St. John's Medical Team operated around the clock and lost count of all
the plasters and dressing they completed during the stay. They were so
conscientious that their services were extended till today!
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As always, St. John's has responded to the Gujarat Earthquake readily as
part of what is well known as the "Bangalore Response" to disasters in the
Indian Peninsula. Three members of the St. John's Team were requested for
by the Government of Karnataka to join the Government Hospitals in the
effected areas. All three, Drs. Sanjay Joseph (Orthopedician), John
Mariananad (Anesthesiologist) and Bijay Agarwal (Surgery) have completed a
hectic ten days in Patan General Hospital. They operated around the clock
and lost count of all the plasters and dressing they completed during the
stay. They were so conscientious that their services were extended till
today! All emergency surgeries have been completed as of Sunday and now
only elective procedures are pending. The Karnataka team lost only one
patient in spite of their busy schedule, which tells of their affectivity
in the field. The main team of the remaining 10 medical personnel from St.
John's flew to Ahmedabad on the 29th February. They carried over 1.6 ton
of WHO essential medical drugs. They proceeded to the Janpath Citizen's
Initiative control room at the JanVikas offices at Ahmedabad and then into
the field. The team was totally independent with tents, sleeping bags and
rucksacks as shelter. Food and water for 48-72 hours was also carried in
for the team's survival till base of established. The team made its
journey by road to Radhanpur, Rapar, Neelpar and finally Bhachau. They
held roadside clinics and also surveyed interior areas to identify areas
not cared for by anyone. Finally at Bhachau they camped along side the
Indian Army Field Hospital and manned the Army camp Outpatient, assisted
with nursing and medical care of Inpatients and with surgery and
anesthesia for procedures. Communication was set up once our own
Koramangala 70-year-old resident Mr.Ramachandra, a HAM enthusiast, joined
the team after driving the entire distance from Bangalore.
The type of medical relief extended and required:
The work predominately included trauma related orthopedic problems like
fractures, limb and pelvic which needed conservative and operative
procedures. Wounds needed dressings and infections had become common.
Failure of the provision of temporary shelters has exposed the displaced
population especially women and children to the cold and wind causing
acute Respiratory illnesses like Pneumonias. Sanitation and unprotected
water supply are problems, which in turn has lead to diarrhea in a few
cases however this is predicted to rise with the failure of protection of
drinking water sources once the packet water supply is stopped.
Psychosocial problems are to be expected in the future with people loosing
family members as well as everything they have ever owned. As a
consequence of this trauma, physical and mental, immediate problems of
shock, tension, anxiety, panic, relief and disorientation may be seen.
This in turn will lead to a disabling post disaster grief, apathy,
unresponsiveness, guilt and the post trauma stress disorder. Dr. Kishore
Kumar and Sekar are from NIMHANS and are expected to move in at the
earliest to tackle these emergency problems by training local personnel in
dealing with such situations. Malnutrition and other specific nutritional
deficiencies may be the future especially for women and children among the
displaced population if food supplies are not continued on a long-term
basis.
Future Medical Needs for displaced population in Gujarat:
Trauma related: Orthopedic and surgical injuries, Infections and wounds,
revision surgeries – nailing, plates, fixators; rehabilitation, disability limitation – physiotherapy, prosthetics.
Exposure related (shelter and clothes): Acute Respiratory Infections,
Infections Sanitation/drinking water related: Diarrhea, dysentery, and
infections Psychosocial consequences: Grief, Depression, guilt,
unresponsiveness, reactions Food supplies: Malnutrition, Vitamin and
Mineral (eg. Iron) deficiencies Gender and Child Issues: Health needs,
routine and specific
Duration of a disaster:
The duration of a disaster is longer than we think. Rehabilitation may be
needed up to a period of three years. There is a lot to do! In the past
week there have been approximately 6000 doctors in the Kutch area alone
and volunteers are becoming a burden to an already stretched
infrastructure. The need today is not to blindly go in now but to wait
till the specific need arises. Medical Supplies are in plenty with
excellent neighbors, roads and airport facilities. This too has become a
burden with people painstakingly sitting down to invent all supplies. We
may have a situation where the mass of volunteers and supplies has
actually been detrimental to the progress of disaster relief from rescue
to the intermediate phase of temporary shelters, provision of food and
drinking water, sanitation apart from medical team support.
Coordination with other groups:
The St John's team will be working in coordination with the Disaster
Relief and Training Cell at St. John's Bangalore and the Emergency
Disaster Relief Team of Oxfam India Society headed by Dr. Unnikrishnan. It
is Dr. Unnikrishnan who will liaise with identified grass root based
agencies / NGOs in the area presently chosen are Janpath Citizen's
Initiative. The first team was sponsored by Care Today (India Today
family).
Future plans:
The Disaster Relief and Training Cell has on stand by two more teams ready
for departure based on actual field needs. Since the assessment team and
the coordinator reported the over burdening of infrastructure, it was
decided not to send in the additional teams which were to overlap team
one. Today the final team member would have returned 9 days after the
disaster. A job well done and a contented group of young doctors that were
able to help people in need!
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