A team of five surgical nurses from Health Sciences North travelled to Nepal from April 30th to May 16th, 2015 to lend medical expertise and provide relief from the devastation of the April 25th 7.8 magnitude earthquake. What they found when they got there was beyond what they could ever imagine. To make matters even more urgent, Nepal was struck by a second 7.3 magnitude earthquake on May 12th.
One of the nurses, Wanda Deloye, recalls the experience in harrowing detail. Here is her story:
When we began this journey a few months back, we had no idea what life had in store for us.
We set off for India and Nepal expecting to have an adventure and make some memories, and our trip did not disappoint. Originally, we had planned on spending a few days in India before beginning our volunteering stint in Nepal through an organization called IVHQ. The nurses (Rachelle Brown, Cora Felbel, Wanda Deloye, Bev Marsh and Emily Hotti) were to volunteer at a hospital in Nepal while the others (Dave, Allen and Juliette Deloye) would spend their time teaching English and organizing sports and recreation at a local school.
We set off, our backpacks stuffed to the limits with protein bars, toys for the kids, medical supplies and our water purifying bottles. We had thought of everything. Or so we thought. After a very long journey to India (nearly 24 hours in transit), we finally arrived in Delhi, India. Straight out of the airport, we were assaulted by the sights and sounds of our new temporary home. Horns blared, auto rickshaws slickly weaved in and out of traffic, cows and goats sauntered up and down the middle of the roads, and everywhere, the smells of incense and humanity wafted to our nostrils.
As soon as we arrived at our hostel, in the heart of New Delhi, and our phones connected to the wifi, they came to life with hundreds of messages from home.
Apparently, while we were in flight, there had been a major earthquake in Nepal with a magnitude of 7.8.
It was still early and the entire picture of the devastation that would follow was not yet known. Immediately, we tried to contact IVHQ to see where we stood with their organization. Our flights to Kathmandu were already booked, as was our return tickets home, also from Kathmandu.
The following day, we received a generic email from them that stated that they would be in touch within 48 hours. That deadline came and went, and all of our emails went unanswered. Finally, on Tuesday morning, Wanda was able to contact someone at IVHQ who assured us that all was well and we would volunteer as planned. We spent the day at the Taj Mahal, only to return home after a long journey on a local train (yes, it is just like the movies) to find an email sent late Tuesday night informing us that, in fact, all programs for Nepal had been cancelled. We were in shock and unsure what to do now that we had travelled half-way around the world.
We had a group discussion about our options. We all decided that we still wanted to go and help in whatever way we could. None of us were sure what we would find when we arrived in Nepal. Would there even be a place for us to stay? Would there be rampant looting and destruction? After emailing our hostel in Kathmandu, we were assured that we could stay there for the duration of our time in Nepal. The contact stated that although they were not fully functional, they were open for business.
The morning of our flight came and we were quiet with contemplation and anticipation of what the next few weeks could bring. For awhile it seemed that we would never make to Nepal, as our flight seemed to endlessly circle over the airport in Kathmandu. It would seem that only two runways were up and running, and the air traffic was quite congested with all the planes arriving carrying aid from foreign countries. Finally, we landed. As we crossed the tarmac, we could see pallets upon pallets of shrink-wrapped boxes, labelled with all kinds of supplies, from tarps and tents, to food and sanitation products, bearing the flags and stamps from countries all across the globe.
The response from the world to aid this tiny country appeared to be overwhelming. But what was it all doing still sitting on the tarmac? Walking through the airport, we met people from all nations, bearing the names of the search and rescue or medical team they belonged to. Mexico, China, Russia, Germany and India were all represented, among many others. All seemed pretty normal in the airport, except for the occasional long cracks running along the floors or snaking up the walls.
Once we started our journey through Kathmandu, we really began to see the damage.
Entire houses, buildings and temples lay in complete ruins while other buildings were held precariously sideways, slumped for support on the ones next to them. Tents filled every open space and people slept on the streets under tarps. At our hostel, the Alobar1000, we learned that there was no hot water, almost no food and no electricity except for a generator that would run for an hour here and there. Candlelight filled the darkened hallways. One of the guests told us how she had been staying at that hostel during the earthquake. As the ground shook, the gas boiler fell from the fourth storey to the ground and spewed fumes and gas. People had run for their lives out into the streets. Entire families were separated, many of whom had not yet been reunited with their loved ones and eagerly waited for news of their condition.
