Respose to the 2015 Nepal Earthquakes

Shortly before noon on April 25, 2015 a severe induction earthquake of 7.8 magnitude jolted central Nepal in the northern part of Gorkha District. About half an hour later a 6.6 aftershock followed. Within about twenty-four hours some twenty-one aftershocks of magnitude between 5.0 and 6.9 had followed in Bhaktapur, Dhading, Kathmandu, Kavrepalenchock, Lalitpur, Nuwakot, Rasuwa, Sindupalchok, Dolakha, and Gorkha districts and adjacent Tibet. Twelve days later a different Himalayan fault slipped with 6.8 magnitude in Dolakha District. Here is a narrative of the activities which you helped to make possible.

 

I awoke on April 26 with a heart feeling of knowing that the simple five needle acupuncture treatment (5NP) that I had learned 1992 would be helpful and readily applicable for those enduring the earthquake’s aftermath having personally witnessed it’s efficacy with body-mind trauma mitigation a year earlier with landslide survivors at Oso, Washington, in 2010 with Haiti’s earthquake survivors and after the 2005 hurricanes in Louisiana while delivering well over a thousand treatments. While contemplating how to do this it became clear that in order to help the traumatized communities in Nepal to recover, I must call upon my own to participate with me. Thanks to guidance from my daughter Lela, my inhibition to asking for help eased and an adventure into “crowd-source” fundraising https://www.crowdrise.com/AcupunctureforNepal through digitally facilitated reality (crowdrise.com) began. Within a week my community made it clear to me with their generous financial and logistical support that I was in a position to act with intuition and commitment.

 

In summary, from the moment of arrival in Nepal this time, I found that lives and the human landscape were dramatically disrupted everywhere. Most structures constructed without concrete and rebar were physically destroyed. Fortunately the quake hit just before noon on a non-work/school day limiting casualties to a fraction of what they might have been. Nevertheless, the losses include some 9000 lives, 28,000 additional casualties, several many century-old temples, hundreds of thousands of homes and businesses, major arterial roads and the paralysis of the country’s torturous journey from a Hindu kingdom to an emerging economically impoverished democracy sandwiched between China and India.

 

An inevitable consequence of such loss is change. Some of that change is positive over the log run. In the months since the earthquake, political parties that had battled over writing a functional post civil war constitution since 2006 have agreed on a document. New building codes have been proposed. Tens of thousands of young Nepalis who migrated to the Middle East for work have returned to help rebuild their communities. The messy business of developing democracy in a market based economy has moved forward potentially leaving the legacy of corrupt system of royal privilege farther into the past.

 

My plane landed safely in Kathmandu on a tornado-like Saturday evening exactly four weeks after the first earthquake. Anjan Joshi, a formerly Seattle based colleague and native Nepali met me at the airport. It had only been five years since my last visit so the environment was familiar except for the quiet, dark stillness in the air, on the road into Kathmandu and in the streets of Thamel. It was immediately apparent that the incessant life force of this ancient civilized valley was in shock. He explained that more than a million working residents had left the valley after the April 25 trembler in Gorkha to assist the recovery of their now houseless families living in surrounding districts. Many had begun to return to work a few weeks later when another quake hit Dolakha shaking apart many already weakened structures and any confidence that normal life might be restored soon. Fortunately his family’s hotel though had been spared structural yet sustained extensive superficial damage. Like just about every other commercial lodging it remained quite closed for lack of staff, guests and restoration of essential amenities such as access to reliable food and services.

 

Along side of the main road into the city seemingly endless clusters of tents became apparent to me almost everywhere open space existed such as sports fields, stadiums, government buildings, hotel courtyards, parking lots and sidewalks. Piles of refuse, mud bricks and twisted metal also came into focus at intersections and in front of collapsed buildings. Lights were dimmed, hotels, businesses and restaurants were closed, other vehicles were few. The most obvious activity was at the police roadblock checking drivers’ breaths for alcohol.

 

I felt grateful that my friend’s hotel had not been badly damaged, and that his invitation to stay would offer me a safe place to recharge each night from future daily activities. The typically omniscient tourists were gone. The service industry workers were away. Most buildings were dark and unoccupied. Most residents were still too afraid to sleep inside in fear that one of the many aftershocks occurring each day would bring everything down upon them.

