The last few days have been action packed, and my work in Nepal is coming to a close. As an emergency physician, my skills will soon be much less needed than those of orthopedic and plastic surgeons, and primary care and infectious disease specialists. Because of the incredible outpouring of active interest from people who are friends of Nepal, many healthcare professionals have arrived, and more are on the way. The government of Nepal has recommended that all people, particularly those in large groups or teams, wishing to help by coming to Nepal do so under the auspices of government approved organizations. This is important to maintain an effective response and deploy resources where they are most needed.

It has been a bit unnerving to experience three significant aftershocks over the past few days. Each was accompanied by a jolt or shaking of the ground or building and rumbling noise, followed by silence, followed by the sounds of commotion as people fled their dwellings. Fortunately, none of the aftershocks was prolonged or destructive, but they serve as a reminder of what happened, and what will undoubtedly happen again some time in the future. The cycle for a major earthquake in this country in modern times is approximately every 75 years.

Today we traveled to Hatia, a community close to Dhading, in order to assess need and provide care. We were greeted by approximately 100 residents with earthquake-related situations, illnesses, and injuries. Nearly all of them are now displaced from their homes. With the monsoon on the horizon beginning the end of this month or early in June, combined with the number of persons requiring new shelter, the timetable is set for an aggressive attempt to provide adequate housing, essential public health education, and water-sanitation-hygiene (WASH) programs. More victims of the earthquake will undoubtedly be found as helicopters are deployed to approach very difficult-to-reach areas, so there will continue to be an immediate medical response as well as the public health efforts.

I have witnessed many acts of selflessness, and heard tales of amazing bravery, including what transpired at Everest Base Camp. The details of everything that has happened in this country related to the earthquake will be best told by those who experienced it first hand. From a personal perspective, I’m impressed by the number of participants in the events and response that has come from the wilderness medicine community. These are some of my dearest friends and colleagues, and my admiration for them has grown by leaps and bounds. Working with my lifelong friend Dr. Luanne Freer has been a privilege. Her knowledge of Nepal and love for the country permeated everything she did this past week. There are many people like her who have come to help, and behind every person here there are dozens at home supporting their efforts.

Saying goodbyes in situations like this is always very difficult. The staff of International Medical Corps and all of the volunteers have been terrific, as always. Many more people will come to assist within different parts of the program here, and both volunteers and paid professionals will remain for weeks or months. The people of Nepal and many of its citizens, such as Om Rajbhandary and a great number of other inexhaustible business leaders in Kathmandu; the Nepal Ambulance Service; incredible doctors and health professionals in hospitals and clinics across the country; and the amazing people of Nepal, are working ever so hard to find an equilibrium and begin to simultaneously manage this crisis while beginning to recover and restore. I wish them all well, and every ounce of good fortune to be successful in their time of need.

 

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