Helping Nepal’s future, one baby at a time
As the earthquake killed more than 7,500 and Nepal is struggling with widespread destruction, international medical help is reaching the country upon UN request. We talked to one of the surgeons of the Italian emergency team. They had just had their first full day at a field hospital in a mountain village, three hours away from Kathmandu.
“We can’t solve all their problems, but we can help nature help them,” says doctor Massimo Fantoni as he wraps up the day, his slight Tuscan accent still bright after many hours of work. In the midst of the debris, one can understand his underlying kind of joy. After all, he’s specialized in neonatal care — he was there when world-known baby girl Azzurra was born in the earthquake ruins of Haiti.
In the aftermath of the Nepal earthquake, the UN put out a request for international help, and this is the help received, country by country.
The Italian emergency team hails from Pisa, and flew in under the colors of Italy’s Protezione Civile and Foreign Ministry at the end of April, bringing a well-tested and ever-adapting field hospital, with 9 doctors covering surgery, traumatology, anesthesia, nursing, obstetrics, radiology and logistics. The operating theatre, under a white tent, includes radiology equipment and high level instrumentation. The hospital also offers up to 10 beds.
With a special expertise on disaster situations, the Italian team worked in the past in Turkey, Algeria, China, Haiti and Sri Lanka, and have been trained organically to work together. Logistics experts and firefighters help assess danger and test the state of buildings and infrastructure. For example, says doctor Fantoni, “the team has been working today in the village to assess which of the buildings that are still standing could be safely used as a school, starting in the next few days.”
After meetings at the Ministry of Health in Kathmandu to coordinate rescue efforts with other international agencies, the team travelled to its operative destination in a mountain area, three and a half hours from Kathmandu, in the Nuwakot district. We talked to them at night, as they wrapped up their first full day at a field hospital in the village of Satbise, in the Betravoti valley.
Team leader Massimiliano Borzetti is satisfied that everything worked out fine on the first full day of work. “Many people had been waiting for us and were already queing when we opened the hospital at 8 o’clock in the morning — we are very tired but satisfied, because after many meetings we are finally able to work and help.” In the previous days, says Borzetti, the team visited other villages, to coordinate with the local government and assess the situation, waiting for a precise location to be assigned. Once Satbise was chosen, the team put up the white tents of the field hospital.
“Technically, we are always prepared, but emotionally, being on the ground is always a different matter — says Borzetti — on top of the destruction, we are operating in a different culture, with different languages, and it’s not always simple to reach an understanding with the people we’re here to help. We need to work at relationships, and we need to consider how difficult it is to travel now after the earthquake.”
Dust, humidity and pre-monsoon heat further complicate things. About 300 people live in a temporary tent camp now, and at the village, people have stopped searching under the rubble: “they believe they retrieved all the bodies from the houses.”
“As to the priorities here — Borzetti adds — nobody so far has asked us for food.” The team has observed stacks of rice bags kept in storage, and is aware of many water springs in the vicinity, which makes it easier to supply water. “The real number one priority here is having a home again,” says Borzetti.
“It's a rural society, and people here work mainly in rice fields. We have seen them going back to work everyday, and carrying stones to rebuild the houses — they never stop. They’re hoping to have schools reopen quickly.”
Some of the people that the field hospital is treating now had been waiting for over a week. When the hospital opened on May 5th at 8 a.m., there was a long queue. “They were waiting under a scorching sun” — says surgeon Massimo Fantoni — today we treated 166 patients, including 45 children, 4 expectant mothers, 4 babies, 1 newborn.”
Some people also travelled down to the village from other places higher up in the mountains. “It’s not like in Haiti, where despite the difficulties, people were close, in tightly knit hubs — says Fantoni — here, they live very sparsely on the mountain.”
Some bones fractures they saw today had been left untreated for days: “they tell us there are still people injured in isolated places, because the landslide caused by the earthquake blocked the road. We’re studying the road above the landslide. As far as the road can be cleared a bit, we’re planning to send up a pickup car with a firefighter and a doctor. We’ll be trying to secure a transport for the injured, but it’s very difficult. No helicopters here.”
Most of the health complaints in Satbise are very typical symptoms in earthquake situations: “they are often the result of the hardening of an already dire situation — the water rationing brings the need to reintegrate nursing mothers’ milk, like one we saw today, who had lost her husband and had no more milk for her baby. We also see many patients with enteritis, which is most often caused by the abrupt change in feeding. Coughs and bronchial pathologies are directly connected to the amount of dust that the eartquake raises — there’s dust everywhere.”
Doctor Fantoni also underlines one special occurrence which is typical of natural disasters: “with a very wide temperature range, the nights can go down to 15° C from the over 30° of suffocating humidity during the day. If you add to this that people were caught by the earthquake with only the clothes they had on them, and they no longer have a house where to store them, they wear all they have at the same time, sweating, especially babies, and then freeze at night because they’re not covered enough.”
The team have been impressed by the resilience they have encountered, apparently leaving no room for shock or fear. “The people here have nothing, they never had. They cope with very little. They are mostly of Induist religion, some of them Buddhist, and tend to be accepting of their fate. When they come to us, they look resigned to what happened.”
“But today we visited this little girl. She had a cough, but we ruled out any physiological reason for it. It was an anxiety response to the fear and destruction brought by the earthquake.”
Doctor Fantoni is confident that the team will be able to assist the 3 pregnant women in the village. “We could have another birth, why not? We’re ready for that, it would be wonderful.”
What do the members of the team do, come the night? Fantoni laughs: “we rest, we’re so tired, we can’t even read… It’s hard to work in the heat and the humidity. Most of the care we provided today would be considered routine, relatively simple care in modern countries. Here, everything is a feat. But we go to bed happy, fulfilled. It’s an amazing experience to be able to help.” And how long are they planning to stay? “As long as we can — says the doctor — as long as they need us and allow us to stay.”