 

During the weeks before leaving I had several contacts with people with whom I have worked with in Nepal and with disaster response. Five years earlier I had spent a few weeks in Kathmandu introducing the trauma mitigation 5 acupuncture needle protocol (5NP) to NGOs in the aftermath of Nepal’s five year bloody civil war at the suggestion of Nepalophile dear friends Ellen Coon and Ted Riccardi. As fate would have it they were in Nepal on April 25 having survived when a Turkish airliner overshot the runway in Kathmandu and crash landed on March 4! Ellen, an anthropologist and ethnographer was interviewing an octogenarian Newar woman on the third floor of a centuries old structure in Bhaktapur when it began to shake apart that Saturday morning. They both narrowly escaped leaving behind a heap of wreckage and dust, so I had a vivid image in my mind of the traumatized states I would encounter in the minds and bodies of other survivors.

 

Ellen and Ted had introduced me to several people and venues in 2010 where I was able to demonstrate the NADA protocol. Carroll Dunham and Thomas Kelly, an active and culturally attuned expat couple had also collaborated with my 2010 efforts to introduce trauma mitigation acupuncture in Nepal. Coincidentally, Diana Fried, the founder of Acupuncturist Without Borders -AWB (www.acuwithoutborders.org), a nimble and globally focused NGO that was birthed when half a dozen of us gathered in October 2005 at post hurricanes New Orleans, had engaged the Dunham-Kelly team to help facilitate NADA (www.acudetox.com) protocol trainings for local health-workers and service learning treks in Nepal later that fall and in 2013). It is fair to say that they had taken the mantle of God-parental roles for nurturing the seed of AWB activities taking root in Nepal over the past five years. This complemented my long nurtured public health vision of local health workers empowered to deliver 5-needle protocol (5NP) in under resourced health care environments. Thus providing a means of enriching treatment capacity in economically impoverished and politically paralyzed communities seemed to portend a trial in action.

 

AWB has been doing important work training providers and assisting disaster afflicted communities with channeling volunteers for almost a decade. This was one of the first occasions where a previously trained core of local providers could be engaged to respond with their trauma mitigation ear acupuncture skills. Diana asked me to serve as liaison between AWB’s US based management team and AWB-Nepal’s developing organization with responsibilities involving quality assurance, standards of care, provider continuing education and organizational development. Though arriving in a sea of unknowns inevitable when a world is in upheaval, I felt assured by the quality and capacity of people supporting my efforts. Past experience and tempered logic projected that good outcomes were highly likely from making the trip as soon as possible.

 

The first few days involved many meetings with people in Kathmandu directly involved with responding to the earthquake. The goal was to learn and acclimate. They started with my hosts and their extended family at Courtyard Hotel in Thamel and AWB-Nepal’s team at their shared office in the Dunham-Kelly nerve center near Gahana Pokari in Tangaal neighborhood of Kathmandu. Almost everyone I met during those initial meetings accepted treatments. This resulted in restoration of their calm, though exhausted re-centered state. The most common feedback I received was that they subsequently slept uninterrupted for the first time in over a month.

 

The first organized field clinic or “health camp” that I attended was in the much destroyed ancient town of Bungamati where I had been invited by the directors of SABAH (www.sabahsa.org) to treat members of a woman’s cooperative of home based workers (one of 26 country wide). Some thirty-five people who had lost homes and had been volunteering with local clean up received treatment in 94 degree heat. Among them were very observant college age students who helped humble my awareness of the critical need to observe consistent, high quality and transparent protocols to build trust and confidence in this strange form of health care.

 

The next day I met with a senior Kathmandu Police Superintendent who had four years with the NYPD more than a decade prior. The purpose was to extend clinics to the officers whose headquarters had been reduced to tents around a pavilion. The Police had been on duty every day since the earthquake. Many had lost their homes and family members. Many had not spent a night with their families in a month. When he learned about the recommendation NYFD chief had given us (AWB) by way of letter of introduction to New Orleans officials about the efficacy and elegance of NADA treatments for responders at ground zero after the September 11 attack on the World Trade Center, he smiled. He then invited me to organize a (AWB-Nepal) team to come as soon as it could be cleared and arranged with his superiors. He liked that most of the acupuncturists would be Nepalese. That finally came to fruition when an AWB-Nepal treated about 100 officers some three weeks hence.

 

Later that day at the AWB-Nepal nerve center in the Kelly-Dunham home, I met with the core of Nepali Acupuncturists trained by AWB in 2013 who had been offering several clinics a week around the Kathmandu Valley. They were members of the Acupuncture Moxabustion and Acupressure Association of Nepal(https://www.facebook.com/Nepal-Acupuncture-Moxibustion-and-Acupressure-Association-321522714539795/timeline/) and AMAAN president Shyam Maharjan. After giving a brief training in “tapping” http://www.tapping.com/ a simple self percussion practice that assists the practitioner with re-centering before each new patient, 5NP treatments were offered to everyone. For most this was their first on the receiving end since the earthquake.

