Delaware medical team to treat Nepal survivors

Doctors, nurses, paramedics and logistics experts with the Delaware Medical Relief Team are headed to Nepal after last week's magnitude-7.8 earthquake killed more than 6,000 people and wounded nearly 14,000.

A scouting mission of three medical volunteers could arrive in the capital city of Kathmandu as early as Monday to firm up housing, food and water and hospital access, according to team co-founder Vinod Kripalu, an internist at Trinity Medical Associates in Wilmington.

The first wave of more than 15 volunteers, joined by a News Journal reporter and photographer, are expected to arrive in Nepal by Thursday, although the timeline could get pushed back contingent upon conditions on the ground.

Local hospitals are "begging" the team to arrive, according to Reynold Agard, a team co-founder and an internist at Premier Physicians in Wilmington. "They've run out of supplies. That's why we've mobilized all our resources here."

The team's first wave will remain in the country for 7 to 10 days. Roughly 25 other volunteers are scheduled to be dispatched in subsequent weeks in three separate teams – fresh waves of medical professionals replacing colleagues who expect to work 16-hour days.

This is the first relief trip for the Delaware Medical Relief Team since 2010, when dozens of volunteers spent nearly four months in the port city of Jacmel, helping victims of the Haiti earthquake. That magnitude-7.0 quake killed more than 200,000 people and left an estimated 1.5 million homeless. The News Journal chronicled the team's trip in a series of award-winning stories.

Emerging from the team's work was the Haiti Family Initiative, a program that has provided activities, clinics, and counseling for families after the quake.

Agard said the team's life-changing experience in Haiti is still fresh in everyone's minds.

"I know it's going to be challenging but you are all committed," he told 20 volunteers gathered in a Christiana Hospital conference room Thursday night. "We will become family."

Ranging in age from medical residents to doctors nearing retirement, most of the Nepal team members are affiliated with Christiana Care Health System and have previous experience volunteering in the Caribbean and Africa. They include an orthopedic surgeon, a pharmacy director, a cardiologist, internists, pediatricians, anesthesiologists, emergency room nurses, physicians' assistants and logistics personnel.

This grassroots approach to delivering aid is unusual in America, according to medical team members. More common are trained teams of emergency medical personnel representing governments and hospitals.

"Here we have a group of people who know each other and know our skills," Agard said. "We have real connections on the ground.

The day after the April 25 earthquake, Kripalu said he began receiving calls from colleagues asking about a potential medical mission to Nepal. He consulted his wife, Chetana, a family physician who also traveled to Haiti. The couple organized the first planning meeting Monday at their Brandywine Hundred home.

Within two days, they had received $1,500 in donations, registered with the Nepali government as a humanitarian aid organization and partnered with the non-governmental organization Helping Hands Health Education, which provides low-cost medical treatments to rural Nepalese. Helping Hands has exhausted its supplies after treating 1,000 patients in the first 48 hours after the quake, Kripalu said.

The team has been in touch with Gov. Jack Markell, Sen. Chris Coons and Dover Air Force Base to try to secure a military flight for volunteers and supplies. They were still awaiting a decision as of Friday. Earlier this week, Air Force cargo jets sent three emergency response teams to the mountainous country in south Asia.

If a military flight is not available, the team will fly commercial to Kathmandu at a personal cost of about $1,200 each. Donations to the effort are being accepted at www.delawaremedicalreliefteam.org.

Members plan to bring essential supplies such as medicine, sutures, blankets and splints, but expect to acquire most of the supplies at newly reopened pharmacies in Kathmandu – or have them transported across the border from major cities in India. Christiana has committed to donating medicine and medical supplies, as has Paris-based pharmaceutical company Sanofi.

Logistics are still fluid, but the team expects to be based in Katmandu at Tribhuvan University Teaching Hospital, which has been operating on generators. Some members could be sent to more remote villages, where many city residents fled for fear of aftershocks. Pounding rains over the last week have led to landslides and impassable roads.

