Nepal earthquake emergency response

Previous updates from the field

MSF currently has 61 staff on the ground in Nepal, who have started activities in Kathmandu and Gorkha. Our priority is to reach people who have not yet received any assistance.

Update: 1 May 2015

24 tonnes of cargo arrived in Kathmandu.
A team is continuing mobile clinic activities by helicopter in remote villages in the mountains to the north of Kathmandu.
A mobile medical team is visiting remote villages in the mountains to the north-west of Kathmandu to provide consultations and assess further needs.
A surgeon is assessing the the capacity of the referral hospital in Bharatpur, south of Ghorka, which has been receiving patients following the earthquake.
A team is continuing its assessment of the location to set up the inflatable hospital that arrived by cargo plane on Wednesday night.
A nurse and a doctor are providing support in the medical evacuation of some patients from Larpak in Ghorka district- A surgical team (surgeon, anaethetist, nurse) is continuing to support the hospital in Bhaktapur. They have managed 5 major surgeries so far.

Update: 30 April 2015

MSF’s first cargo plane has been able to land in Kathmandu and all the contents have been cleared through customs. This cargo plane has come from France containing 4 inflatable tents to construct a field hospital, as well as the necessary medical supplies. The team is identifying the most appropriate location to construct the hospital where the needs are significant and where we can have the biggest added value.
A surgical team will start providing support to the hospital in Bhaktapur district, a heavily affected area east of Kathmandu.
A 3 person team (medical doctor, nurse, logistician) has left Kathmandu in a helicopter to begin mobile clinics in remote villages in the mountainous areas of Sindhupalchowk district, which have been heavily hit by the earthquake and where little or no assistance has been provided.
On Wednesday, a team was able to get more than 200 shelter kits to the village of Gumba in Ghorka district.
On Thursday, further assessments are being carried out in hospitals in Kathmandu and Bhaktapur to evaluate the capacity for management of ‘crush syndrome’.

Update: 29 April 2015

On Tuesday a team assessed the situation in Gorkha District Hospital, which has suffered damage from the earthquake. The in-patient department is destroyed. On Wednesday a truck carrying a rapid intervention surgical kit left Kathmandu for Gorkha (200km north-east) as the road has been re-opened. The surgical team is on their way to Gorkha to set up and begin responding to surgical needs from the area surrounding Gorkha.
On Tuesday a team assessed the Tudikhel makeshift camp in the centre of Kathmandu. The water and sanitation situation is concerning, with people having limited access to clean drinking water and the public toilets overflowing. In terms of medical needs at this camp, currently a team of doctors from Bir hospital (located opposite the camp) have set up a makeshift consultation area and are managing primary health care needs. Many of the people in the camp are from in and around Kathmandu, but there are also a number of migrant workers who can no longer stay in the temporary accommodation they normally stay in in the city. There are also others in the camp who have come from outside Kathmandu after their villages were destroyed in the earthquake. MSF is looking into the water and sanitation situation in the camp urgently.
On Tuesday a team assessed the needs and capacity in four hospitals in Kathmandu, with a focus on trauma and nephrology departments (to understand the capacity to deal with ‘crush syndrome’). Generally these hospitals are overstretched after dealing with influxes of wounded following the earthquake, but also trying to continue to deal with regular patients with chronic illnesses etc. Kathmandu Teaching Hospital has been receiving an increased number of patients requiring dialysis – mostly chronic rather than people with crush syndrome – coming from other hospitals. There are currently 200 patients on their list needing dialysis and they are utilising eight machines to meet the demand. MSF made a donation of wound-dressing kits to two hospitals and is looking into options for supporting specific hospitals in Kathmandu according to the need.
On Tuesday a team returned to a makeshift camp in Bhaktapur (40km east of Kathmandu), where more than 1500 people are staying. They are facing a difficult situation in terms of water and sanitation, with people collecting rain water and lacking latrines. They have yet to receive assistance and have either lost their homes in the earthquake or are too scared to move back to their homes in case of aftershocks. MSF is looking into the water and sanitation situation in the camp urgently. The team also donated dressing and first aid materials to the hospital in Bhaktapur.
On Tuesday a surgical team arrived in Kathmandu and will be deployed as soon as possible with a field hospital, which is due to arrive in Kathmandu.

