With the death toll continuing to climb in Nepal, physicians from major U.S. medical centers around the country are getting involved in the effort, including MedPage Today's own Sanjay Gupta, MD.
Daniel Bachmann, MD, assistant residency director and assistant professor of emergency medicine at Ohio State University in Columbus, knows first hand the perils of traveling to remote locations in Nepal, as he spent time there in 2012 working at a rural hospital. He says the capital city of Kathmandu has some medical infrastructure, but the same cannot be said for the more rural parts of Nepal.
"One of the more difficult parts of medical care in the country is transportation," Bachmann told MedPage Today. He recounts an experience where the road to the village where he was working, 100 kilometers from Kathmandu, was taken out by a landslide after a monsoon.
"It took 6 or 7 hours to get back to the village," said Bachmann. "We had to walk 10 kilometers over a mountainside."
Bachmann is a member of the FEMA Search and Rescue team in Ohio and says two teams from Virginia and California have already been deployed to the area.
Massachusetts General Hospital's Center for Global Health in Boston is currently in the process of putting together a roster of doctors and nurses to set up mobile medical units which will assist in everything from emergent care and critical care to basic medical treatment.
The team will likely consist of a mix of trained medical professionals and cultural liaisons, who will stay for 21 days. If the situation warrants, they will then turn operations back over to the local doctors and nurses. They already have two wilderness medicine fellows in Nepal.
The Center for Global Health was formed 2 years ago to assist in disaster relief and humanitarian aid around the world. It comprises nearly 20,000 employees trained specifically in disaster relief and humanitarian aid. Deputy director of Global Disaster Response, Miriam Aschkenasy, MD, MPH, said the hospital has always thought of helping people globally as part of their mission statement.
"We consider the world as our neighbors," she told MedPage Today. "This is an extension of what we do every day."
Working in a low-resource area requires a different mindset than working at a U.S. hospital, which is why the response team from the Center for Global Health is specifically trained in disaster relief and humanitarian response training. Aschkenasy said that while the instinct of doctors and nurses everywhere is to help, no one should go without being properly trained.
"You don't want to be part of the problem," she said. "Stay home and give money to disaster relief organizations instead."
Richard Keidan, MD, heads up such an organization in his home city of Detroit. A surgical oncologist at Royal Oak (Mich.) Hospital, part of the Beaumont Health System, he is also the founder of the nonprofit Detroit2Nepal, which is currently raising funds for Nepal disaster relief.
Keidan and his organization helped establish a public health, healthcare, and education infrastructure in Khotang, a rural community in Nepal. Together with local nongovernment organizations (NGOs), they built health posts, rural medical clinics, schools, and were working on a birthing center when the earthquake hit.
He is waiting on the assessment of the damage and has been in touch with his staff via e-mail in Kathmandu, but he has been unable to get specifics on the damage from these peripheral communities.
"I can't devise a strategy for emergency relief sitting in West Bloomfield, Michigan," Keidan said, though he said he will go to Nepal as soon as he gets the green light.
Other major medical centers from around the country getting involved in the disaster relief efforts in Nepal include:
- Northshore University Hospital in Manhasset, N.Y., has a neurosurgery resident, Amrit Chiluwal, MD, who is planning a trip to Nepal. He has family there who were unharmed by the earthquake. In an e-mail to MedPage Today he said, "I am getting in touch with people in Nepal and other Nepalese physicians in America to take part in the relief effort. America Nepal Medical Foundation is one such organization that is currently coordinating such efforts. They are meeting this weekend in Denver and will be going there."
- Beth Israel Deaconess Medical Center in Boston is sending a team of 13 to 15 emergency medicine doctors, 1 to 2 EM nurses, and BIDMC's Director of Emergency Management. They are deploying with an NGO partner organization, GR3, and will be based out of Sheer Adventist Hospital in the Kavrepalanchok District, about 30 km southeast of Kathmandu.
- A team from Scripps Health in San Diego will be sending at least 16 nurses, doctors, and support staff in partnership with the International Medical Corps. "Responding to emergencies like the one in Nepal and others we've helped out with in the past not only provides needed aid to victims of those crises, it gives our team needed experience to help out in case of disasters here at home," said Chris Van Gorder, Scripps president and CEO, in a statement.
- Alumni from Yale University started a hospital in Nepal and are currently helping with the relief effort.
Bachmann said he plans to return to Nepal, though most likely that will be next year. He does advise anyone involved in disaster relief to take direction from the U.N. or any other major relief organization and, most importantly, have patience and don't rush in to help just because it seems necessary.
"People want to help, but sometimes you have to be patient and allow the process to work," he said. "Sometimes it takes a few hours or even a couple of days to plan out the best approach."