Chennai's Gujarat diary

The recent killer quake in Gujarat evoked spontaneous response from across the globe. And a team of Chennai doctors from Apollo Hospitals too did their bit when tragedy struck. "It was an emotional response'', they say, in an interview to MARIEN MATHEW.

ONE MONTH and three days have gone by. Tears have dried. A spate of celebrity fund-raising is over. Media has milked it dry of headlines, cover stories, human interest angles et al. The local administration is limping back to life. The rest of the country has moved on. But for those affected by the recent quake and those who had witnessed the suffering, life will never be the same.

However moving the media images are, they have a once removed built-in detachment. There is also the choice to turn away from the harsh, disturbing reality. But the ones face to face with the devastation have no such luxury to cushion them against the raw pain. The experience of the 27 member medical team from Apollo Hospital was no different.

"It was an emotional response. By Sunday as more and more visuals showed the magnitude of the disaster, the urge to do something grew stronger. So I spoke to Ajit (Dr. Ajit Yadav, Consultant Orthopaedic Surgeon). He was about to call me up to discuss the same," explained Dr. V. Shivram Bharathwaj, Consultant, Plastic and Reconstructive Surgeon, tracing the beginnings of the team. They were joined by another Senior Consultant, Orthopaedics and Traumatology, Dr. AB. Govindaraj. Soon, the team snowballed into a group of 13 medics and 14 paramedics with Rs. 18 lakhs worth medicines and equipment provided by the Apollo Hospitals.

The next step was to establish contact with an NGO working there to identify the area to work in. Raju Rajagopal of the Janpath Citizens Initiative and CII (Confederation of Indian Industries) did the groundwork and zeroed in on Morbi, a small town, 40 kms from Ahmedabad. By the time the pilot team from Chennai reached Ahmedabad, a video footage of the Sadbhavana Trust General Hospital, a 60-bed charitable hospital was ready for the doctors.

Once the work spot was chosen, things moved fast. Men and materials moved to Morbi almost immediately after reaching Ahmedabad. Since they had carried almost all the supplies needed, the team didn't have to lean on the local hospital and authorities burdening them further. This made the set-up more efficient and the hospital could deal with the routine work unhindered. "There wasn't much to gain by going to Bhuj, Anjar or Bhachau, the worst affected areas," said Govindaraj. Everything had been razed to the ground and only relief workers and those few who could not go anywhere else stayed back. After the medical team reached Morbi, the news spread through word of mouth and they had a steady stream of patients from the beginning.

"In a disaster situation, the medical requirements change after the first 72 hours," Ajit Yadav elaborated on the nature of their work. As the Apollo team had reached on the sixth day after the quake, they offered definitive care. Many who had had only first aid and primary treatment, but with limb threatening injuries came to them. While the orthopaedics fixed the bones, the plastic surgeons took care of gaping soft tissue wounds that often came with such trauma cases.

Their day in the operation theatre started at 9 a.m and ended at 9 p.m. As there were still isolated lootings of damaged buildings, a curfew was imposed from nine in the night. In Morbi, the Government hospital had developed dangerous cracks and was abandoned. The doctors worked from a tent pitched outside the hospital. The Sadbhavana too was not entirely unaffected. A corner of the roof had fallen down and there were fissures on the walls of the operating theatre itself.

To Shivram and Govindaraj who had never been to a quake-affected region before, the aftershocks were a novelty. They weren't rattled when the building shook only because they were unaware of how precarious the situation was, the doctors admitted. As they saw more victims and damages, the destructive power of such a disaster sank in deeply. In Ahmedabad, it was eerie to see the unlit high-rise buildings looming in the dark even when the streetlights were on. They were awed by the sheer force, size of the calamity. Finally, the human face erased everything else. In Bhachau, reminders of death, like heaped firewood and stench from rubble mounds, were never far. It was numbing to be told that the black spot on the ground you were standing next to was left by burning 150 bodies there the previous day.

Particularly poignant to the doctors was the meeting with Dr. Sharma, Superintendent of the Government hospital in Bhachau.

The shell-shocked man narrated how he had escaped death when the entire hospital collapsed killing patients, doctors and all. He had stepped out for a cup of tea and when he returned after barely five minutes, nothing was left of the hospital. The distraught doctor kept saying pointing at crumbled concrete "the operation theatre was there, OP here and that's my quarters," still unable to take in the loss.

Clinically speaking, the ten-day stint was very successful for the Apollo team. None of the patients developed fever or any post-operative complications. Similar procedures if done in Chennai would certainly have problems healing, they told. " The joke going around was that if you give antibiotics to a patient, the one on the bed next would start feeling better," laughed the doctors. Such excellent reaction was because the patients had had little or no prior exposure to antibiotics.

Most of the people who came to the Sadbhavana hospital were poor and had been robbed off what little they had by the quake. Yet their spirit and dignity humbled the doctors. "There were no clamour, no demands. They were willing to starve 10 hours for anaesthesia and operation," said Shivram. As many knew only Gujarati and not even Hindi, communication was bare minimum.

"They were not normal people any more," Ajit Yadav pointed out. The trauma surgeons who see death in the casualty wards every day were shaken by the number of broken families. "Accident victims have a family to fall back on, a home to go back to. But these people have nothing left to hold them together. There is no temple even to go and pray."

Forty three year old Durgabhen always had a smile on her face when the doctors came for rounds, though her attendant, her husband was glum. The man hadn't had the heart to tell the wife that they had lost all their four children. The couple that hailed from a village located between Morbi and Bhachau was homeless too. A man who had fractured his hand was asked to leave to make room for those with more serious injuries. He turned around and asked, "Jaana kahan? Ghar toot gaya." The doctors had no answers.

The Chennai doctors had no direct contact with any Government agencies. The official machinery had failed totally during the crisis.

But nobody hindered their work and they were allowed to borrow an equipment from the local government hospital. The former Chief Minister of Maharashtra, Manohar Joshi and the local MP, Vallabh Katariya visited Sadbhavana while the Apollo team was there.

The trauma care done by the Medical Director of the hospital, Jayesh Patel and his wife, Hema, a gynaecologist was appreciated by the visiting doctors.

"They were the hero and the heroine of the hour." The quake woke up sleeping Jayesh and the call to the hospital said there were only minor damages. Reassured, the doctor went back to sleep. An hour later came the frantic SOS. When the young couple reached the hospital, the whole area was overflowing with the dead and the dying.

As day wore on, more and more casualties poured in. They treated 300 people that day and counted 79 bodies by 3p.m. The doctors worked non-stop for the next 24 hours till some semblance of order was established. A death register which stated the name, age and roughly from where the persons were, was maintained.

"What we did was just a drop in the ocean," said the city doctors. But it was a learning and a gratifying experience for them. From epidemics to hostile or indifferent reception ... the reasons why they shouldn't go were quite a few.

Even in Ahmedabad, the reactions were not all positive. Finally, it all boiled down to the difference between doers and talkers and the question of conscience.

* * *

Saga of sadness

FOR MORBI, a small industrial town in Rajkot district, the January 26 quake is the second devastation it has suffered in the last 22 years. On August 12, 1979 nearly I,000 people were washed off in the Machchu II dam burst.

Going through old files, one is struck by the similarity of the past and present pictures of the damage and the description of the ensuing chaos. The government machinery had failed to offer succour then too.

Will we ever have a disaster management plan? Have we become so unfeeling and apathetic that even human toll of such proportions fails to move us?

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