Kathmandu, Nepal — An 18-year-old lies on a bed at the entrance of a tent, with an injured head and just a stub where his right arm used to be. “When I saw him I thought he was dead,” said his father, Bim Mahi.
Nearby, there’s a new baby in an incubator, a woman clinging to life in the intensive care unit, a soldier praying in the synagogue, and a triage full of Nepalese who are flocking here based on word-of-mouth reports about the treatment on offer.
It’s just a normal day at Israel’s field hospital in Nepal, still reeling after a 7.8-magnitude earthquake rocked the country on April 25; the death toll now stands at more than 7,500.
One of the first faces that many of the patients see here is that of Avi Alpert, a U.S. immigrant to Israel who had no obligation to conscript to the army but signed up and put himself through basic training at age 42. Now, seven years later, the sense of duty that first got him into uniform has brought him to this makeshift Kathmandu facility.
As of Tuesday night, the field hospital has treated almost 1,000 patients, delivered seven babies — all of them healthy — and performed 50 surgeries. Its team, consisting of nearly 150 medical professionals here as part of their full-time army service or as reservists, sleeps in tiny one-man or two-man tents: even revered doctors like Jonathan Halevy, director-general of Jerusalem’s Shaare Zedek Medical Centre, finds rest under canvas after a grueling shift.
Around here, Alpert is Mr. Clockwork: the man who keeps the emergency room running smoothly, which, in turn, keeps the whole place running smoothly. Despite the fact that we’re standing amid a collection of tents in a large field, doctors are walking around with tablets inputting digital records and people are waiting well under an hour to be seen. It’s a setup that “any emergency department in the world would envy,” said Alpert, a Baltimorean who used to work in New York.
Referral to the various departments is fast — so much so there’s a joke that Tel Avivans will soon start discovering that the quickest way to get a specialist appointment with an Israeli doctor is to fly to Nepal.
Mahi had never met an Israeli before his son was transferred here a few days after the quake. But when he hears the word Israel he smiles, and compliments the care. “Now we’re not worrying for his life as we were at the beginning,” he said.
Sitting on the young man’s bed is 52-year-old Baruch Antolovich, who lives in the Swiss Alps, where he runs a bed-and-breakfast. “I heard on Saturday about the earthquake, began to think, and then on Sunday night, my wife said: ‘So, are you going?’”
Antolovich, originally from Los Angeles, lived in Israel for 12 years from 1995, but has no military training. He also has no medical background. But he’s volunteered in disaster zones in the past, and decided to fly to Kathmandu at his own expense and appoint himself as hospital gofer. “I empty garbage cans, pick up garbage from the floor, feed patients — the stuff nobody really wants to do,” he said. “Everybody has a part.” He added: “I think we’re to be a light to the nation and this is a good example without words, which speaks for itself.”
A few other diaspora Jews have turned up here, including a nurse from New York and a doctor from San Francisco — but Antolovich is the only non-medic. He has been taking food to the young man who lost his arm, and feeding him when relatives are not on hand. “We have a kind of friendship now,” Antolovich commented. “He always has a big smile for me when I come to see him.”
Some of the heroism here takes place away from the bedsides, and in the back rooms. For example, when Pemba, a 15-year-old boy who had been trapped under rubble for five days, arrived, it was the advanced onsite lab that enabled him to survive.
Amazingly, he didn’t have a single visible injury, but there were serious concerns about the effect that spending so long under the rubble would have on his bodily functions. “We did lab tests on him all through the night,” said Olga Garachevsky, standing amid dozens of samples ready for analysis. Pemba received treatment for the impact of his entrapment, and is now recovering smoothly in another hospital — a far cry from the post-trauma care that many Nepalese, especially those in outlying areas, are receiving.
Every day among these tents is a mixture of the heartbreaking and the hopeful.
On Tuesday morning in the Intensive Care Unit, a 37-year-old woman is fighting for her life. Trapped for four days in the rubble, one of her legs had to be amputated. “Below the knee an amputation like this is easy to treat, but this amputation was very high, and it’s very hard to manage,” said her doctor, Eli Schwartz, head of tropical medicine at Tel Aviv’s Sheba Medical Center and the leading Israeli in his field.
