I’ve just joined the International Medical Corps team that will be growing to help meet the needs of Nepal following the recent devastating earthquake. It wasn’t easy to fly in, because the airport has a single main runway and isn’t large enough to park many large aircraft, and there is a great number of relief flights from all around the globe bringing people, equipment, and supplies. Our commercial flight was largely occupied by responders, including an official Japanese search and rescue team, as well as concerned and courageous people of Nepal returning to be with their families. Our plane originated out of Bangkok, was diverted twice to India, and then returned to Bangkok. We were fortunate to get an early start today and reach Kathmandu.

The scene is somewhat reminiscent of what we encountered five years ago in Haiti, with the main exception being that there is much more of a structured healthcare system in Nepal than there was in Haiti, and so the national medical response has been significantly more robust. Still, there are more than 5,500 known victims, and likely many more to be discovered in areas surrounding Kathmandu that are difficult to reach. Furthermore, there will be at least quadruple that number of persons with significant injuries.

Having been to Kathmandu a few times on my way to the majestic Himalaya mountains to trek, including to Everest Base Camp (which was struck by a devastating avalanche caused by the earthquake), it was very sad to see the collapse of buildings—indeed large portions of certain neighborhoods—as well as ancient temples and iconic structures. Soon after leaving the airport, I witnessed resilient citizens sheltering under tents, because their homes were destroyed or structurally unstable, endure a fierce rainstorm with sheets of hail, causing some streets to flood and emphasizing the risk for spread of infectious disease, such as cholera, in the aftermath of the earthquake.

The local medical community has responded aggressively to this situation, and the health professionals have been working around the clock to tend to patients. The overall community led by volunteers is assessing its capabilities to support shelter, hygiene, provision of safe water and food, and integration of its capabilities with those that are coming in relief. The government is working hard to integrate its efforts with non-governmental agencies, other countries, and generous donors of all necessary aspects of the much needed relief effort.

Please keep the people of Nepal in your thoughts and prayers.

​Day 2

Today in Kathmandu was quite different from yesterday. The city has certainly sprung back remarkably. Although its citizens face enormous challenges, the streets were nearly full with traffic, rubble actively being cleared from obstructing piles, and people walking and resuming commerce. There are an estimated 16 camps within the boundaries of Kathmandu, where people are either forced to seek housing or prefer to remain, certainly for sleeping at night, until homes can be replaced or cleared with respect to structural integrity. The camps are orderly and treated with dignity by the occupants and passers-by. We visited one this afternoon to perform a clinic, examining patients who wished to see a physician. Because the hospitals in Kathmandu received the injured soon after the earthquake, we mostly served persons with “routine” medical ailments. They were kind to us and appreciated the attention.

International Medical Corps continues to grow its staff and operations to meet the evolving situation. Side by side with other entities that have responded, including large national emergency response teams, there will be increasing focus on the communities outside Kathmandu, where there is sparse medical care and distances to hospitals mean walks of hours. Some of these will need to be approached by helicopter because of distances, mud- and rockslides caused by the earthquakes that have obstructed roadways, and calls for urgent assistance. It’s anticipated that some teams may need to trek for days to reach certain villages. Much of the coming days’ and weeks’ activities will be intended to avoid the spread of infectious diseases.

We have heard tales of miraculous survival, sadly posed against the grief of many lost family members and friends. Driving through the city past enormous mounds of rubble that last week were sacred temples and monuments, it is striking to think about how much there is to be done worldwide to prepare for cataclysmic natural events. There will be many lessons learned from this catastrophe, and we should take them to heart. One of them is how much better is a world focused on mutual aid and skillful compassion than upon dominance and conflict.

Paul Auerbach is a professor of Surgery, Emergency Medicine at Stanford University Medical Center.