Are nurses and doctors needed for earthquake relief in #Nepal right now?


May 11th update: much has happened since this posting. It is clear that Nepal could benefit from future clinical expertise; but now in hindsight, here is an assessment by a doctor whose opinion I value and respect, the director of Nick Simons Institute http://nepalitimes.com/article/nation/compassion-competence-commitment-after-nepal-earthquake,2236

Update April 29th: please do NOT send your name to me or to CCNEPal. I am not a relief agency and I am not organizing relief efforts. Don’t come to Nepal unless you are part of an NGO – people who “parachute in” with no country-specific orientation will be a burden, not a help. DO send money to a reputable aid group such as AMNF. Don’t collect used clothes or any physical supplies, unless you have a plan for how to ship them here. Nepal can buy them in India cheaper than shipping them from USA.

About humanitarian work in Nepal

I have kept a blog on my work in Nepal since 2011, describing my little volunteer project to train Nepali nurses (and now doctors) in Advanced Cardiac Life Support. I’ve also got a FaceBook page for CCNEPal and a youtube channel where you can find videos that show what the hospitals are like. I travel around the country when I am here but I’m mostly based in Kathmandu.  I’m presently on a Road Trip through “the Terai” – the hot, humid and flat section near the border with India. I’ve watched TV with sadness these past few days.

Out of the 1,775 people trained by CCNEPal, about 800 are in Kathmandu, and I’m sure they are using their skills to the max.

I note that my blog hits have gone through the roof, and many of the search engine terms have focused on my past appeals for nurses to volunteer with me, here. I’ve gotten some emails and messages asking about this as well. I’m sure that some of it is due to a longing on the part of the sender to do something, to actually take a hands-on approach to deal with something that is very disturbing, and which calls for action. That is laudable – you wouldn’t be a nurse unless you had the urge to help other suffering people!

Immediate needs?

In ten words or less: don’t come here on your own, don’t come without an International Non-Governmental Organization to back you up.

Update April 28th: read this excellent article from The Guardian

The fact is, now is not the time for an individual nurse or doctor  to come to Nepal, certainly not without a sending organization to back you up, and most definitely not without a lot of planning. The best advice is to get involved in fundraising and awareness, and to send money to a reputable organization such as the American-Nepal Medical Foundation.

At present, the need in the affected areas seems to be for Search and Rescue, and for earthmoving equipment for recovery. In Kathmandu itself, people are not trusting their buildings and sleeping in the street. As I write this it’s raining. In this early period, they need blankets, tents, food and clean water. The agencies that can supply this logistical stuff, on an industrial scale, will be the ones needed. Any other person will need so much assistance to navigate daily life, that they will probably get in the way. They are in danger of epidemic illness due to lack of clean water, close proximity to potential infected persons, and exposure to the elements.

“These best time to plant a tree is – twenty years ago.

The second-best time is – now.”

I hear that MSF is sending surgical teams, as are other large INGOs. Usually these groups have members that have done international disaster work before, and also can work with locals. I think that one rule learned from most acute-phase disasters is, the people on the ground at the time, need to do the heavy lifting. And they will.

Intermediate needs

In what ways is this situation like Haiti, and in what ways is it not like Haiti? I don’t know, because I never was in Haiti; but be advised, it takes two full days of travel just to get here from the USA, as opposed to a two-hour flight from Miami. In Haiti, the USA aid groups rotated many people in and out for just a week at a time, which would be highly unlikely here. The lead countries are likely to be India and Australia, each of which has longstanding ties to Nepal.

I have the impression that most hospitals in Kathmandu, esp the biggest ones (TUTH, Bir etc) are fully operational. They have plenty of nurses and doctors ( there are a half-dozen medical schools in greater Kathmandu). There is a sizeable population of Nepali nurses and doctors who live in other countries for economic reasons – these folks would be the best volunteers for immediate needs because they are already familiar with the system and they speak the language. There are other regions of Nepal that are relatively unaffected and if it became necessary, personnel from there could go to Kathmandu. I should note that no such call for Nepali personnel from unaffected regions has gone out.

The system of care in Nepal is very different than that of USA, and it takes a while to learn.

Longer term needs

There is a system of nursing and medical education here in Nepal, and CCNEPal has worked with nursing schools and medical schools to offer our program. Just because you would not be able to help right now does not mean that you should not help in the future.

If you have not travelled to a Low Income Country before, there is the very real problem of culture shock, and “reverse culture shock”. This was true even before the earthquake, and without a sending organization you would not get the psychological support to put it into perspective.

Global Nursing  the long run

This event leads to the question of how best to prepare nurses in USA for global humanitarian crises of this magnitude. Groups like Sigma Theta Tau have brought attention to the need, but I wonder about how this has translated into action.  Nepal has historically not been paired with the USA under the W.H. O. scheme of things, which has impacted funding of health-related projects from USA to here. I think it’s time to consider ways that USA and Nepal can collaborate on nursing education as well as medical education.

what to do right now?

Get involved in fund-raising efforts.

If you wish to learn more about the culture and the way hospitals work here, read past blog entries and buy one or both of my books. Neither of them is a best seller, but they were written with the intent of helping a nurse or doctor “get hip” about Nepal before volunteering here.

If you wish to become more global-nursing conscious, start with these twelve steps.

About Joe Niemczura, RN, MS

Experienced nursing educator and problem-solver. I have fifteen years of USA nursing faculty background. Add it with 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. I travel outside of Kathmandu Valley as well. When the recent violence happened, I knew the cities - I had trained people in those locations. 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. Global Health Nursing is not all sweetness and light; not solely milk & honey and happy moms and babies.
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6 Responses to Are nurses and doctors needed for earthquake relief in #Nepal right now?

  1. Martha says:

    Joe,
    I am so glad you are safe. The scope of this tragedy is overwhelming and your advice to send money to relief agencies is one I will do and pass on to others. Bless you for the work you do.
    Martha

  2. Pingback: Florence Nightingale’s birthday in #Nepal after the quake, May 4th 2015 | CCNEPal 2015

  3. Pingback: First-hand eye-witness description of nursing needs in earthquake-ravaged area of Nepal by a Nepali-American nurse | CCNEPal 2015

  4. Pingback: Medical Volunteers are urgently needed now in Nepal Jun 24th 2015 | CCNEPal 2015

  5. Pingback: How a doctor or nurse can prepare for a medical volunteer trip to Nepal since the April 2015 earthquake. | CCNEPal 2015

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