It can be hard to access healthcare in Nepal, says Chatham nursing student, Devin Corboy ‘18. “It’s one of the poorest countries in the world. It’s mostly rural, so access is limited by time and terrain. And if it’s not free or almost free, clients just don’t have the resources to pay.” Devin also points to a shortage of providers (“Doctors aren’t well paid—it’s not as prestigious there as it is here. They work around the clock and it’s often necessary for them to hold several positions”) and—literally—energy (“With rolling blackouts, they spend long periods of time without electricity—often 12-14 hours per day.”)
That’s in the best of times.
But on April 25, 2015, Devin woke to news of a 7.8 magnitude earthquake in Nepal. Approximately 9,000 people were killed and more than 21,000 injured. Devin and his wife had spent time there the previous fall, made friends, and fallen in love with the region. Devin—a student in Chatham’s Bachelor of Science in Nursing program and a nurse in the Pediatric Intensive Care Unit at Children’s Hospital of Pittsburgh of UPMC—knew that he had to help. Just over two weeks later, a second earthquake killed at least 153 people and injured more than 3,200. That was the day Devin arrived in Nepal.
“In third-world trauma environments, scope of practice is directly proportional to your knowledge and level of comfort.”
His Nepali friends had told him the only way to reliably bring in supplies was to carry them in himself, so he showed up with over 100 pounds of medical supplies. “The airstrip was lined with cargo containers with food and other resources from countries who wanted to help,” he recalls. “But the government couldn’t release the supplies because of their regulation requirements. They had to register it. So much food sent over there never made it to anyone because it went bad.”
“When I arrived, my friend drove me to a community health clinic, where I saw people lined up out the door. Suturing and setting broken bones and dislocated limbs aren’t typical nursing practices in the US, but in third-world trauma environments, your scope of practice is directly proportional to your knowledge and level of comfort,” Devin says. “We worked with the highest degree of sterility possible using the supplies I carried from the US. We worked in the street, day and night, through heat and rain, under temporary tarps and in tents because damage to the hospital made it unsafe. Patients arrived on overcrowded buses. Three people per seat wasn’t infrequent, and you’d see men, women, and children hanging off the roofs.” It wasn’t uncommon for patients to arrive in need of critical treatment due to accidents caused by this method of travel that was both unsafe and unavoidable.
After a couple of weeks, Devin and a guide loaded up five yaks with life-saving provisions and set forth to Thame, a village in the Everest mountain region that had been all but wiped out. They made what was normally a five-day trek to the village in two days, hiking 12-hour days carrying 50-60 pounds of supplies.
When they arrived, they saw that one building was left standing, the medical clinic was gone, and people were living openly on the streets. “It was the monsoon season, cold and rainy,” says Devin. “No one had tents. We spent much of our time passing out temporary shelters and tarps.”
Nepal, Take 2
Devin returned home after just over three weeks, but in November, he and his wife returned to contribute through the All Hands disaster response effort. They were there for almost two months. “I had to delay my entry into the BSN program,” said Devin, “but Chatham said no problem, we’ll contact all your instructors, and we’ll figure it out.”
Much of the work in Devin’s second trip focused on demolition and rebuilding efforts, but it wasn’t long before his medical skills were called into action. The Project Director created the position of First Aid and Medical Curriculum Coordinator for him, and among his initiatives was to bring in anti-venom medicine. In the eight months since the earthquake, snakes—most of which were poisonous—had made their homes in all the debris. “There was a high probability that someone would get bitten and die,” Devin said. He coordinated with project partners in the UK to get the anti-venom. “It took about two and a half weeks for it to get here,” he says. “Meanwhile, we were seeing about six baby snakes each day, and thinking ‘oh boy, where’s Mama?’”
Eventually, Devin wants to open a community health clinic in West Africa. He envisions a solar-powered clinic focused on sustainable community health and education that can also provide emergency medical capabilities. He views his experiences in Nepal as simultaneously good training and a valuable expansion of perspective.
“I saw how spoiled we are,” he says. “I was able to bring over pre-sterilized gauze pads and Nepali healthcare providers couldn’t believe how easy they were to use. The way they’d do it is to cut a piece of gauze, heat it to a temperature that kills bacteria, maybe rest it on dirty pants to fold it, tape it to the wound, if they even had tape. In the U.S., we have all these supplies that don’t even exist in Nepal, and we toss them into the garbage when they fall on the floor or the package doesn’t look right. We treated at least 300 people with supplies equivalent to two days worth of what we throw away here. And the mentality of receiving healthcare here is so different,” Devin continues. “They were so appreciative of every single thing we were able to do. In their eyes, it’s not our duty, and it’s not their right.”