As we’re standing with the Mercy Corps and Sewalanka team, discussing the sort of support they might offer the fishermen and net makers, one of the men steps forward. He’s wearing a clean white shirt and resembles Walter Matthau. He has no special request; he simply wants us to know that he has lost everything.

“My son, my daughter, my wife and ” But the fisherman cannot finish his sentence; he breaks down in sobs. All around me, fishermen fight back tears; I succumb. It is another one of those moments when the sheer force of loss hits me like a physical blow. I put myself in this fisherman’s place and wonder if I, after losing everything that gave my life joy and structure, could begin to rebuild after three short weeks.

During lunch at the Siam View, I ask Dominique Kerr, a member of the French Red Cross team, about patients in the infirmary. “We’re not seeing a lot of injuries anymore,” he replies. “Most of what we’re dealing with now is post-traumatic stress disorder.” What’s interesting, Kerr remarks, is that the men, women and children all manifest the syndrome with different symptoms.

“For children, the main thing is fear of the sea,” Kerr says. “They won’t go near the water. For women, they can’t sleep. When they come in, they tell us everything is fine — but soon the truth comes out. They are just not sleeping. For men, it is different. They come in, claiming to be sick and looking sick. But they are not sick; there is nothing physically wrong with them. Then we know it is the post-traumatic stress.”

Our next destination is the town of Baticalloa, 75 miles to the north. Just above Pottuvil, we pass through the ruins of Komari village. Aside from the cleared road, there are no signs that anything has changed since the tsunami. Walking through the empty place, past broken bicycles and torn Bibles, is like being in a hamlet after the plague. Waves break in the background, the occasional coconut falls to earth and bursts on the ground. Otherwise, all is silence, an otherworldly quiet that seems to call for an echoing silence.

After exploring Komari, I ask our driver to backtrack half a mile, to the Finnish Red Cross field hospital. The clinic serves the Komari camp, where we recently distributed footballs and Frisbees to the heirs of the ruined village. At the mobile hospital, I find Dr. Johannes, a white-haired surgeon who spent much of his career working in Cambodia with victims of the Khmer Rouge.

“Everyone here has post-traumatic stress,” Johannes emphasizes. “Yesterday, for example, a woman came in with all the signs of a gastric ulcer: the kind often created by stress. People are coming in all the time, claiming body pains, but when you look, there’s no cause for it. A man came in with severe pain in his knee and we checked him carefully: nothing, nothing, nothing. Nonetheless,” he says, “they seem to improve when you examine them, and listen to them.”

The only effective way to treat people for this condition, he claims, is to talk to them. Just having the medical camp present is a comfort, but the main problem is language. “You can bring in as many psychosocial counselors as you like,” says Johannes, “but if you don’t speak their language, you can forget it. This, I learned in Cambodia.”

Kids, on the other hand, are more nonverbal. “They respond very well when they are given a doll or a stuffed animal,” Johannes observes. “Something they can care about, and protect. It makes them feel stronger, themselves.”

Our drive up the coast toward Batticaloa is interrupted by numerous detours and backtracks. We’ll pass through a town and travel five rough miles up the half-collapsed road, only to find the bridge down. Illustrated with fierce clarity is the sheer breadth of the killer wave. The entire coastline of Sri Lanka is a wreck. Sometimes the damage lies right at the shore, sometimes it extends far inland, but it is nearly universal. Many houses of worship — Buddhist, Hindu, Christian and Muslim — were spared but not all. Just north of Thirrukovil we find a Hindu temple hit by the tsunami. Colorful statues and bits of paintings lay scattered across the roadside like an exploded bouquet.

It makes me wonder, again, if I would have understood — when the water rushed out, exposing the seabed — what was in store. The truth is, I don’t know. None of us had any sense of what precedes a tsunami, as there haven’t been any this severe during our lifetimes. Disaster movies don’t show the water receding; a huge wave simply rushes in, tossing taxi cabs and billboards down the street. Would I have run out to marvel at the exposed reef or run in the other direction? There is no way to reckon whether I’d have been saved by my intuition or killed by my curiosity.

