The Forgotten Care

OP-ED

By Sadikshya Nepal

When CNN broke the news about Dr. Sanjay Gupta performing brain surgery on fifteen-year-old Sandhya Chalisa, the thought that came immediately to mind was praise for the doctor who saved the young girl's life. However, the conversation of Chalisa’s extent of illness and her long journey of rehabilitation is not discussed. In a disaster situation, years of rehabilitation are something no one thinks about. However, for the patients in these stories, survival is just the beginning of a lifelong rehabilitative battle.

Nepal is coping with its worst disaster in over eighty years and our hospitals are clearly overwhelmed. For doctors, saving as many lives as possible is the most important matter. Due to the number of patients flooding in, doctors might not have time to provide thorough care. Dr. Rajendra Koju, a cardiologist at Dhulikhel hospital, echoed that sentiment in a recently released New York Times video. He stated that, “We are not doing everything very correctly because this is a disaster. Everybody wants to do best but some limitations are there and sometimes they are not wearing the gloves properly, or even asking the patient their names on the spot. But saving a life in a disaster, it might happen.”This scenario is not new or unique to our country alone. Hansa Dave of the general hospital at Bhuj noted, one-year after the 2001 Gujarat earthquake in India, that “At the early stages, lots of operations took place without sterilization of instruments. Hospitals had been completely destroyed. There were no operating theatres, no structures. … Now, we see the effects. Many patients are coming in with malunion of bones.” In countries that are coping with catastrophes, sound medical care is rarely practiced and survivors often become lifetime victims of unintentional medical neglect. For most patients severely affected by the different effects of the earthquake, long-term medical rehabilitative support is as essential a part of recovery as saving their lives.

It is likely that we will witness echoes of the earthquake in Nepal in the form of survivors continuing to demonstrate their medical needs due to injuries inflicted by the quake. Some may be minor, but others can be far more concerning. Patients that have currently been treated for head trauma, broken bones, amputations, etc., will need doctors and nurses to continue working with them and providing a sound medical course of action. In most cases, people living in rural areas will require access to medical care as part of physical rehabilitation. To do so, Nepali government needs to ensure that the reconstruction of hospitals, medical posts, and health centers that encountered partial or full destruction is sped up to accommodate people outside the Kathmandu Valley. Aid must also be made available to those who are unable to afford continued medical care.

As people begin their healing, both physical and mental, we need to make sure that these survivors receive long-term medical care, which sometimes can mean more than survival.

The author works at Derek Bok Center for Teaching & Learning at Harvard University in Cambridge, MA. She can be reached via email.