7.8M Earthquake in Nepal - April 2015
Humanity First Response
Mystical. Spiritual. Breath-taking scenery. Full of culture and vibrant. Just a few of the words to describe the landlocked country with China to the North and India to the South; home of the highest mountain in the world and the land of the Gurkha. Nepal.
And it is where on 25th April 2015, an earthquake measuring 7.8M occurred approximately 80km northwest of the capital Kathmandu. Within a few short minutes the Global Disaster Alert and Coordination System (GDACS) issued a “Red” alert meaning that due to the depth, magnitude and vulnerability of the population a high humanitarian impact would possibly occur. Reports soon came in of heavy damage to roads and buildings and multiple casualties, particularly in the rural areas but also in the capital. It quickly became apparent that the hospitals were struggling to cope and with the multitude of aftershocks and damage to the roads delaying search and rescue operations, the Nepalese government put in a call for international assistance.
On that sunny Saturday morning I was packing and moving boxes with my fiancée Lucy, in the process of moving to our new home that weekend. Late morning I received a phone call from a colleague from Humanity First (HF), an international NGO, telling me that an earthquake had occurred in Nepal, that international assistance had been requested and that HF were in the assessment stage of putting a medical team together for deployment. Lucy was within earshot of the conversation and obviously knew what was being said. I put the phone down, briefly told her what had happened, and without any hesitation she simply said to me “go”. Within a few minutes an official HF email had been sent out asking for availability from its personnel to be a part of a team to deploy at short notice. A few frantic emails and phone calls were sent and within an hour, I had been granted permission to take leave from work at short notice and I replied to the email as being “available”.
The next few hours were spent packing, moving and cleaning the old house interspersed with nervous conversation (mainly on my part) about the fact that I would be going out to a disaster. I kept looking at the news and for any updates on my phone; casualties started low then as the hours ticked by the numbers of those injured or killed grew constantly. By late afternoon the death toll was reported to be about 4000. In my mind I knew that HF would send a team, and in the late evening an email confirmed that we would deploy. I have been in the ambulance service for over nineteen years and have been involved in humanitarian work in one form or another for well over a decade in countries such as Sierra Leone, Chad and Mozambique to name a few. But this was the first time that I had been to a disaster. Thoughts and emotions of excitement mixed with fear and anxiety. We would be going into the unknown, the risks of further aftershocks, landslides, dealing with human suffering at its worst and the fact that we could become casualties ourselves went through my mind. Would I cope? How would I feel once there? Would I be able to offer some support, comfort and care to those that needed it?
The next couple of days were spent sorting the new house, building furniture, packing for my trip and trying to spend what quality time I could with my family before travelling to London on the Tuesday morning, ready to fly out from Heathrow that evening. Lots of hugs and cuddles were given to Lucy and my seven month old son, while time was spent playing “Star Wars” with my older stepson and explaining to him what I was going to do and showing him on a globe where I was going to. The realisation of the support that I had from my family was on the Monday afternoon, when after school my “jedi knight” proudly told me that he had told all of his school friends that I was going to “go and save some lives”. The support from my family, friends and colleagues was astounding with a multitude of good wishes and “tear provoking” messages coming my way.
The Tuesday afternoon was spent at the Humanity First HQ in London where all the team got together, equipment sorted and a full briefing was held. The team was made up of twelve people including surgeons, a GP, A&E consultant, paramedics, a firefighter, pharmacist and a logistics support member. We set off to Heathrow, our spirits high, confident and hopeful that we would be able to do all that we could for the people of Nepal.
Twelve hours later, we were in Kathmandu and registered with the government as a UK Foreign Medical Team (FMT). We were given accommodation on the outskirts of the city, a local family providing us with a roof over our heads while we checked equipment and gained as much information as possible about the country, infrastructure and casualties. It’s important to note that in a disaster a foreign team can’t just “turn up”. The affected country has to ask for help and once there it isn’t just a case of picking where you want to go, go there and get on with your job. If only it was that simple. Time was spent form filling, registering with the Health Ministry and attending meetings (hosted by various United Nations departments and the World Health Organisation).