 

The next day AWB-Nepal took me to the long since dried up Pokari (central pond) in Bhaktapur, a UN World Heritage site that sustained significant damages to religious shrines and temples as well as centuries old residential structures. Several dozen large tents donated by the Chinese Government ringed the very old pond bed, upon which an emergency community services tent had been set up. There I worked as part of an AWB-Nepal team with members of the AMAAN. This group had previously been trained with NADA protocol by AWB and was providing several clinics a week throughout the Kathmandu Valley in conjunction with and coordinated by AWB-Nepal. We treated a few hundred that day under blistering heat and during a 4.9 aftershock that visibly shook surrounding buildings and generated a fresh onslaught of frantic patients that kept us busy long after we had been scheduled to shut down.

 

The next day I teamed with New York acupuncturist and Caroline Rath PA, LAc for a five hour journey into upper Nuwakot district northeast of Kathmandu. This was my first clinic outside the valley and offered a glimpse into the devastated lives of village farmers and small businesses. While the winter wheat waited in the fields was begging for harvest and rice planting before the monsoon rains arrive, it seemed all people could do was sift through collapsed houses to gather any materials that might be useful for shoring up temporary shelters or rebuilding their homes. First, we were served a generous early lunch of traditional Nepalese dalbhot (rice, vegetables and lentil soup) by a family whose house had collapsed upon their matriarch a few weeks earlier. Their grace and dignity was palpable and humbling. Their buildings had collapsed but the integrity of stable traditions and community were in tact.

 

We set up a 20 square foot tarp in the middle of a field before the midday sun brazed through a cloudless sky. Medicines and transportation for the clinic were funded by a German NGO called TCM Sozialforum (www.tcm-Sozialforum.org). They respond to urgent needs with acupuncture and basic medicines as it can around the world. Anjali Tamang, a second year acupuncture student had pulled together a team of four acupuncturists, three students, two primary care physicians (myself and a Nepali doctor who is determined to come to the US for an inner city residency), and a public health nurse.

 

By the time the tarp was up, over three hundred women children and older men were waiting to be seen. Many claimed that they had not been to a doctor in five years, others never. It was difficult to tell what was truly going on health-wise for each patient as we had a only a few moments with each person to interview, evaluate and offer treatment or medicine from our very limited inventory. This was a very similar to the process I experienced five years earlier in Port au Prince. Every person wanted to be seen by a doctor, so my hat switched from acupuncturist to doctor to respond to the need. By the end of the day the two of us had seen and prescribed for over 350 patients. Over 200 went on to also receive 5NP acupuncture. It is safe to say that in spite of the abject chaos that seemed to prevail around a very limited patch of shade, by late afternoon when we wrapped up, most everyone was calm and wore faces that had transformed if only temporarily from despair to gratitude. It was clear to us that being seen had provided some healing for most everyone.

 

Most everyday involved being part of a team that staffed an acupuncture clinic at one or more locations. Approaching the trips mid point my destination with an AWB-Nepal team was the ancient hillside city if Kirtipur in Bagmati Zone of Kathmandu District. We set up in the shelter of a community based youth activities cooperative that was established thirty years ago. As was typical, we treated the community leaders and elders first. In this case about fifteen men including a Nepali chiropractor, a massage therapist, a dhammi-jankri (traditional healer), the neighborhood chairman and the founder of the coop who was my age. It was as if we were being vetted for credibility before the rest of the community arrived.

 

Sixty plus year-old Susan Shrestra told me about his harrowing experience on April 25 in Gorkha, a kilometer from the earthquake’s epicenter. He had been with five other much younger colleagues inspecting schools that weekend when the quake hit. He vividly described running 17 hours as fast as they could some 5 km to the road head. He described landslides in process, piling off layers of steep valley walls, burying everything and everyone behind him. Wearily and quietly he recounted taking hours to frantically cross freshly laid spans of rock up to a 1000 meters wide and boulders as large as buildings, all the time wondering if an aftershock would generate a new avalanche of earth. Hearing his story felt like it had happened yesterday. By the time that clinic closed some three hours later, our AWB-Nepal team had treated more than 140 community members.

