Injured Quake Survivors Throng Kathmandu Teaching Hospital, Epicenter of the Nation’s Medical Response

KATHMANDU, NEPAL – Ambulances roar into the entrance of Tribhuvan University Teaching Hospital blaring sirens that have been a part of the daily soundtrack in Kathmandu, Nepal’s capital, since the April 25 earthquake.

Volunteers manage the flow of traffic at the entrance. Tents fill the hospital’s garden. Crowds of people camping on the grounds are wet from the drizzling rain. Others take cover in the hospital lobby.

Doctors treat minor injuries in the garden. Pregnant women wait in tents until they are ready to deliver at the hospital.

A desk at the main gate gives out information about medicine, safety and diplomatic agencies. Nongovernmental organizations, student groups and religious groups distribute food, tea and water to patients and visitors.

Devaki Bhandari, a 21-year-old Kathmandu resident, says she brought her injured mother and brother from their village in Sindhupalchowk, a district to the northeast of Kathmandu, to the hospital last week.

Her 50-year-old mother and 15-year-old brother had been trapped in their home after the ceiling collapsed in the 7.8-magnitude earthquake.

“When I got the news, I couldn’t stay in Kathmandu,” Bhandari says. “Thinking I will be with them even if I died, I came back home.”

Her uncle died while attempting, unsuccessfully, to save his 9-year-old grandson when the house collapsed, she says before bursting into tears. But neighbors saved Bhandari’s mother and brother.

“My mother thought that someone was walking around our house,” Bhandari says. “She moved her leg to produce sound. People outside heard that and rescued her from the collapsed building. Then after, they also pulled out my brother from the rubble of the collapsed house.”

Her brother thought their semiconscious mother was dead, but he realized she was alive after splashing her with water. Community members carried her mother in a bamboo basket to a field.

When Bhandari arrived, she decided to take her mother and brother for treatment in Kathmandu because the care they needed was not available locally. They traveled by bus for four and a half hours to the hospital.

Her mother’s chest was injured, and her leg was fractured. She could not urinate without pain. Her brother’s eye and hand were injured.

Bhandari’s brother was bandaged. Her mother was admitted to the hospital and scheduled for surgery on her leg and chest.

“It has been very difficult for me to look after my mother and brother at the same time,” she says.

Bhandari worries about her mother as she awaits more information. Emotional distress kept her from eating for five days.

“I tried eating a piece of biscuit this morning, but I ended [up] vomiting,” Bhandari says. “Maybe this is happening because I have not eaten for days. Thank God that I still survive.”

She is staying in a tent outside the hospital.

“We do not have proper shelter,” Bhandari says. “We are wet when it rains. We are living amidst [a] crowd of people.”

Bhandari has no money saved for her family’s care, she says. The hospital administration has not charged the family for treatment. But with its pharmaceutical supply depleted, the hospital sometimes asks her to bring medicine.

In the second week after the quake, relatives and medical personnel are still racing to obtain and provide care. People have traveled from other regions of Nepal to camp outside Tribhuvan University Teaching Hospital in the country’s Central Development Region while their relatives receive treatment. The hospital, providing free care, is appealing to other hospitals to send staff and receive patients. It is raising funds to replace dwindling medical supplies.

Hospitals in the districts outside Kathmandu do not have specialists, says Parashu Ram Koirala, chief of hospital administration of Tribhuvan University Teaching Hospital. So patients come to the capital for treatment.

Tribhuvan University Teaching Hospital is the largest hospital in Nepal and one of three government hospitals in Kathmandu.

“Our hospital has the most number of skilled human resource and better services compared to other hospitals,” Koirala says. “Therefore, people come to us for their treatment.”

Unable to document every patient, the hospital staff does not have a firm tally of the number of quake victims it has treated, Koirala says. He estimates that more than 700 people came to the hospital for treatment on the day of the earthquake.

The hospital performed surgery on 1,146 patients as of May 1, Koirala says. Because of the number of people being treated, 90 patients – 48 of whom had severe injuries – still awaited surgery.

Bir Hospital and Patan Hospital, the other two government hospitals in Kathmandu, and private hospitals have also been crowded since the earthquake.

“We are providing free medical care to all the earthquake victims,” Koirala says. “But, to provide them relief from all kinds of trauma, and for easy access to medical services, we have established disaster fund.”

The hospital is collecting money from various contributors to buy the medicine and supplies it needs to treat earthquake survivors. The Ministry of Health and Population provided 2.5 million rupees ($24,620) to the hospital’s fund for treatment of earthquake survivors.

Bhandari says her family’s neighbor, Tara Deuja, from their village in Sindhupalchowk, is receiving treatment in the hospital too. Deuja’s house collapsed in the earthquake, killing her 14-year-old daughter.

Deuja is not able to move her legs. The hospital did not have the medication it needed, and Bhandari was not able to find it on her own. Deuja is receiving treatment, but Bhandari was not aware of specifics.

Bimala Devi Chaudhari, 32, traveled to Kathmandu from Siraha, a district in Nepal’s Eastern Development Region, when she heard that her husband was in the hospital. A painter working in Kathmandu, Chaudhari’s husband had been on a ladder when the earthquake struck. He fell three stories.

“I was very scared when I first heard it,” Chaudhari says. “Thankfully, only [his] leg was broken.”

She is staying outside the hospital waiting for further news about her husband.

“Apparently, it will be cured,” she says. “But I am finding it difficult to believe.”

The hospital provides some medicine. If it runs out, Chaudhari needs to buy it at a pharmacy for her husband.

“I do not have a penny in my hands,” she says. “But his brother and friend have helped a little. “Sometimes the hospital personnel come to visit and ask whether I have money to buy medicines.”

