Life on the Mean Streets

Dr. Peter Meade pedals his bicycle to work and points out the sights along the way.

“That building was bombed,” he says as he tools down Jaffna’s cratered, rubble-strewn streets.

“There,” Meade says, gesturing toward a wall shot so many times it looks like a waffle. “Some guy had fun with a machine gun.”

Meade turns a corner, pedals.

“This is the train station,” Meade says, pointing to a collapsed building. “There are land mines in there. It’s a landmark--of sorts.”

So begins a typical day for Meade, a Los Angeles surgeon and San Pedro resident on one of the world’s more unusual sabbaticals. Meade, director of the surgical intensive care unit at Martin Luther King-Drew University Medical Center, is spending three months in a bombed-out, machine-gunned shell of a hospital short on supplies and crowded with the casualties of Sri Lanka’s civil war.

For Meade, 45, his volunteer work with the relief organization Doctors Without Borders offers an opportunity to succor the sick in a purer way in a place shorn of First World comforts and quick fixes. At the same time, by teaching his peers surgical techniques learned back home, Meade is leaving something behind--and learning something about himself.

“In L.A.,” says Meade, “I take the freeway to work, I talk on my cell phone. I’ve got e-mail, TV, a stereo. You get separated from yourself.”

As he speaks, the doctor walks into a building with holes in the ceiling, crumbled walls and shattered windows. It is the hospital’s maternity ward.

“Here, what you are left with is yourself.”

*

Meade, at the end of his stint at the Jaffna Teaching Hospital, has stepped into one of the world’s most bloody and intractable wars.

Until recently, Jaffna was under the control of the Liberation Tigers of Tamil Eelam, a rebel group claiming to represent Sri Lanka’s Tamil-speaking minority. The Tigers, as they are known, are trying to set up their own state in the northern part of Sri Lanka, which is dominated by the Sinhalese-speaking majority. More than 50,000 people have been killed since the war began 15 years ago.

In 1995, the Sri Lankan army moved in, and the battle left Jaffna ruined and dangerous. Hundreds of land mines lie hidden in the roads and fields. Buildings--raked by bullets, gutted by fire--creak toward collapse. At night, Tiger guerrillas sneak into the city to ambush troops.

At the same time, thousands of people displaced by the battles are coming home, stricken by malaria and tuberculosis, trying to rebuild their lives in a city that has only flickering electricity, almost no phones and only a handful of buses and cars.

Meade recalls the day Doctors Without Borders called to ask him if he wanted to go to Jaffna.

“Where’s that?” he asked.

He arrived in early November, aboard a Red Cross boat that is one of the few modes of transport not regularly under fire by Tiger guerrillas.

Each day, the doctor walks the dilapidated wards, chatting up patients as he instructs his fellow surgeons. Patients with conditions common to every hospital--diabetes, cancer, hypertension--mix with those struck down by the war.

Of the patients who die here, Meade says, most perish from gunshot wounds. But Meade is a trauma surgeon at a Los Angeles hospital that receives as many as 1,000 gunshot victims a year. He says he can handle the worst Jaffna has to offer.

“We have a lot of trauma here,” Meade says, “but nothing like what we have at King.”

Meade walks to the bed of a middle-aged man whose right leg is missing beneath the knee--blown off by a land mine. The doctor prescribes antibiotics and flashes a thumbs-up sign. The man’s blank eyes blink in response.

Since May 1996, at least 119 people in Jaffna have lost their lives or their limbs to land mines. Most of the victims end up here. After just a few weeks in Sri Lanka, Meade has become an expert on land mines, drawing up maps of where they lie and helping organize a program to inform Jaffna residents of their dangers.

Meade was born in Rochester, N.Y., one of seven children raised in a Roman Catholic home. His father worked on a General Motors assembly line.

