Sumathy Pathy, MD, a family physician with a solo practice in Bellevue, Wash., has temporarily closed up shop.

In early January, little more than a week after the tsunami in Asia filled news outlets with stories of thousands dead and millions homeless, the doctor traveled to her native country of Sri Lanka to do what she could.

We needed to take action immediately," said Dr. Pathy.

The journey was far from easy. Because she had to travel on such short notice, she had to hopscotch around the globe before reaching her destination, the Sri Lankan capital of Colombo. The medication she carried, gathered from her own and fellow doctors' supplies, nearly pushed her over the 70 lb. luggage limit, and she ran the risk of jeopardizing the viability of her newly opened practice.

"It's not very good to leave a practice, but I have to make this choice," said Dr. Pathy. "They need me."

She's one of many physicians who went to Asia to provide medical aid in the aftermath of a disaster that was almost incomprehensible in its scope.

"This being the greatest disaster of our time, we are going to do our part," said Gary Morsch, MD, MPH, a family physician in Olathe, Kan., and president of Heart to Heart International. "The aftermath is horrendous for the millions of people who are left behind. They're sleeping in the street or under trees, and they don't have clean drinking water. Food's contaminated. It's a huge public health disaster."

Heart to Heart International provides medical volunteers and pharmaceuticals for areas around the world caught in disasters. Dr. Morsch traveled to Asia in early January with dozens of other volunteers and $5 million worth of donated supplies.

Finding ways to meet a desperate need
Most disaster relief experts say, however, that, although they are grateful for volunteers and goods, what the region needs most is cash.

"What organizations prefer is money. They can translate money into needed people and supplies much more effectively than transporting the same over great distances. That's just the nature of the game," said James J. James, MD, DrPH, MHA, head of the AMA's Center for Disaster Preparedness and Emergency Response.

After this disaster, most medical charities received more requests for volunteer postings than could be accommodated, but volunteers are usually vetted and trained for difficult situations long before incidents such as this occur. Most who ultimately go have experience working in the region.

"Particularly in emergency situations, we try to use people who have had experience because it is a complex environment," said David Olson, MD, medical adviser for Doctors Without Borders-USA.

For example, Dr. Pathy is not just from the area. She also has long worked with the International Medical Health Organization, the nongovernmental organization working towards improving Sri Lanka's health infrastructure. Dr. Morsch has also volunteered in the affected areas numerous times over the years.

Meanwhile, the World Health Organization has appealed for $60 million to provide relief over the next six months. Doctors Without Borders received $40 million earmarked for tsunami aid, which the group has deemed sufficient for its efforts in this area. Now the organization, though still asking for donations for their other work, is suggesting that tsunami-specific money be directed to other charities, most of which continue to face desperate hardship.

"We all need to spend large amounts to help people meet their immediate and more long-term need," said Iain Simpson, a World Health Organization spokesman. "As for donations of medical goods, these can be very useful but need to be carefully chosen and coordinated. Some can be incredibly valuable, but many medical goods can be more efficiently and cheaply bought locally," he said.

In order for physicians to make a distinct contribution, in addition to usual donations to one or more of the numerous humanitarian organizations now providing relief work in the area, organized medicine is stepping forward to help. Numerous medical societies have sent their condolences and offers of assistance to their equivalents in the region, but several are also acting as funnels for relief money.

At press time, for instance, the AMA was considering steps that would allow it to accept donations earmarked for Asia. It is also working to streamline procedures to enable its Center for Disaster Preparedness and Emergency Response to respond more rapidly to international catastrophes and allow the organization to be an even greater resource for physicians who want to contribute, time, resources or money.