Médecins Sans Frontières Australia

	© Tim Dirven Women mourning the loss of family members. Iran, January 2004,

Earthquake in Iran - Diary of a Catastrophe
Part 1

A doctor, an administrator, and a communications officer - all in Bam, in the midst of the rubble, on an emergency mission for Médecins Sans Frontières. The three were part of a 23-member volunteer Médecins Sans Frontières team that came to aid victims of the deadly December 26 earthquake. In the testimonies below, they describe their experiences and the sense of crisis, support, and sadness in the days immediately following a large-scale disaster.

10am, Friday, December 26, 2003
I got a call from the Zahedan team telling us that there had been an earthquake in the city of Bam. We still didn’t know the scope or the number of victims. I turned on the television, but was really surprised to find that only the Iranian network, IRINN, was covering it. They were broadcasting powerful images. The citadel of Bam, an architectural jewel, was now nothing but ruins. The population was panicked and disoriented. A man was sobbing over a blanket. He lifted it to reveal the lifeless faces of his two children. I was stunned. I realized that this had been a devastating earthquake and that we were going to intervene. With my limited Farsi, I understood that 10 medical teams of 20 persons were already on site.

11am - I met Jean-François, the head of mission, at the office. He had already given instructions to send a team on an evaluation mission. We set about drafting a list of supplies that we could send immediately from Teheran. We had 17 medical and basic survival kits. I went with Mohammed to inventory the medical supplies to be sent the next day. We worked until 6 p.m. putting together all the boxes. Meanwhile, the Paris headquarters was notified and everyone was on board to assemble a medical and emergency logistical team. We also received messages from Médecins Sans Frontières teams in neighboring countries, offering to help. That was very reassuring.

The three days that followed were a race against time to obtain authorizations to enter the area, deal with customs and reserve plane tickets to get the teams to the scene of the disaster. Iranians and NGOs, arriving in force, were swamping the airlines. We also had to meet the international teams, recruit national staff and organize the delivery of medical supplies. The field teams met and gave us a list of doctors, nurses and administrators who were ready to depart.

It was really impressive to see how the Iranians - and the Afghans, too - mobilized. Even our housekeeping staff volunteered. The population showed tremendous solidarity. We received contributions of money, blankets, clothing and food. Our office was turned into a warehouse. It all looked a little bizarre but how could we turn away peoples’ gifts? All contributions were sent out in the trucks carrying medical and water treatment supplies. The office was a real hive of activity. Elham, Mohammed, Pouyan and Cambiz were amazingly resourceful.

In all, we sent off 15 tons of BP5 (protein biscuits) by plane, 6,000 blankets from Dubai, 10 tons of medicine and medical equipment from Médecins Sans Frontières Logistique, 6,000 hygiene and water treatment kits and a convoy of 10 trucks from Baghdad. We hired 33 people for the mission.

Now we really have to get to work. We have to sustain the survivors, provide them with medical care and support them as best we can to ease their suffering and the loss of their loved ones.

Agnès Daniel, administrator, Teheran

Bam, December 26, 2003, evaluation mission
I arrived in Bam the night of the earthquake. I felt like the world was coming to an end. All that was left of the city was a pile of stones. I was immediately struck by the high number of deaths compared to the small number of seriously wounded.

Right from the days immediately following the disaster, international aid organizations and the Red Crescent, in particular, reacted quickly and efficiently. Many well-functioning health centers were set up quickly. Hospitals equipped with emergency and operating rooms were organized at different sites around the city.

Médecins Sans Frontières’ response to the disaster was not to provide emergency care that others were in a better position to handle, but to offer general primary care. Small teams went out to areas far from the large health centers to care for victims who could not take advantage of the organized medical aid. Along with Azadeh, an Iranian nurse, I went out to the villages on the outskirts of Bam. We stopped in front of every tent, offering survivors our help. One afternoon, an Iranian driver offered to take us in his car to those places where no medical care was available.

We saw more than 80 patients every day. We started working at 7:30 a.m. and continued straight through, without a break, until 6:30 p.m. We saw many problems linked directly to the earthquake like trauma, wounds, lung infections from dust and gastritis due to stress. Another part of my work involved caring for people with chronic illnesses. Many patients with asthma, diabetes, hypertension and epilepsy no longer had access to their daily treatment.

Finally, thousands of people had lost family members or others close to them and were suffering from post-traumatic stress syndrome. We have to be there to listen and treat their psychological problems.

For all these reasons, I am determined and motivated to continue this mission.

Eric Vanhalewyn, doctor on first mission, Zahedan

Sunday, December 28
I left Paris with a doctor. We arrived in Teheran at around 3 a.m. on Monday morning, December 29. We went to the national airport to take a plane to Bam. The plan was carrying impressive numbers of people and amounts of aid supplies. It reached Bam around 1 p.m.
The tarmac was covered with cargo planes, helicopters and vast amounts of aid from various countries. A few tents were set up around the airport. In the crowd, we could make out the Iranian Red Crescent as well as the Iranian Army. There was a stream of journalists with cameras on their shoulders to film a body left there to be evacuated.

