Death, Disease
and Hope
By Dr Mohammad. Afzal
Arain
(Report
filed from quake site in Pakistan)
As soon I heard about the earthquake
I started preparations to go to Pakistan. I started
to collect antibiotics, painkillers surgical supplies
and other needed supplies. Local hospitals provided
truckload of emergency medical supplies. One of
my patients provided 8 large cases of surgical gloves.
I cancelled all my scheduled surgeries, office appointments
and was on my way to Islamabad.
My prayers were for the affected people and my intentions
were to find the best possible way to help them.
Dr Seed Akhtar, urologist and transplant surgeon,
was in the USA and was to receive an award on being
designated Governor of Pakistan for American College
of Surgeons. SWDR committee members started to have
daily teleconferences and we convinced Dr Akhtar,
who is a Islamabad-based physician, to forego the
honor of recognition at American College of Surgeons
and to return to Pakistan to help the suffering
people.
Dr Murtaza Arain from Chicago went a day earlier
(15 October) to ensure that APPNA doctors were appropriately
received and collection of excess baggage and transportation
of some 100 + boxes to a safe storage area could
be arranged so that the items could be collected
and used when needed.
We had a meeting at Shifa Hospital with various
volunteer organizations and all of the newly arriving
physicians were briefed about the ground reality.
Dr Saeed Akhtar from APPNA and IMANA & PIMA
worked as individual coordinator. He opened up his
home to all of us. Dr Piracha and myself had family
in Islamabad but we stayed at Saeed Akhtar's home
to better coordinate our efforts.
On October 18 we, Dr Piracha, Murtaza Arain and
myself from APPNA, Dr Rehana Kauser, Parvez Malik
from IMANA and Dr Saeed Akhtar (representing any
one who wanted to work) went to various hospitals
and met the local authorities. General Usmani who
was designated incharge of relief efforts for the
entire area told us that the army hospitals have
mobilized their medical staff and do not need assistance
from any one. He requested Tetanus and ATG vaccinations.
Shifa international had designated 100 beds for
the disaster relief and were providing free service.
Their setup was better than most hospitals. PIMS
(Pakistani Institute of Medical Sciences) hospital
looked like Cook County but was ten times busier.
There was continuous flow of injured patients on
"charpai". One wondered where all of these
were going. Patients were fast tracked and got timely
care. I did not see any one standing idle. Everybody
was motivated and was working with full vigor. The
sight was very inspiring.
We met the director of PIMS Hospital Dr Fazle Hadi.
He stated that they were performing an average of
170 surgeries a day. The operation rooms were being
used on 8-hour shifts. He mentioned that they had
ten operation rooms but only seven were furnished.
He said if we could furnish three more surgery rooms
their efficiency would increase by 33%. Islamabad
Polyclinic, air force hospital army medical college
had patients everywhere and hardly had any walking
spaces.
We had a meeting and concurred that we could refurbish
the needed surgery rooms at PIMS. The cost was estimated
at $50,000. APPNA and IMANA each collected $25,000
and the next day the equipment was ordered. We all
felt that it was better to invest in equipment rather
than a cash transaction.
APPNA is not an NGO and members have been doing
relief operations for many years. The earthquake
had done extensive damage to property, infra structure
and life. The injured, paralyzed and limb-loss patients
were pouring in from everywhere. The scene was depressing.
What nature did in thirty seconds would take 50
years to undo.
.
October 19:
Some of the doctors tried to go to different hospitals
and volunteer their services. Most were told that
they had enough doctors but needed more equipment.
Orthopedic supplies, pneumatic drills, anesthesia
machines and C-Arms were in acute shortage. After
some manipulation with the administration most of
the doctors were able to serve the injured with
their expertise.
We wanted to go into the damaged areas to access
the needs of the people so that we could pass it
on to APPNA members and obtain the needed help.
All the roads were damaged and everyone was taking
a truckload of whatever they could get hold of.
Water, food, blankets, clothes, carpets, medicines
and blankets were loaded in trucks. Some of the
homeless, shelterless hungry people stopped the
trucks and took what ever they needed. Truck drivers
felt relieved that the needy came to get what their
needs were. Most of the people did not feel offended.
Dr Murtaza Arain was able to arrange a helicopter
for a short time. We went to Abbotabad and visited
numerous patients with spinal cord trauma and paraplegia.
There were many with fractures awaiting surgery.
The area looked like a flea market. People looked
visibly disturbed.
From Abbotabad we went to Bagh. A young man, perhaps
thirty-year old, had head trauma and had just walked
in with his willpower using the last bit of his
adrenalin. He fell down and stopped breathing. He
was intubated but there was no oxygen or suctions.
We decided to cancel our trip and put him in our
helicopter along with nearly twenty other injured
patients and turned around to PIMS. Dr Seed Bajwa
(neurosurgeon) was with us. We rushed him and had
CT done. The patient was placed on a respirator
and stabilized. He had a fractured orbit and subdural
hematoma.
Due to lack of respirators many patients were kept
alive with Ambo bags pumped by family members who
took turns.
The next day the patient did not show any improvement
and needed craniotomy. When we last saw him, he
was stable and was coming out of danger. I heard
the family members say that when God wants to save
someone He creates circumstances for help. We spent
most of the day at PIMS.
