8/10 : An Earth Quake : PASSAGE TO TANGDHAR on line of control between India and Pakistan held kashmir [ LOC ]

It was 9:20 am, Saturday , 8th October` 2005, the earth shook for us ,like a swing .I was in my room and I rushed ,with my family to the lawn of our home for safety . Earth was still shaking violently. We all were praying, as we had a feeling maybe this was the “dooms day.”
We started to call our relatives and friends trying to know about their welfare. In meantime I rushed to my hospital, unlike my family members, who stayed back in home in state of shock, I could not have that luxury to stay home, being doctor.As I knew it was not an ordinary earthquake, but was not expecting it to be 7.6. Once I reached the hospital, news was broadcasted on radio that it was having magnitude of 7.6 having epi centre in other part of my Kashmir.
We were expecting casualties in large numbers, after a meeting with our Medical superintendent, we prepared our accident and emergency section, usually in the normal time is ill maintained, and minimally equipped like other ER (emergency room) or A&E Departments in all hospitals across the valley. But luckily we received only a few injuries, one was injured because of a falling object, other one had jumped thorough window for safety and were labelled as moderate and non fatal injuries. Many patients reported with psychosomatic symtomatology and were treated for the same.
On Monday, the atmosphere in our hospital was very different as the news and extent of devastation started to become known to every one. In our hospital me and my colleagues and some of our non-medico friends, decided we should make an effort to help the affected, as government may not be able to deal with the crisis efficiently. Luckily being the holy month of Ramadan, as we had expected, we found the people were more compassionate and generous in extending help.
Therefore, we decided to send medical and food relief and we stared to send word to every one known to us through verbal, telephonic and sms to arrange cash, clothes, food packets, blankets and tarpaulin sheets. Tents were out of our budget, moreover they were not available in the market, there were also reports from media that government had brought all the available tents from the market, 2,000 in numbers, although 30,000 were needed.
It took us two days to collect medicine, money, clothes and to arrange transport, as our own personal transport (small cars) were not sufficient for the load we were carrying and the hilly nature of the terrain. As we moved to buy relief material, we were stuck for 2 hours, near the Hyderpora crossing due to the reason that the vvvip was visiting Kashmir, another price, we in Kashmir pay for VVIP movements. Even we showed, our ID to police and pleaded that we are doctors and have to arrange medical relief material, it fell into the deaf ears of the police and Indian security officials who were present at Hyderpora intersection at that time.
Due to the initial detention and traffic jam following the lifting of curfew like situation on the VVIP route, we purchased all the items by dividing our team in small groups and managed to pack these items working very late into the night.
Our team that planned to go to the quake hit area, consisted of three medical doctors, two dentist, six paramedics, and five volunteers among them two engineers. We were lucky that one of the engineers was a local of the area. He knew the topography well; he after consultations with local , had the details of the worst suffering areas, and populace, which as you will learn later, is the most important but often an overlooked aspect of any relief effort.
we were the first among relief teams that disturbuted material in each family at thier collapsed house un like other who disturbuted from thier trucks, ours was also the first medical team that went house to house in worst affected village of bahadurkoot ,epikott
The Materials we carried. Because of the fact that time was of the essence and our own limitations, we were able to collect materials in the form of ration packets, blankets, medicines and water proof nylon sheets of approximately four lacs value in addition to some clothing material, got from a collection made at our place of work and contribution of good-hearted people. They arranged also the transport to the place in the form of three vehicles and managed to get a tent on loan from an agency.
On entering Tangdar. When we started, we were expecting destruction but not of the scale, we subsequently witnessed. Going down the rough, narrow, dusty, spiralling, road Tangdar looked a beautiful quiet place and when the first habitations came into view we could not perceive the devastation we had imagined. In my heart, we thought maybe we should have gone to Uri instead, but we friends knew, where we were headed. As it turned out Tangdhar is a long narrow sloping valley of considerable length bounded on both flanks by tall hills on which the industrious and hard working people have built small terraced maize fields and houses
On the valley floor a few paddy interspersed with maize fields, hutments, houses, mosques, schools, administrative offices and defence buildings are situated. Small hillocks rise from the valley floor and create side valleys on whose sides also people reside. The area worst affected is a region about five-10 kilometers from the place where one enters this valley. The administrative headquarters of the area is situated near the upper end of the valley. A small hospital is also located at this place.
The place we were going to is called Cheetorkoot, which is close to the LOC. The intensive army presence is very noticeable throughout the length of the valley as can be expected for a border area. There are a number of checkpoints on the road, which extends from the point of entry into the valley right up to Teetwal.
