An American Doctor in Quake-Ravaged Pakistan

American medical personnel with ties to Pakistan organized relief efforts after last month's earthquake devastated much of the northern part of the South Asian nation. Madeleine Brand speaks with Dr. Atif Malik about the injuries he saw, and the need for further medical aid in the Himalayan foothills.

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MADELEINE BRAND, host:

And soon after the earthquake shook Pakistan, American doctors with ties to the region organized their own direct relief effort. They've set up an emergency medical facility in the Himalayas. It's still there and doctors treat some 300 patients a day. Dr. Atif Malik(ph) helped organize the effort, called Operation Heartbeat. He arrived in Pakistan one week after the quake. I asked him what his first day there was like.

Dr. ATIF MALIK (Operation Heartbeat): When we first arrived, it was about 5:00 in the afternoon and the sun was starting to set. And there were about a couple hundred people who were surrounding our helicopter and they were, you know, inquiring what we had for them. And we--a little bit fearful. We had heard reports of hospitals and relief workers getting mobbed. But we explained to them that we were physicians and we were there to help them. About four hours into setting up our camp, patients started to arrive. It was pretty dark, but people somehow found out that we were there to provide medical care and they started bringing in the injured. That went on until about 2:00 in the morning and then early in the morning we had another wave of patients starting to come. The first day we must have seen about 600, 700 people. It was the busiest day that we were there.

BRAND: How many people did you treat?

Dr. MALIK: We probably treated well over 2,000 patients in the week that we were there.

BRAND: Two thousand patients in just one week.

Dr. MALIK: Correct. We saw quite a number of things. We saw lots of gangrene, amputated limbs, compound fractures, crushing injuries, lacerations, dehydration, shock, tetanus infections, head injuries, post-traumatic syndrome. In particular, I saw three cases of tetanus where the patients had developed lockjaw, and this was something that I'd only read about in a medical text. These people could not be helped by a tetanus vaccine and they needed immunoglobin, which we did not have.

BRAND: So what happened to them?

Dr. MALIK: Well, we did what we did with most people, vaccinated them, started them on IV antibiotics and IV fluids and transferred them to Islamabad, to the major hospital, hoping that they would get the remainder of their care there.

BRAND: Hoping but not knowing.

Dr. MALIK: But not knowing, correct.

BRAND: Early on, there were reports of a lot of patients needing amputations. Did you see that?

Dr. MALIK: Yes. There continue to be a lot of patients who need amputations. I talked to one of the physicians that is manning our hospital at the present time and she's still seeing about 300 patients a day and a lot of these are very serious crushing injuries. See, the problem is that a lot of these houses are quite far apart and so it's very difficult for them to come down. Additionally, there's a lot of adults in the family are, you know, dead and so nobody can care for the remainder of the family and so it's very difficult for them to be transported down. They're unwilling to leave their land.

BRAND: The current death toll is around 73,000; that's what the Pakistani government is estimating. Do you think that that's accurate?

Dr. MALIK: Well, it's probably accurate for the ground person who's taking the toll--taking the data collection there in Islamabad, but I know that there's over 100,000 people that are still missing. So if you take into account those folks as well as the ones who have died, probably several hundred thousand people that have died. And there's over, you know, 80,000, 90,000 people that are severely injured. They're not even counting the minor injuries right now in Islamabad.

And the other aspect of this is that it's very difficult to make an assessment. For instance, with the tsunami, you were dealing with flat terrain. It's very--it's a lot easier to just, you know, drive around and collect the data. With the Himalayas, it's very difficult to kind of make an assessment.

BRAND: And what is your opinion on the worldwide response to this disaster, the relief effort?

Dr. MALIK: Actually, I'm pretty shocked. For the tsunami, there were 4,000 helicopters donated to help during that disaster, and in Pakistan, there's only about 70 helicopters. Eighty percent of the aid that was pledged for the tsunami, which is $4.1 billion, was given within two weeks. Pakistan so far has only received about 12 percent of the aid. And two weeks post the earthquake, there's only been about $17 million that have been donated.

BRAND: Dr. Atif Malik. He's a doctor who just returned from Pakistan, helped organize Operation Heartbeat.

And thank you very much for joining us.

Dr. MALIK: Thank you so much. Appreciate it.

BRAND: Stay with us on DAY TO DAY from NPR News.

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