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Dr Michael Boroditsky on the road up to Dhunche, the day he arrived in Nepal.
All photos provided by Dr Michael Boroditsky


Waiting area for the emergency and outpatient areas at the Canadian Red Cross Field Hospital


Dr. Michael Boroditsky performs an ultrasound on a patient who is pregnant in the maternity tent of the Canadian Red Cross field hospital


Dr Michael Boroditsky and team in the fully functioning operating suite in the field hospital. "We had limited equipment but not bad overall," Boroditsky says. "The scrub nurse was assigned from the Japanese Red Cross and the assistant was a local Nepalese Doctor who had just completed medical school"


This the 10 bed hospital ward of the Field Hospital where patients are admitted for a variety of reasons,including sepsis in pregnancy, post operative infections,snake bites or stokes.


Boroditsky went on a day excursion to access a patient from one of the many Indigenous Displaced Persons Camps. "There was very difficult access, with only poor trails on the side of the mountains. That day we found a very sick man that had a stroke. With the help of the paramedics from Mexican Red Cross we were able to transfer the patient up the mountain in a stretcher on foot to the ward of the Field Hosptial. It was quite tricky to navigate," Boroditsky says


Transferring a patient by helicopter to the Nepalese capital.


Some of the local children who came to the field camp everyday to learn and play. The Red Cross had a psycho-social team to help people especially children with stress, trauma and just daily needs," Boroditsky says.


"The last day I was there we did a little piñata party for them. They sang and danced." says Boroditsky



 
DR. MICHAEL BORODITSKY RETURNS FROM DEPLOYMENT TO RED CROSS EMERGENCY RESPONSE UNIT IN FIELD HOSPITAL IN EARTHQUAKE DAMAGED NEPAL

August 11, 2015

Dr. Michael Boroditsky, is an obstetrician/gynecologist working in Winnipeg at the University of Manitoba. He had just been speaking with a colleague who had returned from a Canadian Red Cross Deployment from Nepal. The stories and and experience were intriguing. “ I have always wanted to do something like that” Boroditsky recalls saying. What a rewarding experience it must have been.

"Later that same day, my colleague received an email. There was an urgent need for an obstetrician/gynecologist to work for the Canadian Red Cross Emergency Response Unit (ERU) in the remote village of Dhunche Nepal” Boroditsky told the Winnipeg Jewish Review.

"It seemed to be fate. He asked me if I was interested. I would have to be prepared to leave in the next 4872 hours. I spoke to my wife, who with out hesitation told me to go said." He added, "The reasons not to go, such as the cost or using up my holiday time, in the end all seemed selfish."

Boroditsky told the Canadian Red Cross (CRC) he was interested, and lo and behold he flew out to northern Nepal, a mere 72 hours later.

"My colleagues were all terrific and covered my clinics and maternity call. My assistant even came in on her holidays to help coordinate all the changes. My father, Richard, who is also a gynecologist even did my surgical slate later that week. Later the next night the CRC and the International Red Cross had approved my deployment.

“Routinely for emergency relief deployments to be a delegate you require certain screening and week long training with the CRC in Ottawa.” he said This was all waved due to the rapid nature of which this was required. Boroditsky's decision was not without risk. "I didn't have time to be fully vaccinated. I waived the complete vaccination," he said. He explained that he left without vaccinations for Typhoid, Rabies or Japanese Encephalitis” Prophylaxis for Malaria was also a bit of an issue but the ERU is 2000 meters high in the Himalayas, thus the likelihood of mosquito born illnesses were rare, Boroditsky noted.

Due to the rapid nature of deployment, he was unable to contact his daughter Emma to tell her because she was on her overnight for LTP at Bnai Brith Camp. “This did make me a little anxious I would have liked to have spoken to her before I flew to Nepal. Fortunately I was able to contact her when she returned and although quite shocked, she was proud of her Dad.”

Boroditsky arrived at the village of Dhunche, a remote community outside of Kathmandu near the Tibet border. The village was only 110 miles north but it took over 6 hours to travel by car due to the continued poor conditions of the road as a result of continued landslides.

The road to this village had been blocked following the 7.8 magnitude earthquake that devastated this region of Nepal, severely damaging the local hospital. (A medical team of 13 Red Cross Aid workers in Dunche on May 2, 2015 and Red Cross personnel, tents and medical supplies were all flown in by helicopter.)

Boroditsky described the people living in the area as "beyond poor." "They live in desolate shacks or tents, without electricity, and running water. There were many tent villages built into the sides of the mountain due to the destruction of their homes. They were called IDP Camps ­ Indigenous
Displaced Person."


When asked where he stayed, Boroditsky responded, “ the Red Cross Delegates slept in tents. I received mosquito netting, sleeping bag, flashlights and other items on arrival. There was no hot water for showers but we were able to heat up a bucket with a heating coil. Unfortunately only one bathroom for the 16 of us and it was only a hole in the ground. Having said that it was still better than what anyone else had.”

Shortly after arriving, Boroditsky experienced his first landslide. "It's monsoon season and there are torrential rains. It was louder than I expected. They were never really close and you eventually just got used to them. I always felt very safe.” He also noted that in the space of two weeks "I lost about 10 pounds.” The food was quite basic and I guess I was not used to it. Near the end I ate a fair bit of toast and peanut butter.”

The experience however was very worthwhile and he feels good about the fact he helped some people in need. His goal was "to return home safely, not hurt anyone and hopefully help someone," he said. I think I was able to accomplish it.”

Boroditsky said that while there he did a lot of pre­natal care. He was asked to do a variety of different things not routinely within his field.

"My very first surgery was a circumcision on an 8 year old boy. He had a fusion of his foreskin, called "phimosis." This is something I have never done before so about an hour before I researched it on the internet. I am happy to tell you it all went well.”

On the first day of rounding on the ward her assessed the wound of a young boy with a snake bite. “ the night before he was bit by a Pit Viper” Boroditsky explains. He also assisted the Mexican Red Cross paramedics to transfer a patient who had stroke from the IDP camp. Carrying the patient on a stretcher up the mountain, over rocky trails and narrow paths to the ERU. Not your typical Gynecologic care provided in Canada.

Unfortunately some of the Obstetrical outcomes were quite difficult and heartbreaking. Boroditsky recounted how he delivered a baby who was quite ill. We attempted to support and resuscitate the newborn but with limited resources it became a challenge. "In Canada, we would have been able to ventilate the baby and admit it to Intensive Care. But there was no option to do this in Dhunche. So we elected to give the mother her daughter and at three hours of age she passed away in her mothers arms."

Boroditsky recognized care options and resources are very limited in Nepal. This is their reality regardless of the earthquake. "One woman had ovarian cancer, and it had progressed beyond treatment. There is no infrastructure for palliative care. No money to send her to Kathmandu. So explain to her, she likely has end stage Ovarian Cancer. They know there is nothing we can do, I apologized and she went back to her home to die. It seemed almost to be an accepted part of living in Dhunche."

"The last case I dealt with in Dhunche was one of the more difficult. An 18 year old presented pregnant at term and had a severe illness called Eclampsia. She had severely high blood pressure and seizures. We did our best to stabilize her but she was quite ill and I think probably had even suffered a stroke at this point."

In Canada she would have been admitted to an intensive care unit and ventilated and intubated, and

 
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