Thirteen-year-old Riffat Nazir’s right leg was trapped under the door frame when last weekend’s quake brought her family’s two-story mud house down around her in Kashmir.
It took three days for her family to dig out their dead and give them a proper Muslim burial, and three more before they could transport the girl to a hospital near the Pakistani capital. By then, doctors had no choice but to amputate.
Dozens of Pakistani quake victims have lost limbs because of delays in getting the injured from isolated villages to a place with proper health care.
At Rawalpindi General Hospital, where Nazir was recovering Friday from the operation to amputate her right leg below the knee, surgeons have performed more than 200 major operations in the past six days, mostly on patients suffering crushed limbs.
Helicopters have transported a flood of patients from the quake zone to the north, where few hospitals were left standing after last Saturday’s 7.6-magnitude temblor. Rawalpindi’s three main hospitals and three others in nearby Islamabad have been choked by the crisis.
Saving lives over limbs
“The patients are coming late and suffering gangrene in their wounds,” said Dr. Kamran Saeed, an orthopedic surgeon who had performed eight of the 25 or so amputations carried out at Rawalpindi General in recent days.
“You cannot save the leg or arm. You have to save the life of the patient,” he said.
Injured people stranded in remote villages in the mountains of Kashmir and many outlying areas — where thousands have died — have seen no rescue workers. They often have had to rely on relatives carrying them for hours on foot to have a chance of survival.
Riffat’s mother, Rahila Bibi, said that in their village of Hollian, all 60 houses were toppled by the quake, killing about 100 people. Bibi lost two sisters and more than 25 relatives in all. Two other sisters were injured and remain stranded in the village.
“The house was demolished. The cattle are dead, and we have nothing to live on. Everything is destroyed,” said Bibi, wiping tears from her tired eyes with the colored shawl that was coiled loosely around her head.
Villagers using simple tools and their bare hands toiled six hours to free Riffat from beneath the heavy baked mud and timber of the simple five-room house.
It took another three days to locate all the family’s dead relatives and bury them quickly — regarded as a spiritual necessity for Muslims.
Finally, six villagers helped carry Riffat 15 hours on a charpoy — a traditional rope-mattress bed that sits outside many homes in rural Pakistan — to the nearest town on a narrow dirt road blocked by landslides.
After that, they traveled by vehicle for another five hours to the main city in Pakistan’s part of Kashmir, Muzaffarabad, where after a day’s wait, a foreign helicopter brought the girl and her mother to the hospital in Rawalpindi. A day later, she underwent an operation.
Now Riffat lies recovering in bed, blood dripping into her veins from an IV bag and a gray teddy bear at her bedside. She’ll spend the next two weeks at least in the hospital and will be fitted with a prosthesis after the wound fully heals in six to nine months.
Hospital overloaded with quake patients
All but the maternity and pediatric wards at Rawalpindi General have been devoted to the quake emergency — the worst crisis to test the hospital since 1988, when an ammunition dump in this garrison city exploded, killing hundreds.
While the flow of patients slowed Friday compared to previous days, beds for arriving quake victims were still spilling out into the reception area. Doctors, assisted by medical students, have been working around the clock, sleeping when they can.
Saeed said the general emergency care given to patients brought from the quake zone had been “excellent,” although sometimes overtight bandaging and tourniquets by inexperienced medics — without clinic or hospital buildings to work in — have made things worse, obstructing the flow of blood to a wounded limb.
So far, the hospital has treated 947 patients from the earthquake, of which only two have died, said Dr. Shahzad Rehan, the medical superintendent. He expected more amputations would be necessary as others victims like Riffat finally arrive at the hospital.