Batticaloa, about a third of the way up Sri Lanka’s east coast, is the Club Med of the relief world. We spend our single evening in town at Sabharaj, the only open restaurant in Batticaloa packed with expats. The culture shock nearly does me in. I’d forgotten what a circus the aid world can be, when scores of organizations are jockeying for position within a convoluted, often chaotic environment.

Amid the crowded tables and clouds of cigarette smoke, I meet a petite, athletic-looking woman named Isabel. She’s just arrived, charged with directing the French team of Médicins Sans Frontihres. Isabel has been in the country only one day but she already seems like a victim of relief burnout.

“We closed our office in Trincomalee yesterday,” she says. “There was nothing for us to do. Even here in Batticaloa, I don’t yet know where we can be of use.” Several days ago, she reminds me, MSF controversially asked (on its Web site) that people no longer donate money for tsunami relief; there are other global crises with an equal or greater need. Isabel agrees with the statement. She’s fed up with the present situation, with dozens of overfunded relief agencies tripping over each other. They’re duplicating efforts like medical care, she says, while falling short on long-term needs like rebuilding the economic bedrock of the community.

I sympathize with her frustration. Three weeks after the tsunami, much of the relief community seems in a state of disarray, with less coordination and cooperation than one might expect. Nothing is going to waste — whatever comes in is being distributed — but there’s an inequality of distribution, which can lead to anger or violence. And human resources are being wasted. Doctors are being turned away; groups like MSF are pounding the pavement, looking for places to hang their berets.

Normally, the 100-mile drive from Batticaloa to Trincomalee takes a few scenic hours, but the seaside route is impassable and we are forced to traverse two long inland legs, rather than the coastal hypotenuse of an enormous triangle.

The way is lined with Sri Lanka Army checkpoints, barricades and spools of razor wire. A placid lagoon is surrounded by an electrified fence. They’re stark reminders that, during the decades before the tsunami, Sri Lanka was already wracked by waves of violence. Even the disaster has not brokered a truce between the Tamil separatist movement and the Sinhalese government. The LTTE, or Tamil Tigers, accuse the government of shortchanging them on relief supplies and using the disaster as an opportunity to infiltrate their operations. The government, for its part, accuses the Tigers of hindering its shipments and using the tsunami as an attempt to build political capital.

The temptation to use the tsunami for political ends is clearly irresistible. We’ve already seen this with the JVP, Sri Lanka’s once-ruthless Marxist party. In the 1980s, the government launched an all-out war on the JVP, killing thousands of their soldiers and obliterating their leadership. The JVP has since reformed, and is now a legitimate, if marginalized, political player. But now the party is emerging in force, sending huge cleanup crews into devastated areas. Disasters, I’m learning, are great equalizers. The government dares not stop any effort aimed at assisting the tens of thousands of displaced persons here in Sri Lanka. It’s not surprising that the groups who despise the ruling party are seizing this chance to deliver what the government itself has been so terribly slow to provide: hands-on assistance in the villages hardest hit.

Before the tsunami, Trincomalee was a lovely harbor town, occupied throughout its storied history by a dizzying concatenation of stewards. The Danish, Dutch, French and British have all made landfall here, leaving scattered relics of their reigns.

Today rain falls in sheets, flooding the muddy roads. Tuk-tuks slog through the downpour, water up to their running boards. Every vehicle throws up huge fins of water, drenching the bicyclists and pedestrians unlucky enough to be caught on the roadside. The waves of the Bay of Bengal crash against the ribbon of shoreline, clawing at the wreckage of hotels and beach huts that, last Christmas, lined the loveliest beaches in Sri Lanka. It’s the same destruction we’ve seen everywhere but in a sweeter key.