Tuesday, December 30
In the stadium at the center of Bam, Iranian authorities brought together all the outsiders who had come to provide aid - the United Nations unit, firefighters, civil protection workers (from different countries) and the press. Surrounded by this overwhelming deployment of aid, I began to understand the breadth of the disaster.

Wednesday, December 31
The mobile team organized home visits to Baravat, a city of 17,000 inhabitants between Bam and the airport.

Of 75 families gathered in 16 locations (392 people), 74 wanted to remain where they were, preferring to live near their homes and fields. All the families have tents, with an average of 5 persons per tent. In general, we observed that the victims had received enough food (canned tuna, beans and bread) but were asking for fresh products (rice, oil, eggs and sugar). The Red Crescent distributed blankets. The victims were requesting soap, toothbrushes, toothpaste, detergent, heaters and fuel.

Drinking water was distributed systematically but there wasn’t enough water to bathe or wash clothes. Overall, medical needs in the area on the right side of Baravat (coming from the airport) are covered, with a mobile mental health clinic and hospitals (equipped with radios and operating rooms). The illnesses we encountered were largely colds, muscle pain, small wounds and immense psychological distress.

Thursday, January 1, mobile medical team on the northern outskirts of Bam
Of 25 families (around 238 people), 15 want to remain close to their homes and several families have left to join their relatives. All the families have tents, with an average of 5 persons per tent.
Isabelle (nurse) and Behdad (doctor) have conducted 18 patient visits. Of those, 2 people were referred to the hospital for fractures and infections. There are enough blankets, food and drinking water but half the families lack water for washing and bathing. They also need warm clothing. BP5 (protein biscuits) were distributed systematically to all children under 10 as a meal supplement. The area has good medical coverage (mobile clinic and a permanent health center) and appears to have received more aid, hygiene kits and heaters.

During our visit to this area, we went to three clinics, where between 40 and 150 patients are seen daily. Most of the problems are respiratory infections, pharyngitis, pneumonia and colds but also include infected wounds that require suturing, a few cases of simple diarrhea and extensive psychological distress. In addition, patient visits are increasing.

The city of Bam is located in the heart of a magnificent palm grove in a wealthy agricultural region overflowing with oranges and dates. Bam’s residents lived in large, beautiful houses with gardens.

Iran’s health system operates effectively. Health workers are knowledgeable in the area of disaster care and aid to victims. The Iranian Red Crescent has done a good job of meeting the needs, but rumors and criticism tend to fly under extreme circumstances and there are still shortages. The victims complain primarily about the cold (the temperature has fallen below zero) and the difficulty of obtaining personal hygiene items.

Friday, January 2
I visited the city’s periphery again with Isabelle and Behdad. We have the feeling that survivors are beginning to become aware of just how horrible the situation is. They are completely distraught and depressed. After receiving emergency medical assistance, the Bam survivors are coming to realize, little by little, that they cannot remain forever in front of their ruined homes. But they still hope to find the bodies of their loved ones beneath the ruins and do not want to go to the camps organized by the authorities.

Here are a few quotes from survivors’ stories drawn from the thread of our encounters. I present them just as I heard them.

“I was saved thanks to my work. From Monday through Friday, I’m at my workplace in Kerman (ed. note: around 180 km from Bam). I heard the terrible news on the radio. When I got back to my house, I found 28 bodies. That was my family. I buried them.”

“I remember the first tremor. I suggested to my wife, my parents and my children that we spend the night outside. My wife said, ‘If God wants us to die, that’s his decision.’ Today I’m the only one left.”

A man showed us the tent he was sharing with three other men. “We’re all in the same situation. We’ve lost wives and children. Solitude is now part of our lives.”

“I was overwhelmed by the tragedy. The horrible news made me sick. Our magnificent citadel was the pride of our country, Iran. Today it is only a memory.”

A young girl told us that she was visiting with her aunt outside the city when Iranian television announced the earthquake. They decided to return quickly to Bam. When they reached her parents’ house, emptiness had replaced life. Since then, she has spent every day in bed, without eating, drinking or speaking. It’s as if she weren’t a person anymore, but a little doll.

Saturday, January 4
Our mission is becoming clearer, even if it is still difficult to determine specific needs. We have:

a permanent clinic, under a tent in a school courtyard, in southern Baravat, with two doctors;
a mobile clinic staffed by a doctor and a nurse, traveling throughout central and southern Baravat;
a psychological support center with two psychologists, set up in four tents near the citadel in the old quarter, in collaboration with the Ministry of Health and the Red Crescent;
finally, water supply and treatment aid (toilets and showers, to be confirmed).

That’s a taste of what is taking place here. I want to add a few words about the sadness we feel as we look at this ghost town. Bam, with your citadel gone, you have lost your former elegance. You resemble a battlefield ravaged by bulldozers. Only the skeletons of your houses remain. Your gardens have been turned into dust by the earthquake. Your citadel has collapsed like a child’s sand castle. Waves of tears are flooding the eyes of Bam.

Zouina Bouda, communications officer

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