July 3, 2015

It has been a mistake to not write sooner! Now that I’ve been here over a week, and Mostafa has been here over two, there’s so much to share that this first posting is very long. After this, I’ll keep up better and the posts won’t be so long. A few pictures are at the very end of this posting, so skip ahead if you want to see a few pictures.

Please note that for those who know Nepal, I have included a lot of place names in Nepal.  If you do not know Nepal, these will not be very meaningful and I apologize for that.

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It’s been just over 2 months since the first earthquake hit parts of Nepal. I got here a week ago, and Mostafa two weeks ago. We came with the intention of helping the recovery effort however we could. Unsure of what that would entail, we were ready to conduct health camps like what we did from 1999 to 2002, or help families get back on their feet, or help schools  – whatever was needed that we could do. We came with nearly $6000 of donations from friends in the US and Europe.

For Mostafa’s first week, he connected with a group of Nepali doctors from Texas and participated in 4 health camps in earthquake-hit areas: Gorkha (Borlan VDC), Bhaktapur, Bagmati VDC , Nuwakot (Kakani). The day after I arrived, I also joined the group for a camp in Sindhupalchowk (Bhimthar VDC). Altogether, their team saw over 2400 patients in the 5 health camps, and did much good service providing medical and dental care.

Each place that they went, Mostafa said, was stricken hard by the earthquake, with damaged buildings all around. Sometimes they even had to conduct the camps in red-labeled buildings, meaning they were condemned, but such buildings were the only structures left standing.

So what is it like here, 2 months after the earthquake? I had no idea what to expect. The media had long ago stopped reporting on the situation. Our friends had told us that aftershocks were continuing and many were still sleeping in tents due to fears of sleeping in buildings, but otherwise, we had little sense of what it would feel like or look like.

On the surface, arriving at the airport and driving to the hotel, not much seemed different. We had last been here 2 years ago, and at first it seemed like little had changed in those 2 years. But on the way through town, while the vast majority of buildings were intact, occasionally there was a crumbled pile of a former building. Parts of the brick wall around the palace were fallen, as if a giant had taken a bite out of the wall. Corners of buildings were often missing and bricks exposed. But enough time had passed that ruins are tidied up, and people carefully yet nonchalantly pick their way around the wrecks.

The streets of Thamel also seemed normal at first – until we noticed the nearly total lack of tourists. Streets that are normally obnoxious and raucous were quiet, empty. Near Chhetrapati in Thamel, one 6 story building was leaning against its neighbor, and was being held up by a giant cable tied the building to a post implanted in the middle of the road. Every day, workers, young men in T-shirts and flipflops, enter the building with sledgehammers and pound away at the concrete, slowly revealing the rebar skeleton of the building. Others shovel the concrete and debris into a dumptruck. This is happening all over the city: ruined buildings are being demolished by hand with hammers and pick-axes, dismantled one brick at a time and trucked away. It’s as though the open wounds of the earthquake are becoming scars. In the old part of town (Asan, Indrachowk, etc) large timbers have been jammed in the ground at an angle against the sides of the buildings to brace the walls. The worst places are where entire buildings have collapsed into dense piles of rubble, and one can’t help think of the people who were inside at the time of the quake.

Yet despite the temptation to use dramatic and emotional language to describe the situation, there is a sense of the matter-of-fact business of moving forward.  People are calm and quiet, and sometimes even laughing in the way that Nepalis do even when they are upset.

We walked through Durbar Square, which had always been one of my favorite places because of the massive temple complex. The largest of them was simply gone,only the giant lower platform remained. Piles of bricks were everywhere. The huge white building in the complex (I can’t remember the name of it now) had partially crumbled, and it was as if we were looking at ancient ruins. Mostafa said that the world is full of ruins, whether Roman ruins, or Egyptian, or whatever. True enough, but the difference is that to see the ruins created, to have seen the structure before, whole, and then to witness its destruction, evokes an entirely different feeling.

Layers

But as we all know, buildings are just buildings. What matter is people. And so our excursion to a village called Dodhar in Sindhupalchowk the day after I got here was an opportunity to see how people were faring, and get a sense of what was needed. This outing was the final health camp with the group from Texas, offering free health care to people in the village.

