Namaste

I’m sure I don’t need to tell you about the devastating earthquakes which hit Nepal in April and May this year. And if you’ve read this blog before, you may be aware that I spent a month in Pokhara (Nepal’s 2nd city) working in the radiology department of the biggest hospital there in 2011.

So it may not surprise you to read that I’ve just got home from Kathmandu after going out as part of a disaster response team made up of radiographers, radiologists and a sonographer. The team was assembled by RAD-AID, an American organisation which sends teams out to developing or crisis-hit countries which require radiological assistance.

Other members of the team had arrived before me, and were there when the 2nd earthquake struck. They were unharmed although understandably shaken (yes, pun intended) but the radiology team at Tribhuvan University Teaching Hospital took care of them well.

I was packing my bag and booking a cab to the airport when I heard about the second quake. I continued anyway as I figured that help would be even more pertinent now.

My connecting flight from Doha to Kathmandu was cancelled but I was bumped to another 7 hours later so that was fine. While on the plane I got chatting to my neighbour who was a Nepalese ex-pat living in Philadelphia and working as a structural engineer. She had got on the first flight she could, leaving behind a young child and a worried husband. She said that she felt she had no choice but to return home to help, and she was incredibly grateful to all the foreigners coming along to assist in the recovery. Less than 24 hours later I had already come to the conclusion that her skills were much more needed than mine, but I’ll get to that later.

I arrived at the airport to scenes of chaos, but nothing too different from my last arrival there. Our flight had been in a holding pattern for over an hour due to tail wind, and this had obviously affected other flights too, but the chaos was typical Kathmandu.

The hotel was gorgeous and I felt awful. On the drive through the city I saw only a glimpse of the devastation, and the sprawl of tents in every open space. To be staying in relative luxury (a roof, a bed, running water) felt wrong. I was also pretty impressed it was still intact.

I serendipitously bumped into the rest of my team on the stairs a few hours after arriving, so introductions were made and stories shared. S, the Sonographer, was my room-mate and we got on well fairly quickly. Z, the CT tech, was the team lead, and it was apparent fairly soon that he was a bit out of his depth, and F, the Radiologist was pretty chilled out about the whole affair.

It turned out that they had spent the past couple of days in the company of a local radiographer, visiting radiology departments throughout the city. This rang alarm bells immediately. I was lead to believe that there was a desperate need for outside help, and that’s why we were there. Apparently this was the case in the immediate aftermath of the first quake, as the department suffered an increased workload as well as staff fatalities and departures. There was also a radiographer at a hospital in Jiri (one of the worst hit areas, about 6 hours east of KTM) who had contacted the team after the first quake but had fallen ominously silent after the second.

So on my first day we continued the team’s main activity of visiting hospitals, uninvited. I’ll cover the individual days and visits in separate blog posts as they were informative, if next to useless.

Before I had arrived, the team were staying in another hotel and had met some really interesting characters. There was Peter and his documentary crew, Eric and Wes, who were filming and photographing Peter’s activities to be screened at an upcoming fundraiser. Peter’s story is long and impressive. He’s married to an American who is fluent in Nepali and has summited Everest several times. They’ve also adopted 3 Sherpa girls, raising and educating them in a much more luxurious lifestyle than the one they were born into. He runs a foundation committed to educating Nepali girls and lifting them out of poverty. More on Peter and his endeavours later.

Another amazing person is the one who Peter’s foundation is named after, Tsering, who owns the two hotels the team stayed in. A beautiful, ageless Tibetan woman with the ability to just appear whenever we needed her, and at times when we didn’t realise we needed her. Like the evening S and I went for a walk in a storm (out of choice) but after a while our legs were tired and we were soaking wet, facing a steep walk uphill when Tsering appeared out of nowhere and gave us a lift back to the hotel.

Someone who I only met a couple of days ago, but had become a legend, was Jason, a kiwi helicopter pilot who does regular 2 month stints in Nepal rescuing people from Everest. He just happened to be there during the quake and his skills were immediately put to use, rescuing nearly 200 people in the first few days after avalanches destroyed Base Camp. When I finally met him he casually mentioned he was receiving a medal from the President for his services last year. Who knows what he’ll get for this year’s effort. He also had a documentary team from New Zealand following him round, which he was very blasé about.

It was people like these who rescued my rescue mission.

I got frustrated pretty early on with the fruitless hospital tours, seeing fancy DR equipment, plenty of staff, and not many patients; as well as slightly put out (yet very hospitable) department managers, wondering quite what we were up to.

After all, what were we up to? A team of clinicians with skills but no equipment. Not even a portable ultrasound machine. I’d naïvely assumed that we’d have a portable DR X-ray machine and a couple of ultrasounds, but I was terribly wrong. That part of it was my fault, I had never been told that we would have some fancy bit of kit like the Xograph DRagon or whatever, but that was the problem- it was the things that I hadn’t been told.

Like, the fact that Z, our team leader had planned this trip (his first time leaving the USA) since last year, as a holiday / fact finding exercise for setting up long term fellowships at the teaching hospital and didn’t want to lose the money he’d spent on flights, so it was conveniently turned from an elective work placement into a disaster recovery mission when the earthquake struck. Yeah.

