| Healing the Injured | ||||||||||||||
| By Huang Xiu-hua; translated by Tang Yau-yang; photos by Hsiao Yiu-hwa | ||||||||||||||
The news of the powerful earthquake that struck Nepal on April 25, 2015, put all six Tzu Chi hospitals in Taiwan on standby. Their staffs were ready to ship out at a moment’s notice. Of the six, Taipei Tzu Chi Hospital is closest to Taoyuan International Airport, so it got the honor of preparing medicine and medical supplies for the first delegation. In just six hours, they gathered one metric ton of medical supplies and obtained the necessary permit from the Ministry of Health and Welfare to ship the supplies out of Taiwan. On the morning of April 27, four Tzu Chi physicians joined other volunteers at the airport: Dr. Chien Sou-hsin (簡守信), superintendent of Taichung Tzu Chi Hospital; You-Chen Chao (趙有誠), superintendent of Taipei Tzu Chi Hospital; Yi-Kung Lee (李宜恭), director of the emergency department at Dalin Tzu Chi Hospital; and Chien-Hsing Wang (王健興), leader of the trauma team at Hualien Tzu Chi Hospital. At the airport, the Tzu Chi delegation members were quite conspicuous in their blue-and-white uniforms. One passerby asked them, “Where are you off to this time?” When they answered, “Nepal,” the man responded, “That’s what I thought. You Tzu Chi volunteers are always first to reach out whenever there’s a disaster.”
A woman from Thailand who had come to Taiwan for medical treatment donated 10,000 baht (US$297) to Tzu Chi on the spot. A Taiwanese girl and her mother together donated 10,000 New Taiwan dollars (US$323) without leaving their names or address for a receipt. “We trust Tzu Chi,” they said. A few foreign passengers gave the delegation a thumbs-up and said, “I love Taiwan. You’re great.” With this shot in the arm, the delegation took off fully energized to help the Nepalese.
Hurdles Despite their eagerness to help, the delegation faced one challenge after another. When they arrived in Bangkok, they found that their connecting flight to Kathmandu had been canceled, so they had to spend the night in Bangkok. As a result, they didn’t reach their destination in Nepal until the afternoon of April 28. “On the same airplane with us were some Japanese and Korean rescue workers,” said Superintendent Chien. “The Koreans told us they had been on a previous flight that had been turned back.” Hearing that, the superintendent had a feeling that their path ahead would be littered with challenges. Kathmandu’s Tribhuvan International Airport is the only international aviation gateway in the nation. Its relatively small capacity, probably sufficient for ordinary times, was plainly inadequate for this troubled time, when aid workers and supplies were streaming in from all over the world. Chien said that the airspace was so busy when they arrived that they had to circle above the Himalaya Mountains a few times before being permitted to land. They all breathed a sigh of relief when they finally touched down in Nepal.
Baggage claim was another challenge for the Tzu Chi delegation. The medical supplies they had brought were packed in 93 cartons. It took them five hours just to clear the supplies through customs. The airport was simply overwhelmed. When they finally arrived at the hotel they had booked, they were told there were no rooms for them. Another group of guests had been forced to stay at the hotel because their outbound flight had been cancelled. The Tzu Chi volunteers had no choice but to try to find another hotel. They finally found accommodations at a hotel that had closed after the earthquake and that had reopened just three hours earlier. Now that they were on the ground they were close to quake victims, but the doctors could not help the victims yet. They spent the first two days obtaining permission from health and disaster relief officials to practice medicine in Nepal. They briefed the officials about Tzu Chi’s rich history of conducting disaster relief operations, such as providing aid in the aftermath of Typhoon Haiyan in the Philippines, the Indian Ocean tsunami, and the Wenchuan quake in Sichuan, China. Finally, they convinced the officials to issue a permit to each medical member to practice medicine in Nepal. Now that they could treat patients, the doctors visited two hospitals to check out the situation and to see how they could help. At one of the hospitals, they saw a woman, 21 and four months pregnant, who had a broken bone in her hand and a broken shin bone. Lying in bed, she looked to be in a lot of pain. Hospital staff told the Tzu Chi doctors that their hospital had admitted 19 bone fracture patients, including that woman, but were unable to operate on them because they were out of needed supplies to do the job. The staff said that there were 165 more patients facing the same situation at nearby hospitals. Medical workers could only give the patients pain medicine and fix their fractures externally. Nobody should have to endure such pain, but without the proper supplies even the Tzu Chi physicians could do nothing. Superintendent Chao took photos of patients’ x-ray images and sent them through the Internet back to his colleagues in Taiwan. The needed supplies to treat broken bones were prepared for the second Tzu Chi relief delegation to take to Nepal. Orthopedic surgeons Jui-Teng Chien (簡瑞騰), Wing-Him Poon (潘永謙), Zeng Xiao-zu (曾效祖), and Liu Guan-lin (劉冠麟), from Dalin, Guanshan, Taipei, and Hualien Tzu Chi Hospitals respectively, were joined by anesthetist Lin Chang-hong (林昌宏) of Taichung Tzu Chi Hospital on the second delegation, which left Taiwan on May 1 for Nepal. Dr. Chien had gone on a similar medical mission to Yogyakarta, Indonesia, in 2006, after an earthquake ravaged that area. He knew that reliable power might not always be available in disaster zones, so this time he brought along manual bone drills and pliers. Experience helped the doctors be better prepared.
