Spine surgery in Nepal: the 2015 earthquake

Abstract

At noon on Saturday, 25 April 2015, a 7.8 magnitude earthquake struck Nepal. It was centered in the Himalaya northwest of Kathmandu, the capital of over 1 million people. The violent tremors were felt as far away as New Delhi, India 1,000 km from the epicenter, but the worst of its destructive force was experienced in the heavily populated Kathmandu valley and in the remote mountainous villages of the Himalaya. Ancient temples crumbled; poorly constructed buildings collapsed; men, women, and children were trapped and injured, sometimes fatally. Avalanches killed mountain climbers, Sherpa guides, and porters at Everest base camp (EBC). The death toll to date exceeds 8,600 with as many as 20,000 injured. Spinal Health International (SHI), a nonprofit volunteer organization, has been active in Nepal in past years and responded to requests by Nepali spine surgeons for assistance with traumatic spine injury victims following the earthquake. SHI volunteers were present during the 2(nd) major earthquake of magnitude 7.3 on 12 May 2015. Past and current experiences in Nepal will be presented.

Keywords: Spine surgery; earthquake; nepal; spinal health international.

Figure 1

(A) Plate tectonic movements over 50 million years ago; (B) plate tectonic movements leading to the formation of the Himalaya.

Figure 2

(A) Severity map of the Nepal Earthquake, 25 April 2015; (B) world map demonstrating location of Nepal; (C) topographical map of Nepal.

Figure 3

(A) Mount Everest, showing the south side from Kala Patar; (B) Himalayan Frontal Thrust and accessory fault lines; (C) epicenter depth of the 25 April 2015 Nepal Earthquake; (D) structural failure in Kathmandu.

Figure 4

(A) Mount Everest, showing the southside route, camps, and location of the 2014 avalanche; (B) EBC Avalanche of 25 April 2015 from Pumori; (C) the greater tragedy in Kathmandu; (D) epicenter of the 12 May, 2015 Nepal Earthquake.

Figure 5

Patient #1 (A) Preoperative X-ray; (B) preoperative MRI; (C) postoperative X-ray. MRI, magnetic resonance imaging.

Figure 6

Patient #2 (A) Preoperative MRI; (B) Prof Giri of Bir Hospital and Dr Sutterlin of Spinal Health International (SHI); (C) intraoperative photo; (D) postoperative X-ray.

Figure 7

(A) Miracles; (B) smiles; (C) Chet and Binod with Spine Health International (SHI) Banner; (D) Ram guides cameraman Bill Angelucci of NBC News (USA).