 

The next day I also joined an AWB-Nepal team, this time in the Newar village of Satungal, about forty minutes southwest of Kathmandu in Bagmati Zone. This population was hit hard with loss of life and residential buildings. A trekking guide whose two brothers were getting PhD’s in physics in the US showed me around the neighborhood where most of the centuries old post and beam skeletons of three story mostly mud brick houses had been shaken beyond repair. He bemoaned the loss of the home that his great-great-grandfather had built with simple yet intricate carvings framing every doorway and window frame could still be seen. Though at first glance the structure appeared sound, he showed me corners where walls had separated letting daylight through. I met his elder parents whom the family now cared for. He wondered out loud how they would all live forward knowing that the government would strengthen building standards bringing more onerous demands from a corrupt system of enforcement. Though this was a solid middle class neighborhood, he mourned that very few families would ever be in a position to rebuild, including his own.

 

On the last day of May I visited long-term friends Anjana and Purna Shakya in Patan at the site of their destroyed ancestral home in Patan. It was a blessing to see them, hear their descriptions of Nepal’s current challenges and of those facing her NGO called HimRights. (http://www.himrights.org/) This dynamic group generates and administers programs that advocate human rights for victims of human trafficking, reconciliation from war and violence, peace-building, children’s arts and education, and governmental policy development pertaining to the recognition and establishment of basic human rights. Fortunately, many of their staff were present and able to receive treatments that day. Afterwards their son Prajwold took me to the center of nearby UN Heritage site city of Bhakatpur where I witnessed the earthquake’s vast destruction of densely constructed, centuries old residential buildings. Though a few of the precious temples and shrines had collapsed in the UN Heritage Site central Durbar Square, clearly the greatest unrecoverable impact is in the city’s commercial and residential heart. Amid the rubble and grandeur of three and five tiered roofed temples rising dozens of meters into the sky sat groups of elders reciting pujas acknowledging the all pervasive power of the deities in their lives.

 

The pace of offering treatments in communities continued into June with a visit it Sechen Monastery at Bouddha. I worked with AWB-Nepal’s administrative director Priti Thapa, logistics director Prem Dorchio and AWB-Nepal acupuncturist Shakila Rajnit to treat over 200 monks ranging in age from 7 to 60 under sweltering heat. The main shrine building sustained extensive damage. Though the residential structures remained intact and had been inspected and certified safe, most of the monks continued to sleep under giant tarps with fear of being trapped consequent to nocturnal aftershocks if they were inside a building. I was grateful to return there having received teachings from the monastery’s founder, a larger than life Lama named Dilgo Kyentse Rinpoche during the democracy revolution of April 1990.

 

Later I travelled with SABAH to Banepa in Kavrepalanchok District, an hour and a half to the west of Kathmandu. A group of 40 plus cooperative and related community members had been waiting for hours under 90+degree sun for treatments. This was an educated and motivated group of entrepreneurial women who representative of the quiet yet irrepressible force for change, stability and equality that has been percolating in Nepalese society since the divine rule of monarchy began to disintegrate more than a generation ago. Their respectful impatience with our tardiness dissolved in to calm repose once the care began. Afterwards during a question and answer session, a few of the members insisted that I explain why I was not there to teach them how to provide these treatments themselves, to each other. Delighted with their enthusiasm I smiled in attunement with Raji, the SABAH administrator who had assisted me while providing treatments and asked her to tell them that we will start working on learning how that can that happen.

 

The next day I returned to Tharlam Monastery in Bouddha, established in Nepal by Dezhung Rinpoche in the 1980’s. This Lama eminent Dharma scholar bestowed seminal meaningful teachings and blessings upon me some thirty years ago. It has been a privilege to serve the welfare and health of the monks and community there whenever I am in Nepal over the past twenty-five years. Two newly arrived AWB volunteer acupuncturists, Ursula Popp and Alyssa Dazet accompanied me in treating over 90 people that day. Of special personal note was providing care to a very special 94 year old Tibetan Buddhist nun, Ane Chime the surviving sister and member of her generation. I came to know Ane Chime in Seattle long ago. She was quietly revered and had been supporting the establishment of Sakya traditions in the US since 1960. She selflessly practiced being a pure emanation of compassion for over ninety years. Her recent transition is a potent reminder of impermanence, grace and the blessing of experiencing life as a human being.

 

By now it was June 4. My departure date loomed near while tens of thousands of city residents were returning each day. Traffic was becoming dense if not precarious once again. The next opportunity to treat earthquake survivors was a testament to signs of normalcy beginning to resurface. Yet when I arrived with the AWB-Nepal team at Jawakhel Football field in Lalitpur dozens of tents indicated that many continued to sleep, eat and call somewhere very transitory their home. An NGO called Saathi (http://www.saathi.org.np/) that is committed to eliminating injustice and violence against women in Nepal hosted us. We treated some 160 people of all ages in that safe environment. I understand that they were sponsoring similar camps in the Kathmandu Valley that AWB was supporting under the direction of Priti Thapa.