Nilaweli Hospital is a low white structure located a few miles north of Trinco town, a few hundred yards beyond two of the area’s main refugee camps. Dr. Sahadevam, the medical officer in charge, greets me in his office. Sahadevam is a black-haired, compact man, who has set up shop in a region where the suffering varies only by degree. He, like so many others in this region, is frustrated with the lack of progress dealing with post-traumatic stress.

“I can’t even tell you,” he says. “There are so many cases. Yesterday, a woman was brought in; she couldn’t breathe. Clinically, she was normal. But when she returned to her home after the waves, looking for her parents, she found only her mother’s hair.”

There’s an immediate and desperate need, the doctor says, for psychosocial counselors. “But because Sri Lanka is an undeveloped country, we haven’t built a good supply. Still,” he states, echoing his Finnish colleague to the south, “it is imperative that they speak the languages here. So what we need right now is for foreign counselors to come in, and rather than treat people themselves, train qualified, local caregivers in post-traumatic stress counseling. These workers should be deployed in each and every camp,” he adds. “They are needed everywhere.”

It’s urgent, Sahadevam insists, because, as the shock and denial wear off, some people are blaming themselves for the deaths of their loved ones. Tragically, their sense of shame and guilt is being reinforced by equally shattered peers.

“It’s not uncommon for one refugee to tell another, ‘Oh, if only you had taken your kids to church that day or to their auntie’s house, they would have lived.’”

One of Sri Lanka’s greatest strengths, and perils, is its ethnic diversity. I ask Sahadevam if the different religious groups should be counseled on their own terms by the tenets of their spiritual paths.

“There is no need to counsel in a different way,” he states imperatively. “Everyone looks at the tsunami attack in their own way. But we cannot look at everyone differently. Basically, they are all depressive patients. They must be treated consistently.”

“Are their religious leaders available for counseling and guidance?”

“Those people are not making the rounds,” Sahadevam says. “And the refugees, who are packed together, have no way to get to them. Also, most of the leaders are very involved in the relief effort itself.”

In the mosque camps, the religious leaders are busy compiling demographics and coordinating with the aid agencies. The church is feverishly active as well. At the St. John’s Tsunami Relief and Rehabilitation Center in Batticaloa, an Episcopal reverend known as “Father J” (short for Jeyanesan) is spearheading a multilevel effort that includes orphanages, feeding centers, vocational training and emergency relief supplies. (The popular reverend was already immersed in refugee work, providing for families displaced by the civil war when the tsunami struck. Trained at the Hebrew University in Jerusalem, Father J’s commitment to spiritual integration is immediately obvious; St. John’s is the first church I’ve seen with a Jewish mezuza in its doorway.)

As Dr. Sahadevam speaks, I take frantic notes, wondering if the program he suggests — training counselors, teachers and other community leaders in PTSD skills — is an area where Mercy Corps might help. One of my roles, during the past several days, has been as Mercy Corps’ ambassador-at-large, looking for gaps the organization can successfully fill. “Giving medicine is a one-day game,” he observes. “But dealing with post-traumatic stress is a long-term process.”

While we’re on the subject of medicine, Dr. Sahadevam has one more problem he’d like to discuss. Beginning a few days after the tsunami, he explains, vans full of foreign medical teams have been rushing into the camps, unloading medicine on the refugees.

“What we’re facing now,” he says, “are overdose problems.” Some cases arise, it appears, from attempts to treat PTSD with whatever drugs are on hand. “One girl came in yesterday, doubled over with stomach pain; she had taken 18 Panadols (an aspirin-like analgesic). Another woman took seven antihistamines and fainted. One of the first things these medical groups did was freely dispense powerful antibiotics. Granted, antibiotics were needed; some people had injured themselves amid the debris and there was risk of infection. Now, however, we are seeing reactions to their indiscriminate use: pain, swelling and allergic rashes. And the worst part is, the fevers they gave the drugs for are not subsiding! They’re a viral thing!”

