An estimated 14,000 were injured in April's earthquake in Nepal. The caseload is overwhelming hospitals in Kathmandu, says Dr. Bianca Grecu-Jacobs, a resident in emergency medicine from California who was working in Nepal when the quake struck.

"[In] the lobby areas, patients just are on the floor waiting," Grecu-Jacobs says via Skype from Katmandu. "They strung up IVs for patients who need them in whatever manner they can."

Grecu-Jacobs is now helping out in a hospital with logistics, working on sanitation and trying to prevent infections. The day of the earthquake, she says, she had been enjoying a bit of a holiday, mountain biking with colleagues. Suddenly, everything changed.

"We felt it," she tells NPR's Rachel Martin. "The first thing that we noticed was a house: One of the walls had just fallen down in a huge cloud of dust. It was almost like an explosion happened."


Interview Highlights

Hospitals' biggest problems

With those crowded conditions also come concerns with sanitation and infections. Many patients have open wounds that are now being exposed to other patients with similar conditions, dirt. People ... weren't able to be properly cared for quite some time before getting to a hospital. So cleanliness is also an issue, along with space.

Many locations have power

The infrastructure in Kathmandu prior to the quake was not wonderful, so actually many homes, hotels, hospitals actually have their own independent power supplies. There are solar powers all over the city. Many places have generators.

The challenge of homeless patients

The hospital is also struggling with where to discharge patients. Even patients who otherwise don't need the hospital have nowhere to go. They have no home; they have no clean environment, so even if they have wounds that could be cared for at home, the concern is that if there's no home, how will they care for those wounds? Will they just come back again with another infection?

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Transcript

RACHEL MARTIN, HOST:

We get a glimpse now into just how difficult it is to care for the estimated 14,000 injured survivors of last month's earthquake in Nepal. Bianca Grecu-Jacobs is a resident in emergency medicine from California working in Nepal when the quake struck. Connecting with her was difficult, but we managed to reach her via Skype this past week in Kathmandu. She was helping out in a hospital, managing logistics, working on sanitation and trying to prevent infections. Doctor Grecu-Jacobs told us when the quake hit, she and a couple colleagues were taking a day off up in the mountains.

BIANCA GRECU-JACOBS: We had actually taken a bit of a holiday. The clinic is six days a week, and they said, go enjoy for a few days. So we were up in the Annapurna region. We did feel it. We were actually on mountain bikes, and so the first thing that we noticed was a house. One of the walls had just fallen down, and a huge cloud of dust - it was almost like an explosion happened.

MARTIN: What about the clinics. Do those hospitals or clinics have electricity, water, necessary medical equipment?

GRECU-JACOBS: As far as electricity and water, the infrastructure in Kathmandu prior to the quake was not wonderful. And so many homes, hotels, hospitals, actually have their own independent power supplies. There are solar panels all over the city. Many places have generators. So as far as electricity goes, the power to the most essential areas has been possible.

MARTIN: Can you describe the conditions of the patients that you've been seeing? What are the most common injuries?

GRECU-JACOBS: What I was able to see were a lot of orthopedic injuries and then a lot of infections starting. But the doctors have been working extremely, extremely hard around the clock to try to do their best. But resources, such as even the time to sterilize equipment, have just limited some of their abilities.

MARTIN: From your vantage point working with patients in these clinics, what is the most pressing need right now?

GRECU-JACOBS: I think the most pressing need, at least from what I've seen, has been space. The lobby areas, patients are just on the floor waiting. They've strung up IVs for the patients who need them in whatever manner they can. But with those crowded conditions also comes concerns with sanitation and infections. Many patients have open wounds that are now being exposed to other patients with similar conditions, dirt. People had wounds that were - they weren't able to be properly cared for for quite some time before getting to a hospital. And so cleanliness is also an issue along with space. And then the hospital is also struggling with where to discharge patients. Even patients who otherwise don't need the hospital have nowhere to go. They have no home. They have no clean environment. So even if they have wounds that could be cared for at home, the concern is that if there's no home, how will they care for those wounds? And will they just come back again with another infection?

MARTIN: Dr. Biancu Grecu-Jacobs, joining us on the line from Kathmandu, thank you so much.

GRECU-JACOBS: You're very welcome. Transcript provided by NPR, Copyright NPR.

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