Over a week has passed since a 7.8-magnitude earthquake hit the Nepali districts of Dhading, Gorkha, Rasuwa, and Sindhupalchowk, and many villages have yet to receive humanitarian assistance. While the most critically injured people were evacuated in the days immediately after the earthquake, those who remained are trapped in their villages, as avalanches and landslides have cut off roads and walking paths.
Since April 29, Doctors Without Borders/Médecins Sans Frontières (MSF) medical teams have been traveling by helicopter and on foot to treat people spread across some 15 isolated mountain villages.
On May 3, an MSF team also set up a temporary clinic in the area of Chhapchet, in Dhading district, and began providing basic health care and minor surgical interventions. The team will work to spread the word in the surrounding villages that people can now come to the clinic to receive care. On May 4, another team landed in Lapubesi in Gorkha district, and will stay there for three days to provide medical assistance in the area.
"We are seeing people in need of basic health care, as well as a number of people with wounds sustained in the earthquake that have now become infected," says MSF nurse Anne Kluijtmans. "We are cleaning and dressing wounds, as well as distributing antibiotics and pain medication. We have also treated cases of pneumonia, including among children."
Food, Shelter, and Mental Health Needs
With many villages completely or partially destroyed by the earthquake, the most significant need is for shelter, while some of the more isolated villages in the mountains are also facing shortages of food. MSF teams are distributing high-energy biscuits and blankets in Kyanjin Gumba, Rasuwa district, and in Nampa Golche in Sindhupalchowk district. They have also provided more than 500 shelter kits in Gorkha district. Teams are continuing to explore the most effective ways to transport both food and shelter materials into the mountains, where temperatures at higher altitudes can drop below freezing at night.
There are also significant mental health needs stemming from the traumatic experience of the earthquake. Mental health workers are being added to MSF teams to begin providing psychological first-aid in some of the most-affected villages.
While hospitals in and around Nepal’s capital city of Kathmandu were overwhelmed with patients in the first days after the earthquake, the pressure has abated somewhat and the rush to treat patients with acute trauma has passed. People are now waiting for more minor or follow up surgeries, as well as treatment for regular illnesses.
MSF has made supply donations to some hospitals in the capital. In Kathmandu and Pokhara, the authorities responsible for emergency management have mobilized a unit of local nephrologists to treat cases of crush syndrome, a medical condition common following earthquakes characterized by shock and renal failure after a crushing injury.
An MSF surgical team provided support for three days at the hospital in Bhaktapur, on the outskirts of Kathmandu, in order to help the staff there operate on waiting patients. In the town of Arughat, in Gorkha district, MSF is setting up a 20-bed inflatable hospital to provide initial treatment for wounded.
Tackling Logistical Challenges
Serious logistical challenges, including continued congestion at Kathmandu airport and the fact that the majority of the most-affected areas are inaccessible by road, have hampered MSF’s efforts to scale up activities quickly. “Our priority is to reach people in places where no one else is going and who have not received assistance,” says Dr. Prince Mathew, who was one of the first MSF staff members to arrive in the country. “So it has been a huge challenge logistically to get the necessary supplies in through the congested airport, and secure the air transport we need to be able to provide medical assistance and deliver shelter and relief materials to the people in most urgent need.”
MSF now has more than 120 staff members in the country and has flown in more than 80 tons of supplies, including the inflatable hospital. In addition to flying supplies into Kathmandu, MSF teams working across the border in India’s Bihar State were able to quickly transport shelter, hygiene, and kitchen kits by truck to Gorkha, 200 kilometers [about 124 miles] northwest of Kathmandu and close to the earthquake’s epicenter.
“We will increase the number of clinics as quickly as possible,” says Dr. Mathew. “Our teams also plan to distribute tonnes of shelters, hygiene materials, and cooking equipment. With the monsoon season approaching, we’re worried that the window of opportunity to reach people in these areas is rapidly closing.”
On April 25, 2015, a 7.8-magnitude earthquake struck Nepal, with its epicenter in Gorkha district, 200 kilometers northwest of the capital, Kathmandu. As of April 30, the government of Nepal reported 5,582 deaths and 11,175 injured. More than 130,000 houses were destroyed and 85,856 damaged.