 

That afternoon I visited Umesh Regmi in the offices of Friends of Needy Children an education focused program of the Nepal Youth Foundation (www.nepalyouthfoundation.org). After treating their office staff, we discussed future opportunities to provide trauma mitigation for students, teachers and parents in communities that they serve in earthquake affected districts. Much of their activity supports new construction and now rebuilding of schools and primary education programs.

At 6AM on June 5 my efforts rejoined a TCM-Sozial Forum trip to Sindhupalchok District. After passing a cluster of damaged and abandoned, eighteen story new apartment buildings above Bhaktapur into Nagarkot, we descended into and up the Indrawati River valley past Malamchi to a village called Palchockshera in Ishok. The road had been destroyed by landslides in several places leaving large building sized portions of rocky mountainside behind. Most every structure on the hillsides and along the valley floor had collapsed. Though the ancestral home of our hosts was a total loss, they served us a delicious traditional meal from their temporary housing shared with another family in a corrugated steel animal shed. Ironically an English League football match flashed over satellite television in the background. Modernity meets traditional village life in surprising ways!

The nearby village was so destroyed that we required more than an hour to locate a suitable site to set up the clinic. We eventually did so behind a collapsed midwifery/acupuncture clinic at the base of terraced fields and surrounded by shredded timbers, shards of rock and mud that comprised foot thick walls and buried cellars containing precious seed that was in urgent need to be planted. Every other site was overwhelmed by the chaos of destroyed buildings except the bus stop. After treating the village elders, a stream of some 140 women, children and older men received treatments under 90+degree heat. At the end of the day our team of seven regrouped for a refreshing swim in the fast moving river before making the five hour return journey to Kathmandu along a different route via Panchkhel and Dhulikhel in Kavre District.

 

On Saturday, the traditional day of rest and prayer in Nepal, my host Anjan Joshi conducted me to a back chamber of the Anapurna Hotel where an NGO called Smile Nepal (http://www.esmilenepal.org/) had been serving a daily meal to homeless male and female teens since 2010. Previously I circulated a more detailed description of that experience. Treating almost 20 of the youth produced a previously unwitnessed calm and quiet among this collection of highly stressed and hyper-vigilant youth. The director could not believe what she was seeing. Return trips to Nepal will focus more specifically on serving groups with chronically unmet needs.

 

The afternoon took me to the Yellow Gompa at Swayombu to join an AWB-Nepal team of Priti, Prem, Shakila and AWB American volunteer Alyssa. We treated some 115 monks and refugees over a few hours including the Abbot of the monastery. All were still living under tents in the courtyard though six weeks had passed since the earthquake and their residential buildings had been certified safe. Aftershocks were continuing to be a daily event fueling anxiety and fear of a building collapsing during the night.

 

June 7 would be my last full day of providing treatments that by then had personally exceeded 600. I joined an AWB-Nepal team lead by Shyam, Priti and Prem supported by AMAAN acupuncturist Rachana Bhatarai, Ursula and Alyssa. This took place in the pokhari (a central community water access point) in Swayambu at the base of the ancient Hindu and Buddhist “monkey” temple mount. The international Red Cross had established an encampment there for hundreds of families who had lost their homes. Coincidentally, one of the tents under which we provided about 100 treatments had been provided by Tzu-Chi International Relief. This Taiwanese NGO was the very same with which I had served over 12 days providing care in Port au Prince, Haiti post 2010 earthquake.

 

I flew out to Dubai on the evening of June 8, but not before attending to few more opportunities to share the five needle protocol for my hosts, the founders of Smile Nepal and the home offices of SABAH in Lalitpur. All told that day I administered about fifty more “calming to the core” treatments. I cannot say enough about the excellent work of these two NGOs and the fledgling AWB-Nepal that I was privileged to work with. All three are home-grown and locally staffed. The first two are also self-funding, while AWB-Nepal still relies upon funding to support staffing through the primary AWB office in New Mexico.   All three are grappling on the steep learning curve of grant-writing and appeals for donations while continuing to grow and deliver their meaningful programs. All three will continue to grow through their countries recovery from the earthquake and as a part of Nepal’s ongoing political and economic development.

My mind is clear that a return trip to further capacity to give deliver treatments is warranted. My volunteer work with AWB and the organizations that I was fortunate to partner with shall continue. Empowering individuals, communities and organizations to direct their paths in health lives in the heart my personal and profession mission statement.

Of course none of this could happen without the kind, compassionate and generous support of community.

Namaste

 

 

 

 

 

Leave a Reply

You must be logged in to post a comment.