When a Trek Becomes a Rescue
Written by Mr Peter McClelland
Thursday, 01 October 2015
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Just after midday on the April 25, 2015, the earth moved for four dramatic and tragic minutes in the landlocked, desperately poor nation of Nepal. Dr Gaynor Prince, a SCGH emergency physician who says she thrives on a challenge, suddenly found herself in the middle of a 7.3 magnitude earthquake.

Gift-of-the-Givers-Kathmandu-Hills210 It’s important for us as doctors to challenge ourselves and stretch our boundariesGaynor had travelled to Nepal to attend an emergency medicine conference. Her skills would be put to good use.

“When the earthquake hit I was in a small monastery village called Tyengboche near Everest Base Camp. It’d been snowing, we’d been walking for about three hours and I was looking forward to some hot soup. I had the cup in my hand and it ended up all over the table. Everything was shaking violently and I wondered what the hell was happening!”

“The possibility of a disaster like this wasn’t at the forefront of my mind when I left Perth for this conference but one of the presentations discussed the fact that they were due for a big shake because the last major earthquake occurred in 1934. So after that I was definitely thinking about it.”

Though Gaynor had been to Nepal previously, she was unfamiliar with the area she found herself in.

Safe shelter a priority
“I didn’t know the terrain very well but Tyengboche turned out to be a good place under the circumstances. It was on a small hill in the valley and that slight elevation provided some degree of safety. Everyone was shocked and scared. We got out of the building quickly because there’s no mortar in the walls and each rock vibrates at a different frequency. When the middle rocks start popping out of the walls, it’s not a good idea to be inside.”  

“It was important to find out where the epicentre was so we’d know which way to walk but, understandably enough, it was difficult getting any information.”

The location wasn’t the only piece of luck for Gaynor because one of her travelling companions had a particularly impressive CV.

“I happened to be with a doctor from the UK who is a reservist in the British Army and specialises in major incident planning – the perfect guy for the situation. We didn’t know anything about the rising death toll and we were concerned about landslides so we decided to stay overnight in a tea house made of wood. After another 6.8 aftershock, we stayed one more night.”

Destruction-in-Durbar-Nepal-220 Destruction in Durbar

Panic stations and consequences
“Then we trekked for six hours to a Himalayan research centre at Pheriche and by the time we got there the helicopters had been going in and out all day. That was dangerous in itself, people running around refuelling and an empty jerry can was sucked up into the rotors grounding one chopper.”

“It taught me the value of standing back and thinking clearly, taking a moment to process information even in the middle of a major disaster.”

Despite her hospital ED expertise Gaynor’s eventual role concentrated on logistics.

“Most of the emergency physicians were situated at the main teaching hospital in Kathmandu while we focused our attention on the Grande Hospital north of the capital. They were evacuating patients due to a lack of shelter so we helped them set up a field hospital and my role was less hands-on medicine and more logistical in nature.”

“After that I flew back to Kathmandu and joined up with a South African medical team called Gift of the Givers, a disaster relief foundation. They’d had experience in the 2010 Haiti earthquake and they put 80 people in Nepal within 48 hours. I worked with them up in the hills in a primary care health clinic when most of the acute needs linked with the earthquake were over.”

Importance of primary health
“In fact, just over a week after the disaster only about 10% of the patients we were treating had quake-related issues.”

Despite the importance of a global and compassionate response, Gaynor is well aware of some of the inherent complexities associated with foreign aid in these circumstances.

“It does raise some big questions: The ramifications of setting-up a primary health care service in a country that hadn’t had one before the disaster and the consequent expectations of the local people afterwards were two complex issues. I have to say I was a bit torn by all this, particularly given some of the behaviour of the Nepali government.”

“Corruption is a problem and this aspect of politics directly affects the local people. There’s only one international airport and initially the Nepali government was taxing everything that came in by plane. At one stage they were only allowing tarpaulins to be off-loaded and they’re pretty ineffective against wind and rain. With the monsoon season just four weeks away it was pretty inadequate!”

Post-disaster, Gaynor ponders on both the experience itself and the value for medical professionals in stepping outside their comfort zone.

“I was a little bit flat and emotional when I got back but it was nice to get a good night’s sleep. It’s important for us as doctors to challenge ourselves and stretch our boundaries because it’s a catalyst for reflecting on the work that we do and going to developing countries certainly gives you a different perspective.”