COLOMBO, Sri Lanka — The two doctors are adrenaline junkies who thrive on their daily dose of medical and emotional trauma inside a busy Bay Area emergency room.
But stepping off a plane Monday evening into the humid bustle of this seaside capital, Mark Stinson and Neil Jayasekera were confronted with an even more manic, seat-of-the-pants style of delivering medicine.
Tired and dirty and 9,000 miles from home, they became two more wide-eyed foot soldiers in the international aid campaign launched in the wake of the devastating magnitude 9 underwater temblor and resulting tsunami that have claimed an estimated 150,000 lives across southern Asia and left countless others injured or homeless.
Responding to what they call the worst natural disaster of their lifetimes, the two friends enlisted with Relief International, a small Westwood-based humanitarian aid group. They joined thousands of people worldwide who have volunteered in the disaster aid effort.
On New Year's Day, Stinson and Jayasekera hurried from their 10-hour shifts at Contra Costa Regional Medical Center in Martinez, Calif., to begin their 30-hour journey to this island nation.
Their immediate goal was to bring medicine and expertise to survivors and help pave the way for a long-term aid program.
But standing in their way is a host of logistical hurdles, including land mines planted in some outlying regions by the separatist Liberation Tigers of Tamil Eelam. Even before the tsunami, there were numerous infectious diseases here that are considered nearly extinct in most of the developed world. And the corpses that litter many coastal areas of this impoverished country, some say, could also pose health risks.
Looming is the specter of such diseases as cholera, dysentery, malaria, encephalitis and dengue, a potentially fatal illness that can cause swelling of the brain and shock due to bleeding. Some infections could be spread by contaminated water or poor sanitation, others by mosquitoes and other airborne insects.
The physicians fear that such diseases, if allowed a footing, might cause another wave of death and panic.
"We still don't know the real needs of the survivors here," said the 46-year-old Stinson, a lanky man with hiking shoes and a graying beard. "We won't know until we get out into the field and see for ourselves."
But an e-mail Stinson recently received from a fellow physician in Sri Lanka offered a clue to the dire need: "Send suitcases of antibiotics," the note urged.
The story of the two doctors illustrates the challenge facing one small relief agency among hundreds that have brought assistance to southern Asia. With an annual budget of less than $10 million and a decade of experience in similar disasters, Relief International (www.ri.org) is dwarfed by groups with 10 times its funding that can dispatch scores of aid workers. Relief International has sent half a dozen or so, including Stinson and Jayasekera.
Championed by prominent people such as Kitty Dukakis, the wife of former Massachusetts governor and presidential candidate Michael S. Dukakis who sits on its board of directors, Relief International in the coming months will take part in the sometimes hardball competition among aid groups seeking a share of the pot being filled by the United States, Japan and European nations.
Over the next two weeks, Stinson and Jayasekera are expected to visit clinics and shelters in hard-hit areas of Sri Lanka, which is roughly the size of Ireland. Consulting with local doctors and treating patients, they will make recommendations about which potential projects the agency should pursue.
The two doctors bring different motivations to their task.
For Stinson, a veteran of Relief International campaigns in Iran, Afghanistan, Kosovo and India, the urge to respond was immediate -- like answering an emergency call back home.
Jayasekera, the 42-year-old son of a Sri Lankan expatriate, had not volunteered before. The decision came slowly as he continued to watch horrific TV images from the island nation that contrasted sharply with the magical stories his father had told him about the former Ceylon, which had been known as the Pearl of the Orient.
"This is the biggest national disaster I'll ever see in my life -- a huge earthquake sends waves all the way to Africa and devastates my father's homeland," Jayasekera said. "This is why I went to medical school. I knew I had to go."
So Jayasekera called Stinson and announced his intentions, even if he had to pay his own fare. Stinson hooked his friend up with Relief International, which decided to send a mission to Sri Lanka, in part, for the contacts that Jayasekera could provide through distant relatives.