Cooperation The first and second delegations combined provided nine doctors. They split into three groups and went to work in Bhaktapur, a heavily damaged area 30 minutes by car from Kathmandu. The first group, led by Superintendent Chien Sou-hsin, performed surgeries at Madhyapur Hospital. The second team, led by Superintendent Chao, staffed a mobile clinic; they visited out-of-the-way villages or places in the mountains to treat patients. The third group served at a free clinic station in front of a health care center in Bhaktapur. At Madhyapur Hospital, Superintendent Chien and Dr. Chien shared one operating room while Drs. Poon and Zeng shared another. Dr. Lin was the anesthetist for both rooms. Physicians from both countries worked well together. Dr. Lin even assisted in the C-section delivery of a pair of twin girls, 3,000 and 2,900 grams (6.6 and 6.4 pounds). The event made international news. Superintendent Chien said that in the aftermath of the quake, the medical facilities he saw in Nepal were less than ideal, and the air-conditioning had not yet been repaired. Despite these conditions, the doctors worked adeptly, showing their mastery of surgical skills. The local nurses demonstrated an impressive work ethic too. Working with the surgeons, they toiled away from eight in the morning till late at night, resting only briefly when the power went out. The nurses not only assisted in operations, but also applied plaster for casts after surgeries and pushed patients to where they needed to go. Chien was impressed by their hard work. Once the power went out right in the middle of an operation. Tzu Chi surgeons used solar-powered LED caps—developed by Tzu Chi—as flashlights and continued working. Some aid workers from Norway marveled at the devices and the technological prowess of Taiwan. Tzu Chi set up a free clinic station on April 30 in a tent in front of a health care center in Bhaktapur. Superintendent Chao recalled the day they hung up the banner for the Tzu Chi station: “When Superintendent Chien and I arrived at the site, we borrowed two tables, put them side by side for our examination table, and opened up shop.”
People were at first dubious about the Tzu Chi doctors. “I could hardly blame them for not being more trusting,” Chao observed. “They didn’t know where Taiwan was, much less whether we were good or bad guys.” Fortunately the doctors soon won the locals over. Their warm, friendly attitude when they saw patients, and their gentle, careful touch when they dressed wounds impressed the Nepali. Nirdesh Shakya, a local doctor who had studied medicine in China for seven years, also helped shrink the distance between the visiting doctors and the local patients by assisting as an interpreter. When the doctors returned the next day, the staff at the health care center, now friendlier, took the initiative to inquire if they needed any help. The Tzu Chi doctors also demonstrated their generosity by giving the center much needed medicine, such as antibiotics. When the doctors returned the third day, the center staff had already set up the clinic for them. The day after that, some nurses and nursing students from the center joined the Tzu Chi doctors in providing care. Camaraderie between the two sides grew day by day.
Mobile clinic services A mobile outreach clinic grew out of the stationary clinic at the health care center. Chao recalled that on their first day at the stationary clinic, he and Chien treated patients while Drs. Wang and Lee established a file for each patient that included information such as name, sex, age, and symptoms. Impressed by the meticulous, conscientious work of the doctors, a nurse at the health care center broached the idea that the doctors should visit her village up in the mountains to help her fellow villagers. With tips like these, the Tzu Chi doctors were able to go to out-of-the-way places, places where few other aid organizations had ever gone. The next day, Chao and Chien drove to the nurse’s village, a place called Chhaling, and conducted a free clinic at a run-down community center. They could not treat as many patients as they would have liked because they did not take enough medicine with them, so they returned the following day. The health care center sent two nurses to go with them and observe. When the nurses saw for themselves that the doctors really meant to help, they suggested another nearby village for them to visit: Pikhel. That village had been damaged even more severely. The doctors agreed to the suggestion. When they arrived at Pikhel, some villagers quickly took out what furniture they had left and set up a clinic for the doctors. Poles and tarpaulins were used to provide shade, but it was only big enough to accommodate the doctors and the patients they were treating. All the other people had to wait for their turn in the sun, sweating profusely.
