The rainy season in Nepal usually starts in June, but this year heavy showers and winds began to make intermittent appearances starting the beginning of May. At home, I look forward to listening to the gentle sound of rain falling on the roof as I fall asleep. In Nepal, rainstorms are a much less subtle and gentle affair. Just the other day, a storm hit Dhading and Kathmandu. I watched from an upper porch as the sky quickly turned black, the rain began to pour mercilessly and the wind violently picked up speed- dangerously hurling earthquake debris through the streets. As the first earthquake had done to stone homes, the winds and the rains swiftly destroyed newly created tent homes. While no one was injured in Dhading, a few individuals died after being struck by flying debris in Kathmandu. This is just a taste of what the monsoon season may bring.
Of course, the winds and the rains take a toll on the relief teams as well as the local population. The day following the storm, the helicopter had to reroute in order to pick up one of our teams in the field early. The storm had destroyed their campsite and they spent the night wet, cold and unnerved. While the mobile medical team in Dhading never had to deal with a destroyed campsite, we did have to make a few emergency helicopter landings after flying unwillingly into rainstorms.
On one occasion, our pilot had to set the helicopter down on a mountain ridge until the rains eased and he could once again see the mountains on either side of us. While our helicopter pilots always use GPS, no skilled Nepalese pilot will ever fly through the mountains without visibility. The same day, our last helicopter run had to make an emergency fuel landing in a mountain village- having used up too much fuel on the previous emergency landing. Luckily, we have arguably some of the best pilots in the business. All of our pilots have military background and many years of experience. Many of them have grown up in the Himalayan Mountains- one even flew us over his home so that we could wave to his mother. In addition to excellent pilots, all of our flights have a long line helicopter rescue specialist onboard- his name is Tshering. Tshering is quite famous in these parts for the number of high altitude and technically challenging rescue missions he has successfully accomplished in the greater Himalayan Mountains. He has climbed Mount Everest six times- four of those times without oxygen -and he owns his own expedition company. It was with Tshering and our pilot’s help that we found our next mobile medical unit location.
Due to government issues outside of our control, we have had to continue our work in the neighboring district of Gorkha instead of Dhading. On the day of the mobile medical unit, we loaded onto the helicopter and headed to the predetermined site. Once on the ground, it was clear that the village was not in need of our immediate assistance- a welcomed surprise. I jumped back onto the helicopter and headed to scout out the mobile medical unit back up site. Being near the epicenter, the backup location is in great need of assistance, but a number of relief groups are already hard at work in the area. Frustrated and running out of time, I pulled out my map and laid it on top of the helicopter side basket. Both Tshering and the pilot have flown all over Nepal assisting with relief efforts and, as a result, have a good idea of where the most damaged areas lie and where relief groups are working. With their help, a third location was selected- a village named Aprik.
Aprik does not sit high up in the mountains; rather, it sits in a low-lying basin surrounded on all sides by towering hills. We landed precariously on the edge of a cornfield and I jumped out with a translator to try and verify if the area needed assistance. As I moved away from the helicopter and the dust cloud began to settle, I began to see first one, then two, then hundreds of pairs of dark eyes peering cautiously out of the cornfield. Eventually, a few villagers ventured towards me. When nothing terrible happened, the rest of the eyes began to move closer and in no time many villagers surrounded us. It was clear that the village had been badly damaged by the earthquake and, per the village chief, no medical help had yet reached them. After sending the helicopter to pick up the medical team, we followed the villagers on a never-ending trail through cornfields, over demolished homes and around cow pens, until we came to what was left of the school. Because the school still had a stable metal and aluminum roof, we were able to clear out the remaining debris and turn it into a covered clinic and campsite. As soon as the medical team arrived we opened clinic, as over a hundred patients were already assembled and waiting patiently in line. By the end of the first day, we had seen two hundred patients and were out of supplies. For the first time ever, an early morning supply drop had to be organized by satellite phone in order to continue running the clinic the following day.
On that first day of clinic, a woman had approached us crying. Her young teenage daughter had been inside of their stone home during the earthquake. The house collapsed and crushed her left leg. They were able to carry her to the nearest health post, where she was evacuated to Kathmandu to repair her open femur fracture. After surgery, she was sent home in a cast- she has been bed bound ever since. The young girl’s mother was beside herself and begged us to visit her home. There was enough light after clinic, so a small team of nurses and doctor’s walked to the near-by home to assess the young girl.
We followed the woman until we came upon a small dark shack that sits directly across from a large pile of mangled wood, rock and aluminum- their previous home. After entering the shack and letting our eyes adjust to the darkness, we found a young girl lying on a thin mat on the ground- her left leg enveloped in a large cast and a desperate look upon her face. The physicians assessed the leg and decided to remove the cast- a decision that immediately brought a wide smile to the young girl’s face. With a pair of old trauma shears and a lot of sweat, the cast was eventually removed. One of the nurses with us had a similar injury only a few years ago and spent the next hour teaching the young girl and her family all of the physical therapy techniques she had utilized in her own recovery process. Using the skills we have as health care professionals is rewarding, but being able to transform our own struggles or traumatic experiences into a tool to heal another is incomparable. Sometimes the compassion, kindness and help we offer another becomes the very cure our own beings require.
Most of the injuries we treat are physical, though occasionally, we come across a person seeking to heal a much deeper wound. On our second day of clinic, we encountered such a patient- an elderly woman. She waited patiently in line with all of the other patients. When her turn for registration came, she denied having any physical ailment, but insisted on registering all the same. Confused, registration brought me her paper. As they explained the situation, the elderly woman sat quietly- not participating or even acknowledging the many conversations going on around her. Her face was drawn and the weight of whatever internal burden she was carrying seemed to almost physically rest on her shoulders.
I assigned her to two of the most gentle and caring nurses – who happened to be working as a team that day. Before the woman could even sit down, she erupted into tears. True to form, both nurses immediately came to her side and gently escorted her to a seat. They sat beside her and let her begin to tell her story. The elderly woman began by speaking about her daughter. She described her as beautiful, kind, generous and a wonderful mother of two children. Her daughter died in the earthquake, leaving the elderly woman to care for both grandchildren. As the woman continued to cry and speak about the pain of losing her daughter, the nurses cried with her and did their best to comfort her. After awhile, the elderly woman left- with a heartache that only time can heal, but with a lighter step and a genuine smile on her face.
To be compassionate, to care and to love is to open our hearts to suffering, as it causes us to share in the pain and suffering of another. Allowing our hearts to experience and carry that pain for even a moment has the power to renew the courage and strength of another. Even as health care providers, sometimes the greatest gift we can offer is companionship and empathy when our patients find themselves alone in the darkness of their grief and suffering- as those nurses did for the elderly woman in Aprik.
Relief work can be difficult. We often find ourselves in the middle of war, famine, disease, and disaster- we see humanity at its worst. More often, we witness great courage, strength and compassion- we see humanity at its best. We are able to see humanity rise above atrocious circumstances and we are able to assist them in their fight for dignity and life. It gives us hope for humanity, hope for the future and the determination to continue. There is goodness in this world and it’s is worth fighting for.