Update: 28 April 2015

A team is doing further assessments of hospitals in Kathmandu, including looking at capacity for treatment of ‘crush syndrome’. Depending on needs, MSF will support hospitals with supplies and HR.
Relief items (1000 shelter kits, 500 hygiene kits, 500 kitchen kits) are on the way by road from Bihar (India) to Gorkha. These will be distributed to affected people in villages outside Gorkha.
A 35 tons charter with inflatable hospital and drugs is departing from Bordeaux, France, to Kathmandu.
A team is assessing the situation in makeshift camps in Kathmandu and Bhaktapur, with a particular focus on the water and sanitation situation.

Update: 27 April 2015

A team assessed the situation in two main hospitals in Kathmandu (Bir Hospital and Teaching Hospital). Both have been receiving wounded and are now lacking supplies. Patients are sleeping in tents in the grounds of Bir hospital.
A team did an aerial assessment by helicopter of areas to the east, north and west of Kathmandu. Of approximately 65 villages viewed, around 45 had visible damage or were destroyed. These areas are isolated and only accessible by helicopter. One village – Warpak – 45 km from Gorkha, has suffered extensive damage and the team plans to respond there.
Teams arrived by road from Bihar (India) to Gorkha (200 km north west of Kathmandu). Gorkha town itself has not suffered damage.
A team assessed the situation in Bhaktapur (east of Kathmandu), which has experienced destruction. Hospital does not have a functional operating theatre and all cases are being referred to Kathmandu. People are staying in makeshift shelters in the open-air and the sanitation conditions are concerning – no latrines and water is scarce.
A surgical team and rapid intervention surgical kit arrived in Kathmandu late Monday night and will begin assessments on Tuesday.

Update: 26 April 2015

Four MSF teams departed this morning from Bihar state in India and are currently at the border with Nepal clearing with authorities before heading to the areas affected by the earthquake.
A surgical team composed of eight highly skilled staff will this afternoon leave Brussels for Kathmandu. The team will set up a surgical unit as well as run mobile clinics aimed at reaching affected people in remote areas.
One MSF team from New Delhi, India, is now headed for Kathmandu after initially being re-routed back to India due to aftershocks. The team is expected in Kathmandu later today and will start providing medical assistance.
One team of medical and non-medical staff is headed for Kathmandu Valley from Japan.
More emergency supplies are being sent from Bordeaux, France today.
Another MSF team from Amsterdam will depart today with additional medical and water and sanitation capacity.

MSF previously worked in Nepal from 2002 to 2009.

Why were we there?

Armed conflict

Historical

MSF has worked in Nepal since 2002. Teams provide healthcare to people still affected by the conflict between government forces and the Communist Party of Nepal which lasted from 1996 until 2006, and by the resurgence of violence that accompanied a chaotic peace process. MSF worked where help was most needed, including in basic healthcare, reproductive healthcare and water and sanitation provision.

Despite Nepal’s struggles with political stability after the peace process, MSF left the country as government agencies and developmental organisations started to take a longer-term approach to covering the people’s health needs.

Teams worked to increase knowledge about reproductive health and called for better access to good-quality public health services. Through a number of national radio announcements and education at local level, MSF also addressed the issue of oxytocin misuse. The drug, used to stimulate contractions in pregnant women, is widely misused. This can result in foetal and neonatal deaths, and ruptures of the uterus. The drug can be used safely in small doses if the baby is overdue, but in Nepal it is common to take high doses to try to induce a birth prematurely, especially to make the birth take place on a religiously significant date.

In May 2009, MSF handed over programmes in the isolated mountainous Kalikot district. Up until then MSF had offered basic and secondary healthcare, tuberculosis treatment and emergency services with a special focus on healthcare for pregnant women and children under five. In 2009, MSF carried out more than 10,000 consultations and assisted with 192 deliveries.

In December 2009, MSF handed over its last remaining programme in the Terai region of Nepal, which provided free medical services, emergency consultations, maternal healthcare, and treatment of acutely malnourished children. In the areas affected by internal unrest MSF used mobile clinics in the most neglected areas and transferred patients needing more care to its facility at Gaur District Hospital. MSF carried out more than 10,000 consultations and assisted more than 1,300 deliveries.

In the areas where it worked, MSF left behind an improved level of care for mothers and newborns, and better trained staff.