The road itself follows a fast moving stream, which empties itself into the river Neelam at Teetwal. The road further damaged by the earthquake is in a very bad shape, but drivable unto Chitrakoot only and efforts were being made by the army to make it motor able right up to Teetwal. Brief Description of the devastation. The road itself gives the first hints of the intensity of the earthquake. Even as one crosses the Sadhna Pass and enters the valley the retaining walls on the side of the road has given way at most of the places because of which the road is extensively covered with rubble, gravel and small stones.
Bulldozers and labourers working continuously since the quake have moved most of the big rocks and earth. The sides are very unstable and fresh landslips are occurring and will continue to occur for a long time. Big trees have been uprooted at many places along the way. Mighty boulders, broken off from the rocky cliffs were a constant testimony to the force of the quake.
Down towards Teetwal extensive and deep cracks are seen on the surface of the road. The widest crack I saw was about a foot wide and about two feet deep near Chitrakoot .Towards Teetwal extensive stretches of the road, which had been carved along hill slopes, had been completely buried by landslips so that not even the traces of it were left. It is the case with most of the paths connecting the different villages.
They either are buried under rubble or have slipped into oblivion. There is a small bridge which leads to a village called Bahadorkoot made of heavy steel girders and thick beams of wood which has been rendered impassable because a very big bolder, having detached itself from a big rocky cliff considerably high up, has landed on it and mangled the steel tresses. The road leading to Bahadorkoot is now landslips have filled up a stream as the original course of it. Even the small mountain walking paths have been obliterated in most of the places.
All types of buildings; residential, religious, public, utility, have been damaged all along the valley, the severity increasing as one goes down towards Teetwal and its adjoining areas, where there is complete destruction. Saying so there are pockets of utter ruination even high up in the valley as can be seen as one travels along the road leading to Teetwal.
At places, the houses built high on the mountain faces have been moved down the slopes to a complete ruin. Water carrying irrigation conduits and canals are destroyed; steel water pipes are now nothing more than reminder of water supply schemes. Electricity poles have been levelled; at places, even the wires have snapped. The Construction materials used by the locals.
The most noticeable thing when one looks at the ruins is that the buildings, those that had been multi-storeyed as well as small single storied structures, were mostly made on a wood framework. The walls of these buildings were constructed of stone and loose sandy clay mortar. At some places, cement was used in the mortar material.
The ceilings and roofs were made of wood. It can be easily imagined how quickly these structures could have succumbed to the violent quake. We saw a few structures that had survived and mostly they were made of dressed stone and reinforced cement concrete. These include a few residential houses, some government and defence buildings, but even they have been damaged to a varying extent.
The agencies working for quake relief and what those working with them said. When we entered Tangdar, we met individuals working for various government departments and a few non-government agencies. Various government departments had deputed most of those whom we met. As can be expected most of the local government functionaries had their own personal tragedies to attend to and naturally they could not be expected to react optimally, either mentally or physically to the events, and the rescue and relief work, barring a few exceptions.
Saying it plainly the local administration had been overwhelmed to such an extent by the magnitude of the disaster that it had simply collapsed. Those deputed from other areas were also not functioning at the maximum. For example, those working in health services were mostly send unprepared, ill equipped, and lacked the necessary training and motivation to work in the environment they were in.
They had also to worry about their own day-to-day needs. Considering this, they were doing the best they could in the circumstances. It was but natural that when we met them, some among them tried to dissuade us from going to the place were intending to go. Other issues needed to be tackled before we went towards Teetwal. Of primary concern was the news, as told to us by those returning from the interiors, of looting of the relief materials.
We had to wait for nearly 3 hours before we could manage a police escort to accompany us. In this, the local police and civil administration proved very helpful. However once we started and moved through the affected areas this news turned out to be highly exaggerated. There had been some instances of the same, but how else do you expect a dishevelled and disheartened people to react.
This also brought us face to face with another reality that needed to be tackled, that of reaching to the people who could not compete with their neighbours in collecting whatever limited material we were carting.
This also applies to the ones who were there before those and us that were to follow and is among the foremost problems of any relief work. Plight of the people. The first thing that we noticed, as we were moving through the devastated villages reroute to Teetwal was the calm. There was no wailing or crying as would expect from people who had lost there loved ones.
Maybe they were still unable to come to terms with their own personal misfortunes or were busy struggling for their own survival and the survival of their families whose needs in terms of food, water, shelter, clothing, and medical care had overshadowed their grief. All along the road that leads to Teetwal there were survivors either sitting in front of the ruined houses or by the sides of the roads waiting for some succour, some help, to cope with the situation, they were in.
