The destruction and hope in
Kerauja is a picturesque village that sits between two massive mountains with a population around 3000. When the quake came, it wiped out many lives and left only around 4 buildings intact.
When we landed there, the villagers were rebuilding their houses, scrapping off the grains from the mixture of mud and stones and moving their belongings uphill to their animal sheds — गोठ. Kids started to pick up our bags and ran up the hill faster, to the clinic site, than we could take our bags back.
The trails were gone and the village was cut off from the rest of the country. We met a couple of Nepal Army soldiers camping out to provide relief materials but their own rations were running out. I have developed a huge respect for the Nepal Army personnel.
The bureaucracy is dysfunctional as is evident in the district coordination meetings but the army and police, I would argue, are the functional arms of the government that have worked well against all odds to maintain peace amongst the chaos. Their presence has been reassuring.
One soldier said his own house was destroyed in his village but he was there helping others pull their loved ones from the debris. He cried as we let him use our sat-phone to call his family to inform he was alive and found out that all his family members were safe. Then they quickly divided themselves to help us manage the hundreds of patients that lined up to see us.
We still saw trauma and minor injuries from “falling rocks” — ढूंगाले लाग्यो. While the initial injuries were caused by the quake and falling debris, the current ones were caused while rebuilding their broken houses or cleaning the debris for their belongings. It seemed as if fate had decided to kick them twice.
All the structures were destroyed and even the health workers were busy repairing their own houses in the villages. The animal sheds — “गोठ” were spared so people were now moving in with their animals or into empty sheds as the animals were killed by landslides.
We took care of hundreds of patients on two different sites because of the overwhelming need. Many had mental health issues and psychological trauma and this should be prioritized and integrated with the primary care delivery when rebuilding the next generation of healthcare system in Nepal.
The scale of destruction made our team members feel down and low but we left Kerauja on a positive note.
We cared for a young man with double valve replacement. He only had meds for 3 more days as the rest of them were buried in the debris and it would take him at least a week to walk/trek/drive to the nearest major town because of the destruction of walkable trails/roads.
Life and death can be vividly binary in the hills of Nepal — rebuild your house/harvest the wheat/save your animals OR walk a week to get your life saving meds. We ordered the meds from a 24hr pharmacy in Kathmandu that was sent with our helicopter the next morning.
He chose the former, we helped him with the latter.
Bijay Acharya, MD
America Nepal Medical Foundation