Partners International is pleased to present Postcards
from the Field, a new series of essays highlighting the efforts
of clinicians who are either working overseas in a clinical setting, or
who are working cross-culturally in a local setting.
All members of the Partners community (including international alumni) are welcome to contribute to this series and if you would like to share your story, please send your essay and photos via email to eanolan@partners.org.
The quake’s official death toll of 80,000 takes only the recovered bodies into account, yet thousands more were buried alive in their homes, schools and businesses. Now, over four months later, more than three million people find themselves stranded without shelter in the grip of a brutally cold Himalayan winter. I had traveled to Pakistan in order to be of some value to the early relief and rescue missions, and witnessed the catastrophe even as it was unfolding. Injuries, mostly orthopedic, ranged from multiple compound fractures to crushed spines and pelvises; in many cases, family members carried out amputations as a rescue measure. Mobile field hospitals catered to a colossal volume of patients evacuated from mountain homes, who were suffering not only from significant physical injuries but also from hypothermia and severe psychological trauma. Very soon, complications from wound infections, tetanus, malunion of bones, contracture formation, and inadequate first aid began to surface on a very large scale. Gangrene became a particular problem, leading to a second wave of amputations. Overcrowded hospitals and congested campsites were soon treating tetanus, as well as communicable diseases such as cholera and diphtheria. This earthquake has been described as the biggest natural disaster in a century. To their credit, the international and national organizations that arrived on the scene launched one of the most difficult rescue operations these mountains had ever witnessed; it was swift, coordinated and, against staggering odds, extremely efficient. NGO efforts notwithstanding, from what I saw, it was the generosity and ingenuity of everyday people that ultimately changed the face of this catastrophe from irresolvable to manageable. If one thinks of a miracle as a shift in perception from fear to faith, then this was the story of a miracle, or perhaps a thousand tiny miracles. Hands literally moved mountains. Surgeons worked seventy-two hour shifts. Nurses and theatre technicians performed under heroic conditions; medical students assisted in procedures, operations and first aid as if perfectly trained. Small businesses took over relief operations for multiple tent cities and hundreds of people. Housewives brought their personal cooking utensils on handcarts and bicycles. Government officials buried their dead and reported to work that same day. Plumbers, electricians, vocational trainees, truck drivers, all became spokes in a wheel that pushed ahead one patient, one helicopter load, at a time. The generosity of spirit with which my BWH colleagues and friends arranged boxes of medical supplies and supported my endeavor in every possible way enabled me to undertake this effort, the memory of which I will always cherish. In this business of helping and saving lives, we live by many rules that bind and regulate our work, but it is elemental to remember this one overarching dictum: from time to time, we must seek meaning through service for its own sake. Editor's note: Medical relief efforts are ongoing in the quake zone. If you wish to volunteer or contribute medical supplies, please contact Naila Moghul, M.D. via email at nmoghul@partners.org.
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