We left Kathmandu around 6 am and headed towards Bhaktapur. Just outside of Kathmandu (past Koteswor) we had to slow down for some huge crinkles in the road where the earthquake had shifted the road several feet. But for the next 3 hours or so as we traveled through Banepa and then Dhulikhel, things looked intact, and busy and crowded as always. We took the turn-off for Panchkal and entered Sindhupalchowk,  and gradually there was more green than cement. Entering the beautiful expanse of the Indrawadi River valley, a very lush and rich agricultural area, we began to see house ruins every now and then, but very sporadically.

Finally we crossed the river and made our way about 1 km up on a very rough road to our destination village. Suddenly we were met with a scene of complete destruction. The village had had about 120 households, but the brick homes were simply crumbled. Most of them were just half walls remaining. On the hill above were 2 or 3 larger homes still standing, but otherwise there were no intact homes. In their place now were small structures that looked like miniature airplane hangars: arcs of corrugated tin, some open-ended, some with the ends bricked in, or covered with tarps. This was the temporary housing provided to families. (You can see these in the background of the picture at the top of this blog.)

We set up for the health camp in the one school building that remained, just two rooms. Men were already working on rebuilding the other building for the school, pouring edges of the walls where only the foundation remained. We began the health camp as villagers began arriving and lining up. The children were lined up in order to be seen; there were perhaps 75 children of all ages. They were very well-behaved, strikingly quiet, and in tough shape, with very poor clothing. The adults were also in extremely modest clothes, not with the fancy clothes that people often wear to the event of a health camp. This was a very humble village, and we encountered no thulo manche behavior of anyone trying to get special treatment or push his/her way to the front of the line due to privileged social status. We learned it was a Majhi village, an ethnic group that was new to us. We learned that 21 people had died in this village in the quake.

The day was very hot with intense sun, and as we were escorted through the village to where they had made lunch for us, it was immediately obvious how uncomfortable the tin can homes must be. In the sun, they became ovens. We wound our way through the narrow lanes of the village passing through corridors between broken homes where it looked as though clean-up had hardly begun.  Standing and waiting for lunch, being surrounded by the ruins was a very powerful experience. It only required a very slight shift of awareness to imagine being there when the quake hit, imagine the sounds of walls cracking and bricks falling and dust billowing, and the sounds of people within and without. One could so easily sense the feelings of complete fear and confusion that would have swirled in the immediate aftermath. The people around us had gone through that, had pulled their neighbors from the rubble – or had been pulled out themselves. No wonder the children were quiet.

The health camp was very effective; the doctors saw about 250 patients. Most complaints were not necessarily earthquake related, but there were those who came with injuries that were healing – ribs, wrist, head. One of the last patients was a young boy named Milan. He was about 7, and was so weak that his mother was carrying him. He had been unable to keep food or water down for 5 days and had had a fever. The local health post had given the mother many bags of various medicines, which he had taken and which had overloaded his system, especially his liver, and along with being completely dehydrated he was in very bad shape. We gave them a ride to the hospital in Dhulikhel along with 3000 rupees ($30) to help cover their expenses. Over the next 4 days we followed up, and finally learned that he had recovered and was headed home. (He is at the bottom of the header picture of this blog, starting to blow up a pink balloon.)

We had already been making plans to return to that village, and so the day after Milan got home, we went back to his village as well as a village 5 km above.

How To Help?

Two months have passed since the earthquake. The newspaper said that over 597,000 homes had been completely destroyed, and 230,000 damaged. But acute injuries have been treated, temporary housing is up, and basic needs are being met due to deliveries of food, water, etc by many organizations and countries. Someone told us that China had delivered 100,000 boxes of basic supplies for families such as soap, towels, combs, and much more. People had been given tents, and rice and lentils.

So what was needed? How could we help?  When one’s house is destroyed and all belongings buried, what do you need to try to regain a semblance of ‘home’ again? We began to think of those little things that might help in that regard, as well as critical things:  mosquito nets, soap and shampoo were of primary need. Then towels, a mirror, a flashlight. Before going back to Sindhupalchowk we went shopping and bought 50-60 of each thing, with plans to distribute to those families who needed them in Dodhar or in the upper village, called Tinghare.

This time it was a MEPO excursion. We were using the donations from many friends to buy the supplies for this trip, and to arrange transportation as well. We had to rent two 4×4 vehicles to take us there and back, and we got an excellent price of about $90 complete, which entailed leaving Kathmandu at 5:30 am, driving about 3 hours, including 30 minutes uphill on a very very rough road, and then returning around 9:30 pm.