A walk around Kathmandu was eye opening. A city full of history and culture where the force of nature had shown no mercy and did not discriminate. Ancient temples and modern buildings destroyed, people sleeping in open spaces, scared of going inside in case there were further aftershocks, buildings cordoned off in case of further collapse, the smell of funeral pyres where the mass cremation of those killed had taken place. Yet everyday life went on. People going about their business in the markets and tourist areas selling trinkets, woollen goods and pictures, the constant sound of vehicle horns and the chaos of traffic that you would encounter in any city and the general hustle and bustle of city life. All of this was mixed in with groups of police and soldiers searching buildings and clearing debris, dust filling the air. Seeing all of this was sobering. The myriad of thoughts filling my mind of what we would encounter over the next few days. We would soon find out.
Within a couple of days we were on a hired bus, the roof loaded with our medical kit, tents and supplies heading into the province of Gorkha at the request of the Health Ministry, close to the epicentre. After a few hours travelling along winding roads we reached the town of Gorkha where we went to the local hospital. A Swiss Red Cross team were already at the hospital working closely with the staff. The hospital was well maintained, staffed and with a steady flow of patients all appeared in good order. After a few discussions it was decided to carry on deeper into the province, higher into the mountains to a village called Badasse. We had no idea what we would find but reports stated that there was significant damage, that a high number of casualties were likely and that so far, no medical teams had yet reached the area. This was the place to get to. However getting there was the issue. The tarmac had ran out in Gorkha. We were faced with dirt track roads barely wide enough for a single vehicle, rutted, rocky and crumbling. The only way to get there was by a mountain bus in a treacherous three hour journey. The hazards to the team were high. Aftershocks, landslides, poorly maintained vehicles and the risk of an accident were to name just a few. But the benefits far outweighed the risks. We were there to do a job and we intended to get on with it.
A few hours later after a bumpy, nerve racking but scenic ride through the hills of Nepal we arrived in the late afternoon at Badasse. We were met by some villagers and a small unit from the Nepalese army who were helping to clear damaged buildings. The school had been damaged and many of the houses had been destroyed. We were told that those that had been injured had already been cared for by the locals or had been taken by their families to the hospital in Gorkha. However, it was possible that there was a need for medical assistance in the area. As time was getting on and the sun was setting over the spectacular scenery of the hills, we decided to make camp for the night and prepare a medical centre the next morning. We had no idea if were needed but we had come this far and we intended to stay and offer assistance to those who needed or wanted it. Weariness took hold of us and we spent our first night under canvas, the first of many.
Word had spread throughout the area that a medical team had arrived and early the next morning we were met by a small group of villagers requiring medical assistance. This group steadily grew and it quickly became apparent that we would be doing what we came to do. We built our medical centre with tarpaulins, para-cord and bamboo sticks with the help of the locals and the army and, by lunchtime over a hundred people with a whole host of injuries and illnesses were waiting patiently to be seen; young babies and the elderly, mobile and infirm, male and female. Our makeshift medical centre had a reception and seating area, triage and basic assessment, pharmacy, consultation and a majors area with full resuscitation facilities. On that hillside deep in Nepal, we were providing an A&E department with a full scope of medical care to people who had been subjected to one of the earths most powerful and destructive events.
By the end of that first day there was a quiet sense of achievement and comfort knowing that we had given help, support and treatment to well over one hundred people. The spectacular lightning storm that evening with a similarly striking sunset was surreal; in one direction the setting sun casting a warm glow over the terraces of the hills, in the other direction a partially collapsed school and homes flattened. There was frustration. Some of the patients told us that medical aid was still needed further on. Nearly a week after the earthquake there were still villages that hadn’t received any help, medical or otherwise. The problem was getting to them. The roads were treacherous at best. The aftershocks were frequent and at times gut wrenching. One aftershock that we felt had caused a landslide in the next valley sweeping three buses off the road, the fate of those we could only imagine. The only other real option was to use helicopters. However there were “red tape” issues. Our contacts who attended the cluster meetings in Kathmandu and who were in regular contact with us were literally begging for the use of a helicopter. We even marked out a landing pad in the hope that sometime soon our request would be granted.