We had a wrap-up meeting for the day and shared
our observations and made plans for the next day
October 20:
We had an early morning meeting at Dr Saeed Akhtar's
residence about the next step of planning. We went
by road to Muzzafarabad and visited other neighboring
villages. We also visited several makeshift hospitals
and medical camps of different NGOs. Everyone was
dedicated to whatever they had taken on and was
very busy. There were numerous sick people who had
no place to go. In medical camps they got food and
shelter along with medical care. Almost all the
camps were crowded. We visited the prime minister
of Kashmir in a tent where he was staying. He said
people called him prime minister of the graveyard.
He said he saw a little boy buried under the rubble
who was crying, " Ami, save me; Abboo save
me. " The prime minister said that no help
was available to lift heavy concrete slabs. Finally,
when he returned with help the voice had silenced
forever. On this he started crying. We spoke with
him about thousands of people and children who had
lost their limbs and those who were paralyzed due
to spinal injuries. We told him that if APPNA EC
and membership give us their blessings we will try
to open a 25-bed rehabilitation hospital and endeavor
to get physical therapists and artificial limbs
from the USA. We will request various specialists
and organizations for help. After one year we could
gift the hospital by APPNA to the people of Kashmir.
He became emotional and promised that he will be
part of the project and promised to sustain it.
At Muzzafabad we saw nothing but destruction. Buildings
had collapsed all around. Cloths were covering streets,
people were wandering aimlessly. There were more
volunteers than local people. The streets had an
unpleasant odor of the dead bodies. There was hardly
any building which was intact. It was a very tiring
day and due to winding roads I got very nauseated.
We had our usual planning meeting at the end of
the day.
We were all the time in touch with the APPNA officers
and members of the SWDR committee and updated them
with our findings and passed on the list of needed
items.
October 21:
We planed to visit Abbotabad and Balakot (hardest
hit area with near 100% destruction). We passed
the Hassan Abdal and Haripur Hazara area. Abbotabad
had no visible damage. Mansehra had few damaged
buildings. After we crossed Mansehra the scene appeared
different. Balakot was completely destroyed. Everything
had flattened out. Numerous children of all age
groups were found wandering like chicks. I saw a
small baby sitting next to a pile of food. He had
only a shirt on. She did not know that she could
pick up a small cloth and cover herself.
Many children had dust in their hair. They looked
like lost kids. No adults were with them. The DSP
police said that eight police officers died in their
home. He himself had a broken hand but was on duty.
He said one police officer tried to dig out another
person, got a minor injury which turned into gas
gangrene leading to the amputation of his hand.
He said he was able to come out of his home with
a broken hand and saw a three-story building across
his place which went up in the air and went it fell
two floors were completely destroyed. He heard screams
of people asking for water. He said that after the
earthquake the well water level went down and he
had to go to the river to get water for the people.
One of the local people told me that even the birds
got disoriented and looked like they had gone blind.
They were falling on the ground and dying. After
his statement I looked around and I did not see
any bird in the area, not even on the garbage area.
(They may have left due to too many people).
We visited several clinics in the area. The best
furnished was a makeshift hospital by UAE.
We went further on the road on top of the mountain.
Even with all the destruction the valley looked
very beautiful with tall mountains and a river flowing
at the bottom. There was smoke everywhere from burning
debris.
October 22:
We visited some of the patients at different hospitals
and gave away the charity money to the needy. I
was told that it takes four thousand rupees to go
to Muzzafarabad from Islamabad. Some of the family
members who were stranded with the injured at Islamabad
hospital wanted to go back and look for other family
members to find out if they had survived. I distributed
money to help them.
We had a meeting at Shifa international. They had
designated a section of the hospital as brain center
of the relief efforts. Several young boys and girls
were volunteering their time and to my pleasant
surprise they appeared well versed with computer
techniques.
Dr Saleem Nagra, general surgeon with orthopedic
experience, arrived and declared that he has brought
$ 100,000 from Canada which was raised by his community.
Due to spread of tetanus, many people had died and
several others were on respirators. A lot of them
were being managed by family members. Dr Ingra donated
seven respirators and was willing to purchase other
equipment.
There were acute shortages of pneumatic orthopedic
drills. One was purchased from Karachi for $20,000.
Dr Murtaza Arain called his hospital in Chicago
and to his surprise he was told that they only used
battery powered drills and the pneumatic drills
were becoming antique. His hospital immediately
donated two of them which will be reaching Islamabad
soon.
October 23:
We have been able to furnish two surgery rooms at
PIMS, thus increasing their efficiency by 33%.
Seven respirators.
Three pneumatic drills.
Six anesthesia machines.
About two million dollars worth of medical and surgical
supplies.
A plane load of ten thousand blankets, ten thousand
tents, and medical supplies (IMANA & Islamic
Relief).
Arrangements are being made to send possibly two
planeloads of medicines through a major drug company.
We have also been able to arrange:
All the doctors will be received at airport.
Assist them with immigration and baggage collection
and transportation.
Provide accommodations and meals.
Provide a place where they be best utilized with
respective expertise.
Arrange tour of the affected areas.
All the volunteers can feel secure and have no worry
about anything except to do service to humanity.
Future plans:
Immediate needs are being taken care of.
Intermediate needs are addressed and will be accessed
daily and necessary actions will be taken as needed.
Long-term:
Putting together a 25-bed rehabilitation hospital
for amputees and paralyzed patients. Provide psychological
assistance to children and adults. We will also
plan to access any future needs and make available
any services we are able to provide.
I will request all those who have know-how, resources
and ability to help us in putting together this
hospital.
In the end I want to thank our social welfare and
disaster relief team members who have been working
tirelessly since the day this earthquake disaster
happened.
People of Pakistan make me feel proud of them. They
have forgotten all difference and everyone feels
that the earthquake has hit their own home.
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