Monday, October 24, 2005

The truth is frustrated and the facts are faded

I just received an email from someone who wanted to know the truth involved in a msg they received. This email will remain anonymous for the sake of privacy, but from what I remember when I was up there, this email paints a very accurate and appropriate picture.

I do have my reservations about what was said regarding P.I.M.S. as I have been going there quite frequently during the first few days after the victims started pouring in and I think that for its capacity, the community is doing quite well for its medical facilities. Many people have been kind enough to setup local satellite hospitals to take the load off major hospitals such as P.I.M.S. to help recovering patients etc. Although I had a positive angle about that, I am not a doctor and the gentleman who wrote this email is so he would certainly have a better understanding of the scenario.

I did imagine things to be this chaotic and the beureaucats in their high chairs need to put their jeans on and some duct tape on their incessent lips and go do some real work instead of yapping on tv like celebrities.

**Also please note I HAVE TENTS COMING IN, SO IF YOU NEED TO DISTRIBUTE OR KNOW OF PEOPLE WHO ARE, KINDLY CONTACT ME FOR FURTHER ARRANGEMENTS. These are canvas tents 12x15 feet tents and are 3300 rps a piece. If you need them in larger numbers, let me know and I can arrange for them to be made and delivered to Islamabad.**

I have just returned to Rawalpindi from Garhi Dupatta in Azad Kashmir. To be honest, I have not read any of the previous correspondence on this site -it is too painful to get involved in the petty nonsense that some people are involved in and the "holier than thou" Quranic Jargon that is being thrown in each other’s faces. If this offends someone, then so be it. I think that is important to know what is going on up there and what can be done to truly help.

THE SITUATION IN ISLAMABAD: First of all, with each passing day, hundreds are dying. I was invited to work at PIMS, so I spent a few hours there on Monday. There appears to be no sense of urgency there. To me, it seemed like just another day at a government hospital. Loads of patients in the hallways. Dozens of school kids in uniform running around, medical students involved in heavy duty poondi, junior resident level doctors sitting around in their respective offices, no attendants in sight and absolutely nothing being accomplished. There was one wound being debrided in the operating room. The CEO (or equivalent thereof) asked me to relax and rest for a couple of days! The chief of surgery happened to drop by for a meeting. I offered my services and he was quite offended by my remarks that not much appeared to be going on. I was told that in the preceding 8 days, they had placed 12 chest tubes and had performed 1 splenectomy. He was proud of their achievement. Tens of thousands dead, uncountable others injured - quite an achievement indeed. The ICU had nine patients in it. Nine. On our insistence, they agreed to send us to Mansehra.

MANSEHRA: Drove to Mansehra. The destruction becomes evident past Abbottabad. You can see the images on TV. The smell of death however has to be experienced. The government degree college in Mansehra is now a makeshift hospital. 2nd year med-students were dealing with infected open fractures, using diclofenac as pain medication. I spoke with the Swiss orthopedic surgeon running the outfit. He offered us positions as floor nurses. Literally. When I insisted that we had much more to offer, he quite impolitely asked us to leave. Balakot is about two hours from Mansehra. There is no building left standing. There are hundreds still decaying in the open. After dark, every vehicle is looted by the desperate locals. It is hell on earth. We chose not to stay.

MUZAFFARABAD: We received an offer by PIMA (Pak Islamic Medical Assoc) to man their field hospital in M'abad. I reached there Tuesday morning. The roads are extremely tenuous. There is a sea of tents of various outfits from all over the country. These are manned by a variety of people, from house officers and medical students, to high school kids. No attendants. Thousands of Indians and no chief. The hospital needed a surgeon. There is not a single qualified surgeon in the whole city. Not one. No buildings are standing. There no clean water and little electricity. Cell phones do not work. We kept moving on.

