths, so quickly, he corpses so horribly disfigured by the sun and the beating they took in the water they were almost unrecognizable. There was no time to identify all of the dead before they were buried in mass graves. Families never got a chance to say goodbye and may never know where or if their loved ones were buried.

Hambantota, a fishing village on the southern coast was devastated, with more than 4,000 dead. Among them were more than a thousand mothers. In an instant, a generation of women wiped out.

There are so many widowers and orphans. How will they go on? It's a question Dr. De Silva is trying to comprehend.

De Silva: “Post traumatic stress -- which we should take into consideration very much in this kind of situation. Because most people have lost their whole families. And the children, children have lost their parents. It's very sad.”

Curry: “One thing I've come to notice is the Sri Lankan people can be described as stoic, keeping the emotions in.”

De Silva:  “There are very few who really want to talk about it.”

Dr. De Silva says it's a tradition here for parents to do everything they can to shield their children from heartbreak.

De Silva: “In Sri Lanka, they don't expose the children to so much tragedy.”

Even when a family member dies.

De Silva: “Small children -- sometimes their relatives won't tell them. Breaking bad news can be very, very hard.”

Two little girls haven't seen their mother since the tsunami struck. For their aunt the news may be too hard to tell the children, or herself. Now when her two nieces, 7 and 9, ask about their mother, she tells them she's away in another country with a new job. 

Across Sri Lanka care givers and spiritual counselors have stepped in to offer psychological and spiritual comfort. And aid organizations are sending experts in post traumatic stress to help, but even the most experienced are challenged by the conditions they find.

Michael Finnegan is the psychologist for the Maryland State Police and a volunteer for Catholic Relief Services. It is so important for us to be able to recognize what we have lost. He's there to help train care givers, hoping to give them tools to cope with both the enormous pain they are seeing and the stress they themselves are feeling.

Michael Finnegan: “You see people here that have seen hundreds and hundreds and hundreds of individuals die, walking past the bodies not being able to rescue people that were being swept out to sea. These individuals are suffering psychological scars.”

He gave a clinic for the doctors and nurses at the hospital that had to deal with more than 1,200 corpses. Some of the victims are relatives and neighbors of staff members.

How long will the mental scars last after the physical scars have healed?

De Silva: “There was a child who was only child in the family and she has seen both her parents being washed away. That traumatic situation will haunt her life forever.”

What does she tell the children who have suffered so much? Can they ever be normal and happy again?

De Silva: “I told her, ‘Now you had a second chance in your life, which a person rarely gets. Life is very precious. While you live, you do good as much as you can, so that at the end of it, you will have something to look back to.’”

Dr. Amalie Da Silva is working to help every child and grieving parent to start again, and in the process she's helping heal her island nation.

De Silva: “Sri Lanka is surrounded by sea, which was a blessing earlier -- and now we want to make it a blessing again.”

Doctors and relief workers in the tsunami zone will have their hands full for years to come. Nearly half a million people were hurt in this disaster, and up to 5 million people were left homeless.