The next few days were physically and mentally challenging. Ninety degree heat, humidity, a hole in the ground as a toilet, dodgy bellies and a tap to wash under were minor discomforts compared to what the Nepalese had been through, and given that on that hillside we had provided care to over a thousand people we didn’t mind the discomforts. The majority of patients presented with medical problems such as respiratory and mental health. People were scared about further quakes and many didn’t know what had happened to their families. There were traumatic injuries, infected wounds and dental problems. Whatever the injury or illness, concern or anxiety, we did all that we could. IV fluids and pain relief or simply holding a hand we gave what was needed. The strength and resilience of the people was humbling. They walked through the mountains overnight for many miles or were carried on peoples backs or on makeshift stretchers to reach us. No one complained, no one pushed or shoved. They waited patiently to be seen and gave their thanks when they left.
On our fifth day at the village, despite repeated requests for the use of a helicopter we were told that out best bet would be to return to Kathmandu and “hopefully” catch a helicopter there. A team of four (including myself) set off early the next day on a six hour bus journey back to the capital, leaving the rest of the team to carry on with the work in the mountain. The plan for us was to get a helicopter to Lapu and carry out an assessment of the area, not just on medical need but also on food and shelter. The journey back was cramped and hot on a public bus; people standing and also on the roof. It was a true adventure taking in the sites and imagining what it would be like to explore this stunning country. Back in Kathmandu we endured yet another “whacky races” taxi ride back to our lodgings. No obvious highway code, compulsory use of the horn and a general free for all on the roads.
The next day was spent at the cluster meetings and continual trying to get a helicopter. However it became quickly apparent that the helicopter would be a “no go” for a multitude of reasons. The initial response phase seemed to be coming to an end. The concern of the UN and government was that in a few short weeks the monsoon season would have started. Food and shelter was slowly becoming the priority and medical aid taking a backseat. We trekked back to the house where we were staying and met the rest of the team who came back after spending another day treating even more patients.
Our time in Nepal soon came to an end. Back in Kathmandu when it became clear that we wouldn’t get a helicopter we attempted to get to another village, approximately two hours outside of Kathmandu. After a three hour journey to a town where we met elders from the village we were hoping to go to, we were told that the journey was “possibly another four or five hours” on a mountain road, worse than the one that we had encountered in Gorkha. With daylight rapidly fading, a storm looking highly likely and doubts about if there was a medical need at the village discussions took place about whether we should continue. We were due to fly home in two days and there was a significant risk that we could easily become stranded in the village due to the location and weather. The pros and cons were deliberated, but, in the end with heavy hearts, the team made the decision to head back to Kathmandu. The risks far outweighed the benefits. Our work in Nepal for now, was done.
The flight home was tinged with missed emotions of sadness at leaving, not knowing what was going to happen to the people we had seen, and the happiness at seeing our families. We had seen devastation and heartbreak. We had made friends with the locals and the family that gave us a roof over our head. The stunning sunrises and sunsets. The “Top Gear” mountain drives. The elderly man who had walked through the night, bent double with age and using a walking stick to get to us just to hear someone say “you’ll be ok”. The toddler with fear in his eyes. The snoring in our communal tent. Endless mickey taking of each other. The images of the crashed buses and lorries on the mountain sides. The thoughts of going into the unknown and apprehension at the start of the trip and that first phone call. But, we had done it. We had given some support, comfort and care to those people. A group of strangers with a common goal going out to help complete strangers.
Why did I do it? We are lucky in this country. We have the resources, knowledge and expertise. We have a health care and welfare system. We have a special number that anyone can call at any time in times of distress in the knowledge that someone will come to help. And we have our families who support us on every step when we go into the unknown. Our families who will always have that help and support when needed. Many countries, for whatever reason don’t have that due to politics, economy or geography. Would I do it again? Try and stop me.