The clinic started at 11:30 a.m., but at 1:30 in the afternoon Dr. Nirdesh Shakya, the Nepalese physician who was with the group, received a phone call from his hospital asking him to hurry back to tend to some business. He had to drive back, but because the entire group came in one car, everyone had to go back with him. Seeing the long line of people waiting to be treated, Chao felt really bad about cutting the clinic short. He urged the two nurses to relay to the villagers the team’s apologies and their promise that they would return the next day. When they arrived the next day, the crude canopy made up of simple poles and tarpaulins was gone. It had been replaced by a nice orange tent. The Tzu Chi doctors knew that materials to put up a tent were hard to come by after the earthquake, so they especially appreciated the villagers’ heart-warming gesture. Dr. Chao called the tent “a really decent clinic.” Treatment for patients resumed. At noon, the villagers insisted that the doctors and nurses stay for lunch, but they declined and went on to the next location for more patient care. They ate simply—instant rice that they had brought along. Many of the local nurses and nursing students assisting the Tzu Chi doctors were earthquake victims themselves. They were living in tents, without power and in need of daily necessities. Yet even though their lives were as hard as those of the patients they were serving, they didn’t hesitate to step forward to give of themselves to others. The doctors had nothing but respect for them. One of the nursing students, Rosemi, worked with the doctors for many days in the mobile free clinics. One day when they went back to the health care center, she pointed to a toppled house with a yellow door across the street and said that it was her home. Chao asked where she lived now, and she answered that she was living in a tent. She said that she realized that difficulties and challenges loomed big before her. All the doctors felt for her after hearing her story.
Suffering The first and second medical delegations left Nepal on May 5 and May 6. They were followed by other delegations of doctors, nurses, and pharmacists from Taiwan, Malaysia, Singapore, and Indonesia.
Gradually the need for emergency care subsided. As people began cleaning up their homes and moving things away, muscle tears, soreness, bumps, and bruises became the main reasons they sought medical help. Tzu Chi doctors maintained the clinic outside the health care center while also visiting quake victims in tent areas to offer care. In one of the tents they visited, they saw a woman lying on her side. She was too thin and small to be 32 years old. Though she was under a blanket, she exuded an abhorrent odor, possibly because of severe bedsores. The physicians examined her. Dr. Zheng Shun-xian (鄭順賢), an infectious diseases specialist at Hualien Tzu Chi Hospital, suggested that they clean her sores first to stave off sepsis. Dr. Zhang Yao-ren (張耀仁), a deputy superintendent of Taipei Tzu Chi Hospital, concurred, so they did that for her on the spot. Dr. Tzu-Yung Chen (陳子勇), a neurology surgeon with the Tzu Chi International Medical Association, later diagnosed the woman with some kind of congenital cerebrospinal disorder, which had left her with restricted mobility since birth. Her condition had led to chronic malnutrition and anemia, as well as the bedsores. Since she needed further examination and care at a hospital, volunteers asked for help from Dr. Nirdesh Shakya to arrange her admission into a hospital. Superintendent Chien could never forget the sight of a woman and a girl squatting and sitting by the roadside. They were impassive and quiet. “I didn’t know if the woman was mourning because she had lost contact with a loved one or had lost someone dear.”
Superintendent Chao, too, saw his share of suffering. One day as the medical delegation was driving past a bus station in Kathmandu, he saw a line of people more than a mile long. They were waiting for buses to take them home. When the Tzu Chi group went by the bus station again that evening, there was a riot going on. People were jockeying for position to get on a bus that would take them home. “They were intent on going home, but there just weren’t enough buses,” Chao said, “and since communications were cut off, they couldn’t reach their families by phone. They must have been really anxious to know what had happened to their loved ones. I really sympathized with them.” After the doctors returned to Taiwan, they were still concerned about the quake victims—images of what they had seen in Nepal lingered in their minds. At the same time, their hearts were warmed when they thought back on how they had worked hand-in-hand with local doctors to treat injuries and relieve suffering. They knew what the quake survivors were up against on their road to recovery, but they took comfort in the knowledge that Tzu Chi would accompany them on that road. |
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