Following a night of aftershocks following yesterday's earthquake, I'm joined in the helicopter by Lies, one of the Emergency Coordinators, and Shiresh, another of our Nepali doctors. Our plan is to start high north again, to the final settlement before the Tibetan border, and rapidly work our way back to the villages near the epicenter to assess the impact and if necessary evacuate injured people to Kathmandu.
The day is a blur. Up at 05:30 and in the air before 08:00 we stop in 10 places in as many hours, some only a touchdown to establish that no one was injured and that a health worker is reachable; others for longer, doing fast dressings, antenatal reviews and taking notes about damaged paths and contaminated water supplies.
Phoning the MSF base in Katmandu © MSF
Our fourth stop is Simituan, the village I watched vanish into a dust cloud yesterday. Miraculously everyone is OK! We talk about how cut off they are from everywhere now, but happily they have not only a nurse but a midwife too in their midst; two slender, beautiful girls who accept our donation of drugs and dressing kits with shy smiles.
In the seventh village there are three seriously injured people with deep, dirty and complex wounds from being crushed under falling debris. There’s no way to treat crush injury or wounds of this severity on the mountainside, so Lies and I stay in the village while Shiresh flies them back to Kathmandu.
After the thrum of the helicopter vanishes into the distance and the dust from its take off settles, I feel like I can both hear and breathe properly for the first time in over 24 hrs. These three people are the worst we have seen so far; incredibly it seems very few people have actually been injured this time. A freak “blessing” of both of these earthquakes has been their timing. Thank God they were during daylight hours when people were likely to be outside.
Right there, sat on the narrow dusty terrace where the heli had left us and crowded round by inquisitive children and adults alike, Lies and I run a mini-medical clinic with my patchwork but slowly improving Nepali and the help of two young lads that have a similarly hazy grasp of English.
However our mutual enthusiasm is bounded by no language barrier. During one particularly challenging consultation where I am required to mime projectile vomiting in front of about 40 people and everyone is reduced to gales of laughter I recall something I have once heard about effective communication only being 10% verbal and 90% non verbal. That would certainly seem to be proving true in this case! As is I hope the old adage of laughter being the best medicine.
By the time the heli returns for us and we are ready to leave, the whole community is standing on the edges of the terraces, smiling broadly and namasting and waving us off.
Our next stops are three villages that we have already visited in the days before the second earthquake. We hear of people who were attempting to use roads who died in fresh landslides and families who were beginning to rebuild homes now too scared to salvage materials from the fresh collapses. Some communities have an almost frenetic air to them – people jostle closely around us on the narrow terraces as if seeking reassurance from our mere presence, even though we have only come to assess, not to offer anything. By this time I am getting tired and the close packing of people makes me a little nervous – the middle of a crowd on a steep terrace would not be the ideal place to be standing in event of another heavy tremor.
As we take off from the tenth stop Lies calls it a day for our explo team and KC swoops the helicopter round to head back to Kathmandu. I rest my head against the helicopter window, take a swig of water and reach up to rub my face. A gritty film of dust chafes between my fingers and cheek, and my teeth feel similarly coated. As weary as I am I have a deep sense of gladness that I was able to be part of the team that went out today.
We still have work to do this evening back at the base - our clipboard full of rapidly scrawled notes has to be summarized neatly onto the MSF masterfile for the medical and logistical coordinators to access and immediately plan the days ahead in terms of clinics and distribution.
I think back to the one group of laughing villagers that we left standing amid the ruins of their homes and hope that laughter will keep them going for a time. Their needs are still huge, and the emotional toll of such an unexpectedly huge second quake will take a very long time to heal not just for them but all the communities that we have seen.
But it feels good to be here – very good to have a plan – and very good indeed to be able to help. It may sound strange, but this is one earthquake I wouldn’t have missed out on for the world.