The monks' orange robes flickered like candlelight among the black garb of priests, the cream-colored prayer scarves of rabbis and the American flags of the community agencies who had gathered there to shepherd families through the spiritual crisis and the banal paperwork associated with death.

"The first food you saw, as soon as you walked in, was from the Buddhist Vihara," said William Doyle of Annadale, who within days of losing his son had started to network with other grieving families. "I took hundreds of widows there. We'd always stop there first and all I would say to them was, 'This is such and such, she lost her husband,' and they'd give her a big hug and a kiss and they'd give her a $1,000 check. It took all of about a minute or two."

To give without expecting anything back is key to the Buddhist tradition, said Bhante Kondanna, the spiritual leader of the Vihara in Port Richmond.

"If I stand with you to share your burden, to share your sorrowful event or sad situation, at least you can feel comfortable and think, 'I am not alone; there are people for me,'" he said. "We felt sad when we were watching the towers collapsing. This was like the unsinkable Titanic. That was the image we had, the symbol of New York. We thought that was going to stand there forever."

Three years and four months after the terrorist attacks, the tsunami roared out of the Indian Ocean, killing an estimated 280,000 people, some 40,000 of them Sri Lankans -- the country of origin of most of the membership of the Buddhist Vihara.

9/11 FAMILIES

With the survivors of the tsunami now beset by grief, Sept. 11 families acted on the spiritual precept that out of pain, something positive can still flower -- donating the funds that have been put toward resuscitating a decrepit hospital across the globe from New York.

"I'm watching e-mails come back from so many families saying we want to do more for the Sri Lanka people," said Doyle, who helped found the World Trade Center United Family Group, one of the largest support systems for Sept. 11 families in the country, which has grown increasingly involved in charitable work.

The bond between the Sri Lankans and the Sept. 11 families was deepened by a shared ache that some had no physical traces of loved ones to bury: Victims of the terrorist attacks vanished by fire, and casualties of the tsunami were consumed by water.

"We felt so close to them," said Doyle.

In less than a month, the members of World Trade Center United Family Group amassed nearly $150,000 -- made up of scores of thousand-dollar checks written by families now back on their feet to families whose footing had been washed away.

The donations have gone toward the construction of the "Sept. 11 Families" emergency care wing, slated to open by the end of this year on the grounds of the 100-year-old Moratuwa de Soysa Memorial Hospital in Sri Lanka.

The modern addition will stand out in the complex of crumbling, low-slung buildings, which serves both as a hospital and what is known here as a "medical orphans home" for roughly 150 patients.

It will make emergency care available to the 177,000 residents of Moratuwa, a small city just south of the capital, where the 13,000 people were displaced by the tsunami and 68 people lost their lives, which was largely overlooked by aid organizations targeting more decimated regions.

FINANCIAL NEGLECT

Situated at the end of a long dirt road about a block inland from the beach, the Moratuwa de Soysa hospital escaped direct damage from the tsunami, but it has endured years of financial neglect.

It has become a way-station for patients who might otherwise be cured with the right operation and a home of last resort for those with nowhere else to go.

Most of the wards lack window glass. There is no air conditioning to fight the fierce heat and humidity.

Flies cluster on wounds. Stray dogs and cats play under patients' cots, where straw and wooden planks double as mattresses.

The burn unit is one bed with a mosquito net where physicians apply oil rubs.

An Alzheimer's patient in her 70s, who is too disoriented to feed herself, can only recall that she used to be a beauty queen. She was found wandering nearby streets and brought here to stay indefinitely. Her eyes are filmy, like raisins bloated in water.

On a cot nearby, another patient with a sharp smile and wispy, white hair recently lost one leg below the knee and probably will lose the other to gangrene. Her wooden prosthetic is almost too heavy for her twig-thin arms to lift.

Until the emergency room equipment arrives and the wing is functioning, the residents of Moratuwa must travel in the hospital's only ambulance to Colombo for urgent care -- a journey that can take as long as two and a half hours in rush-hour traffic.

Trauma victims and patients in acute cardiac arrest sometimes do not make it through the ride.

