The earthquake struck at 11:58 on Saturday, April 25th, 2015. There was violent shaking like never before ever. The Magnitude 7.8 earthquake lasted for over a minute. It continued the whole day and late into the evening with large and violent shakes. Roads cracked, house turned and shifted and some collapsed and some cracked. Old buildings mostly cracked or collapsed. Heritage monuments including principal pagodas in all three towns of Lalitpur, Bhaktapur and Kathmandu collapsed. The monumental Dharahara tower collapsed and turned into rubble. Luckily Saturday being a holiday, all offices and schools were closed. Casualty was lower than predicted. Our hospital had no OPD on Saturday. Structural damage to the hospital has been negligible.
Most casualties and fatalities occurred in the old parts of town and also from the nearby hilly districts of Dhading, Nuwakot and Sindhupalchowk. The old town of Saankhu in
Kathmandu district had 1000 houses out of which only 400 remained standing. Landslides and avalanches occurred in the mountains. Search and rescue was not possible immediately.
Nepal Orthopaedic Hospital had people coming in from late afternoon. Place was very chaotic. Patients refused to stay indoors as there were powerful aftershocks and the hospital was shaking like a vibrator. Most patients were kept in the first floor on Saturday.
April 26th was quieter with only moderate jolts of aftershocks. Whole team of doctors and nurses and paramedics came in for regular work.
We had a joint meeting in the morning with all departments including radiology, anaesthesiology, orthopaedic surgeons, physiotherapists, ortho surgeons, administration, emergency, nursing, pathology and pharmacy. Plan was to remain organized and work in a co-ordinated manner. We temporarily shifted the operation theater to the emergency room on the first floor. All patients were kept on the first floor in the general wards and in the lobby and physiotherapy department. OPD patients were seen at the front of the hospital in front of the circular garden.
Surgery was planned for six patients with open and closed tibia and femur fractures. Suddenly there was this big jolt of earthquake measuring 6.9 on the Richter scale at around 12:56 in the noon. There was chaos in the OR and everywhere. People were running helter- skelter. The organized activity turned very disorderly. There was no room left in the front of the hospital as all patients from the first floor came pouring out in the front open space. There were more patients coming to NOH from outside than we could handle and there were patients' relatives and by-standers crowding the place. Crowd management became very difficult. Police were called in to control the crowd and all except one attendant was allowed for each patient. The gate into the hospital was controlled and finally the scene turned manageable.
Patients, attendants and health care givers all were frightened. Only three surgeries were possible that day and OR had to be cancelled. Decision was made to turn NOH into a field hospital. NOH asked for tents from Red Cross and Army and other organizations. No government help came through. NOH had run out of medicines and plaster casts and bandages and painkillers. Finally at 400 pm one tent donated by UNICEF arrived and it was quickly assembled by NOH staff and there were impromptu tarpaulin tents made to house the patients in the front space of the hospital. NOH canteen ran out of food and arrangements were made to stock food for staff and patients and also for medicines and supplies. All shops were closed. Chaos was compounded by rain and quickly patients were arranged tightly under the UNICEF tent and the makeshift tarpaulin covers. By late evening one army tent arrived and some more patients were housed there with some being stationed in the reception and registration areas on the ground floor.
Till morning X-rays and lab tests were done and in the afternoon, these were stopped and splinting and bandaging of fractures and dislocations were done. Open wounds were cleaned and dressed and splinted. We called that damage control. Dislocations were relocated with IM analgesia. Most patients were advised to come later for admission as there were not enough beds. Around 60 patients needed surgery.
April 27th had less powerful aftershocks and NOH field hospital was running smoothly. Morning meeting was held quickly and surgery was planned for patients. Plan was to shift patients in the ground floor wards and in the evening and maybe start surgery normally in the regular OR next day. Lab tests and x-rays were done on all patients. Patients were admitted according to need. Patients were given free snacks by the hospital and all patients were treated for free.
The load of patients needing surgery is very high and patients will still be coming as other hospitals are also packed. We need to help these patients. We need medicines and implants and food and support for these patients who are injured bodily and psychologically. Some patients were buried in rubble and rescued, some had loved ones die in front of them. Nepalese are very poor. They cannot afford surgery. We need financial help for treating them. We need a lot of money for that. The nearest guess is that we will need money to treat at least a hundred inpatients. If we can treat patients for free, more patients in need will come for treatment to NOH.
NOH is a non-profit, non-governnmental organization and we need to pay our staff salary. If we keep on treating the patients for free, NOH will not be able to pay staff their salary this month.
. You can also get our account details by calling us at the following numbers: 977-1-4911725, 977-1-4911274, 977-1-4910505.
Nature has been very harsh to us. Let me thank you for all for sending your messages of support. Please spread the word for financial support to victims of the earthquake so that needful surgery can be done. Please help NOH so that we can help earthquake victims.
I pray to the Almighty that this punishment be stopped and the jolts stop on the poorest peoples on earth.
Dr. Saju Pradhan
Nepal Orthopaedic Hospital