Israel Defense Force (IDF) delegation to Nepal

img

Israel Defense Force (IDF) delegation to Nepal                                                                                            

Col. Dr. Eyal Furman

 

20150505_03283620150505_10130720150505_14264120150505_143955

 On Saturday, April 25th 2015, a 7.9 magnitude earthquake occurred in Nepal.

Following the earthquake, its consequences and the request for assistance issued by the Nepalese government, a decision was taken to deploy an Israeli aid delegation to Nepal, consisting of two main actions: search and rescue capacity led by the national rescue unit of the Home Front Command and a medical response effort led by the IDF Medical Corps' field hospital.

In the midst of the planning phase, additional elements were integrated such as an initial assessment team, security, logistics, humanitarian action, training, coordination with the host country and spokesmanship.

In the eve of April 25th, the assessment team consisting of 7 delegates from rescue, medical and logistic fields were dispatched in order to plan the location and structure of the full aid unit, as well as to establish contact with the Nepalese administration. On April 26th, communication was formulated with the Nepalese military and governmental agencies, the situation awareness was dispatched to Israel, the base location for the overall delegation as well as the field hospital was planned in coordination with the Nepalese administration, and set in a football field in the vicinity of a helipad and a local military hospital in Katmandu.

In parallel to the departure of the initial assessment team, the full delegation consisting of approximately 250 members was being organized, 50% medical providers, 25% rescue responders while the additional 25% were other providers (security, spokespersons, logistics, training). In the following two days, the full teams were flown to Nepal, along with the logistic, rescue and medical equipment. This proved to be a challenging action, due to earthquake aftershocks and the damage inflicted on the Katmandu airport. After 82 hours from the earthquake, the Israeli field hospital in Katmandu was operationalized and admitted casualties.

The delegation stayed two and a half weeks in Nepal; unfortunately, no live victims were rescued from the rubble; the field hospital's team provided medical care to approximately 1600 casualties, 40% of them suffering from injuries or complications related to the earthquake. The rest needed routine medical attention. The cooperation with the Nepalese, the United Nations bodies and the local hospital located in the vicinity was excellent and the delegation was highly appreciated for its actions by the Nepalese governmental officials and the population. Most of the casualties that were injured resulting from the earthquake were orthopedic cases and debridement and the delegation consisted of professionals required to treat them, such as surgeons, orthopedics, vascular and plastic surgeons. In addition, the delegation consisted of ophthalmologists, ear nose and throat physicians, gynecologists, pediatricians, internal medicine physicians, infectious diseases specialists and family practitioners.

Most of the areas destructed in Nepal were in villages outside of Katmandu and in ancient buildings in the city, leading to the question as to the appropriate location of the hospital – within or outside of the city. As the reference is to a highly comprehensive hospital, capable of providing surgical capacity, intensive care, laboratory, imaging and hospitalization capacities, and considering its size and advanced capacity, the decision was to locate the hospital in Katmandu, adjacent to a local hospital, near a helipad. The existing hospital served as a target for local presentation of the residents needing medical attention, thus the perception was that the Israeli field hospital reinforce the capacity of the local hospital to admit and treat the many casualties, even before the existence of the Israeli hospital be publicized. The two hospitals (Israeli and Nepalese) shared equipment, personnel and additional resources (Nepalese physicians for example, manned surgical teams operating in the Israeli hospital and vice versa).

The Nepalese hospitals which I visited, although their medical equipment may at times differ from what is commonly used in the Israeli healthcare system, is based on highly qualified and competent medical personnel. The competency in responding to an earthquake was evident, and transferring the patients to areas external to hospital buildings was implemented wisely and appropriately in a relatively speedy time-frame. Considering infrastructure gaps, the decision was made not to evacuate ventilated patients from the local hospital's intensive care unit, as their transfer could have expedited their death compared to leaving them inside the building. This decision seems appropriate.

An additional topic is community medical services. The Nepalese residents do not have medical insurance and do not receive routine medical attention. Many residents self-evacuated from their homes to the street mostly because they feared imminent damage. These residents used inner (though were out in the open) residential areas even many days after the earthquake, leaning on aid received from humanitarian agencies. Up to the departure of the Israeli aid delegation, I did not encounter any wide organizational assistance that responded to the need to provide community medical services in these temporary facilities.

As to the structure of the delegation and its times of function, I would like to share some insights:

  • Weight of the equipment – there is a need to aim for a limited weight as much as possible. Tents instead of solid infrastructure; modular beds and only vital medical personnel. At later phases, additional equipment can be provided if needed.
  • Rescue team – should be deployed in the very early stage, along with the initial assessment team, utilizing light search & rescue equipment, so that they can initiate assistance within a few hours. The heavy rescue equipment can be added when the full team (including the medical and additional personnel) arrives. This early involvement may contribute towards life-saving.
  • Following several medical cases that I witnesses in the Katmandu and surrounding areas, the creation of a field hospital is recommended. To facilitate this, mobile medical teams should be established, consisting of a physician, medic, paramedic or other medical professionals, working in coordination within the populated areas to provide emergency or routine medical services.
  • The cellular communication in Katmandu was partially serviceable within a few hours. It is possible to utilize this type of communication, in parallel to satellite communication. More so, provision of advanced computer services to the initial assessment team as well as in the field hospital is needed. (WiFi service was provided in the field hospital, enabling communication of the members, including consultations with Israeli colleagues concerning complex cases).

To conclude, the Nepalese people are impressive in their resilience, though aid is needed, considering the significant crisis caused by the earthquake. The State of Israel and the IDF gladly contributed to the provision of qualified routine and emergency medical services. The IDF field hospital deployed rapidly and provided a vital response to the stricken population. More so, an exceptional cooperation was formulated with local authorities and administrations, military as well as medical professionals. Though the aim was to provide services and response to Nepal, the Israeli teams learned extensively from the Nepalese hosts concerning disaster management of severe disasters and hospitals' emergency management.

20150506_11343620150506_11350520150506_12163420150506_161032

20150505_07061720150507_064329