From CCNEPal April 26th, 2015 about medical and nursing volunteers in #Nepal after the earthquake

An excellent summary from the New York Times  – click here.

For readers of this blog, you know that I have been teaching critical care nursing in Nepal since 2011 and I have made eight trips here. I am here for the 2014-2015 academic year to continue this work for the past ten months.

I have heard from most, but not all, of my Kathmandu friends. Because I am a foreigner, many people from Kathmandu called me, to see that I was okay.

For the record, I was in Bhairawaha Nepal on the day of the quake. Several hundred miles away. In Bhairawaha, I noticed something odd at 11:56: the water in the glass on my desk was sloshing back and forth all by itself. I immediately got up, alerted the other people nearby that it was an earthquake, and we all left the building. The cacophony of nearby birds signaled that something unusual was happening.

Here, nothing was damaged. Not only that, but it was mild enough that things stayed on the shelves and tables. I spent much of the day (it was my day off) answering emails and messages to re-assure my friends that I was safe.  I am fine. I am not personally inconvenienced in any way.

I am on my long-planned “Road Trip” – fifteen sessions of my course outside the Kathmandu Valley. Five have been completed and ten remain. I am teaching today.

I would point out that CCNEPal, my organization, has trained 1,775 nurses and docs in Life Support skills, and about 800 are in Kathmandu. For that reason, I suppose you could say that CCNEPal has “pre-positioned” for this event (though I would not wish this on anybody).  to all my former students I say – “Go get ’em!”

Pictures I have seen on FaceBook indicate that at least several large hospitals are intact and open for business. Also there is ample capacity to shift medical personnel from other areas of the country that were unaffected, to Kathmandu itself. In the immediate period, this is probably the most effective thing. The problem is going to be getting the nurses and doctors to where they are needed, since the airport will be full and we don’t know the road status.

We know very little about the conditions in rural areas.

I am 100% certain that the Nepalese people will be helping each other, it is something I have always admired about this beautiful country. There is ample capacity to shift medical personnel from within the country, and I am sure that such a move will be easier than to bring in people from outside.  For those who wish to help, I guess the first thing is – send money to aid organization of your choice. (not to me!)

In general, I think it’s too early for nurses and doctors to come here unless they speak fluent Nepali and already know about the hospital system (most hospitals are intact). There are many many Nepali nurses and doctors working abroad, they should be the very first ones to come back here, if anybody does. I do not think the needs will be quite the same as they were directly after Haiti, for example.

From reading about other disasters in other parts of the world, I think that the early period will focus on recovery of victims. The time when foreign nurses can help will be down the road, when disaster fatigue sets in, and also to “backfill”  basic health services in unaffected areas where the Nepali nurses have and doctors have been shifted to Kathmandu.

We will all learn more as the full extent of damage is revealed in coming days.


About Joe Niemczura, RN, MS

These blogs, and my books, and videos are written on the principle that any person embarking on something similar to what I do will gain more preparation than I first had, by reading them. I have fifteen years of USA nursing faculty background. Add to it fifteen more devoted to adult critical care. In Nepal, I started teaching critical care skills in 2011. I figure out what they need to know in a Nepali practice setting. Then I teach it in a culturally appropriate way so that the boots-on-the-ground people will use it. One theme of my work has been collective culture and how it manifests itself in anger. Because this was a problem I incorporated elements of "situational awareness" training from the beginning, in 2011.
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7 Responses to From CCNEPal April 26th, 2015 about medical and nursing volunteers in #Nepal after the earthquake

  1. Tracy J. says:

    Joe, Thank you so much for the update letting me(us) know you are safe. I was very worried about you knowing you spend a lot of time in the region hit by the earthquake. If there is any thing I can do from this end to help, please let me know. If I can do it, I will. Stay safe! Tracy

    Date: Sat, 25 Apr 2015 23:28:03 +0000 To:

  2. Pingback: From Nepal April 26th, 2015 about medical and nursing volunteers in #Nepal after the earthquake | Tjamrog’s Weblog

  3. Gaynor says:

    Shifting medical personnel from other areas of Nepal to the Kathmandu valley is much less important than bringing in disaster agencies to help. This is apart from the fact that other areas of Nepal are also affected – many villages in Gorkha have been wiped out. There will be little in the way of supplies and equipment for medical personnel to use anyway, and what they have now is probably quickly running out. The majority of medical personnel have little experience in disaster management, nor do government agencies.

    The most important problems are to do with public health – shelter, clean water, food, sanitation, protection from infectious disease, and safety from unstable buildings. As well as equipment to locate buried victims and get them out. However, very few victims are found alive after the initial 24 – 48 hours, which is why the ones that are found make the international news and give people the impression this is the norm. Disaster agencies brought in from outside are essential – they have the knowledge, planning, experience and equipment to deal with a disaster of this magnitude.

    • I agree 100%

      I guess my main point is, an individual foreign nurse or doctor is not what is needed right now.

      • Gaynor says:

        Sorry, I thought you said it was the most effective thing to do.

        I agree though that individual foreign nurses or doctors are not needed at this point. Possibly not even down the track. There are more than adequate numbers of medical personnel – training and education are the main needs, and encouragement/incitement to work outside the K’du valley. Not to mention better infrastructure, a truly democratic system of government, and an end to corruption! But that’s a debate for another day…

  4. thanks. I know it sounds heartless to say that individual nurses or doctors from foreign countries should not come – but – the fact is, the immediate medical needs are – immediate and need to be addressed by people already there.

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