The situation is similar to what’s happening with the political parties; in an atmosphere like this, nobody dares stand in the way of assistance, no matter how self-serving it may be. All foreign aid groups, whatever their origin, have agendas to fill. First, they have to be here, as it would look terrible if they weren’t. Next, they are legally obliged to spend the money donated for tsunami relief in the affected areas. If their mission is medicine, they must find a way to provide medicine — even if the camps are knee-deep in Cipro. The result is a free-for-all, at least as far as drugs are concerned. Ironically, many of the refugees, overwhelmed with drugs, still lack basics like mats, mosquito netting and hurricane lamps.

A structure for coordination exists here in Trinco. Responsible agencies are drawing up needs and sharing their findings with their colleagues. But there are scores of aid groups, and not all of them are part of the matrix. From the refugees’ point of view, the distribution is piecemeal; they have no way of knowing when a distribution is wise or unwise.

The only solution, Sahadevam believes, is to require medical agencies to follow proper channels and coordinate with the Ministry of Health. Beginning next week, he believes, the MOH will visit the camps and tell the camp leaders which NGOs have the authority to give out medicines. The refugees will be cautioned against other suppliers and told what to do. “It’s quite simple,” Sahadevam explains. “When unauthorized people come and offer you these drugs, ‘Just say no.’”

The Republicans in the House are likely to pass a continuing resolution keeping government running for the time being that includes $3.7 billion in offset funding for disaster aid. The Senate’s measure contained $6.9 billion. The latest news is that Rep. Louise Slaughter failed to get the Democratic proposal into the resolution, making it likely that either the House will fail the pass the resolution (many Republicans don’t support it because it doesn’t cut enough spending), increasing the risk of shutdown, or the Senate will stay in session next week and pass it with more disaster aid, forcing it back to the House, where it could fail again.

This is a great way to fund a government, right?

I imagine that the GOP is betting that obstructionism and a potential shutdown will be blamed on “Congress,” generically, and they have learned that they can absorb that hatred and turn it into voter cynicism that leads to increased support for conservatives who hate the government. Reid and the Democrats, meanwhile, will probably cave at the last second to avoid a shutdown. And everyone will say, “oh dear, what is wrong with Washington,” and the answer to that question will remain “Eric Cantor.”

UPDATE: Well, the other problem is “John Boehner,” who is just very bad at his job. The continuing resolution failed 195-230, with Democrats holding out due to the FEMA funding mess and dozens of Republicans voting no because Boehner has no control over them.

Of course Rick Perry doesn’t want to see Texas burn, so it is rational of him to ignore his rhetorical distaste for the federal government and demand that it help. And Texas could use the help, because Perry and the Republicans who control all three branches of Texas government have severely slashed the budget of the Texas Forest Service.

Perry’s fanatical opposition to raising revenue to close Texas’ budget gap meant that his allies in the Legislature had to find creative ways to cut costs, like cutting $34 million over the next two years from the agency that fights wildfires. The Forest Service is mostly volunteer-based, and the cuts will largely affect the state’s assistance grants to buy volunteer departments the tools they need to fight fires.

The Forest Service was appropriated $117.7 million for the 2010-2011 fiscal year. That is not enough to cover the expense of fighting the fires currently burning across the state. For the 2012-2013 fiscal year, which began this month, the agency was appropriated $83 million.

The state has already approved supplemental spending to pay for firefighting that has already taken place, which is also $61 million short of what is needed. So, in other words, the budget intentionally appropriates less money than everyone knows the Forest Service will actually need in order to maintain the illusion of fiscal responsibility. And the Republicans will demand more federal money to make up the gap. While decrying federal spending.

Ken Layne draws a connection between gutting the Forest Service budget and the growing trend of municipal budget slashing done primarily to prove seriousness about the moral necessity of “austerity” in these Tough Times. But Perry’s not allowing everything to go to hell, like the people of Costa Mesa, Calif., so much as he’s requiring fiscal irresponsibility to pay for very basic services, like putting out fires. No new taxes and balanced budgets until it turns out we need money really bad!

