The recent 7.9 magnitude earthquake devastated the Kathmandu Valley. Thousands of people died. Scores needed costly orthopedic care. With less than 200 trained orthopedic surgeons in a country of nearly 29 million people, and as one of the poorest countries in the world, Nepal continues to need help caring for the injured and disabled.
Nepal Orthopedic Hospital, dedicated to the charitable care of the poor, is one of the few Nepalese hospitals providing contemporary orthopedic care. Over the last 5 years, Operation Walk Chicago has partnered with Nepal Orthopedic Hospital in Kathmandu, Nepal to develop a joint replacement program and upgrade their orthopedic surgery capacity.”Fortunately, Nepal Orthopedic Hospital is standing”, reports Victoria Brander MD, co-founder and Director of Operation Walk Chicago. “But there are trauma patients on the lawn, in the stairwells and hallways awaiting triage and care. They are operating in a makeshift theatre on the ground floor because everyone is afraid of the continuous aftershocks. The system is overwhelmed. They are in desperate need of resources — blood donations, money, surgeons, nurses, fresh water. Everything.”
Operation Walk’s involvement with Nepal Orthopedic Hospital, during the Great Earthquakes
Working in Nepal during the Earthquakes: Journal Entry
May 12 , 2015
by Victoria Brander MD, Founder and Director, Operation Walk Chicago
Over the last 5 years, Operation Walk has partnered with Nepal Orthopedic Hospital to develop a program for elective hip and knee replacement surgery, which reduce pain and improve function in patients with painful arthritis. Arthritis of the hip and knee is one of the leading causes of disability in Nepal, and across the world. Because of its high cost, lack of specialized facilities, and inexperience with the procedure, joint replacements are rare in Nepal. One study estimated that over half of people living in rural Nepalese villages suffer pain or disability from arthritis. The societal impact of untreated arthritis in Nepal is profound –families survive at subsidence level and cannot withstand losing a provider to disability from arthritis.
Nepal Orthopedic Hospital, with our collaboration and led by its medical director, Dr. Saju Pradhan, has a developed an excellent joint replacement program. We had planned to bring a team of 30 specialists back to Nepal in November 2015 to perform about 40 free hip or knee replacements. However, the earthquake changed everything.
On Saturday, April 28th, 2015 Nepal suffered a 7.8M Earthquake, the worst natural disaster to hit Nepal in over 75 years. Hundreds of thousands of people were left homeless. Entire villages were flattened. Cultural significant areas, such as the Unesco World Heritage sites of Bhaktapur, Patam and Kathmandu Durbar Square, were devastated. Scores were dead or wounded. About 12 hours after the earthquake Dr Pradhan and Dr. Anil Shrestha (founder of Nepal Orthopedic Hospital), reached out for help. The hospital, fortunately was standing. They were inundated with earthquake victims, mostly poor and had lost everything. They had no idea how they would continue to pay for and provide care for the hundreds of patients that were showing up.
We made a deal. We decided the ethical, compassionate and appropriate choice was to convert the hospital into a 100% charity facility for earthquake victims. We agreed that Drs. Pradhan, Shrestha and their staff should focus entirely on caring for patients. Operation Walk Chicago would focus on obtaining the resources, and we would guarantee payment, at least initially, of the hospital’s operating costs, work to obtain the critical medical instruments, implants and supplies, and send medical teams when needed. No patient would be charged or turned away, and patients & staff would be given 2 meals a day. Many staff would go one to work 12-16 hours a day, some sleeping at the hospital, and many whose own homes were damaged or destroyed or whom had lost relatives.
After that day, Nepal Orthopedic Hospital, together with Operation Walk Chicago (long distances as well as with out teams in the country) cared for over 1500 patients. A small Operation Walk Chicago team (Dr Scott Cordes, Dr William Gilligan, Dr Kirin Chekka, Nurse Liz Cumpian, OR scrub nurse Eliot Rosado, and Dr Victoria Brander) arrived over a week after the earthquake, when Dr. Pradhan indicated he needed our surgical expertise. We saw the patients filling every bed, in every hallway and even being treated in field hospital tents on the lawn. At one point, the hospital, usually a 100-bed facility had 180 inpatients. We helped NOH care for patients with devastating pelvic trauma, femur fractures, children with multiple trauma. With other partners, such as Project Cure and Direct Relief, we arranged delivery of critical medical and surgical supplies, one of which arrived the day before the second earthquake.
We visited some important towns, witnessing first hand the unspeakable destruction and suffering of the Nepali who live there. Although the devastation was heart-breaking, it was inspiring to see the busloads of Nepalese volunteers helping their fellow citizens in Saankhu, carefully removing, brick by brick, debris from collapsed buildings. We were left speechless in beautiful Bhaktapur (a Unesco World Heritage site), where piles of bricks lie in place of the magnificent temples and homes there we saw on our last visit to Nepal, during better times.
Over two weeks after the Great quake (as the Nepali started to refer to the event), the capital city, Kathmandu, started to come to life again. Although there were hundreds of thousands still homeless, there appeared to be a process taking shape,with roads starting to open, and long delayed relief starting to reach teh villages outside Kathmandu (however remote villages were still unreached). Foreign first responder crews, those that helped dig out and rescue trapped, started to leave, making room for medical personnel, engineers, and other humanitarian volunteers. The Nepali had started to become less afraid, as the aftershocks dissapated.
On Monday, May 10th there was a prolonged, loud rumble which led to violent shaking; many buildings which had sustained structural damage during the first quake started to collapse. It was a 7.4M earthquake, and it was followed shortly after by a 6.3M earthquake minutes later. The Nepali people were so terrified and overwhelmed that this second quake exposed panic; they ran into the streets, screaming. Many of the new injuries that poured into our hospital were obtained because of panic – fractures sustained from jumping out of 2nd or 3rd story windows. Our team was operating on a patient (in a 3rd floor OR) when the 7.4 temblor struck. They stayed with the patient, protecting the unconscious patient from injury. Dr Cordes recalled first hearing a deep rumble, thinking it was one of many aftershocks the team experienced over the week. But it was longer lasting and then the building began to violently shake. They could hear screaming from all over the hospital – especially from the terrified patients who were lying in traction in bed and thus could not move. The Operation Walk team finished the case and wheeled the patient into a field tent again set up on the lawn. Over two hours, they and the hospital employees returned into the hospital to removed patients and set them up on the lawn, where, according to Dr Pradhan, they will start again, from scratch.
Operation Walk Chicago is collecting donations for the Nepal Orthopedic Hospital in Kathmandu, Nepal. All donations will be used to provide emergency and followup charitable orthopedic care for the poor, who will be disproportionately affected by this profound tragedy. Donations can be provided on our Donations Page. Please indicate “Nepal Relief” on the form.
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