Some brave ones among them had already started to build makeshift sheds and shelters from polyethylene sheets and the tin roofing of their destroyed homes. How grossly inadequate their efforts were we could imagine. The winters are closing in, higher reaches had first snowfall and there is already chill in the air. As we reached the village of Chitrakoot, we saw what appeared to be different habitations on the hillsides on the opposite side of the mountain valley, which we later came to know were the villages Bahadorkoot, and Ipeekoot, and had been among the worst hit.
As it was getting dark, we waited unsuccessfully for lights to light up from these villages. All we saw were maybe 6 to 7 bonfires. We also met some government functionaries who were busy in compiling statistics about the devastation. Even as night was closing in there, were people at the place were we camped who were asking for material assistance? We met a person who to me seemed to be a rather stoic, but broke down when we talked to him.
An ex army man he was to put it politely, very much critical of the government efforts at rescue and relief. He being the only person in his family who could go out and try to garner substances to sustain his family, he had been a loser to families who had a few more survivors that are able-bodied. All that he had managed to collect during the last 2 days was one blanket and a small packet of food grains, which he said, was given to him by an acquaintance in the army. He very persuasively asked me to ensure that whatever we were carrying be equitably distributed. It was past night when we unloaded and sorted the materials we were carrying.
As we sat in our tent lit by candles, planning the next day’s work, another of the many aftershocks that have been occurring, since the quake, jolted the valley followed by frightful rumbling sounds, which we learnt, was due to loosened rocks falling over the mountainsides. It is not difficult to comprehend the terror that these events have on the people who have lived on these, seemingly unassailable mountain slopes for ages and had lost so much to nature’s fury in those few moments. Relief efforts until we arrived.
This can be summed up briefly, as there is little to write about. The armed forces had undertaken rescue operations, some preliminary relief works, and its agencies had importantly managed to keep most of the major roads open, but apparently they also had been overwhelmed by the situation and the diversions in the form of high profile visitors, journalists and their touring had not helped much. The civil administrations seemed content in compiling statistics and planning to dump food materials at Chitrakoot.
They were trying to figure out ways to carry and distribute the same to the affected populace in the difficult to access hillside villages, as they it seemed had not anticipated the non availability of local labourers and porters, who were in fact more interested in their own and their families survival rather than working for wages. The civil government as on that day had been completely sidelined by voluntary effort. The only government agencies that had to a limited extent reached the difficult to access areas were the health services, fire, and emergency services department. The police were there, but other than providing security to the high profile visitors, were it seemed, still trying to figure out their role in the relief effort.
How we started.
Being primarily a medical aid trip we set up a camp at Chitrakoot and managed to treat about 400 odd cases. These cases were mostly injury related, including some very badly managed and untreated wounds. There were many patients of varied physical, psychosomatic and psychiatric symtomatology. A number of patients reported for minor ailments. The cases included a fair proportion of children and women. Other relief goods we were carrying were distributed with the help of our local friends. They exerted and tried to make the distribution as equitable as could be possible, and managed that part fairly well, with the help of the lists provided by the people themselves. They ensured that whatever little we had with us reached and most needy families and individuals.
Visit to Bahadorkoot.
A small group comprising of three doctors, 3 paramedics and a couple of volunteers trekked to the village of Bahadorkoot, which is about 4-5 kilometers from the place where we had set up our camp. The access to the village involves a steep climb up a hilly path. Tiring and difficult even to climb even in ideal conditions the trek has become all the more difficult because of the landslips and the altered course of the stream, which used to be alongside the path, and that is now flowing were the path used to be.
At many places, there is difficulty in securing a firm foothold as the soil has become loose. There is also a perpetual danger arising from loose rocks and boulders falling from above on the pedestrians. Similar is the case with paths leading to other villages and habitations. How they will manage to shift relief supplies and maybe later construction material up these slopes is hard to imagine. It is also difficult shifting and moving patients for medical help.
We were carrying some basic emergency medical material with us. We had planned to disburse the medical supplies and to may be doing some dressings as we expected all the major injuries to have been attended to for this was the fourth day since the quake. Started our work, to our surprise we found, many patients with untreated wounds and even untreated fractures, who were obviously in great discomfort and pain.
We did however manage, within our limited resources to help as many as we could. This included distributing medications, giving anti tetanus injections, I/v antibiotics as stat doses, dressing materials and even plastering number of fractures and also in giving some knowledge to a few local residents regarding basic wound care and we stored some dressing materials with these individuals.
