May 27th eye-witness report #2 by Nepali nurse from USA after earthquake relief expedition


Editor’s Note; Unita Magar, RN is a nurse who now lives in Omaha, Nebraska. She attended nursing graduate school in New York City but Unita is originally from Rukum district in western Nepal. She is active in NANA, the professional association for Nepali nurses in USA. With her colleagues, she flew to Kathmandu after the April 25th earthquake. Here is the story of her trip to the affected area.

On her FaceBook page she posted 150 pictures. I will cull those and add some to this blog. For now, the text is important enough to rush to print. The words are hers.

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For our first trip, our medical team consisted of 11 health care professionals in total: 4 NANA nurses, 3 NAN nurses, 3 medical doctors and 1 health assistant. Altogether, we were 29 of us with river rats (rafting brothers), a mouse (Frank), mountain cats brothers (Climbers) and a local’s team (Bobby dai and his team).

We were able to see 245 patients in about 9 villages in total. On the first day, all of us stayed at the base. On the second day, we divided the team into three groups. First team stayed at the base, second team went to Yangri and the surrounding villages and the third team went to Yarsa, Chunti, Bhotang Gumba, Thorbang, Meu Gau, Kuldi and Mane Gau. The roads to the villages had multiple landslides – some of them had huge rocks and fallen trees blocking the roads. The teams had to walk or crawl up the rubbles to get to the other side. Our team had one doctor, two nurses, one river rafting brother, one kitchen brother and two locals. Initially, when we left the base, we did not have any locals in the team. We were told by Bobby dai that we would find someone as we walked to the village. We found two locals who were very willing to take us around at Bhotang Gumba, our first stop. The hike to Bhotang Gumba was quite steep. From there, we moved from village to village stopping at a public school that had been badly damaged from the first earthquake for our lunch that consisted of chiura (beaten rice) and dalmot, roti (chapati) , boiled potato, small amount of salt wrapped inside a tissue paper to dip potato in and buffalo jerky. It tasted so good. It took me back to my childhood days, when I would go to fetch woods with group of women in the jungle during my summer visits to my grandparents in Rukum and we would rest to eat our lunch of bhuteko makai (popcorn), bhatmas (soybean seeds) and ussineko aloo (boiled potatoes). It made me nostalgic.

We went from door to door on that day, asking, “Yaha kohi birami hunuhuncha?” (Is anybody sick/ill here?). Sometimes, the answer would be “Yes,” and at other times “No.” If there was any sick person in the house, we would stop by, open our rucksack of medical and dressing supplies, examine the patient, treat, educate and then go to the next house. At some places, we would use the side of the road to place our rucksack and treat patients.

At one of the villages, we used our whistle to alert and call upon the villagers. This particular village sat lower on the same mountain to the village we were treating patients at. It was perhaps 10-15 minutes hike, but with rubbles of stones from fallen houses everywhere it may have taken us longer to reach there. When we blew the whistle and screamed at the top of our lungs – “Yaha kohi birami hunhuncha” (Is anybody sick and needs to see a doctor?), some of the villagers turned their heads around and screamed back, “chaina,” (No).

On the way to the villages, two of our team members slipped through the mud and fell on their backs. Thankfully, nobody got hurt. One of them had left behind her two young sons in the States to help with the relief work. Bless her heart for the sacrifice that she made for the people in Nepal. We also had another didi on our team who also left her young sons, one of them as young as three years old to help with relief work. Bless both of their hearts, only they know what it means to leave behind their young children for a cause.

It took us whole day to cover all the villages. At one of the villages, rice and noodles were being distributed by a local group. We purposefully chose to sit in between that particular village (which we had already covered) and the village that we had yet to see, to capture patients from the village we needed to see yet. The technique worked because the villagers stopped by with their ailments and we were able to see quite a few patients. It was already about 5.45 pm – getting dark and we needed to be at the base by 6 pm. We were tired and without any energy as we kept getting pages from the base camp asking us about our whereabouts. By then we were beyond exhaustion to even answer our walkie talkie. However, we knew and were conscientious about not leaving any patients behind without seeing them.

As we walked towards the base, we stopped by a hotel (only hotel in that village) to treat ourselves to wai wai soup (noodle soup). Oh boy, did it taste good! It had never tasted so good. I practically gulped down the whole bowl in two minutes and looked around to see that my team mates had only eaten few spoonfuls. I felt embarrassed. When the tab came, the total payment was very less than we had thought. Nima didi and I thought, the hotel owner probably gave us a big discount. Simple generous gestures like this was present everywhere.