Immediately, Dave, Allen and Juliette met with the organizer for All Hands and were signed up to bag relief kits in the morning. Wanda explained what had happened with IVHQ to the employee (Tashi Gale) at the hostel, who advised that we contact Dhulikhel Hospital. This hospital was one of the largest in the Kathmandu Valley, and due to its location near Everest and its proximity to the hardest hit areas, was struggling to handle the large influx of patients. As soon as the nurse manager at Dhulikhel heard that a group of five Canadian nurses wanted to come and help them out, she immediately offered to have the hospital bus pick us up in the morning.
As things have been going on this trip, the next morning, the hospital bus proves impossible to find among the two-kilometre stretch of buses and people. Finally, we are ushered onto a local bus, with the assurance that it will drop us off close to the hospital. With a hope and a prayer, we board the overcrowded bus, pressed like sardines into each other, even as more people scramble to ride on the roof. It is suffocating, loud and claustrophobic hour as the sweat rolls down our backs in the stifling heat. Just when we think we are never going to get there, that we have taken the wrong bus, the people at the front shout at us that this is our stop. We squeeze our way through, finally out into the fresh air. The amazingly breathtaking sight of the Nepal rice terraces, rising high up into the sky in all directions, greets us as we make our way to the hospital.
Outside the gates it is already chaos and we haven't even made it in the door yet. Nurses and medical staff swarm everywhere.
Patients in dirty clothes, with still dirtier wounds, lay on filthy mattresses out in the sun in the main square of the hospital. We make our way into the hospital and inquire as to where our contact is. After much searching, we are led to a conference room and instructed to go in. It is jam-packed with all sorts of people.
As quietly as we can, we make our way in and sit down. The head doctor is discussing the disaster and how to help Nepal and its people rebuild, repair and heal. Nurses and doctors each discuss their observations, and a few foreign doctors that have been out into the hardest hit villages in helicopters tell the stories of those who have been injured but have been unable to get any medical attention yet. Finally, the head doctor eyes rests on us and he asks us who we are. We introduce ourselves and he nods and welcomes us. We learn that this hospital has a capacity of 300 patients, but over 1,000 patients are currently admitted. More arrive all day by helicopter and ambulance and army, and the building that is still under construction, with no electricity and very little plumbing, is being used.
Once the meeting ends, we set off with the nurse manager and get a trial by fire. On that first day, we worked in the operating room where patients came in an endless stream, to lay on filthy used linens in their week-old unwashed clothes and bodies, to be repaired.
As flies swarmed around their wounds, surgeons did their best to disinfect the areas that were being operated on, and anesthetists did their best with limited equipment to keep their patients sedated. A feat that was often unmanageable.
Patients would remain unconscious for only brief periods of time before waking to moan in agony and reach for their open wounds only to be given enough medication to sedate them for a further few minutes.
Each surgery was an endless cycle of tormented waking and blissful unconsciousness.
The resourcefulness of the staff there was amazing and the toughness and strength of the patients was awe-inspiring. Through every door, in every wing, in every building, there was an unending train of stretchers, patients, doctors, nurses, families, children crying and the scent of festering infected wounds. We spent the day doing dressing changes outside on the ground in the courtyard, learning new ways of caring for people when resources were thin, and aiding doctors in whatever ways we could.
We were exhausted after nearly twelve straight hours of the non-stop chaos and sat tiredly, but satisfied, on the bus ride back. Dave, Allen and Juliette had spent a productive day making nearly 4,000 relief bags and were set to begin on food rations the next day. The nurses discussed what the best course of action was to improve the situation of the patients and a consensus was reached that a terminal clean was in order, both of the facilities and the patients.
The next morning, we purchased cloths and buckets as the hospital had nothing to wash their patients with, and we set to work. Every inch that we could get our hands on of the under-construction building housing hundreds of people was scrubbed and Viroxed. Patients were washed as one nurse held up a large sheet of foam we had found to offer some measure of privacy. We taught hand hygiene and encouraged the use of the hand sanitizers as often as we could. More dressing changes and the filling of medications for entire wards filled up the rest of our day.
While we were at the hospital, we had noticed that a small group had sent up tents in the tiny grass area. Various flags hung from a rope and laptops were set up on picnic tables in the sweltering heat. One of the nurses headed over to inquire about their team and to see if we could be of assistance, and had stopped to take a picture of a pond filled with thousands of tadpoles, when she heard the team leader say, "Now if only I had a few nurses!". Bev turned around and replied, "I'm a nurse. And I have four more over there". It was fate or a sign or perfect timing or whatever you want to call it.
Dr. Fahim Rahim had arrived in Nepal the same time as us and was heading up his organization, the JRM Foundation, to get relief out to the people of Nepal as quickly as possible. Along with his team, that included an orthopedic surgeon, an ICU doctor and an ER nurse, he was running the most efficient disaster relief team in the entirety of Nepal. Somehow, his magician helper named Bettina, had acquired him a helicopter.
