The report held in Gorkha visit for Medical relief On Monday 27 th to 29 th April 2015

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The report held in Gorkha visit for Medical relief On Monday 27 th to 29 th April 2015 On Saturday the 25 th of April at 11.56 am a 7.

1 The report held in Gorkha visit for Medical relief On Monday 27 th to 29 th April 2015 On Saturday the 25 th of April at am a 7.8 magnitude earthquake shook Nepal, its epicenter was 80 kms northwest of Kathmandu. It is the most powerful and deadly disaster to affect Nepal since the 1934 Nepal Bihar earthquake, affecting more people than last year s floods. The management of International Nepal Fellowship (INF), were asked to send a medical relief team to Gorkha, the district headquarters 30 kms south of the epicenter, to provide immediate support to the local services. Without any briefing on what to expect, the Nepali INF camps team were tremendous in their response. We had returned only 3 days earlier from Rolpa, after a month working on two camps. We hastily repacked the 3 tons truck and land- rover with medical supplies and a large tent and food, so that we could be totally self- sufficient. The emergency response team was led by Eka Dev with Robin Lama, Rabi Gurung and Privithi Baral. The INF ex- pats were Neil (an anaesthetist ) and Hilary Fergusson, Artur Neumann, Thomas Meier Doctors Ian and Claire Ferrer, and 2 doctors from United Mission to Nepal (UMN), Josh Riggsbee and Rebecca McAteer. We left Pokhara at 0500hrs on Monday the 26 th, with the media correspondent for World Vision, Matt Darvas, telephoning a near- constant news feed of on- the- ground information to BBC, CNN and other major news sources. This was an entirely new perspective for us on reporting, we certainly never envisioned being on the front end of news coverage. Nearly all the news pictures you have seen are from the Kathmandu valley, which is built on an old sand lakebed, which makes the ground unstable. Poor building standards led to the collapsed buildings, falling rubble and heavy casualties there. Gorkha is a rural district in north- central Nepal, very near the epicenter, but surprisingly on arrival we found most of the concrete buildings 1

2 still appeared intact. We went to the Chief District Officer, and asked where they wanted the team to go. At that point only local and two international disaster response teams had arrived on the scene. We were sent to two villages, Pokharidanda and Mailun, north east out of Gorkha, in the VDC Bunkot. Although only 9km away, it took an hour on mud track roads which were only just passable with our 4X4 vehicles. Before entering the villages the local guide who travelled with us ensured it was safe to visit and that we would be welcomed. There we found almost total devastation: all the local stone and mud houses had collapsed; over 90% of the housing stock and only a few concrete built ones had survived. In Pokharidanda nearly all the 50 houses were just rubble, but only one person had died. The remaining injured in the villages were remarkable few, because the quake had hit in the middle of the day when schools and offices were closed so most people were out in the fields. We ran two clinics, where we treated about 450 patients. It seemed everyone had some problems but only a few had wounds which needed dressing, as the most seriously injured had been able to get to Gorkha hospital. We were a great psychological help - most families (even with intact houses) were sleeping under tarpaulins, many in the middle of their fields, and we were the first people to arrive and offer help. Many of them thanked us for coming. We returned after dark, and visited Gorkha hospital, which had additional Nepali staff, and was not overrun with casualties, so after very late dal bhat eaten in the street, (no- one wants to sleep or eat inside, even in Gorkha itself) we went to the Army parade ground and bivouacked overnight under a tarpaulin, along with many homeless Nepalis, where the army made us very welcome. On the 28 th we were asked to provide two medical teams, to go by army helicopter to remote areas, which had received no medical help. With a few minutes notice we rushed to pack two emergency boxes, and drove the helipad, only to hear the Indian army helicopters circle and fly off, being too big to land! From Gorkha all the logistic support had to be small private 4/5 seat copters which the government had commissioned. We waited half the day and while there we spoke to the few villagers who were evacuated, but they were too shocked to provide much information. Their injuries were not severe, and the trickle of patients off the small helicopters had not overwhelmed the local hospital. We were questioned by reporters from the Financial Times, Associated Press, Du Monde and The Guardian, trying to give them accurate information. At 1315 hrs the first team of Josh and Rebecca lifted off to Keraunja which was a 30minute flight North, accompanied by a Nepali reporter and one young woman trying to get back to the village to which they were headed. Her name was Urmila and she proved invaluable in navigating the intricacies of her village s culture and decision- making. Heavy clouds had gathered all morning, and just as they flew off, a major thunderstorm broke, leaving us fearing for their safety. Bizarrely some cellphone coverage still worked, and a text from Josh saying they were sheltering en route reassured us. It became clear that no more helicopters would fly during the storm, so we headed back to the Army headquarters, offering a lift back up the hill to one of 2