GARHI DUPATTA: I finally rendezvoused with the group from George Washington University that I had originally planned to go with. They had reached there a few hours before we did. I helped set up the field hospital. Check the map. This place is 20 miles from the LOC. It is the farthest medical facility out there. First contact point. Over the next four days, we saw about 1500 patients. We set up a two table OR and various examination stations. The major abdominal/thoracic injuries are now dead. What we saw were heavily infected wounds. Open fractures. Gross osteo. I lost count of the number of the number of guillotine amputations needed. Florid tetanus. Meningitis. Sepsis. Pelvic fractures. Numerous paraplegics and quads. People with jelly for spines. Brain exuding from open skull fractures. Ruptured bladders with urinomas in the thigh. The fascinating thing is that these people were still alive this far out. Natural selection, I guess. The fittest survive. With two surgeons, including myself, one anesthesiologist and numerous internists, cardiologists and pulmonologists, we were still busy from0600tomidnight. The army arrived the day after we did and set up a helipad and a unit next to us. We were able to evacuate about 40-50 patients each day after stabilizing them. Unfortunately, I knew what awaited them in Islamabad. We were choppered out today. We have left a fully functioning hospital to some docs from DOW. They'll be there until next week. Then a surgeon will arrive from New Jersey. Teams from Canada, Belgium and Australia have since arrived and setup in-patient facilities proximal to our hospital. Again, family practitioners, but no surgeons. We were able to send some relatively stable patients there, so as to avoid flooding Islamabad.

ASSIGNINGCREDIT/POINTING FINGERS: The US choppers are flying nonstop. Hats off to them. No nonsense. Efficient. Courteous. They flew over us to distal points, dropped some supplies, returned the remaining to be stored at Garhi Dupatta and evacuated our most critical patients out. This went on during all daylight hours. The Agha Khan foundation has acquired Swiss helicopters and was also working in a similar fashion. No evacuations, however. The Pakistani army is another story, unfortunately. There were about 300 soldiers twiddling their thumbs as we struggling to get something done. In my view, they should have been sending out teams with tents and supplies to find the countless up in the mountains that are unable to make it down. Instead, there are grand plans to make tent cities, where people are expected to come down and settle. Nuts. Every patient had the same story. Two or three kids dead. Parents dead. Siblings dead. A wife and a couple of kids injured, but still alive and lying in the open. They had to make the choice - bring the child that they thought would survive. The average trek was four days one-way.

WHAT YOU CAN DO: Don't just send money to random sites. There is enough there already that needs to be distributed. Send Tents to specific people that you know will distribute them to the people still up there. Tents. Tents. Tents. Did I mention that they need tents? Clothes are a-plenty. They just need to be distributed. Once again, they need to reach the people who will wear them. The best thing you can do, however is go yourself. Find a week or ten days. Go to Garhi Dupatta. Rough it out. Do some wound care. Deliver a few babies. Treat some infections. Just do it. Do it now. The contact person is Farzad Anjum. He is a cardiac surgeon at GW. Find him on the web. He'll point you in the right direction. If tickets are in issue, tell me. I'll give the contact for the Disaster Relief Network. They'll pay for airline tickets and incidentals. Sponsors are out there. What they need is your time and effort. Once I have caught up with my sleep, I'll give you more details. I the mean time, please cut out the Bulls**t lecturing and verse quoting and buy a ticket to Pakistan. Time is running out.

2 Comments Post a Comment
Blogger machinecode said :

this is the kind of info that we need, what is happening on the ground.. The asian TV networks are just glossin it up saying everyone is doing a grand job.. This is reality for the people on the ground.. Its the pak mentaliyt of being a sardar !!!

thanks for the report..

October 25, 2005 5:43 am  
Anonymous Anonymous said :

I do have my reservations about what was said regarding P.I.M.S. as I have been there off and on and I think that for its capacity, the community is doing its efforts quite well. However the lack of organizing people have resulted in such chaotic situations as described.Most people who could not contribute much in cash or kind have been there to offer physical and moral support (mostly students) we must not disregard these feelings and efforts on account of a few bad eggs whom we must pin point and put them away and I am sure we will be left with enough sincere people who can manage the situation. Although the gentleman who wrote this email have a first hand information of the scenario.But still I think it is the case of more doers than sensible leaders to put the energies to the right pockets.We must pray to Allah that those who are in the leading positions take this eyeopener for the betterment of the relief efforts, Amen.

October 26, 2005 12:47 am