Physician in Nepal reports on post-quake conditions

Others from the Stanford Emergency Medicine Program for Emergency Response may join Paul Auerbach soon in the earthquake-ravaged country.

Emergency medicine chief Paul Auerbach is in Nepal to aid those affected by the recent earthquake. Other Stanford caregivers may soon join the effort.
SIM Central and South East Asia

Paul Auerbach, MD, chief of emergency medicine at Stanford, has gone to Nepal to assist with aid efforts there at the request of the International Medical Corps. He reported April 29 that Kathmandu is springing back from the disastrous April 25 earthquake, and that response teams are increasingly focused on rural communities where hospitals are hours away.

“Some of these will need to be approached by helicopter because of distances, mud- and rockslides caused by the earthquakes that have obstructed roadways, and calls for urgent assistance,” Auerbach, a professor of emergency medicine and the Redlich Family Professor at the School of Medicine, wrote in an email. “It’s anticipated that some teams may need to trek for days to reach certain villages. Much of the coming days’ and weeks’ activities will be intended to avoid the spread of infectious diseases.”

On April 28, Auerbach’s first day in Kathmandu, he described the scene as “somewhat reminiscent of what we encountered five years ago in Haiti, with the main exception being that there is much more of a structured health-care system in Nepal than there was in Haiti, and so the national medical response has been significantly more robust.

“Still, there are more than 4,000 known victims, and likely many more to be discovered in areas surrounding Kathmandu that are difficult to reach. Furthermore, there will be at least quadruple that number of persons with significant injuries.”

A small cadre of individuals may leave the week of May 4 to join the IMC working group, said Colin Bucks, MD, associate director of the Stanford Emergency Medicine Program for Emergency Response, or SEMPER. “Since many of us have co-workers and family in Nepal, I think we all feel a natural affinity towards the situation in that country. We want to support their ongoing recovery efforts as much as possible. Our primary goal is to reduce suffering and speed healing as much as we can be a part of that.”

Paul Auerbach

Stanford had mobilized 11 doctors and nurses, Bucks said. But based on the most recent assessment of conditions in Nepal, they were told that the team as a whole would not be needed. The most urgent request is for orthopedic surgeons. Bucks said he would coordinate the rapid deployment of any Stanford orthopedic surgeon who had the flexibility to depart soon.

Auerbach is a co-founder of SEMPER, which organizes, trains and maintains teams of physicians, nurses, emergency medical technicians and support personnel to be ready to depart for a disaster scene within six hours following a call for help. SEMPER provided similar primary care support to Haiti earthquake victims in 2010 and, most recently, to those injured in 2013 during Typhoon Haiyan in the Philippines.

In Nepal, Auerbach wrote in his latest post, “We have heard tales of miraculous survival, sadly posed against the grief of many lost family members and friends. Driving through the city past enormous mounds of rubble that last week were sacred temples and monuments, it is striking to think about how much there is to be done worldwide to prepare for cataclysmic natural events. There will be many lessons learned from this catastrophe, and we should take them to heart. One of them is how much better is a world focused on mutual aid and skillful compassion than upon dominance and conflict.”

Michele Barry, MD, professor of medicine and director of Stanford’s Center for Innovation in Global Health, is sharing information about other ways in which Stanford is assisting relief efforts. “The disruption of water and sanitation increases risk of a potential large-scale cholera outbreak, particularly as cholera is more common during the spring season,” Barry said. “Stanford cholera experts are exploring vaccine needs and assessing stockpiles.”


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