A graduate of Notre Dame, Meade started his medical studies in Mexico and returned to the U.S. to graduate from Albany Medical College in New York. In 1988, he began working in the trauma ward of King-Drew Medical Center, where he’s been ever since.

Dr. Edward W. Savage, medical director at King-Drew, said Meade either works or is on call nearly every day of the year.

In his spare time when he is in L.A., he flies to Mexico with Orange County-based LIGA International, a group of volunteers who provide free medical care to villagers. He also works with Mission Doctors Assn., a Los Angeles medical charity.

“Peter is a devoted and committed physician, beyond being a nice guy,” Savage said. “The first thing I thought of when he told me he was going to Sri Lanka was, ‘How am I going to cover for the guy?’ ”

He’s the same in Jaffna, his colleagues say.

“He works all the time,” said Dr. Claudette Bardin, a French Canadian pediatrician who is also working in Jaffna for Doctors Without Borders.

*

Meade stands under a porous ceiling at the bullet-scarred hospital, where he works and reflects on the people who come here.

“Nobody fakes it here,” he says. “Who would want to be a patient?”

In the fourth hour of surgery to reconnect the artery of a man whose thigh has been blown open by an AK-47, Meade pauses, holding the man’s pink artery between forceps.

“Just like L.A.,” he says, his voice muffled by his white surgical mask.

As Meade strolls the open-air halls of the hospital, he recounts some of the more intense moments he’s experienced since arriving.

There was the 16-year-old boy who found a small box floating in the Jaffna lagoon and carried it home, thinking it contained treasure. As his family gathered around, the boy tried to open the box with a hammer. It exploded, killing his sister. The box was a land mine.

There was the night when a group of men asked if they could bring in a wounded friend through the back door, without registering. When Meade insisted that the wounded man sign according to the rules, his friends took him away.

“He never came back,” said Meade, who suspects the man was a Tiger guerrilla. “I don’t know what happened to him.”

When his day is over and he returns home, there is the regular rattle of machine-gun fire outside the Doctors Without Borders house. Not long ago, he and his two roommates, both French volunteers, went up to the roof to watch the explosion of artillery shells.

Now walking into the children’s ward, Meade pauses to greet a few kids before stopping at the bed of a 10-year-old boy. Days before, a wall collapsed where the boy and his brother were playing. The boy pushed his brother to safety but could not escape the falling wall.

“His leg broke backwards, and the bone severed his artery,” Meade says.

The boy is sitting up on his bed, whimpering over his scar, but Meade is pleased he has a leg at all.

“I have taken off so many legs from mines, it was nice to save one,” he says.

During the operation, Meade had to work with faulty, outdated instruments. The Jaffna Teachers Hospital is short of almost every medical necessity, from surgical gloves and muscle relaxants to oxygen and EKG paper. X-ray stills hang to dry on a clothesline.

“If this hospital was in the U.S., it would have been closed a long time ago,” Meade said.

*

At King-Drew, as in Sri Lanka, Meade enjoys instructing resident surgeons on the intricacies of their tasks. He has won several teaching awards, many of them conferred by the students. Dr. Arthur Fleming, director of trauma and chairman of the department of surgery at King-Drew, recalls that Meade once used a $5,000 teaching prize to buy textbooks for his students.

When he leaves Sri Lanka, Meade says he’ll ship medical textbooks to the doctors there.

“I’ve never known such grateful students,” he said.

Meade is walking home, pushing curfew. The sun is going down over Jaffna, and its pocked streets are nearly empty.

“Here’s a land mine survival tip,” he says. “If you walk on the asphalt, you will probably be OK, because they can’t get them under there.”

He passes in front of a group of schoolboys.

“Hey, how ya doing?”

The kids return the greeting and dissolve into giggles.

When Meade gets home, he will sit in the communal living room and discuss his day with his roommates, as he has done every night for the past 10 weeks.

“People talk about wars, but it’s not the battlefields,” he says. “It’s about people, the suffering of people.

“This is what war does.”