"This new building is great assistance from 9/11 families," said Cooray Vidyashekhara, a soft-spoken man who has volunteered at the hospital for over 20 years, as he watched barefoot construction workers sift sand to make cement to be used for the Sept. 11 Families Emergency Room -- the shell of which is nearly complete. "We were shocked when it [the terrorist attacks in New York] happened and had America in our consciousness."

HOSPITAL WING

The hospital wing will have 12 beds reserved for emergency care patients. An X-ray wing adjoining the facility is being constructed next to the building, donated by a French medical organization.

Government and humanitarian organizations have pledged to purchase electrocardiogram machines and a battery of additional medical equipment.

The infusion of aid might return some dignity to the hospital, which is now the picture of slipping government attention.

According to the most recent data from the World Health Organization, the Sri Lankan government spent the annual equivalent of $35 per capita in 2004 in its health care budget, where universal coverage provides basic care for all residents.

Even so, the funding stream varies from region to region, and the amount of money for local hospitals shifts with the political tide.

While some Sri Lankan provinces saw increases in public health dollars in recent years, the overall budget to care for Moratuwa residents dropped by nearly 70 percent between 2000 and 2002, according to a report issued last year by the Institute of Policy Studies of Sri Lanka.

The region was allocated 6.7 million rupees ($67,000) in 2000 for health care, but two years later received just 2.2 million rupees ($22,000) from the government. The capital budget to maintain the hospital's buildings practically evaporated -- going from 570,000 rupees ($5,700) to 91,000 rupees ($910).

"After the tsunami, it's been even less," said Vidyashekhara. "Everybody went to help other places that were more damaged .... We could have helped so many more people [after the tsunami] if we had this assistance then."

TSUNAMI INJURIES

More than 500 injured Moratuwa residents flocked here after the tsunami chewed apart the beach communities.

The bodies of those who perished in the calamity were laid out on concrete because space had run out in the morgue's two small freezers. Patients slept on the floor of the wards, sometimes waiting days for care because there were not enough supplies or staff to tend to them.

P.D. Nanaka, a former maintenance worker with chiseled cheekbones and thick, youthful lips arrived at the hospital with a crushed hand, after his bedroom wall had fallen on it in the tsunami.

He waited a week in the overcrowded ward, watching his hand swell and darken before doctors performed the first operation. When his condition did not improve after several days, they scheduled a second surgery, he said.

"After I was in the bed and I woke up and no hand. I was screaming," said Nanaka, 30, straining to contain tears as he explained that, at the time, he didn't know they intended to amputate. "I could not eat for six months after because I had bad dreams."

He has come to depend on his brothers and sisters to support him because seeking work is too humiliating a task.

"People always look at me and say how can we give you a job without a hand," he said, burying his truncated arm in his front pocket, to show how he hides the disfigurement when he approaches potential employers. "When they see, the next day they say not to come back."

MINIMUM CARE

Had Nanaka been wealthy, he could have traveled to the emergency center in Colombo or paid for a private doctor.

But he receives the minimum level of care available under the country's universal health coverage.

"I am very sorrowful for the situation. Every year it's less. We need more service," said Manel Fernando, a nurse at the hospital since 1973 who spoke wistfully about the hospital's once-thriving maternity ward, which she said was shuttered due to lack of funds.

Ms. Fernando serves patients food and dispenses their medicine. She cleans their bedpans and gives them oil rubs. She keeps notes on patients' condition for the small, rotating staff of doctors, who cannot always visit patients every day.

"We work harder now than before," she said. "And people have to wait here longer."

A former print-setter who lost his vision from cataracts two years ago, then lost contact with his wife when he was moved between hospitals, said he has waited at the hospital for months for an operation to see again.

It costs the equivalent of $160.

"Even if she comes, I cannot identify her anymore," said the man, about his wife, as he patted the air. "I will have to touch her to know it's her."

The Sept. 11 Families emergency wing, once it is completed, will not be able to ease his burden; he requires an eye surgeon and a standard operating room.

But the facility will certainly save thousands of Moratuwa residents in need of immediate medical attention.

"I think that this is a step in the right direction; we understand there's an ongoing need," said Anthony Gardner, the executive director of the World Trade Center United Family Group, who expressed interest in deepening the relationship with the Moratuwa de Soysa Hospital. "When we started in October 2001, it was about helping each other. From that it has grown to preserving their memory through good deeds. This just shows how much the 9/11 families want to help others in need."