They spent their days working the hospital, trying to get it in order, and making large amounts of food and medical supplies appear out of thin air. They would airlift hundreds of kilograms of food to villages that had not yet even been reached by any other organization.
For over a week, people in the remote villages had been literally starving to death, suffering from unimaginable injuries and sleeping in the open air with no water and no shelter.
Asking locals at one village would direct him to the next place that was in desperate need.
For over a week, his tiny team powered through and reached an enormous amount of people. For two days, free remote medical clinics were set up and we sweated our way through triaging and treating nearly 1,000 people with supplies and medicine that they had brought with them. This medicine almost never made it. At the airport, the Nepal government wanted to tax the 30 cases of medicine as an import. It would seem they changed their minds after it was pointed out that the CNN cameras and reporters would be more than happy to report such a travesty to the world.
Although Fahim's supplies made it through, many others were not so lucky. Untold numbers of aid that was sent, sat at borders and in airports, unable to be moved without the heavy tariffs and taxes that were being charged. Fortunately, for the people of Nepal, Fahim and his team had acquired an amazing local network and did so much good as a direct result of not having to deal with the bureaucratic red tape.
It was a learning and teaching experience for all of us, from delivering a baby in the back seat of a taxi, to teaching the best practice for dressing changes, and assisting in procedures that required us to be resourceful in ways we never imagined.
The day of the 7.3 magnitude aftershock, we had been invited by our nursing colleagues at the hospital to celebrate Nursing Week with them. We had slaved over a ridiculous hot plate at the hostel to make a large pasta salad. A feat that took over three hours. We had stopped at a market on the way to the hospital to pick up a few fresh vegetables, and were just finishing chopping them, when the earth began to shake.
Now, we had been feeling smaller aftershocks for almost the entirety of our trip, but nothing like this.
People ran screaming and crying from the building. We walked out onto a cement slab and looked up at the buildings above us that shook and swayed for a long 25 seconds.
Windows shattered and people hugged each other while we held our breath and waited to see what would happen.
Finally satisfied that it was over, we set off to find Bev who had been in another building. Shaken, but unharmed, we made our way up to the main courtyard. Once again, the patients had to be evacuated from the hospital. Triage areas were set up and the long task of moving over 700 people outside began. Before too long, another 6.8 magnitude tremor shook the buildings and our nerves.
We stayed as long as could before deciding that we had to get back to Kathmandu and make sure that Dave, Allen and Juliette were safe. Their task that day was to be clearing debris from some of the hardest hit areas and no doubt the aftershock would have been felt by them. After making a dash up the hill and through the perilous old buildings, we finally found a taxi willing to take us. The streets were filled with people, once again displaced from their homes, once again setting up tents. More buildings had come down and still the aftershocks came.
As we walked up the long alley leading to the hostel, Dave, Allen and Juliette appeared and we all hugged for a long time. We learned that the area they had been clearing debris had been quite unstable and many of the buildings and temples had come crashing down in a hail of dust and bricks as the tremor shook the area. They had all been separated at the time and were unsure of each other's safety. Allen had run through the dust searching for Dave and Juliette. Upon finding Juliette, shaken and in tears but much better once she saw her family, she recounted how she had turned to see people trying to make their way out of their houses only to have them collapse and bury them underneath.
We had a long discussion about where we should sleep that night, with the aftershocks still coming. In the end, we decided against going to a tent city.
We packed everything we owned and kept our shoes beside us in case we had to make a quick break for it.
Some people slept, only to be awoken by tremors throughout the night, while others paced uneasily almost until the sun came up.
Nepal was an experience that we will never forget. The nurses have no doubt that our training and experience on the Surgical Services unit prepared us well for our time as disaster relief nurses. With our broad range of skills and knowledge, we were a highly adaptable group that were a valuable asset to all we met. We taught and were taught and took home memories that will last a lifetime. Not one of us wanted to leave. The people of Nepal are a generous and welcoming community.
It pains us to think of the families lost, the children orphaned (which brings us to a whole other problem of child trafficking after disasters), the homes destroyed and heritage demolished. But we have learned that the people of Nepal are a resilient and resourceful people. So many people have reached out to us, commenting how we were an inspiration, that they were proud of us.
As Canadians, living in this privileged and amazing country, we are global citizens and we have an obligation to the world to share some of our wealth and knowledge.
We can tell you, first-hand, that there is no better bang for your buck than the JRM Foundation. They are currently hosting a "Million Dollar Challenge" to rebuild Nepal, from schools to ensure that children are not lost in the shuffle to child trafficking to feeding and rebuilding families.