Inside Nepal’s Next Challenge: Overflowing Hospitals

3 minute read

Hospitals throughout Nepal are flooded with patients, with thousands in need of care for acute injuries after a massive earthquake that the country’s leader said may have killed up to 10,000.

“Most public and private hospitals sent all of their pertinent staff surgeons to Kathmandu Teaching Hospital, which is the trauma center, and it’s so overrun that they are treating people in the streets,” says Cindy Aliza Stein, director of global programs at Real Medicine Foundation (RMF), who is helping coordinate the response. Other hospitals in the area are doing the same, partially because of high numbers of patients and partially because of structural damage and trepidation among many to be inside buildings amid the risk for aftershocks.

Even the weather has become a roadblock to care. “It’s monsoon season, so the rain has started,” Stein says, stressing that hospitals need more tents and tarps to do medical care and triage effectively and to prevent survivors from being exposed to the elements. Many physicians working the crisis have slept very little since the earthquake struck Saturday.

MORE: Medics Race Against Time to Save Nepal’s Quake Survivors

“There are very complicated fractures and not enough medical personnel to actually handle them,” says Dr. Martina Fuchs, the CEO of RMF. “Often in these situations there are more amputations than actually needed. That’s really sad and means longer-term rehabilitation. Being handicapped in a developing country is really difficult.”

If patients are not immediately attended to, the fear is that injuries can become infected, result in long-term complications or even prove fatal. And medical responders are struggling to access people in rural areas. “There are areas in villages where they are saying up to 80% or more of structures are demolished,” Stein says. “Over the next few days that’s the focus.”

Aid groups are also trying to care for survivors with pre-existing conditions, like cancer or diabetes, who may need special medical attention or medication. “The impact of the earthquake has dramatically reduced the capacity of the health system to resume the delivery of health services, as well as other services such as water and sanitation,” says Jim Catampongan, an Asia-Pacific health coordinator for the International Federation of Red Cross and Red Crescent Societies.

MORE: 6 More Ways to Give to Nepal Earthquake Relief

Overcrowding issues are not only reserved to trauma centers. Bottlenecks of volunteers at the Kathmandu Airport have also caused some organizational headaches. “The vast majority of organizations have not registered beforehand through the ministry’s process and they are arriving with a lot of staff and large amounts of supplies,” Stein says. “When they hit the airport, the import of goods that were unsolicited has actually caused a bunch of logistic problems. We are trying to prevent that by coming by land and trying to procure things as local as possible.”

Catampongan adds that Nepal has made significant health gains in the past 10 years despite being a poor country with weak health infrastructures. “The risk is that many of these gains could be lost,” he says. “We could see resurgence in epidemic-prone diseases likes malaria and cholera, which Nepal has worked hard to control. Spikes in malnutrition is a major issue in the country especially for pregnant women and children. We could also see a drop in services for issues like noncommunicable disease, HIV and tuberculosis.”

See India's Rescue Operations in Quake-Devastated Nepal

Indian soldiers, left, on a rescue mission to Nepal rush to board an Indian Air Force aircraft near New Delhi on April 26, 2015.
Indian soldiers, left, on a rescue mission to Nepal rush to board an Indian Air Force aircraft near New Delhi on April 26, 2015.Altaf Qadri—AP
Plastic containers with drinking water are loaded into an Indian Air Force aircraft headed to Nepal, at a base near New Delhi on April 26, 2015.
Plastic containers with drinking water are loaded into an Indian Air Force aircraft headed to Nepal, at a base near New Delhi on April 26, 2015. Altaf Qadri—AP
The shadow of an Indian Air Force aircraft carrying relief material is cast on clouds as it approaches landing in Kathmandu, Nepal, on April 27, 2015.
The shadow of an Indian Air Force aircraft carrying relief material is cast on clouds as it approaches landing in Kathmandu, Nepal, on April 27, 2015. Altaf Qadri—AP
Nepalese volunteers unload relief material, brought by an Indian Air Force helicopter for victims of Saturday's earthquake at Trishuli Bazar in Nepal on April 27, 2015.
Nepalese volunteers unload relief material, brought by an Indian Air Force helicopter for victims of Saturday's earthquake at Trishuli Bazar in Nepal on April 27, 2015.Altaf Qadri—AP
Nepalese soldiers unload relief material brought in an Indian air force helicopter for victims of Saturdayís earthquake at Trishuli Bazar in Nepal on April 27, 2015.
Nepalese soldiers unload relief material brought in by an Indian Air Force helicopter for victims of Saturday's earthquake at Trishuli Bazar in Nepal on April 27, 2015. Altaf Qadri—AP
Nepalese villagers watch as relief material is brought in an Indian air force helicopter for victims of Saturdayís earthquake at Trishuli Bazar in Nepal on April 27, 2015.
Nepalese villagers watch as relief material is brought in by an Indian Air Force helicopter for victims of Saturday's earthquake at Trishuli Bazar in Nepal on April 27, 2015. Altaf Qadri—AP
Nepalese villagers injured in Saturdayís earthquake await evacuation at Trishuli Bazar in Nepal on April 27, 2015.
Nepalese villagers injured in Saturday's earthquake await evacuation at Trishuli Bazar in Nepal on April 27, 2015. Altaf Qadri—AP
Nepalese soldiers carry a wounded man on a makeshift stretcher to an Indian Air Force helicopter as they evacuate victims of Saturday's earthquake from Trishuli Bazar to Kathmandu airport in Nepal on April 27, 2015.
Nepalese soldiers carry a wounded man on a makeshift stretcher to an Indian Air Force helicopter as they evacuate victims of Saturday's earthquake from Trishuli Bazar to Kathmandu airport in Nepal on April 27, 2015. Altaf Qadri—AP
Nepalese victims of Saturday's earthquake lie inside an Indian air force helicopter as they are evacuated from Trishuli Bazar to Kathmandu airport in Nepal on April 27, 2015.
Nepalese victims of Saturday's earthquake lie inside an Indian Air Force helicopter as they are evacuated from Trishuli Bazar to Kathmandu airport in Nepal on April 27, 2015. Altaf Qadri—AP
An Indian Air Force person walks carrying a Nepalese child, wounded in Saturday's earthquake, to a waiting ambulance as the mother rushes to join after they were evacuated from a remote area at the airport in Kathmandu on April 27, 2015.
An Indian Air Force member carries a Nepalese child, wounded in Saturday's earthquake, to a waiting ambulance as the mother rushes to join after they were evacuated from a remote area at the airport in Kathmandu on April 27, 2015. Altaf Qadri—AP
Victims of Saturday's earthquake wait for ambulances to take them to hospitals after being evacuated at the airport in Kathmandu, Nepal, on April 27, 2015.
Victims of Saturday's earthquake wait for ambulances to take them to hospitals after being evacuated at the airport in Kathmandu, Nepal, on April 27, 2015. Altaf Qadri—AP
A man sits with a child on his lap as victims of Saturday's earthquake wait for ambulances after being evacuated at the airport in Kathmandu, Nepal, on April 27, 2015.
A man sits with a child on his lap as victims of Saturday's earthquake wait for ambulances after being evacuated at the airport in Kathmandu, Nepal, on April 27, 2015.Altaf Qadri—AP

More Must-Reads From TIME

Contact us at letters@time.com