East of Kathmandu is an area of Nepal called Kattike, Sindhupalchok where the Médecins du Monde (MdM) team were heading. A landslide had blocked the road but when the army cleared it, the small medical team moved in and set up a tented mobile clinic in the small village along a river between steep, rocky mountainsides.
For two weeks they treated on average 80 to 90 patients every day. In the beginning, the two nurses and one doctor primarily treated wounds, but soon the cases included an epidemic of diarrhea and contaminated water-related illnesses. The medical team planned to switch out with a new team every week.
Then the second earthquake hit on 12 May causing multiple landslides, blocking the road in many places.
'Our vehicle can’t get out,' says Nished Rijal, a Nepali who has been managing the clinic since it started more then two weeks ago. 'It’s only possible on helicopter now…or to walk, but it’s six hours walking and we don’t know the situation. What we’ve heard is there are many landslides, maybe 10 to 15, so we don’t know if it’s even possible to walk out. Maybe in some areas we can climb over the landslide, but others maybe not.'
Injuries and infections
Many of the seriously injured from the first earthquake were evacuated to Kathmandu for treatment, but people with minor injuries stayed behind, most receiving no treatment. What the medical team now sees are people with seriously infected wounds.
'Yesterday we saw a lady with a bad infection who had a cut from a stone,' Nished describes. 'When she heard that MdM was running a clinic here, she came, but it was very difficult to manage. We used to have 80-90 patients every day, but now we are having 50-60 per day. But that number is interesting in context. I’ve seen people who have walked seven to eight hours to come to the clinic.'
Nished said that people are also leaving the area if they can, like an exodus heading for Kathmandu out of fear of more earthquakes, more landslides, and the monsoon rains coming.
The team can hear landslides from their tents every night. 'Last night there was a big one that sounded like a huge boom,' said MdM’s Logistics Officer, Stevy. 'It was a landslide just 200 meters away on the other side of the river – a big one with huge rocks.' Even so, the team sleeps well after 14-hour workdays.
Stevy was in the village when the second large earthquake struck a few days earlier, standing just 50 meters from a collapsing house. They dug through the rubble with picks and shovels, not knowing if anyone was inside. No one died, and they treated only eight injuries, but one of them serious. A piece of metal roofing sliced one woman’s arm to the bone with only a small bit of skin and muscle hanging on. The doctor managed to stitch her up. They are hopeful she will be fine with continued follow-up visits.
The only way in or out
The helicopter on this day is taking in two Nepalese nurses and a Logistics Officer to replace three staff in Kattike. It’s the first time for the two nurses to ever step foot in a helicopter and they’re excited and a little scared, holding hands tightly through the most of the flight.
One of the nurses, Pratiksha Shah was on her way by car to the clinic three days earlier when the earthquake hit. They saw landslides and houses fall, but continued on their journey until the road was completely blocked by a landslide with enormous rocks.
'We don’t have any access by road now,' Nished said, 'and we don’t know when the road will be cleared for vehicles. We can’t walk as it’s very difficult and dangerous. The only option for us to run the clinic now is through the helicopters.'
Médecins du Monde isn’t about to let a blocked road stop them from doing their work. Since 2007, MdM has worked in Nepal, including this district. They are planning to set up more mobile clinics in other areas that will also likely be accessible only by helicopter.