Few days ago, we went to Singla as as part of a team with the International Medical Corps. This included providers from MGH & Scripps (UCSD), and student volunteers from Nepal’s public health and pharmacy schools. Singla Village in Gorkha District is a small hamlet perched on top of the high hills of western Nepal. It forms a peninsula-type structure with two steep cliffs on either side and a massive mountain to the north. Around 1000 people are “trapped” in this beautiful village. This village has been supplying a cadre of young men to the trekking industry and to the middle eastern construction companies. Just like in all the other villages we had visited, all you see are the elderly, young wives and small kids. You only see a handful of young men. Because of its importance in the Manaslu trekking circuit, there is even a western non-profit foundation for the village — Friends of Singla.
We landed on a small piece of rock formation that had visible cracks from the quake. Our extremely skilled pilot placed the bird on the stable part of the rock and we quickly unloaded our materials and medications. As we hiked some 500 ft uphill to set up our camp in the school area, we saw the destruction that the quake had caused. There were cracks all over the grounds of the village. We used the remaining undamaged classrooms of the local primary school as our clinic site. Locals pointed out that they had recently covered cracks on the school ground using dirt and stones.
The first quake wiped out nearly all the houses in the villages and the aftershocks crushed every old structures that remained standing. Before starting medical services, we took a quick tour of the village. All we saw was rubble: what remained of the houses was piled over one another. What used to the streets was now filled with debris and what filled people’s homes: torn clothes, shoes and books. . Granaries lost, utensils crushed, latrines destroyed. A stench of decaying animals and human waste hung in the air. A couple was trying to get into their house from a destroyed roof. The wife got into the attic by moving the tin sheets and retrieved a blanket. It was covered with dust and a part of it looked burnt. She cut the burnt part with a sickle and saved the blanket. It is cold in the mountains.
By the time we returned from our quick tour, the school grounds had turned into a makeshift medical camp, filled with patients waiting to seen. A young boy with a deep wound in his foot from falling rocks was brought forward. His wound was infected, requiring surgical debridement and intravenous antibiotics. An elderly woman had a fractured ankle and had received no treatment. Both of them needed to be evacuated immediately, and they were taken away in our chopper to Gorkha Hospital, a 10 min flight that they had to wait more than 10 days for.
We then moved our focus on the hundreds of patients that had already lined up. As we setup our registration area, we saw that the locals were engaged in an animated discussion. I inquired what was going on and what I heard humbled me as a “relief worker” and made me proud of being a Nepali.
Atithi-devo bhava (“Your guest is equivalent to God”)
Nepal is known for its respect and love for the hundreds of thousands of guests that come to visit the country. I saw this tradition alive in Singla. They were having discussions about who was going to hand over the rice and food materials they had saved to feed our 15-person medical team. Singla hadn’t had a single food drop since the earthquake and people were skipping meals every other day to ration their own food. Despite this, they were offering us meals. We vehemently disagreed and informed them that we had brought our own food. They then insisted that they would do the cooking. No one seemed to mind that we still hadn’t started the clinic because despite losing virtually all of their possessions, they were busy making generous offers that we simply could not accept. The final compromise was that our team would cook but we would use their pots, pans and utensils. Everyone was happy and we started seeing patients.
The destruction faced by people in Singla from the disaster was overwhelming but that was well-matched by their generosity.
Bijay Acharya, MD
Massachusetts General Hospital