For survivors, scars linger

MEDAN, Indonesia -- These are the lucky ones. Fate sent them to the crumbling wards of the Pirngadi General Hospital instead of to their graves. Here, where many victims with the most complicated injuries from the Dec. 26 tsunami were evacuated, survivors embark on daunting recoveries.

Sent in military planes, the patients wake up in this colonial-era hospital in Medan, about 260 miles southeast of Banda Aceh, the devastated city on Sumatra's northern tip that most call home. They recount improbable escapes and terrible losses without shedding a tear. They huddle together in wards that have become miniature refugee camps. They talk of returning home as soon as possible.

Room 8 is for the amputees, many who lost legs shattered by sharp objects as they clung to trees and rooftops. Ward 9 is for children -- among them two boys who lost both parents and one boy who hardly speaks. The host of relatives accompanying the patients lurk in the hallways and lie on beds, suffering their own hurts, which are unseen and often unspoken.

Hundreds, if not thousands, of tsunami victims have been evacuated to hospitals across Indonesia, since the main hospital in Banda Aceh was destroyed, said Dr. Amran Lubis, cardiologist and chief of medical services at Pirngadi.

''I myself lost six friends," said Lubis, recalling those successful doctors and their beautiful homes by the sea.

In the days before the military and foreign doctors poured into Banda Aceh to set up a new medical system, a large number of the critical cases were routed to the Medan hospital, one of the nearest medical facilities in the region. Even now, compound fractures, respiratory problems, and other complex injuries are flown here from Banda Aceh.

A second wave of victims -- those suffering from pneumonia after swallowing sea water and sleeping outside -- is beginning to appear in the wards.

This hospital, built by the Dutch in the early 1920s, has become yet another scene of concentrated loss, so much so that the minister of health visited yesterday, making her way past stray cats and peeling paint to greet the Banda Aceh patients.

Eighty-one tsunami victims remain at the Medan hospital. Dozens have been discharged, and six who swallowed too much sea water passed away, Lubis said.

But perhaps one of the greatest lasting injuries these survivors must overcome is psychological. Doctors at the hospital said they have found it remarkable that almost none of the patients cried over their lost relatives.

''There is a fairly acute condition, deep mental trauma, when the patient is still without expression," said Dr. Latifah, a psychiatrist from south Sumatra who has counseled patients in Banda Aceh. Like many residents of Sumatra, she goes by one name.

''You don't want to leave them alone," she said, adding that the crowded conditions at hospitals and refugee camps might help heal them by providing some sense of community in a time of grief.

In a long room full of a dozen beds, a 65-year-old man named Katiman talked cheerfully about how he was fished from the roiling waters hours after the tsunami snatched his wife, two of his children, and his home in Banda Aceh.

''My leg was rotten," said Katiman, who like many Indonesians goes by one name, gesturing at the stump just below his knee after doctors amputated. He cannot remember what caused the injury that invited gangrene to set in.

His son, Yuswandi, a 30-year-old bicycle taxi driver, sat beside him on the hospital bed. Physically unscathed, the son stoically recounted how he had been drinking coffee with his wife and their 2-year-old daughter when the wave caused their house to collapse. His daughter was just learning to speak, he said. She could already say ''mama" and ''papa."

''I found their bodies at the mosque," he said, as if he were discussing someone else's life.

Hamdani, 26, is not a patient; he is tending to his sister-in-law, who sustained a chest injury and lost her spouse in the disaster. But Hamdani's story of how everything that mattered in his world had vanished -- his wife and the baby they were expecting, as well as his small business -- reveals his own long road to healing.

He had been preparing to open his food stall in Banda Aceh when the earthquake hit. Soon after, he saw the black water rising.

So he ran about a mile to his home to get his wife, who was eight months' pregnant with their first child. He gripped her hand and those of their small nephew and niece, and the family fled. The water caught them in a narrow alley with such force that they were separated.

He climbed a tree as the torrent of water pulled at him and ripped off his clothes. When the water was still chest-high, he climbed down and waded in search of his wife and relatives.

''Every time I saw a body, I would turn it over, but it's not my wife," he said. ''It's not my wife. It's not my wife."

He said he checked 35 bodies, and then collapsed in the water where their house once stood. He searched for three more days, but never found his wife nor his nephew and niece.

Now, he sleeps in the hospital corridors, eating food provided by other people's relatives. ''I don't have any plans right now," he said.

At the far end of a mazelike hallway, in the children's section, a woman in a green scarf fanned an 8-year-old boy. Her name is Yultini, the boy's aunt, and she smiles down at him tenderly with a brilliant row of teeth.

''He has lost his father and his two twin brothers," she said.

The boy, Muhammed Afiqia, was found in a swamp, still clinging to a tree, with a badly injured leg. ''He was unconscious," she said. ''His eyes were open, but he couldn't recognize anyone."

The first time he spoke was at the refugee camp, when he saw his mother, whose shoulder bones had been crushed. He cried out to her, ''Mama, I don't want to die without you," Yultini recalled. But he has not said much since.

As adults talked about him, the thin boy slurped on a piece of chocolate and stared joylessly into space, or perhaps at the red race car on the opposite wall that he asked for but does not play with. He is far from his mother, who is in another ward. He only began talking again after the doctors operated on his calf, which was severely wounded and is now bound tightly with gauze.

Yultini, who sleeps on a mattress at her nephew's bedside, recounted the losses of the other children in the ward -- one lost a toe and both his parents, she said. Like a mother dishing out dinner, she went down the list, recounting their suffering. Only afterward, in passing, does she mention her own loss.

''I was married for 27 years," she said, smiling at the memory of her husband, who worked for the Finance Ministry. She had no children, she said, but the tsunami made her a widow.

''I lost my husband, but I know I have to be strong for my nephew," she said.

As she spoke, another boy bounded into the room carrying a pocket video game.

''This kid lost his parents, and he has no relatives with him," said Yultini, introducing Aditya, who appeared to be about 10 years old. Aditya got a line of stitches in his groin, she said, adding: ''He's fully recovered, but we don't know what to do with him, so he still sleeps here in a hospital bed."

When a visitor asked the boy whether he wanted any gifts, he shook his head no, looked up at her, and grinned.

Yultini smiled back at him, and said, ''Aditya has a lot of mothers and fathers right now."

Farah Stockman can be reached at fstockman@globe.com.