Nepal two: Nevermind the aftershocks...

Emma Pedley speaks about arriving in Kathmandu as part of the aid response to the earthquake

I left the UK on the night of Sunday 26th and had a stop-start journey to Kathmandu.

Owing to the small size of Kathmandu’s airport, the frequent disruptions from aftershocks, the volume of tourists getting out and the even larger volume of aid pouring in to the country, flight scheduling is a haphazard and changeable affair.

For myself and the British Fire Service Search and Rescue team I was travelling alongside, all champing at the bit to arrive and work, our motto became “hurry up and wait” very quickly!

I consider myself lucky however – after only a 24 hour delay in Delhi I was able to join the MSF team in Kathmandu.

Arriving as I did at night, it was hard to see peering though the taxi windows the exact state of the city but I was relived to see the silhouette of many tall buildings still etched against the night sky. A few times we drove past collapsed walls and subsided buildings, but overall the roads (at at least the ones that we took) were passable.

Some routes we took were vaguely familiar to my eyes but one particular large roundabout was weirdly altered. The Buddhist stupa in the centre seemed oddly misshapen and lumpy around the bottom. We whisked past before I could take a closer look.

The next day, driving once more through the city, a few heartbreaking details were clearer. Only about one in 10 of the shops were open, the others were tightly shuttered  – their owners, who knows where? Injured, trying to find relatives in the countryside, it’s impossible to be certain.

Overall the city has fared surprisingly well – the modern and more affluent parts at least. As always in any disaster it is the poor who feel the worst effects. As we drove past the roundabout again the reason for its distorted appearance became clear. A small tent and tarpaulin village had sprung up at its base; entire families either homeless or too traumatised and fearful of tremors to return to the homes they have left.

The same pattern of displaced people is repeated in every open space all over the city. The older brick houses showed signs of cracks, fallen roofs, collapsed walls. We drove past one roadside building which looked as if a giant hand had reached down and just ripped away the external wall leaving the internal rooms starkly open to view like a tumbledown dolls house.

There is something deeply jarring about being able to see so intimately and intrusively into someone’s home like that – all the signs of ordinary lives rudely disrupted told out in the items left behind – a double bedstead hanging forlornly out of a gaping third storey – a desk and chair in the room next door abandoned. So many precious personal things that people are still too afraid to re-enter their homes to retrieve.

Later that day as we drove back past, a small crowd was gathered at the crumbled wall at the base of the same building; the brick heap a little higher now, a dust covered too-still figure of a man sprawled motionless at it’s base. This is the price people are paying for gambling on entry into their own homes.

The MSF teams that have gathered in Kathmandu are a funny mix of expat staff that were in Nepal on holiday – lived through the earthquake!- and stayed on regardless to help. Added to this are two super-experienced MSF veterans that were here to prepare for an international training, and the rest of us who dropped everything and hopped on planes from our home countries to pitch in. 

MSF teams working on supplies © MSF

MSF teams working on supplies © MSF

MSFs last active mission in Nepal closed in 2011 – and happily we still have a strong network of Nepali nationals both in the capital, and out in the remoter areas, many of whom have come back to work with us. This is invaluable and has made setting up here so much faster than it would have been otherwise. The team atmosphere is friendly and super energetic. At this stage even only a few days into our response, trips and assessments have been made on the main hospitals in town and also on the larger few of the displaced peoples' camps.

Overwhelmingly the sense among the team is one of relief . Many MSFers now here also worked in Haiti after the earthquake, and although there are many parallels to be drawn, the damage and death toll seems to be more limited.

Many things play into this, the biggest being the timing of this particular earthquake; it was during the day, a dry day, and a Saturday to boot. People were largely out in open spaces, no children were in the schools that collapsed and as such the loss of life is blessedly much reduced. Imagine if  the same shake occurred just 24 hours earlier on a rainy weekday.

Some tremors have happened since. Aftershocks are totally normal and are of a low scale compare to the 7.8 initial quake, however they are heart stopping for the local population for whom each tremor brings flashbacks and fears of another “big one”. For someone new here however, they are a low grade rumble, perhaps like a lorry has just driven past outside, barely registering in your awareness. I even slept through the largest a couple of nights ago.

Preparing medical supplies for the next day's mobile clinics © MSF

Preparing medical supplies for the next day's mobile clinics © MSF

Our immediate plan is clinics and needs assessments in the remote areas – which are likely to be our focus – trying to get where no one else can or will. This kind of work in this sort of terrain is fraught with challenges. Extreme geography and impassable roads make nearly all but helicopter transport out of the city valley impossible; extreme weather, the possibility of further landslides and altitude sickness make working when we can reach villages very risky, and the small scattered location of the settlements meaning that multiple trip and assessments are needed in one days journey.

The HeliClinics  of the past two days (comprising a doctor, a nurse, a nurse focusing on psychological support, and a water/sanitation expert) managed to visit a total of 18 separate locations, made rapid assessments the villages’ acute needs and treated a total of 80 people for wounds and infections. A distribution of blankets/shelter equipment is also taking place as I type and tomorrow (Sunday) is likely to be my turn in the HeliClinics as the teams rotate to prevent fatigue.

Thus far, stymied by a lack of available helicopters, I have had to rein in the “hands on” side of my drive to be here and just do what’s needed – go out with local purchasers for logistic items, help with the massive task of receptioning and preparing for distribution the 15 tonnes of medical supplies that we have already received – there’s more to come!

Funnily enough I thought the lack of patient contact would be frustrating – and in some ways it is, but in others it’s good to just be here, doing what’s needed to support the medics we have been able to mobilize.

And it’s enough to see the country that I still love pulling itself back together – people in the street buying, selling, living and still laughing; clean up teams making human chains to clear debris and reopen roads – the beautiful, spirited people of this incredible country are beautiful still.

Bruised and battered maybe, but unbroken.