Emergency and humanitarian action

One month on, Sindhupalchok’s district-level field hospital adapts to a changed scenario

For a month now, a Norwegian Red Cross field hospital has provided critical medical care for the residents of Sindhupalchok, a mountainous district northeast of Kathmandu that was significantly affected by the devastating earthquakes that rumbled across Nepal on 25 April and 12 May. Though the district’s premier health facility in Chautara was rendered unserviceable by the first quake, local medical staff provided emergency care under tarpaulins for days on end in the dusty field where the camp now stands. Babies were delivered, bones were plastered, and emergency, life-saving health care provided.

Since the Red Cross facility opened on 4 May after being deployed by WHO in coordination with Nepal’s Ministry of Health and Population, 4 410 patients have been treated. One hundred-and-sixty-five surgeries have been performed and 17 babies delivered. The facility is staffed by Nepali medical professionals that ordinarily work at the district hospital next door, as well as around 30 Norwegian Red Cross staff. With aftershocks decreasing in severity and frequency and emergency needs giving way to more routine care, the hospital is now working much the same as the district facility usually would.

According to Norwegian Red Cross Deputy Team Leader Ranveig Tveitnes, Nepali doctors and nurses and their Norwegian Red Cross colleagues are doing their best to replicate the working methods of the district hospital. “We try to follow what people are used to and how the district hospital normally works,” she said. At present, the hospital is receiving between 150 and 200 outpatients daily, while an emergency unit continues to be staffed around the clock.
WHO/Michael Vurens van Es
When the Chautara field hospital first opened, between 50 and 60 X-rays were carried out daily. According to Jay Kumar Yadav and Lillian Lunden (pictured), demand for the service has now returned to normal levels. Since the facility opened, 624 X-rays have been carried out. Deputy Team Leader Tveitnes says that before the camp was set up, local doctors were effective in tending to the fracture cases presenting: “The doctors here had done an amazing job evaluating whether a bone had been fractured or not, just by feeling. They are very good doctors. They’re young, and often in their first or second year out of medical school,” she said.
WHO/Michael Vurens van Es
The tent outside the X-ray machine once sheltered crowds from the blazing pre-monsoon sun as they waited for their suspected fractures to be diagnosed. As the number of those requiring X-rays decreases, the tent now gives shelter to those with less urgent needs.
WHO/Michael Vurens van Es
These days, the field hospital’s surgery room is used less often. According to staff, the difference in the workload over the past two weeks has been significant as the emergency phase comes to an end. In total, 165 surgeries have been performed at the facility.
WHO/Michael Vurens van Es
Sushma KC, 18, had been working at Sindhupalchok’s district hospital for five months before the 25 April earthquake hit. After the field hospital was set up to replace the district’s damaged facility, she began working in the maternal and child health care ward looking after newborn babies and their mothers. “I’m very satisfied working with the Norwegian team here,” she said. According to hospital staff, three babies requiring urgent medical care would not have survived had pre-existing facilities not been replaced.
WHO/Michael Vurens van Es
Ganesh Bahadur Tamang, 78, lives eight kilometers from Chautara. He suffers from chronic asthma and regularly seeks treatment at the district hospital. For the past month he has experienced increased difficulty in breathing, and finally checked himself in to the field hospital on 1 June. He now keeps a nebulizer by his bed, and says he is happy with the treatment he is receiving.
WHO/Michael Vurens van Es
Asdis Gudmundsdottir, medical logistician at the facility, will be looking after the camp’s stores until the field hospital is eventually replaced by a permanent facility. “If I’m not here nobody can do anything as they won’t find the supplies, and will run out of them,” she said, adding, “The most important thing is to be organized from the beginning.”
WHO/Michael Vurens van Es
As Nepal’s rainy season approaches, the importance of building sustainable facilities that hold up under adverse weather conditions cannot be overstated. Before erecting the tents, Red Cross staff in collaboration with district health officers ensured that drainage systems were dug around each tent, and then filled in with pebbles. Massive gutters surround the camp’s perimeter, while water, sanitation and hygiene facilities are visible throughout the facility.
WHO/Michael Vurens van Es
District Health Officer Sagar Rajbhandari says that it has been a pleasure working with the Norwegian Red Cross as their assistance has allowed health care officials in his district to ensure a rapid and thorough response to the disasters. “It’s our privilege to work with the Norwegian Red Cross,” he said. “In such conditions I’m very happy that we are providing medical services to the residents of Sindhupalchok. It is our duty to provide these services to the public at all costs.”
WHO/Michael Vurens van Es
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