We then made our way to the base camp joking amongst ourselves – feeling accomplished, although way too late than our curfew time of 6 pm. But, we were all so happy and well-satisfied that we had been able to cover all the villages even if it meant working till dark. Only at night in our tents did we realize about the aches in our bodies and feet.

We could not have done it without our 4 brothers – 2 brothers carrying our backpacks and 2 local volunteer brothers, who refused to be acknowledged for their time and effort. They literally held our hands to help us climb a steep hill, jump from a wall or go across to the other side through the narrow roads strewn with rubbles. Without their help we probably would have fallen and scraped ourselves numerous times. They also acted as our health educators during times when three of us got extremely busy treating patients. They taught the villagers to wash their hands before eating and after using toilets, to boil their water before drinking and not to eat meat of the dead animals.

On that day our team was able to see more than 50 patients. A young boy of about 9 years old was also referred to a hospital in KTM for hematoma on his lower back. He seemed to be in a lot of pain. It took us a while to convince his parents to send him to a hospital in KTM. The mother kept mentioning that they could not leave the next day because there was a “Ghewa,” a funeral ritual to attend to. It was a serious case and the boy could not wait to lose anymore time. We also communicated the need via our walkie talkie with the base. Next morning, two brothers had to run to the village to get the boy so that he would not miss the helicopter. He was airlifted the next morning to Kathmandu with other patients with critical conditions. Satish dai and Ang dai personally contributed money for the helicopter.

Next afternoon, we had to leave for KTM. Our initial plan was to stop by the village Dhap and distribute Phenyl liquid, dettol soap and few other supplies before heading to KTM. This is because Dhap was the only village that had a very bad odor – smelled of something rotten and we were concerned about the public health issues there. However, we could not do so because we had to take another way towards KTM as a vehicle had fallen down from the mountainous road we had initially intended to take.

The ride was bumpy as the vehicle jumped up and down on the gravels. The road was muddy, very narrow, winding and often perched on the steep mountains. This meant if the vehicle missed even an inch on the side of the road overlooking the river, we would all be tumbling and tumbling and then tumbling some more until we reached the bottom. What made me cringe and hold fastened to my seat was that the driver would look at the passengers instead of the road while talking and driving. At one time, I even pointed it to the driver dai ; perhaps it was rude but I couldn’t resist.

Just before we reached KTM, our tire got punctured. Perhaps, it happened for a reason. Fixing the tire took us about thirty minutes and this made us reach our destination thirty minutes late, but what we were met with on the way we could not believe our eyes. We were distressed to find a driver stuck inside the truck that had landed on its head on the side of the road as it slipped from the hill above. It was drizzling as well. The truck had slipped from the exact location our vehicle was parked. The skid marks from the tires were still visible – scary! It could have been us. The truck was vertically standing on its head with its tail in the air. Talk about disaster! Just then a van full of police also drove by and we directed them to the accident on the road below. The driver was finally rescued by Ang dai and the team after numerous attempts. The rafting brothers took care of the crowd control while the medical team attended to the driver. The conductor apparently did not get hurt. Initially, I was also made to hold hands with the rest of the crowd, while I struggled to explain to them in the dark that I was also part of the medical team and I needed to deliver supplies to them. The driver was conscious, however his face gave an expression that he was in shock. While we were still busy applying bandages to his visible injuries ambulance arrived and he was taken to the hospital.

By then I had sort of become numb after seeing so much in such little time. If I was feeling this way just by seeing them, what about the people who have experienced so much loss and in so little time? I cannot even imagine. But, such strong, resilient, generous, humble and content people filled with so much gratitude even with all their losses – offering you their tea, their limited food and resources even after knowing they may not have enough. What we were doing was very little compared to their gratitudes and generosity. May God bless them for eons and eons and give them strength to live through this. Bhotang VDC, you will always have a special place in my heart.

Thank you to our local volunteer brothers for bringing villagers in some villages. The villagers were ready for us to see them when we reached there.

Conditions we encountered most were URI – dry cough, stomach ache, GERD, headache r/t PTSD?, ankle pain, muscular pain, wounds, cuts & injuries r/t earthquake, I & D, diarrhea, a case of ascites, a case of CHF, and few other conditions.

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I will add some photos from her FB page. If anybody wishes to get in touch with Ms. Magar, send me a message and I will get it to her.

Also – in Kathmandu. I am told that the inpatient areas of most hospitals are having very low census right now because nobody is having elective surgery. Also, no patient seems willing to be admitted to a room on the second floor of any building, so the hospitals are reconfiguring to keep as many patient beds on ground floor as possible. Finally, the families are insisting to be with their loved on at all times. I know some will think this is a generalization. But – it’s what I have heard…..

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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