And the fact that our group hadn’t even been registered with the Ministry of Health (as is required, and only bloody polite, in these situations). This meant that not only were we unauthorised, but we were also excluded from info and meetings with other aid organisations which could have actually led to us providing help (although the bureaucracy of said meetings would have prevented us anyway). We gatecrashed those meetings when we found out the details, cos, y’know.

So I played along for a few days, and then S and I found other endeavours which were actually in need of outside assistance. The main one being an orphanage on the edge of the city which had become swamped with children from a city centre building which had been destroyed. This is where I met another inspirational person whose drive and determination was utterly incredible. Kalpana is a young woman who fell out of a tree as an infant (her earliest memories are of being in hospital, she doesn’t know how old she was) and broke her arm, so her parents abandoned her at the hospital. They abandoned her because she was literally “damaged goods” and would be of no use to them. She has had multiple surgeries to fix her arm, and yes, it has developed abnormally, but damn. Bearing in mind the things that she has achieved with one fully functioning arm, I’m intimidated to imagine what she’d have got up to with two!

Kalpana was resident at Balmandir Orphanage, and when she “aged out” she came back to work with the special needs children (she calls them her Tigers) as well as running an organisation called Creative Nepal, which aims to educate Nepali teenagers beyond basic level (one of them is a pharmacy student!) and empower them with skills that they can use to help others. Part of her education included a residential English course in London, and while she was there, she visited the coast for the first time, and went to the beach where I used to go when I bunked off school. Weird huh?

Kids in so called “developed countries” have it all on a plate and whine about hard work, when people like Kalpana and her housemates strive to improve their lives and those of others when they’d have every excuse to give up. I know, because I was one of those kids. I used to bunk off from my grammar school classes just because of bullying. It was easier to go sit on the beach.

So I spent most of my time at the orphanage because I felt like I could actually assist with looking after the children, rather than traipsing round local hospitals, getting interrogated by the staff.

Z guilt tripped me shortly after S left (her early departure was scheduled due to work commitments rather than frustration at the situation) and said “surely while you’re here you ought to do something vaguely radiological to justify the trip”. So I spent a morning shadowing radiographers at TUTH and wishing I was at the orphanage. Then at about 3pm I got a phone call from Kalpana saying that Upasana, a 9 year old with advanced Cerebral Palsy, had been admitted to hospital in respiratory distress. I took this as my cue to leave, and went with Kalpana to the hospital.

There was nothing I could have done as a radiographer at TUTH (their working practices are shocking, and their staffing is back to normal) but I was able to help with Upasana, if only for a short while.

While all this had been going on, tweets and Facebook messages were going up, detailing our rescue efforts. Incredibly misleading tweets and Facebook messages like the ones below:

 

Not a technologist, not doing anything radiological…

 

All that happened in this meeting was us displaying our ineptitude to a legitimate humanitarian aid group with amazing funding and infrastructure

 

This really annoyed me- this wasn’t anything to do with RAD-AID, this was Peter’s supply trip, S&I asked if we could tag along so we bought a load of sanitary supplies, hired a Jeep and joined the convoy to the village to hand them out. F was wearing scrubs. He shouldn’t have worn scrubs, because the villagers thought he was there to provide medical help and he couldn’t.

 

These “updates” really pissed me off, as it was yet more misinformation, attempting to legitimise our team’s presence in a disaster zone. About a week into the trip I was considering aborting early as I felt I was just wasting money by being there, and could potentially be a waste of resources if another quake hit and I needed help. Mid way through emailing the travel agent and feeling sorry for myself I got a message from Kalpana, nothing pertinent, just a “how’re you doing?” message. And I snapped out of it. From a selfish point of view I was really enjoying my time at the orphanage; the kids seemed to enjoy playing with me and I was able to be an extra pair of hands to feed the Tigers. So I stayed.

I barely saw the other RAD-AID guys, I occasionally bumped into them at breakfast, and one time I was returning from the orphanage just as they were leaving for dinner so I tagged along, but I wasn’t part of the team anymore.

And herein lies the problem- when I initially volunteered to go, I expected to pay for everything, naturally. Then I got an email saying that the Society of Radiographers (my Union and professional body) had agreed to fund it as part of their partnership with RAD-AID’s fellowship program. This was entirely without my input so I was quite pleasantly surprised, and somewhat relieved as I’ve moved house recently and my rent has significantly increased. And so my quandary: the intention of the trip justified SCOR funding (bear in mind the money they used comes from radiographers’ subscription fees) but the outcome certainly doesn’t. So what am I to do? I’ve paid for the hotel (which wasn’t a small amount) but do I offer to cover the flights as well? Bearing in mind I was mislead into travelling to Nepal to begin with.

But it was a life changing time, I fell head over heels in love, and have agreed to a life-long life-improving input into the lives of two very young girls (massive blog post to follow), and I met people who have completely changed my perspective on many things that I thought I had squared in my mind.

So there you are. Opinions are most welcome as I’m not entirely sure what mine is.

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