Let me be clear: I am in Bhairawaha, not Kathmandu. I am hundreds of miles from the capital city. I normally teach critical care nursing in Kathmandu and spend about fifty per cent of my time outside the Kathmandu valley. I decided to make a six-week circuit trip to the locations outside the valley, because it’s more efficient. Ever since the bus accident I have been a bit skittish about bus travel, and to do a circuit trip means that overall, I am not on a bus as much as if I was going out-and-back, out-and-back all the time.
Things are fine in Bhairawaha. We felt the quake. I knew what it was immediately, since I had lived in San Francisco years ago. I also knew that Kathmandu was in big trouble.
we had some aftershocks here. The only inconvenience was that Cable TV was not available.
So, today the decision was, to continue teaching my class, the one I teach to nurses and doctors. There were seventeen MBBS docs who showed up more or less on time. And off we went.
It was my usual class – lots of interactivity, lots of group work, students taking video of each other and critiquing.
Until lunch. I had just dismissed the class for lunch, and was alone in the classroom.
at 12:54 we had an aftershock, and this one was the most powerful since the original quake, here. The building shook and people screamed. I realized there was no place to run, I was too deep in the building to get to the outside. I went under a concrete doorframe and stood. The shaking stopped.
The patients and “patient parties” in the orthopedic ward nearby, decided to pack up and move outside, under the awning in the parking lot. The ortho ward was now empty.
Twelve of the seventeen docs in the class returned at 1:30 PM, and we held a vote as to whether to continue for the day. I realized that their bodies were in the class but their minds were elsewhere. We adjourned until tomorrow.
Four told me they wanted to stay and specifically work in ecg. So, we stayed and I guided them through this subject. This section was rather pleasant and collegial.
A guy came at 2:50 to tell us that at 3 PM there would be an earthquake bigger than the original one. He seemed so sure. we stopped. the four students left. I stuck around to pack up. On my way out I met one of the nurses who took my class for nurses that just ended Friday. As we walked,she told me that in ICU, there were two patients on the ventilator who could not be moved outside, and as long as they were there, nurses needed to stay inside ICU with them. I told her “I’ll keep you company,” and went to ICU with her.
I got there in time to catch the tail end of a “patient party counseling session” in Hindi language, between one of the senior attending doctors and about six panicky family members who wanted their loved one outside. The patient was on a mechanical ventilator for which the oxygen came from a large cylinder. The ventilator could not be run outside. I thought the doc did a great job of explaining. The family acquiesced and stayed.
I went to look at the parking lot – in this section there were many patients . I thought about taking a photo but didn’t. I couldn’t judge the mood of the crowd.
And this was Bhairawaha.
Far from the epicenter, far from the crowd.
On Twitter I got an inkling of rumors in Kathmandu. Evidently today the rumor was that a tiger had escaped from the zoo. ( false). and they too heard the rumor about the 3 PM quake that was going to be so powerful ( 3 P.M. came and went.) I read that somebody interviewed a seismologist who said “this isn’t the ‘Big One’ – the ‘Big One’ will be coming later.” and I think that this may have morphed into the rumor. That seismology guy, and the person who published that story needs to know that what he said got changed around until the listeners heard something else entirely. This happens all the time.
So – the power of rumor is alive and well. In USA we’ve had the equivalent force – I recall just before the November election when the Fox News channel seemed to be deliberately spreading lies to whip up hysterical fear about Ebola. But it’s much worse here, where it is easy for the collective opinion to turn into action before any body can stop it. This is a “collective culture” – meaning that the will of the group can overtake reason on the part of individual members and things get out of control.
This illustrates the Number One Rule of Public health: Never do or say anything that will create fear and panic in the general population. and the authorities here need to establish firm control over the flow of information. The fact that TV seems to have gone down, is not helpful.
This is still a humanitarian disaster of epic proportions
Now, I don’t want to the reader to think I have lost sight of the big picture. Information is still coming in, especially from the hill country of Nepal, and things do not look good. The casualty list continues to grow. The first forty-eight hours is when people will die if they are trapped, and this will happen before the international search and rescue teams arrive. One rule of these international disasters is that the people on the scene have to rescue themselves.
The collectivist culture, by the way, can work both ways. It’s not entirely a bad thing. It can harnessed to create a better situation. If there is anybody who can work in a group to pull people out of the rubble, it’s the Nepali people.
That’s enough for now.