March 16, 2005

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Agents of change

It was a long way from the rarified world of pediatric cancer medicine at Stanford, where the finest technologies are at Pillai's fingertips. Victims came in by the minute, with up to 70 patients filling the beds each hour.

Vacationing in Kerala last December, Pillai -- a pediatric oncologist at Lucile Packard Children's Hospital -- was caught directly in the tsunami and its aftermath. Images of the disaster are etched indelibly in her mind: Parents fainting at the sight of their dead children; broken bodies, crushed by crumbled homes; the smell of rotting flesh; and daylight blackened by hundreds of funeral pyres lining miles of beach.

Yet in the midst of such despair, Pillai also found signs of hope.

"When working in a tragedy, everyone is roasting together -- every moment is very full," she said. "The humanity in people comes out in a very clear level."

Such moments leave their mark. Since returning to the Bay Area, Pillai can't stop discussing the sense of mission -- and accomplishment -- gained. Pilai's, and other medical professional's, experiences are driving peers toward joining a growing movement to aid the underserved.

"Twenty years ago, there were isolated incidents of physicians' participation in overseas projects. Now there are any number of organizations with yearly and bi-yearly trips to do medical outreach programs," said Dr. Jerry Shefren, chief of the General Gynecology Division and part of the international program at Stanford.

"Clearly, there's an increase. There's an overwhelming need in underdeveloped countries -- it's quite dramatic. You can make a major, major, impact in a relatively short period of time."

Reflecting this trend, many medical institutions are tapping into doctors' desires to impact communities at home and abroad. Stanford has an international program of humanitarian aid in Central America and Africa. Kaiser Permanente has created a pay category to reimburse medical staff who engage in community-based volunteerism.

According to Palo Alto resident Dr. Sarah Beekley, a pediatrician at the Redwood City Kaiser, the health care giant is realizing this kind of experience can be a boon to staff recruitment.

Physicians are starting to join Kaiser based on such opportunities to engage in humanitarian relief, said Beekley, who was in Sri Lanka after the tsunami.

When the tsunami struck, Pillai was in the coastal area of southwestern India helping build a state-of-the-art cancer center.

Three successive waves hammered the coastline right before her eyes. In minutes, all that was familiar was taken away: roads, buses, fishing boats, and the tiny, pastel pink stucco homes dotting the coastline. Many children, home for the holidays, were swept out to sea.

The devastation was unfathomable and exacted a profound psychological shock, Pillai said, adding the hardest hit have been women and children, nearly 50 percent of whom no longer have a living bread-winner in the family.

Traveling in mid-January, Beekley witnessed this dismal reality. She visited rural hamlets, making her way over roads pocked with potholes to reach inhabitants living as much as three hours away from the nearest town.

With the monsoons dumping rain, much of the land hadn't yet drained from the tsunami. "People were living in tents in the mud. They had no cooking utensils, no birth control, no medicines," she said.

Beekley kept an eye out for emerging infectious diseases, assessing medical conditions in the area, treating rampant respiratory infections and dysentery.

The devastation shocked outsiders, including members of the press, she said. But Beekley felt privileged to lend a hand.

"At the end of the day, we were able to say we did something. That's the privilege of being a health-care worker. You have an incredible opportunity to go into this area. You will never feel as fulfilled as you have after this experience," she said.

Since Pillai returned to the Bay Area in January, nearly every waking moment outside her duties at Stanford -- for 40 hours each week -- has been consumed with giving talks and lectures related to the tsunami survivors.

Those efforts have begun to pay off. Pillai, who has long worked abroad under the auspices of the nonprofit Mata Amritanandamayi Center, said the aid organization recently secured a $3.9 million donation in medical supplies from Direct Relief International for tsunami relief.

At the center's San Ramon warehouse, boxes are brimming with medical supplies destined for shipment to the region. Local hospitals, including Stanford and Kaiser, have donated supplies and equipment.

Pillai plans to return to Indonesia in four months to continue providing medical care, saying the disaster has only intensified her commitment.

"There can't be worse disasters than what we saw. The forces may be different, but the destruction can't be worse," she said. "Now I have full confidence in what we are doing."

Beekley returned from tsunami-ravaged Sri Lanka with a similar sense of urgency.

Already, based on the reports from Beekley and other doctors, Kaiser has committed funds for teams of physicians to travel to Sri Lanka for two-week stints on a rotating basis. One hundred physicians are expected to participate. The medical teams not only minister to the injured and sick, but will also do collaborative teaching, bringing in technical equipment, and helping develop a medical school planned to open in 2006, Beekley said.

"For me day to day, it has re-motivated me to expand my work to be more locally- based community work," Beekley said. She remains dedicated to seeing the Sri Lankan project continue at Kaiser. Before she went to Sri Lanka she was teaching a six-month program on physician volunteerism. Her experience has validated her teaching. "All of the things I've been preaching, I got to go and do again," she said.

E-mail Staff Writer Sue Dremann at sdremann@paweekly.com.

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