Valliammai sits cross-legged on the hospital floor, her forehead wrinkled in worry. Her pregnant daughter is curled up on a nearby bed, but that is not what bothers Valliammai.
She worries whether anything is going wrong back home. Because at the tsunami shelter, another daughter is ready to give birth, swollen and uncomfortable. Heavy November rains continue to fall. And children and grandchildren need to be fed.
"I have to get back," says Valliammai, who uses one name like many in South India. "I don't know if they can manage."
Since the tsunami destroyed the village of Akkaraipettai a year ago, killing Valliammai's husband and throwing the lives of her grown children into chaos, this thin grandmother has been the one person her large extended family can count on.
Her patience, perseverance and love have kept the family together through struggles with money, grief, even mental illness. Only now, as fall rains turn the village streets to mud, are any signs of hope emerging, both for Valliammai's family and Akkaraipettai.
Permanent homes are finally being built, solid two-story buildings a half-mile from the coast. All the people who live in Valliammai's shelter will be able to move there, most likely by spring, officials say.
Fishing, the main livelihood of Akkaraipettai, continues to rebound. Many men have already gone back to work. Relief agencies have donated fiberglass boats; government loans and grants have helped build and repair about half the number of large trawlers that fished the ocean before the tsunami.
Valliammai, though, is still counting every rupee, worried about how she will feed everyone since her husband, a fisherman, was killed. Her plight is not unique.
Nearly all tsunami victims worldwide are still living in temporary shelters or with their relatives, according to a survey released in early December by the San Francisco-based Fritz Institute. The problems are bureaucratic, but in India they are compounded by flooding. The survey also shows that most families here make much less money than before.
For tsunami survivors, the emotional burdens have been as trying as the financial ones. But in Valliammai's family, glimmers of progress show the resiliency of a population that has overcome hardship before.
The children and teenagers in Valliammai's family no longer have nightmares, no longer stand up crying in the middle of the night. The teenage son once given anti-psychotic drugs for a mental breakdown has not had a relapse.
Even Ramachandran, 35, Valliammai's oldest son, has accepted that his wife is dead.
Few changes symbolize the new hope in this family like the two pregnant sisters, Chandrakala and Kalaivani. Both women were married off shortly after the tsunami, in arranged marriages dubbed "tsunami weddings." On her wedding day, Kalaivani couldn't even remember her new husband's name.
Now Kalaivani, 19, is more than eight months pregnant. As part of cultural traditions, she has returned to her mother's shelter room from her husband's home, about an hour north. Here, she will wait until she gives birth. Valliammai will help take care of the baby for the first three months.
Chandrakala, 25, about six months pregnant, is in the hospital with some kind of infection, but doctors say she will be fine. They say her unborn baby is healthy.
This hospital stay does not worry the family much, even though no one knows what is wrong with Chandrakala.
But within weeks, what happens to her is yet another reminder about life, death and grief.
Compensation long gone
Valliammai, who is about 55 years old, supports her family however she can. A relief group gives US$33 a month to help her children in school, but Valliammai uses the money to buy food. She sells fish when she is not busy taking care of her family.
The government compensation for the death of her husband is long gone. Among the big expenses: an old fishing debt and the cost of weddings for a daughter and a son.
Mainly, Valliammai runs from one child's crisis to another. After one son lands in the hospital for kidney problems, she takes her family's horoscopes to an astrologer. He tells her that her family is just going through a bad time.
Her son Mano, 15, seems better since his tsunami-related mental breakdown in the spring. But he still talks too loudly and reacts angrily to minor problems. He behaves strangely, waking up his family in the middle of the night by turning on the light, combing his hair and powdering his face. Mano was almost expelled from school two weeks earlier, because of poor attendance.
"You're going mad," Kalaivani tells Mano, who hit her on the back because he wanted a pencil.
"I am mad," he responds.
The shelter, built to last only until August, continues to deteriorate. Walls the consistency of cardboard rip apart; doors fall off hinges. Rats have moved in, scurrying along support poles on the walls or behind bags of rice.
One afternoon, Valliammai sits in her dingy shelter room. There are dirty dishes in one corner, and a pile of firewood in another.
Valliammai is watching three granddaughters, the children of her son Ramachandran. He has largely neglected his daughters and his mother since the tsunami killed his wife and two other children. He turned to self-pity and alcohol, while Valliammai watched over his daughters the best she could.
Outside, a storm brews. Winds thrash the thatched roofs. Ramachandran walks in, and begins to joke with his daughters.
He is curt with his own mother, yet this is a milestone of sorts. It is the first time he has visited his mother's room since the family moved to the shelter.
Almost every night, Ramachandran puts away about six shots of alcohol; he says he does this so he will not dream of his wife and dead children. But his outlook is less gloomy than in the previous months.
He has decided not to put his older daughters in a hostel, a cross between an orphanage and a boarding school. He says he cannot live without his daughters nearby, even if they spend their nights with Valliammai. Most of the time, he keeps a towel over the framed photograph of his dead wife, whom he married for love, rare in the village.
Ramachandran is now an oddity in the tsunami shelter, one of the few men widowed by the tsunami who has not yet remarried, one of the few fishermen who has refused to return to the sea.
Instead, he sets up a loan business, using the government compensation for his dead wife, daughter and son. So far, business has not been good.
He has lent about half the US$13,800 from the government, but his customers are not paying him back on time. He has spent most of the other half - on savings accounts for his daughters, a motorcycle, a mobile phone, a sister's wedding, a brother's hospital costs, alcohol.
In a bow to family wishes, Ramachandran agrees to an arranged marriage with a woman from his own fishing caste. The ceremony is set for January. Ramachandran even tells his older daughters and shows them a picture of her, wearing the red-and-gold sari that he gave her.