The shortfalls in FEMA’s disaster aid account have been obvious to lawmakers on Capitol Hill for months — and privately acknowledged to them by FEMA — but the White House has opted against asking for more money, riling many lawmakers.

“Despite the fact that the need … is well known,” Reps. Robert Aderholt, R-Ala., and David Price, D-N.C., wrote the administration last month, “it unfortunately appears that no action is being taken by the administration.” The lawmakers chair the panel responsible for FEMA’s budget.

FEMA now admits the disaster aid shortfall could approach $5 billion for the upcoming budget year, and that’s before accounting for Irene.

As a result, funds to help states and local governments rebuild from this year’s tornadoes, as well as past disasters like hurricanes Katrina and Rita and the massive Tennessee floods of last spring, have been frozen. Instead, FEMA is only paying for the “immediate needs” of disaster-stricken communities, which include debris removal, food, water and emergency shelter.

“Going into September being the peak part of hurricane season, and with Irene, we didn’t want to get to the point where we would not have the funds to continue to support the previous impacted survivors as well as respond to the next disaster,” FEMA Administrator Craig Fugate told reporters at the White House on Monday.

Republicans controlling the House and the Democratic-controlled Senate may be headed toward a battle over whether to cut spending elsewhere in the budget to pay for tornado and hurricane aid.

A top leader in the tea party-driven House says that chamber will find those offsetting spending cuts. The Senate, however, is likely to take advantage of a little-noticed provision in the recently passed debt limit and budget deal that permits Congress to pass several billion dollars in additional FEMA disaster aid without budget cuts elsewhere.

“We will find the money if there is a need for additional money,” House Majority Leader Eric Cantor, R-Va., told Fox News on Monday. “But those monies are not unlimited, and we have said we have to offset that.”

But Sen. Dick Durbin, D-Ill., who presided over a recent hearing on disaster costs, says the number and cost of disasters have grown dramatically over the past few years.

“If (Cantor) believes that we can nip and tuck at the rest of the federal budget and somehow take care of disasters, he’s totally out of touch with reality,” the No. 2 Senate Democrat said Tuesday.

Earlier this year, the administration requested $1.8 billion for FEMA’s disaster relief fund, despite pent-up demands for much more. Appropriations for last year totaled four times that amount.

FEMA estimates that the request still left the disaster fund short by $2 billion to $4.8 billion for the upcoming fiscal year. Those are figures the agency provided to Congress this spring — before Irene or the tornadoes that destroyed huge swaths of Joplin, Mo., or beat up the South.

With recovery operations from Irene still in the early stages, FEMA spokesman Rachel Racusen said it is too early to know whether that projected shortfall has increased or by how much.

“It’s just too soon to know what any uninsured losses will be,” Racusen said.

“Even though the president himself said that we are going to do everything we can to help these communities rebuild, the rhetoric has not matched reality, and the Disaster Relief Fund is running out of money,” Aderholt said.

The likely vehicle for replenishing the disaster account is the homeland security spending bill for the budget year beginning Oct. 1. The House passed the measure in early June, but the Senate has yet to act.

A House-Senate collision over disaster aid would risk further delays in replenishing dangerously low FEMA disaster accounts.

“It’s too early to tell what the damage assessment will be and what next steps may need to be taken,” said Meg Reilly, a spokeswoman for the White House budget office.

It’s hardly the first time that longer-term rebuilding projects like schools and sewer systems have been frozen out to make sure there’s money to provide disaster victims with immediate help with food, water and shelter. But it’s frustrating to communities like Nashville, Tenn., which is rebuilding from last year’s historic floods.

The Obama White House is just the latest administration to lowball disaster relief requests. Over the past two decades, Congress has approved $130 billion for FEMA’s disaster account. But the bulk of that money, $110 billion, has been provided as emergency funding in addition to the annual budget.

Associated Press writer Alicia Caldwell contributed to this story.