As they did in Haiti, the doctors expect to perform a large number of amputations, along with treating patients with heart conditions and diabetes who haven't had access to medicine since the quake.

The Delaware community has rallied behind the effort. A former Haiti team member donated warehouse space in Wilmington to stockpile supplies. Newark infectious disease doctor Albert Bacon donated medicine. Kirkwood Pharmacy is offering relief team members vaccinations at cost. A Walgreens on Naamans Road is supplying free scrubs.

Team leaders are still checking with Christiana Care Health System officials to see if full-time medical personnel would be eligible for paid administrative leave to assist with the effort. That and a free military flight might encourage more doctors to participate. Two surgical residents who attended Thursday's meeting expressed concerns about the trip's cost.

As with any trip abroad, members discussed logistics such as vaccinations, visas and traveler's insurance. But talk quickly turned to disaster preparedness – bringing water purification tablets and arranging emergency evacuation if necessary. One anesthesiologist worried about toting controlled substances through customs.

Sagar Bhandary, a Nemours pediatrician who grew up in Kathmandu, said he was still on the fence about participating. His parents' home survived the quake. But for two days they slept in their car, anticipating the next aftershock that would topple their home.

Now, Bhandary said, locals need financial help more than additional volunteers on the ground.

"Their first response was don't come," he said of his friends and family.

Other team members familiar with Nepal cited an overwhelming, long-term need. While the infrastructure in Nepal is more advanced and the government response more coordinated than in Haiti, public health officials warn of a major disease outbreak with so many residents trapped and untreated.

"When you went to Haiti, there was so much need, it was incredible," Kripalu said. In Nepal, the team will travel 7,600 miles "to say we love you guys and we care about you."

Watching the aftermath of the Haiti earthquake on TV, Agard said he was stirred to help establish the Delaware Medical Relief Team.

"When I saw them extracting people from under the rubble, it moved me so much," he said. "Everyone responded right away."

He recalls interacting with the desperate and the destitute in a shattered country, where a dose of Tylenol provided a measure of comfort.

"The family would just worship you for making a difference," he said.

Medical professionals involved in relief work must not only be at the top of their game technically, Agard continued, but be the consummate consolers. Several return seeking psychiatric counseling.

Amy Pollock, who handled logistics in Haiti and is on the U.S.-based team for Nepal, expects smoother operations in Nepal. The team has notified government and nonprofit agencies well in advance of their arrival. They've learned from their mistakes in Haiti, she said.

During the Haiti trip, the international medical aid organization Doctors Without Borders ordered the Delaware team to vacate a hospital. Delicate negotiations followed and the team remained in place, sleeping in cramped rooms and tents in a hotel courtyard.

As part of the volunteer participation form, Pollock said, respondents were asked to rate their risk tolerance on a scale of 1 to 5.

"Anyone with a 1 or 2 shouldn't come," she said.

News Journal reporter Esteban Parra contributed to this report.

Contact Margie Fishman at (302) 324-2882, on Twitter @MargieTrende or mfishman@delawareonline.com.

ABOUT THE JOURNALISTS

Margie Fishman covers features for The News Journal. She is an award-winning journalist with more than 16 years of experience

Margie is a former fellow of the Center for International Media Ethics and the International Center for Journalists and a former judge of the Agahi journalism awards in Pakistan. She traveled to rural north India last year to report on an innovative all-girls school with Delaware ties.

Daniel Sato has been a photographer/videographer with The News Journal for four years, where he has worked on projects on prescription pill abuse and the resulting heroin epidemic, crime in Wilmington and the growing threat of sea level rise.

Daniel first traveled to Nepal as a photojournalism student in 2006 where he documented social entrepreneurs with the Ashoka foundation. He has also worked in Indonesia documenting the building and opening of Green School, a bamboo school on the island of Bali.