Afterwards we got a chance to move around the village. It presented a picture of near total devastation. We were not able to see even a single dwelling that had not been destroyed. It is difficult to describe the feeling one gets after seeing homes so completely ruined, all that was left of them was a heap of stones and wood on the ground covered with remains of tinned roofs.
At number of places we were offered tea and local bread, but we politely refused on one pretext or another because of seeing their sufferings At one or two places, exhausted looking men of the fire services who were still looking for dead bodies under the wreckages met us. One of them were seven year old girl nageena, who’s mother and father were lying in srinagar hospital, her grand father who had returned from Pakistan administered on 6th of October on last bus plied between to divided parts of Kashmir, last when we left village they still were struggling to find out, even today we are curious to know what happened to her
We met one of their men who were asking for drinking water from the villagers. They also wanted us to provide them with some bandages and like because some among them had sustained minor injuries, and were not sure, when they would be free to go to any medical centre to have their injuries attended to. As we walked through the small fields, the tall maize that was at present un-harvested, one could sense the isolation that the inhabitants of the scattered houses must have felt when the quake happened. Wrecking, graves, trying to cope with the situation residents, was what had been left behind.
As we were moving back towards Chitrakoot, we had intended to go towards Teetwal, as volunteers as our relief supplies were already exhausted but we met an elderly respectable looking gentleman who after looking at the us with no relief supplies advised us against the same as the people there may mistake us for government functionaries and assault us. Remember this was the fourth day after the quake and other than, some medical teams nothing substantial had reached there, possibly because the road leading there was still closed.
Our shortcomings
Leaving aside the volume of our supplies, which were grossly insubstantial considering the magnitude of the needs there, were deficits even in the area of providing medical aid, which was our primary goal. As the patient profiles was not what we had fully anticipated, there were bound to be many shortcomings. This was compounded by the remoteness of the area, the terrain where we were to operate, and absence of communication mechanisms. Intensifying the difficulties was the absence of any mechanism to coordinate our effort with the other agencies working there or those planning to work there.
Even there were difficulties in keeping our team members motivated enough to keep working there possibly because had not been sufficiently made aware beforehand of the difficulties they were to face while operating in the area we were in.
Lessons learnt by us about relief work and tips for those volunteering to help.
1. Collecting relief materials is the easier part, ensuring that it reaches the neediest is difficult. Try to involve people who have been there and know the topography as well as the needs and urgencies. Try to find some local person to help. Avoid dumping materials at one place or distributing right from the vehicle carrying them, find a local ngo who can guide
2. Before dispatching materials try to ascertain the needs of the people you plan to help. The government instead of being a spectator should advise those volunteering to help with frequently updated lists of needs and ways by which the volunteers can help.
3. Do some groundwork before you distribute relief? If possible identifying the most deserving should be one of the tasks before material distribution and work force activity.
4. Have a definite plan as to what you will be going there for. Prepare your members mentally for the problems likely to arise and dissuade those from going who are likely to become liabilities to the rest of the team. People with staying power will be an asset to any team.
5. Go prepared with things that are necessary for your own well-being, so that you may function optimally in unpredictable and sometimes hostile environment.
6. Someone has to coordinate the voluntary effort. In our setting, the civil administration has to take this job seriously. Presently there is a multiplicity of coordinating agencies often working at cross-purposes. In such a situation, those willing to work should try to liase with those who are already working there.
7. Make a habit of constant encouragement of your team members and your own self. Do not expect it from the devastated people and most certainly never from the government functionaries. Work only for the appreciation of the affected.
8. There is a inclination and an undercurrent of politicising the relief effort in all such situations, avoid being a part of it or being used as a tool for furthering the political and PR agendas of interested individuals and groups. This will help you and your team to avoid getting involved in unnecessary local politics that will distract you from the work you have planned.
9. Government is the one agency that will eventually be the one to stay when others have left. It is still early for it to become organized and start the final phase of the disaster management effort i.e. rehabilitation, having not reacted sufficiently in the first two phases of rescue and relief. Urgent unmet needs. While returning from Tangdar we passed many vehicles carrying materials headed for Tangdar. Still it is pertinent to mention what we felt were the needs of the people that required priority specialized medical caregivers like G P`s ,trauma surgeons and counsellors for psycho social couselling. First aid and dressing kits. Warm clothing, Tinned baby food, waterproof tent age, insulting nylon foam sheets, Bedding other than blankets, tools for reconstruction like hammers, nails, chisels saws and like. Kerosene lantern, candles and stoves. Containers for food, water and kitchen utilities and utensils.
Contributed by:
Dr Niyaz A . Jan ......... c/o http://kashmirdoctors.blogspot.com
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