Finally, after sixth day of GRAND DISASTER, I was back to my
hostel room. Taking a bath, a shave, changing cloths followed by good sleep
refreshed me. Truly speaking, the earthquake tragedy that has already taken
life of 7000+ people was a great learning experience for me as a medical
student, as a to-be-doctor-soon person. Of course it went hectic, also kept us
tired and sleep-deprived, but was a life time experience.
Before I start, I would like to appraise the
PAHS-Disaster-Management-Plan that helped us to instantly start acting like
actors in play. We were able to initiate our work, i.e. seeing victims of
earthquake, without being told. We knew what to do, we knew there is no one to
ask for and no time to delay.
And next, I would like to appraise my junior friends. The
first, second and third year (The 3rd, 4th and 5th
batch of PAHS) students who are yet to be exposed to clinical care and who
neither know about disaster management, worked with great enthusiasm in this
disaster. They were actively and effectively involved in possible clinical
care, management, patient transport and transfer, providing health education,
taking part in organized health camps and everything.
The thing I will remember most in this earthquake is few-friends-of-mine,
who are my colleagues at our medical school. During the earthquake they were at
Barpark-Gorkha, the epicenter of the earthquake. News told that about 75% of
house collapsed by 1st shake and 100s of people died at the instant.
Fortunately, they were saved then. From evening, their contact was cut. We
didn’t know how they were. News next day informed that, almost all remaining
houses too were collapsed by the after-shocks. The rescue team couldn’t go
because of landslide in the way. We tried to contact them hundreds of time but
couldn’t succeed. We were immensely worried that they may not return alive. We
were sure rescue helicopters or whatever help would be sent as soon as possible
by our academy. We went to senior personnel of our academy, and knew that we
were over-expecting. Let me not spend more words in complain, but we were not
satisfied. We had no other way except praying. On 3rd day evening,
they returned back safely with interesting stories about how closely they saw
their death and then came back alive.
I was at my study table when the 7.6 rector scale shook
Kathmandu. Me, my room partner and everyone in the building would have died if
the fragile building of our hostel had collapsed, thankfully it didn’t. After a
few minutes, when we reached hospital with our white coat and stethoscope,
there were hundreds of victims. All field, open spaces were full of injured
people. The declaration of “disaster-state” in the hospital was understood. If
it had not been a Saturday, there would have been a clinical director to depute
us to different treatment areas. It was a Saturday and very few doctors and
staffs were there at hospital. We reflexively started seeing victims as per
disaster protocol. Like actors in play, we knew our part. We started doing
without being told. We were oriented to disaster management plan, and had not
to start learning our role then, we already knew it. We started color coding
every patients and simultaneously managing the condition. As per plan, critical
patients whose life was in danger and needed immediate care were categorized RED and taken to the emergency. Non-Serious patients whose life
was not in danger and care can be delayed were categorized YELLOW,
and managed adequately. Walking wounded with cuts, bruises etc. who need
minimal care were categorized GREEN, and these were managed for pain, active bleeding etc.
and discharged. The patients who had died were categorized as BLACK. 
From next day, we all individually applied dozens of
plasters each to fracture patients, dozens of sutures for cut injuries and
several dressings at wounds and surgical sites. Truly speaking, this was enough
to cause back pain.
I remember the first patient of mine that day. He was lying
down. I checked his breathing, which was absent. I managed air way and
rechecked, still absent. Then I slided my finger over his neck to feel his
carotid pulse, this too was absent. I took my stethoscope and kept in his chest
to listen heart sound, this too was absent. My hands went like numb, I knew he
was dead and should be coded with BLACK code. CPR is not to be done during
disaster. I called a faculty of mine to declare death, who was seeing other
victim beside me. He reassessed my patient, and asked me to code him black and
take him to mortuary area. That was 1st dead body among the four
dozens death of that day in our hospital. Identification of dead body is
important and complex sometimes. If a family members of our dies, we definitely
need the dead body, don’t we? Every dead patient I saw, a family member was present,
but was himself/herself injured and couldn’t go with the body. Thus I took and
neatly wrote name and phone number for identification.
Out of so many patients I saw that day, a case of
shoulder-dislocation worth a memory. This is an orthopedic emergency condition.
We have learnt the maneuver called Kocher’s method to relocate the dislocation,
but haven’t done it ever. Seniors do it. But there was no orthopedic surgeon or
resident. I had to do it, or no one would. I called a friend of mine, make the
patient sit in nearby chair and tried the method. The shoulder was easily
relocated in 1st attempt. Then we fixed it with bandage, gave pain
killer and discharged him.
By the evening, number of patients had decreased. Many
faculties and doctors had arrived. Then a few friends of mine and me were given
responsibility to see the patients at nearby army camp field. We did that. We
first took the logistics given by WHO to make temporary 40-beded-hospital at
army camp field. We managed Green patients there and referred red and yellow
patients to Patan Hospital.
We were among lucky people at Kathmandu. I talked to
friends, all of them were staying out in fields under tarpaulin/tents. They were
troubled by closed shops and grocery stores. Though we had a lot to work, we
were provided with safe shelter and free-hygienic food at hospital. Also the
lot-of-work was learning opportunity. Many people are relying on beaten-rice
and noodles being distributed. Poor them.
Let me also mention people who came to our hospital with bad
intentions. The thieves who reached inside our medical school and almost robbed
classroom laptops. There were thieves who were robbing gold jewelries from nose
and ears of female dead bodies. I wonder how disgusting human can be. I
remember a man during Mahakali flood last year, he saved a drowning girl and
himself raped her later. Experts
say, there is increase in sexual abuse, rape, sexually transmitted disease and
unwanted pregnancy due to rapes during disasters. This is same throughout the
world. The severely affected villages of Sindhuplanchowk, Rasuwa etc. is yet to
get any help, any intervention. I wonder how pathetic situation might have been
there.
In addition, it rained after earth quake. I hope it didn’t
damage the grains, rice, pulse etc. in collapsed houses. This will cause
starvation after the disaster. If it destroys the crops, the maize and wheat
are still in field now, it will cause starvation and death due to starvation
throughout the year among poor countrymen.
This tragedy created immense loss. But instead of some 10,000
death, it could have been hundreds of thousands. The electricity, mobile, road,
airport, food supply etc. could have been halted for weeks with little more
severe earthquake. If it had not been Saturday- may kids would have died in
school, many people would have died in busy footpath around Newroad and
Lagankhel. The timing of earthquake proved to be lucky. Thanks to Nepal
Electricity Authority who continued the power backup soon, before the
generator-fuel-storage of hospital evacuated. Thanks to the mobile networks
that kept working and allowed to call and SMS even after balance had exhausted.
Thanks to Red Cross and other organizations who came with help, tents etc.
Thanks to people coming ahead on their own for volunteering, blood donation,
food and tent distribution. Thanks to number of people and organization who
donated food and medical supplies to hospitals. Many many thanks to Nepal army,
APF and Nepal Police for their immense effort in rescue of people inside
collapsed buildings.
This was an unlucky and bad accident, a very unlucky and a very
bad accident. But this also became a way to bind us with a feeling of brotherhood.
This was also a wonderful opportunity to learn for all of us.