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Thai nurse Pakamas Boranbubha examines a young girl’s injured mouth as her family looks on.

These days, the ocean laps calmly against southern Thailand’s shores. The sun sets on quiet beaches; the air smells tropical. This is what people love, why they call it paradise.

No one expected a schizophrenic sea to rise against the coast the day after Christmas, swallowing people, homes, hotels, boats, everything. There was no master plan for the aftermath. No hospital blueprints, no step-by-step guides telling nurses and doctors how to handle more than 8,400 injured and 5,000 dead.

“I was ready for the conditions, but what scared me: so many dead,” says Sripoapai Lunanithikul, RN. As head of emergency nursing at Wachira Hospital in Phuket, a Thai island that attracts more than 3 million tourists each year, she helps her staff train for plane crashes, ship wrecks, fires, floods. “Every kind of accident,” she says. But not on such a monstrous scale.

Immediately after hospital staff heard about the deadly waves, Lunanithikul says, they called around the country for help. “Doctors, nurses and other departments all came right away.” Within minutes, health workers were dispatched from Bangkok, far-away provinces, private hospitals, the Navy. “We had many ambulances from other places.”

Foreigners came, too. “It’s been an amazing response,” says Kate Baldor, RNCS, an instructor at Worcester State College in Massachusetts. She was vacationing in Bangkok when disaster struck. When the news broke, she hooked up with an international relief team and headed south.

Baldor landed in Phuket, at an airport-hangar-turned-relief-center for patients awaiting evacuation flights home. “We have had fresh water, food, everything we’ve needed,” she says. Everywhere, supplies: empty beds with IV drips, trunks of medications, stacks of bottled water, a table full of noodle cups, fried chicken and rice, water hot and cold, drink boxes, apples, backpacks. Amid all this, a female patient with a patched up leg is wheeled down the ramp and lifted into an ambulance, en route to an evacuation flight headed for Germany.

Helping hands

By most accounts, Thailand has been lucky throughout — plenty of love and compassion, quick hands and sharp thinking, food and water readily available, working phones and computers, medicines on hand. Baldor calls the relief effort “oversupplied rather than undersupplied.” The worst of life rallied the best of people’s spirits.

Many of the first workers on scene had no medical training, but did what they could to help the injured. “There were thousands of helpers,” says Walter Dreier, an Austrian with no medical background who spent days picking through muck, searching for bodies in Thailand. “They say if this happened in Austria, they are not sure they could handle it like the Thais.”

He witnessed the transformation that followed in the disaster’s wake. Aid stations sprouted from ravaged fields. Government offices became meeting points, and hospital waiting rooms turned into telecommunications hubs. Ingenuity was the rule.

And ingenuity became the nurse’s mandate — bridging language barriers and diagnosing in the field, without tools. Lunanithikul says preparing patients for 12-hour flights to Europe required imaginative thinking. “We just improvised,” she says. “When they were very sick, they couldn’t get up. We didn’t have enough urine bags, so we had to modify. 85 We tied a bottle around a man,” while female patients were diapered.

Menstruation pads also ran out, so nurses purchased more. “I bought my own thermometer, towel, everything for the patients,” Lunanithikul says. One diabetic patient lost her medication, so “I gave her mine.”

She also played host to doctors and nurses who had come to Phuket from afar. That meant buying dinners — lots of them. She plucks a restaurant receipt from her purse, totaling 6,200 baht. That’s about $105, an exorbitant amount of money for food in Thailand. But that’s Thai hospitality.