The tragedy of this case goes even deeper. The woman’s 24-year-old daughter, born after she was raped at age 13, was also badly injured by the quake. She was hospitalized nearby, but died, and the authorities came to the Israeli hospital with the news.
But despite the heaviness weighing on everyone’s minds, joy reverberates through the place when there is something to celebrate. The births get everyone cooing. And signs of recovery also bring delight.
In the course of Tuesday morning, a woman, discovered by a rescue team in a village and brought to the hospital a few days ago unable to move or talk, is suddenly both moving and talking. Alaluf Heli, a 34-year-old who had helped to look after her, was elated. “Sometimes when I’m tired and missing my children it’s really very hard, and this kind of thing helps to give me the drive to continue,” he said.
Meanwhile, Bika Rana, a 25-year-old Nepalese soldier, is sitting in a wheelchair, feeling a new sense of encouragement after learning that his injured leg is healing well. “I’m happy, and hoping that I will be able to get back to my normal life.” he said, after recounting how his house collapsed on top of him as he tried to flee the quake.
The best light relief of the day comes suddenly, almost like a flash mob, when the crowd of people waiting for admission grows large. They are in for a surprise — or rather, five red-nosed baggy-trousered, balloon-inflating surprises. The Israel Defense Forces and the Israeli Embassy are hosting a team of medical clowns, from the Israeli NGO for medical clowning, Dream Doctors, which paid for its own flights.
As they mime, play and generally act daft, it becomes clear that waiting for a doctor has actually been transformed into the most entertaining experience that people have had in days. One of the clowns kneels down to a patient on a stretcher, with visible leg injuries from the quake. He affixes a red nose to him, and mock-interviews him for an imaginary TV station using an inflatable microphone. The patient Bata Nepali, a 53-year-old shopkeeper, has plenty to be glum about — he’s not only injured, but his house is destroyed. Yet he’s loving it, and declares in his mock interview that he wants one day to do a real television interview, and use it to praise Israel.
One of the clowns goes into the emergency room, where a young boy needs a lengthy and painful-looking change of dressing on his foot. Smadar Harpats sings, grunts and mimes, and woos him with balloons and airplanes all the way through the procedure, and the boy responds with big, broad, heart-melting smiles. It fills the whole ER with positive energy.
Harpats — or “Sunshine” to use her clown name — has been astounded by the response to clowning here. “Even children who have lost a leg, or who have been through other terrible pain, quickly decide they want to play,” she said.
Soldiers in the field hospital worked on Shabbat, and will do so again this weekend. This isn’t a violation of Jewish law, but rather following the rule that work should be continued even on Sabbath in cases of medical need. And religious soldiers are accommodated in the camp in a range of areas.
The food is kosher, there is a synagogue tent with three daily services, and a rabbi. An eruv is in place to allow carrying on Shabbat. And the hospital even kept the mitzvah of hachnasat orchim, receiving guests, last Shabbat. Around 100 Israelis who were still in Nepal, were hosted for Friday night dinner where, in line with army rules, Kiddush was recited before the meal started.
Judaism isn’t the only religion among soldiers. Ashraf Kheir, a 32-year-old Druze-Arab from Peki’in, said that his faith played a part in his keenness to serve Nepal via the IDF. “The education we have is to help every human being — and we have to be faithful to our country and its operations,” said Kheir, a paramedic and nurse, adding: “I just received a letter from my father saying how proud he is of me.”
The 200-strong official Israeli mission to Nepal, which is advising the government on managing the situation as well as running the hospital, is due to pack up and leave in the middle of next week. But when its members return to Israel, many will still mentally be in Nepal.
Eli Schwartz, who has the 37-year-old patient clinging to her life, said that he worries for people like her once the IDF pulls out. Nepal, with its limited health infrastructure, will be overloaded, he said. “These are severe wounds that need long-term care, and we’re worried about who here has the skill to deal with people like this when we leave.”
Schwartz, who said he regards Nepal as a “second home,” as he lived and worked here for a stint a few years ago, added: “It feels like you save life — but who knows what will happen later on?”