NL

Dr. C: How can I help my friends in Nepal?

With all the devastation — both physical and emotional — in Nepal, there's only so much one person can do to help, writes St. John's physician Nikhil Joshi.

In the 2nd of a five-part series, Dr. Nikhil Joshi chronicles his work in his beloved Nepal

Tents in the courtyard of a hotel where Dr. Nikhil Joshi is staying in the tourist district of Thamel in Kathmandu, Nepal. The hotel owners sleep in the tents instead of inside the building. (Submitted by Nikhil Joshi)

My pager is going off.
 
It's Mr. Anderson. It's got to be. The guy was in anuric renal failure. I knew he was obstructed from the tumour. I fought and lost to get him a repeat scan of his abdomen. Why didn't they just listen to me? It's him and I'm sure he's tanking. I'm sure he needs…

Wait a minute. I'm in my hotel room in Kathmandu. I am not in my call room.

The beeping is coming from an excavator or some other sort of heavy machinery backing up next to our hotel to remove some debris. I breathe slowly to bring my heart rate down. I'm dripping with sweat.

I look out of the window. In the courtyard of my hotel there are tents set up. That's where my friends who own the hotel are sleeping — on the ground outside.

In the 2nd of a five-part series, Dr. Nikhil Joshi chronicles his work in his beloved Nepal

The earthquake and subsequent aftershocks which happen almost daily have affected them. I can see it plainly.

People are scared. They're scared that there will be another earthquake, or that the buildings that are still standing will fall. They're scared that no help is coming.

It's different now; quiet, sad almost. Only the children laugh and smile.

They also have an element of post traumatic stress disorder (PTSD).

PTSD happens to many people. It happens to soldiers, emergency medical services workers, nurses and physicians. We joke as medical residents that we all have an element of PTSD, and the sad part is it's probably true.

Everyone has a different trigger. For me, it can be certain sounds such as a pager or, because of cancer, whenever I feel my neck.

Emotional damage isn't visible

Here in the tourist district of Thamel there is physical trauma all over the place. Durbar square, a popular and important tourist destination, is levelled. My hotel has cracks in the walls, staircases that stretch out over two floors.
In this town near Kathmandu, earthquake damage is more severe. (Submitted by Nikhil Joshi )

People think I'm crazy for sleeping on the third floor. The villages, where the true devastation lies, are even worse.

But there is so much more mental trauma and it doesn't show up on camera lenses or in video footage. This city is silent, and tense.

Businesses open late and close early. The Kathmandu night feels uneasy, as if everyone is just waiting for one more thing to happen before the lid is popped off. I haven't seen any aid workers, media people or tourists walking the streets.

It wasn't like this before. The days were energized, people would laugh and be busy. Shopkeepers would hustle to get you into their stores. Car horns would constantly be honking and there was always music blasting.

It's different now; quiet, sad almost. Only the children laugh and smile.

Nepal, a country whose major life line is tourism, has suffered a major setback. The sense I feel when I walk into businesses and see people is one of uncertainty. Of worry. "How will we survive?" "What's going to happen next?"

The task before me is cripplingly heavy. How can I help? How can I help when an entire country is suffering from PTSD? When they have seen their homes destroyed, their children buried, and their foundations figuratively and literally broken?

I don't have any answers, but I know that I will make sure my friends sleep in their beds by the time I leave. I will try to give them some normalcy and laughter. I'll help them forget a bit. And with time, maybe I can even help them heal.

That's the best I can offer.

Dr. Nikhil Joshi's diary on his journey to Nepal will continue next Monday