With much relief we skyped with Esha this morning. Esha Thapa is the Executive Director and one of the founding members of SIRC. It was 9pm her time, we spoke to her via Skype on her mobile as she stood in a field with her husband Kiran and many neighbours, while her two little girls Ahana and Avika slept close by. Her family is OK, their house looks undamaged but as a precaution, they continue to sleep outside. The aftershocks continue, one particularly strong one while we were skyping – fortunately her kids remained asleep and Esha was unharmed. It quite alarmed us to witness this but Esha took it in her stride. I think we were more terrified than she was.
The younger girl Avika age 1.5 years old has been really spooked with the earthquakes and clings to her mom constantly. Esha’s older daughter Ahana aged 5 years old thinks the whole experience is an adventure, sleeping outside, playing all day with the many kids in this field and gets mad when the aftershocks stop her in her fun with her friends. Long may that last.
Communications have been difficult. With no electricity, it’s hard to charge a laptop, much easier to charge a mobile phone. The internet connection is down which means a laptop is not worth anything anyway. Mobile signals by Nepal Telecom are up and running while other mobile providers are down. Easiest way to communicate is through Facebook, texts to mobile phones and of course Skype calls to mobile phones. This is how the SIRC staff are communicating with one another and with INGOs and governmental agencies.
To allow SIRC staff to be close to their families yet continue to provide health care, those living in Kathmandu are working out of the acute care hospitals, bringing at-the-minute spinal care expertise to the acute care medical professionals at Bir Hospital as well as Kathmandu’s Teaching Hospital. For those staff living in Bhaktapur, Kavre and Banepa, they are working out of the SIRC centre in Bhainsepati ensuring the existing patients are being taken care of and preparing for the onslaught of patients expected to be referred to SIRC for specialized SCI rehabilitation.
Esha and Dipesh (SIRC Administration Director) have also split up their responsibilities – Esha remaining in Kathmandu and liaising with the coordinated unit of Handicap International and Médecins Sans Frontières and other INGOs, while Dipesh is keeping the centre operating and also connecting with acute care hospitals in Banepa (Scheer Memorial Hospital) and Dhulikel Hospital (about 20 mins east of the Spinal Centre).
Remember, SIRC is a rehabiliation centre and was never set up to provide acute care. Minor surgeries can be performed at SIRC, and certainly things like stitches, sprains can also be handled there. We talked this morning of SIRC setting up an emergency care tent for the Kavre area that would take care of the more minor injuries, thus freeing up the acute care hospitals in the area such as Dhulikel Hospital who have over 1,500 patients needing primary acute care today. So anything that SIRC can do to alleviate that is a good thing.
SIRC kitchen staff and many of the other support staff all live locally to the centre, so as expected, patients are continuing to be fed and cared for, with fresh food on hand and where medical supplies are available. Esha confirmed potable water and electricity are not a problem for the centre – there is much to be said for being self-sustainable, a lesson for us all.
Stephen Muldoon of Livability also joined the call and based on Stephen’s discussions with Eric Weerts of the coordinated unit of Handicap International (HI)/MSF, suggested SIRC map out a budget to cost out the temporary expansion of the # of SIRC beds from 52 bed to 115 beds within the existing building. Currently the centre has 38 patients (it’s currently a 52-bed facility). Filling the centre to capacity will allow them to intake an additional 77 patients immediately. If needed, a further expansion could be possible on the grounds of the centre. Anything is possible.
Costing is something I can do (finally, something I can do!) as Esha and I had worked on these costs last year – we wanted a clear sightline into the exact costs of rehabilitating a spinally injured patient so we could be transparent to our donors on how their precious donations are spent.
The cost per SCI patient is approximately US$2,300 for a 3-month rehabilitation program. This costing, once finalized will be submitted to funding agencies such as MSF and other INGOs and will also be used for us to plan for any shortfalls that will require our own fundraising efforts. Stay tuned for updates on how you can make your donation directly to SIRC – in the next day or two I promise!
SIRC will also need to determine its priorities, in conjunction with the NGO/health care coordination process that HI will bring. This includes ensuring the appropriate expertise is available to handle so many SCI patients. The good news is Dr Raju, Dr Jas and Sheela will be arriving in Kathmandu imminently. You will remember these are the Nepalese doctors with SCI expertise currently based in Dhaka. It seems some of their colleagues will also come for at least one month, if not longer. Their travel plans are already underway.
There were further discussions and brainstorming on the practicalities of ramping up the centre in light of what is ahead. It sure helped that all of us westerners on the call have spent significant time at SIRC and understand what is needed on the ground.
Our next skype call is set for Thursday, Esha is keen to have continued access to this little group of SIRC advocates and we are more than happy to contribute and provide her with the support she needs.
More to come as I receive further updates. In the meantime, SpiNepal continues to update their blog.