A rural doctor’s earthquake experience

This is the story of a doctor’s experience in the worst case disaster situation, it is a story unsung bravery and of the courage staff at Jiri Hospital, Nepal, displayed during and after the disaster - Dr Roshan Khatri, Medical Superintendent at Jiri Hospital, Dolakha district east of Kathmandu writes.

The strike:

We had just finished examining new cases on that day, May 12th 2015. We were following up with investigation results in our patient examination room when the earth beneath us began to beat the drums.

Our team and patients had experienced violent shakes in the April 25th quake, and remembered the noise of massive drums being beaten deep underneath, were aware of what was about to happen next so soon cleared the room and were running in all directions.

The only word anyone uttered was “ayo ayo, bhuichalo ayo, bhaga bhaga” ( Earthquake, earthquake, run, run). It took some time for me to gather myself, some time to mentally assemble my next step. I remembered running in cases of earthquakes is a big no, the advice is to find a table, a bed, a door frame and save your head. I was sitting on a chair, had my arms on a table and a bed just a few steps away. But this time it was big, the shakes were violent and I realized that the walls of this building would not be able to with stand it. I had to run, to flee for safe ground or risk being crushed.

Photo: Our pharmacy building turning into rubble just as the earthquake was happening.

As I stepped outdoors, clouds of dust were rising from all directions and hospital staff and patients were running in all possible directions searching for open ground.

The quake struck at the busiest moment of the day for our nursing staff so I tried to run towards the indoor block knowing they would need help, suddenly one of our laboratory staff who was panic-stricken and so shaken from the quakes emerged out from the lab and collided with me and she fell flat on the ground.

She was totally blank and wasn’t able to speak. I helped her up and took her to open ground, where I saw almost all the patients and staff. Up in the nearby town all we could see was clouds of dust and smoke. We could hear loud thuds of houses turning into piles of stone and wood.
I felt that at any moment flocks of injured people would be rushed into the hospital and we should be ready to receive them. But our story was no better. Our store rooms, and our inpatient ward building were like ticking time bombs ready to drop flat into big piles of rocks.

All the hospital staff were panic-stricken. Everyone was trying to make contact with their families, although this was futile, with telephone networks long gone, local staff had already rushed to locate their loved ones.
 
I tried to gather as many staff as I could. Everyone was shaken; scared, in a turmoil of thought processes, it was a situation where your senses and brain decide to give up on you, there was a unique combination of fear, confusion, anxiety and emotion. I had to shout at the top of my lungs to gather their attention. I grabbed each of the shaky ones and console them. I told them that this was our moment, that it was us now who should be brave and be prepared for the worst case scenario.


Photos:  (Left) Counselling room for patients and discussion room for doctors and nurses and (right) Pharmacy and guest room.

We decided to use our badminton court as emergency arena, while the bigger challenge lay in gathering our medical and emergency supplies from piles of stones, all the time the earth beneath us still shaking.

Time was of essence so I decided that each of the men would rush inside the building one by one, grab the first thing they could see and walk out as soon as possible. staff wanted to take part in this as much as the men did, if not more and in no time, we were all able to set up our emergency triage center, gather adequate medical supplies, and be prepared for the emergency management of all cases about to come within few minutes of the disaster.

Photo: Our makeshift hospital – with sincere gratitude to all the donor agencies for the tents and supplies. In this picture is our Out patient department, Inpatient ward with 18 beds, Post-op tent with 3 beds, and a Emergency tent plus a duty room.

The Rebuidling

With the harsh monsoons knocking at our front door, all we lack now is the pleasure of time!

We have gathered all the resources possible and have started rebuilding. Our target for now is to shift all the patients, outpatient clinics and the quarters indoors within one month.

Our first priority was to provide safe and clean drinking water to all our patients, staffs and the public, hence we have setup an electrical water purification plant near our tents. (photo right)  This supply is open to all patients, visitors, staff and the public.

Strange but true, number of regular surgical cases increased drastically after the quake. It was a very difficult time for us, more for the new mothers, a very strange world indeed to welcome our new-born. We had to conduct seven C-sections within a period of one month since the first quake in April and 20 normal deliveries. Five of the deliveries were conducted in the open since the patient and the family didn’t approve of going indoors.

Photo: First time mother of one day along with her baby leaving the hospital early morning on a bamboo basket carried by the father. Their home is six hours away for a normal person without a bag pack. I wonder how and when they might have made home?

Editor's note:
Roshan has informed us that the Jiri hospital management committee decided to begin with reconstruction as soon as possible to shift their patients, their hospital and staff indoors. The hospital management committee is supervising all works and strictly governing the financial activities. "We are relying on many different friends like yourself on this project, hence we are regularly providing financial updates and feedback. We will acknowledge the receipt of any aid as soon as we receive it and give you the detailed worksheet of its expenditures."

If you wish to help Jiri Hospital bank details are as follows:
Prime Commercial Bank Limited
Swift Code: PCBLNPKA
Jiri Branch
I.B.A.N. : 008-00800436SA
A/C HOLDER Name: Jiri Hospital Samiti saving account

Roshan adds that details of activities are on Jiri hospital facebook page. Some of Jiri hospital's activities have been covered in the national dailies. You can also follow his personal blogpost for details of the earthquake, damages caused to the hospital and everyday activities.

See more articles from the WONCA Working Party on Rural Practice feature