On this second trip, we went with two young doctors as well as Mostafa, a Nepali friend Bhola and his nephew Santosh, an old American friend named Craig, and a young Nepali man studying public health at Yale named Priyankar. Our first stop was to go past Dodhar to a village called Tinghare. We arrived at the village and set up at the local school. Since the buildings had been damaged, they were holding classes in large tents donated by UNICEF. This village also had suffered extensive destruction of homes, and had had 8 deaths, but we realized that it was not as overtly poor as Dodhar. Although it was more remote, the families were better off, and many of them had second homes in Kathmandu and thus had not qualified for temporary housing. Consequently they had rigged their housing in large chicken coops, or barns, structures that had withstood the earthquake, not being made of brick.

We held a smaller health camp, and conducted some health education about using soap and shampoo regularly to avoid skin problems. We gave away soap and shampoo to those who really seemed to need it; there were a handful that seemed to be in quite rough shape. But we quickly realized that to distribute mosquito nets, etc to some people but not others would be extremely difficult. Unfortunately, the people had already gotten used to being given things, and had a bit of a sense of entitlement. They didn’t seem to have the needs of the people of Dodhar, so after seeing patients, we drove back down the hill to Dodhar.

Milan, the boy who had gone to the hospital, was waiting for us – smiling broadly and looking strong and healthy! It was wonderful to see him, and he was full of hugs and affection.

Mostafa and the doctors followed with some patients and dressed some wounds while Craig and Bhola and I met with the headsir of the school in order to discuss how to effectively distribute the mosquito nets, etc.  We brainstormed various ideas: only give to those who lost a family member? Only give to those with lots of children? Ask the headsir who was the most needy? It was a touchy situation, how to avoid a mob scene when we didn’t have enough of everything for everyone. We wanted it to be as equitable as possible, and avoid any hoarding  and minimize greed. Finally we decided on an experiment: Bhola would talk to the crowd and explain that there would be two ‘packages’ available: a mosquito net with a bar of soap, OR a flashlight with a large bottle of shampoo. He asked them to please choose one, based on what they really needed, and not take what they didn’t need or already had, but instead leave it so that someone who needed it might get it. And it worked! People lined up and Bhola went down the line and asked each person (only one per family) what they needed. They then came and got whichever one they had requested. We also then gave mirrors and towels.  The people were grateful and calm and helpful.

So, as a result, here is a summary of what was given so far:

Mosquito nets: 60 families

Rechargeable flashlights: 60 families

Soap: 60 people

Shampoo: 60 people

Mirrors: 30 people

Towels: 60 families

Notebooks, pencils, sharpeners and erasers: 300 children (grades 1-10)

Now that we’re getting more of a feel for what is needed, we’re beginning to see that people need cash more than things, so that families can either buy what they need, or can put it towards rebuilding their home. But the process of giving cash is going to be very tricky, so we are still working on how to do that.

Another big area of need is the schools. Dodhar, for example, is rebuilding its school, butall of its supplies have been lost: maps, books, benches, boards, etc.

We are contemplating focusing our efforts on helping this one village of Dodhar get back on its feet by helping re-equip its school  and assisting the village to rebuild (for example, their water supply was disrupted by the earthquake and so we may be able to help them repair it). If these things look viable, we may do that rather than jump around from one village to another, offering only spotty help. By getting to know this village more deeply, we can better focus our efforts and assistance.

 

Nepal summer 2015 Dodhar and Tinghare (1) (Small)

A building ruin in Thamel being demolished by hand and trucked away.

 

Nepal summer 2015 Dodhar and Tinghare (10) (Small)Bags of medicines and supplies to take to Tinghare and Dodhar in Sindhupalchowk.

Nepal summer 2015 Dodhar and Tinghare (12) (Small)

 

Nepal summer 2015 Dodhar and Tinghare (52) (Small)

 

Nepal summer 2015 Dodhar and Tinghare (21) (Small)

In Tinghare village

Nepal summer 2015 Dodhar and Tinghare (16) (Small)

Some basic hygiene education and playing a game at Tinghare school before the health camp.

 

Nepal summer 2015 Dodhar and Tinghare (23) (Small)

Eye infection of 4 day old baby being treated at Tinghare health camp.

 

Nepal summer 2015 Dodhar and Tinghare (43) (Small)

Driver Vishnu helping give away mosquito nets to villagers in Dodhar.

Nepal summer 2015 Dodhar and Tinghare (32) (Small)

The children of Dodhar.

Nepal summer 2015 Dodhar and Tinghare (50) (Small) Nepal summer 2015 Dodhar and Tinghare (35) (Small)

 

 

 

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