Desire to serve drove Del. medical team while in Nepal

WILMINGTON, Del. — By the time the Delaware Medical Relief Team landed in Philadelphia on Tuesday, they had treated thousands of earthquake survivors, committed to building more than 240 homes in Nepal and showed villagers who had lost everything that everything wasn't lost.

"Sometimes, I ask myself why I'm doing these things," admitted Kathryn Gollotto, a sports medicine doctor who joined the third wave of volunteers this week. "The desire to help others is too deep."

The second wave, a nine-member team of doctors, nurses, physician assistants and logistics experts accompanied by The (Wilmington, Del.) News Journal, arrived in Kathmandu on Mother's Day to deliver medical care and supplies to communities near the capital. Two days later, on May 12, a 7.3-magnitude earthquake threatened to abort their mission.

Instead, the team rallied to finish out the week, seeing more than 1,000 patients in their final three days.

"We will work until daylight stops or we run out of patients," promised physician assistant Patrick Phelan. Gutsy and sincere, Phelan was among three team members who attempted to drive six hours and trek several more hours to the remote village area of Syabrubesi to treat some of the hardest-hit Nepalese.

A landslide blocked their path. Phelan compared the adventure to bungee jumping, which he wouldn't dare do back home.

"The end part is making me jump," he said.

That elusive "end part," helping others who can't help themselves, drove team members to ignore their own gnawing fears, leave their families and comfortable homes and fly to a shell-shocked country whose own government had ordered relief workers to go home days earlier.

Arriving two weeks after the first, 7.8-magnitude earthquake, the team mostly treated minor wounds and listened to complaints about chronic joint pain, upset stomachs, sleepless nights and, yes, acne. A group of nurses spent 20 minutes trying to convince a stubborn elderly man to go on blood pressure medication or risk a stroke. The man eventually left with a year's supply.

The Nepal mission was a major departure from the team's work in Haiti, where doctors performed lifesaving surgeries shortly after a devastating 2010 earthquake.

To date, the combined death toll from the two Nepal earthquakes is more than 8,500, along with an additional 21,000 injured. Some 600,000 families have lost their homes.

Less than a week after the first earthquake, the Delaware team gathered dozens of volunteers and mounted a highly orchestrated effort to respond swiftly. They fielded a three-person advance team to confirm logistics on the ground, communicated regularly with Nepal-based coordinators and overcame bureaucratic hurdles to secure spots at hospitals and makeshift clinics.

"You don't have to have money to make a difference," said volunteer Stacy Myrie, a medical assistant in dermatology.

Growing up poor in Jamaica, Myrie recalls praying on an NGO-issued Bible when her grandmother was seriously ill with a stomach infection.

If God would spare her grandmother, Myrie promised to devote her life in service to others.

This week, she joined the third wave of medical team volunteers, a young, energetic group calling themselves the "Crazy Eights." A fourth group of about 10 volunteers is expected to depart Saturday, providing a sense of continuity in a country that has slipped from international headlines.

DIFFERENT STANDARD OF CARE

Bernie Racey could either buy a new microwave or build a house in Nepal.

Recently, the Christiana Care physician assistant proudly showed a cellphone image of his legacy: a basic tin structure with a brick foundation that promises to keep one Nepali family dry during the coming monsoon.

All this for the bargain price of $100. In the next several days, building materials for more than 240 homes will be distributed by Helping Hands International, a Christian relief organization that will match a percentage of the medical team's donations. Benefiting families will participate in the rebuilding effort.

"To fully reach out to a grassroots organization is more authentic," explained Racey, a father of two who encouraged his neighbors in West Grove, Pa., to donate. "I am setting an example for my boys."

It was a frustrating, emotional week for Racey and other team members, who couldn't help but compare Nepal's hobbled health care infrastructure with the standard of care in the United States.

Communicating through interpreters, volunteers focused on the basics, cleaning stitches with bottled water, lancing a pus-filled nose abscess to produce a fountain of blood and recommending rice and bananas to stop chronic diarrhea. Nurses initially suggested bread until a local reminded them, "We don't have bread here."

For much of the trip, the team was in damage-control mode, addressing chronic issues that were long ignored, misdiagnosed or improperly treated.

With two doctors for every 10,000 people, health care in Nepal is beyond the means of most citizens because of insufficient government funding. Only about half of the poorest Nepalese seek treatment when they are ill, because of problems with access and affordability, according to research by the World Bank.

Nepal ranked 139th in life expectancy, with the average Nepalese living less than 66 years, according to a 2010 World Health Organization study.

A visit with a woman who lost movement in both legs left Racey exasperated.

Ram Devi Sijakhwo, 50, had a bone fracture pushing into her spinal cord, requiring immediate surgery. However, it wasn't scheduled until two days later.

"If this came in at any emergency room at any hospital in Christiana, it would've been done that night," said the physician assistant who works in neurosurgery.

"It's disturbing to know that where you're located and born affects your access to care," he said.

"To walk away from something like that, I've never done that," Racey said. "It's killing me."

TEMPORARY FIX

Bombarded by hardship, the medical team banded together by bowing their heads in prayer each morning and blowing off steam with laughter each night.

Constrained by resources and time, they delivered Band-Aids and hope to patients who were most appreciative.

Even a stray dog received a splint on its right leg, before chewing it off.

"We didn't come to sightsee. We came to work," said team leader Reynold Agard, a Wilmington internist who brought along his wife and 28-year-old son.

"It's a real pleasure serving these people."