'I was itching to help'

A rickety old bus took me to Nagapattinam town, district headquarters. I quickly found accommodation. Next stop, the Collectorate.

The collector is the top official in a district, usually a member of the Indian Administrative Services (IAS). The collector's house had been hit. His work was being shared with a notably competent collector sent by the government from another district.

The large, imposing Collectorate building was buzzing with activity. Marquees in the grounds, with banners and plastic chairs, housed volunteers. A white board displayed statistics. Seventy-three villages were hit in the district, with 19,6184 people and 36,860 houses affected. Over 6,000 bodies had been recovered, and over 5,000 dead cattle. 91,036 people were being housed in 96 relief camps. I was itching to help.

A policewoman was at the enquiry desk. I asked her where I could find the relief team from the Christian Medical College, Vellore.

"All doctors report to the Deputy Director of Health Services," she answered.

"He allocates duties to them. You can try at the DDHS office. It is only a mile up the road."

I trudged there in the merciless heat. I asked for the DDHS. A man asked me to write my name on a slip of paper, I wrote: "Dr Joel Almeida, Public Health Specialist".

A young doctor introduced himself as a Health Officer. The DDHS was out, he explained.

"Are you a public health specialist?" he asked.

"Yes. I've come from the UK to volunteer. I'm looking for the CMC Vellore relief team.

"We need you here," he said. "You can help us to plan the disease surveillance. Don't go out to the clinics. You'll just be handing out tablets. In any case, we know nothing about the CMC Vellore team. You are a public health specialist, aren't you?"

"Yes. I worked for the World Health Organisation," I replied.

"Good. Give me your mobile phone number," he demanded.

"I don't have a mobile phone," I confessed.

"Get a mobile phone," he ordered. "Come back here at 6.30pm. We have a meeting with the Additional Director of Health Services and DDHS, to plan disease surveillance."

After acquiring a mobile, I rushed back in the twilight. On the way, I saw a French medical team who had brought about $500,000 of medical supplies.

The DDHS was in, but sitting quietly to one side while an important official occupied his chair and held court. Mr Important showed me the proposed data collection form for disease surveillance. It seemed to have been lifted from a textbook. I chose my words carefully.

"This is very thorough. It can be tried and improved with experience," I said.

Mr Important smiled. A large mosquito landed on me.

"Are the mosquitoes malarial?" I asked.

"Certainly," he smiled back.

I got out my insect repellent and started applying it. There had been no time to arrange tablets before I left the UK. A man came in with forms.

"Why do you write 'typist' here?" Mr I barked. "You should write 'stenographer'. Look, we have visitors from England. We have to do things the international way. Order 100 tubes of insect repellent," he said.

The next day I set off to meet Dr S, a GP whose private clinic is close to one of the worst-hit beaches.

On the train to Nagapattinam, he had described to me the immediate aftermath of the tragedy.

People lay shell-shocked on the beach, beating their chests and tearing their hair in grief.

The mortuary at the primary health centre collected over 100 bodies, mostly young children. Many had been flung into thorny bushes and suffered lacerations.

The doctor used all the tetanus toxoid injections available. But people were more concerned about their missing children fisherfolk who would pay him in fish rather than cash. They usually came to him for anaesthetic injections to ease stings from sea creatures. Now, in 10 minutes, their lives had changed forever.

I found his house. We set off for the school where hundreds of survivors were being housed and fed.

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