3 the passengers of the helicopter, who had been sent to make an assessment. He shared the photos and video clip from his phone, and we saw the devastating extent of the disaster. In the rural areas every house was totally destroyed, and people were dazed and shocked, just standing waiting, in pouring rain. Some were under tarpaulins; all looked frightened, with vacant empty eyes. He told how landslips have taken out the pathways and mud roads, turning a 1 day journey to these VDC areas into a hazardous 4 day trip. The blessing is that fatalities were very low, as people were outside at the time of the quake; but the destruction of housing and access is total. The INF team regrouped and it was evident with the torrential rain that the muddy tracks we travelled yesterday would now be impassable, and the only way into the areas north of Gorkha would have to be by air. Two hours later with the weather lifting, we returned to the landing area to be told no more medical teams would be flown in as they were concentrating on sending relief supplies and evacuating casualties. After seeing the phone footage, it was clear that what were needed was bass, gass & capass ; shelter, food and clothing. This was the right decision, and as Gorkha hospital was coping well, we decided to return to Pokhara, to see if we could be deployed anywhere else, and enable the truck and land- rover to be used elsewhere if necessary. On the 29 th an INF emergency response meeting planned how best it could help. There was a request from Dhading to supply relief materials, medicines and possibly a medical team. The camps team spent the day repacking the required medicines into the truck. We heard late in the day that an Indian Team was already at Dhading; so only the supplies are sent. We were also asked to survey the capacity in the Pokhara hospitals the next day, as the government has decided to evacuate any remaining casualties west to Kathmandu in the heavy Indian helicopters to Pokhara for treatment. In the afternoon we were delighted be reunited with Josh and Rebecca who had been lifted out with 10 casualties to Pokhara. They tell us their story: The rain and poor visibility forced the pilot to stop mid- route on top of a mountain (literally, landing on the flat ridge of a cliff) where they waited out an alarmingly gusty thunderstorm. They then flew on, reaching the village of Keraunja, landing on a terrace cut into the side of an almost- vertical mountain, which is at foot elevation. Standing there, face to face with seventy or so villagers with burlap sacks over their heads to shield themselves from the rain, they realised that there was physically nowhere to go to get out of the downpour. Every standing structure had been literally decimated. Eventually some of the villagers decide to take them up to the site where the Keraunja health post had previously stood; it had been the only health post in a six hour walking radius (no roads or vehicles in this sort of terrain). They met the local village healthcare worker, Samjhana an extremely bright, competent young woman with excellent medical & managerial skills and evaluated several medical patients together, seeking to fully affirm and reinforce her standing as a healthcare authority in the community. They were told that there were no longer any open overland routes and the landslide risk remained high, so getting out will be tough. No communication 3

was possible via the satellite phone, but they were told that there was cellphone reception an hours walk up the mountain, so they planned to head there first thing in the morning with Urmila and her

They were thrilled beyond words to see the contents of a helicopter s drop were kits from USAID, complete with tarps, mats and blankets.

Unbelievable Nepali hospitality was shown, and small meal of dal bhat (rice and lentils) cooked by a few of the women over an open fire, they took their places with the rest of the family under the

4 was possible via the satellite phone, but they were told that there was cellphone reception an hours walk up the mountain, so they planned to head there first thing in the morning with Urmila and her brother. It was still raining and there was minimal shelter, and they were unsure where to spend the night. They were thrilled beyond words to see the contents of a helicopter s drop were kits from USAID, complete with tarps, mats and blankets. The contents of this plastic sack meant they would not have to sleep out in the mud and rain, as there was literally no other place to lay down. Unbelievable Nepali hospitality was shown, and small meal of dal bhat (rice and lentils) cooked by a few of the women over an open fire, they took their places with the rest of the family under the tarp, arranged in a long row, and tried to get some sleep. On Tuesday the 29th they got up at 0600hrs and hiked up the mountain ridge as planned and managed to establish their first contact with the rest of the INF team in Gorkha Bazaar, and their families. They alerted us of the situation and request helicopter evacuation for themselves and three additional injured patients. From the ridge, they were asked by a few villagers to trek to another village an hour further down the mountain for medical care. 4

After seeing two more patients with fairly severe crush injuries from rockfall and determining their need for medical evacuation too, they were startled to see an Indian Army helicopter circling for

It was a challenge to communicate meaningfully while a military chopper- blade is cranking overhead, but somehow they got the message across about five additional injured patients, and were able to

Along with a group of stranded Nepali trekkers, they began the flight direct back to Pokhara and arrived back on terra firma at 12:30 pm, less than twenty four hours after taking off from Gorkha

5 After seeing two more patients with fairly severe crush injuries from rockfall and determining their need for medical evacuation too, they were startled to see an Indian Army helicopter circling for a landing in the valley below them. Realising the copter could have no possible way of knowing they were there, they raced down the mountain to catch them before they dropped supplies and left. It was a challenge to communicate meaningfully while a military chopper- blade is cranking overhead, but somehow they got the message across about five additional injured patients, and were able to pick them up in stages from the two villages. Along with a group of stranded Nepali trekkers, they began the flight direct back to Pokhara and arrived back on terra firma at 12:30 pm, less than twenty four hours after taking off from Gorkha Bazaar. On Wednesday 30 th April the INF medical team completed a survey of the main hospitals in Pokhara. Although stretched, they had responded brilliantly. Many evacuated patients were able to be discharged after initial treatment, with about 120 remaining as in- patients mainly with limb fractures and head injuries. All were stable and should make good recoveries. We offered medical support in all the hospitals, and additional bed capacity at Green Pastures Hospital & Rehabilitation Centre particularly for patients with spinal cord injuries. It is now anticipated that patients from Kathmandu will be flown across to Pokhara to reduce load on the overwhelmed services there. 5

6 The summary cost of Gorkha Medical relief: SN Particular Amount Remarks 1 Medicine and surgical supplies Rs: General Supplies Rs: Food and Housekeeping supplies Rs: For the team members 4 Travel and transport cost Rs: Total Cost Rs: Eka Dev Devkota Camps coordinator INF Nepal camps@nepal.inf.org 6

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