Treating Nepal’s wounded after the earthquake

Published: 1 June 2015 4:18 CET

By Lucy Keating, IFRC

In recent weeks, Dr. Johan has had to perform some difficult surgeries at the Norwegian Red Cross field hospital in Chautara. Fractures are the most common injury. When the earthquake struck, buildings crumbled. It is estimated that 90 % of all structures in Chautara, in the district of Sindhupalchok, are damaged or destroyed. The earthquake was indiscriminate, injuring everyone from babies to grandparents.

“People were arriving with all sorts of fractures and impact wounds to their limbs. Some of the wounds were open. There was a lot of soft tissue damage and we were doing a lot of skin grafts,” Dr. Johan says. At home in Norway, Dr Johan is a gastro-intestinal surgeon at a large city hospital where he largely treats cancer patients. His work at the Red Cross field hospital couldn’t be more different.

The state-of-the-art tented compound was erected in the days after the earthquake, which struck on 25 April. Chautara was also close to the epicentre of the second tremor on 12 May. But a month on from the first quake, what concerns the hospital staff is the number of people arriving with old wounds. The earthquake has cut off remote communities and disrupted local health facilities. Patients have to walk vast distances to get to the hospital, with injuries and ailments they have had for weeks.

“Word got out about this hospital and people are coming from great distances. Just two days ago I operated on a 3 year old girl with an infected toe,” Dr Johan explains. “She came from a remote village which was completely flattened. Her grandmother had travelled 3 hours to bring her to us. The family is clearly very poor; the girl had no clothes and was covered in lice, reflecting already poor living conditions. When I was able to look at her, her toe was severely infected. When I opened it up, I found 50 live maggots inside. I had to remove half of her toe and will operate on her several more times to make sure the wound is absolutely clean so that it can heal. She was in a lot of pain but she is being very brave.”

Care at the hospital doesn’t stop at treatment. Discharge is also a big issue. Most of the patients have no homes to go back to as their families are living outside under makeshift shelters made from tarpaulins and materials salvaged from the rubble.

“Often we will keep patients here a little longer than they strictly need to be. Our psycho-social support team are able to offer some help to them and their families, many of whom are still traumatised by the quake,” Dr. Johan adds. “On a practical level we offer assistance with transport back to their villages and in many cases we are able to give them a tent to make sure they have some shelter. Living out in the open is simply not conducive to recovery.”

The Norwegian field hospital will continue to operate in Chautara for the next 2-3 months while the district hospital, badly damaged in the double-quakes, is relocated. But with the arrival of the monsoon rains, conditions are going to become even more difficult. It will become harder for staff to keep the hospital clean and hygienic and the rains will bring with them the risk of diarrhoea and cholera.