Chaudhari is worried about her family’s financial situation. Her husband is the breadwinner; she does not earn income.

“Until he is cured, I cannot think how I am going to earn,” she says. “Also, we have no savings.”

Chaudhari’s brother-in-law brings food to her at the hospital. Sometimes she gets food given out around the hospital. But she has received no other aid.

“I don’t know what the government is doing,” she says. “The government should have provided some money in such situation. Even if my husband gets well, he cannot go to work right away. Therefore, we need money.”

Ambika Khanal, 30, and her family were inside their house in Arghakhanchi, a district in Nepal’s Western Development Region, when the quake hit.

“We were standing holding each other,” Khanal says. “We wanted to go out, but we didn’t have courage to do so.”

A house next to theirs collapsed.

“Our main entrance to the house was blocked as the debris from the next house settled in front of our house” Khanal says.

Eventually, they made their way out.

“We felt like our house had collapsed,” Khanal says. “There was not a single percent hope that we would survive. But, I started looking for ways to get out of the house. We were blanketed by dust. But I fumbled in the dust and found the way out of the house. I felt very safe when I got outside.”

Others were not as fortunate.

“Everything has been devastated,” Khanal says. “Five member of my landlord’s family ended up in a single grave. Yesterday, the rescue team pulled out the dead bodies with great difficulty.”

Khanal is in disbelief.

“When I think about it, I don’t believe that I survived such situation,” she says. “We have survived, but we also lost everything we had. Also, our source of income is lost. We are living in a tent. The house we used to live in is cracked, and the place where our shop used to be has totally collapsed.”

Khanal brought her pregnant sister-in-law to Kathmandu to ensure the baby is OK. Khanal is camping outside the hospital while her sister-in-law receives care inside.

“We do not have money,” she says. “Not only money, we have nothing with us. I do not have a single penny on my hands to buy medicine.”

Crying, Khanal says she sent her 4-year-old son back to the village to stay with her brother because she doesn’t feel the hospital campground is safe.

“I have no idea how my life will move forward,” she says. “How would I educate my children? We are still living inside the tents.”

Ram Hari Shrestha, 34, says her 10-year-old daughter, Neharika Shrestha, was alone watching television at their home in Bhaktapur district in the Kathmandu Valley when the earthquake struck. The house collapsed. Shrestha reached the house an hour later.

“I went cold when I saw that scenario,” Shrestha says. “Tears started to roll out of my eyes. She was pulled out by the neighbors, as she was trapped in the middle of a collapsed building.”

Shrestha brought her daughter to the hospital for treatment of a broken right thighbone. Doctors inserted four steel rods to rebuild it.

Neharika says she forgets what happened. Her leg is in pain. She worries about her best friend, Kirti.

“I do not know anything about her,” Neharika says. “She might be at home. I do not want to go to school at all. I might go after I recover.”

Shrestha says her daughter is OK mentally but that she worries about her physical health.

“I am worried about her future,” Shrestha says. “I am worried if her wounds will heal. I love her very much. It is a dreadful experience. I pray to God, hoping she could stand and walk like before.”

Shrestha says the family lost everything, including its garment store.

“Nothing is safe,” she says. “Nothing is usable. The shop is completely destroyed.”

Shrestha and Neharika eat meals outside the hospital, where the mom is camping while the daughter gets treatment inside the hospital.

“We will think what to do later,” Shrestha says. “There is nothing in my mind right now. Maybe I will again open a shop.”

Thakur Tamang, 31, says he and his wife were napping at their house in Nuwakot district in the Central Development Region at the time of the earthquake.

“We thought it was a small-magnitude earthquake, like we used to have,” he says. “But it continued shaking. Therefore, we jumped out of the window.”

Tamang and his wife hurried to look for their two children, who were in the family’s second house.

“By the time we reached there, the house had completely collapsed,” Tamang says. “We couldn’t stop ourselves from rescuing the children, so we tried to enter the building from all possible sides.”

His 4-year-old son suffered two broken legs.

“I took him to the district army headquarter on motorbike,” Tamang says. “The army provided ambulance. We haven’t paid for anything from our pockets so far. But, it is difficult to manage food.”

Doctors at the university hospital performed surgery; the boy has a cast on his lower body.

Tamang’s 7-year-old daughter and wife are safe. He has minor feet injuries that did not require treatment. His father, who was also been trapped in the house, is being treated for eye injuries at a nearby hospital.

The hospital and various aid groups offer food. But the family does not have a tent, so it is staying in the lobby.

“The whole nation is grief-stricken,” Tamang says. “The international community has helped a lot. We do not want to rebuild our houses right away. We need some food and a little space to live. We are happy that these kids survived, and we worry about their future.”

Dr. Saroj Ojha, a psychiatrist at Tribhuvan University Teaching Hospital, says the earthquake has taken an enormous psychological toll on survivors.

“Everyone is terrified,” he says. “Since yesterday, I have counseled 30 people who said: ‘I am scared. I am scared,’ all the time.”

The staff is providing free counseling to survivors 24 hours a day.

“We advised them to think positive, be busy, and also to exercise regularly,” Ojha says.

Meanwhile, the hospital is striving to extend its care.

Tribhuvan University Teaching Hospital’s chief cardiac surgeon and former executive director reached Sindhupalchowk on Friday with six team members and 2.5 million rupees ($24,620) to provide care, medicine and counseling to injured and affected people there, Koirala says. The team will refer seriously injured people to the hospital in Kathmandu.

In its effort to provide treatment for a steady stream of patients, the hospital is coordinating care with other Kathmandu hospitals, Koirala says. The hospital has asked Bir Hospital to send surgeons and psychiatrists.

Yam Kumari Kandel and Rachana Upadhyaya, GPJ, translated interviews from Nepali.