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"I left Delhi with two colleagues at 11am on Sunday, but a strong aftershock closed the airport so we couldn't land until 8pm. We'd circled above the city for hours and were diverted back to Delhi. When we finally made it into the airport, it was utter chaos."
Dr Prince Mathew normally coordinates MSF’s projects in Bihar state in India, but was quickly deployed to Nepal following Saturday’s earthquake.
"Thousands of people were trying to leave and hundreds were trying to get in to provide relief. At 1am we were able to make it out with the medical supplies we’d brought with us.
Knowing that it would be extremely difficult to get people and supplies in and quickly through Kathmandu airport, four of our teams working in Bihar state, India, had set out by road on Sunday morning with medical supplies and a truck carrying 1000 shelter kits, 500 hygiene kits and 500 family kits.
On Monday, after some delays at the border, our teams and supplies were able to reach Gorkha, a town 200 kilometres north-west of Kathmandu, close to the epicentere of the earthquake.
Back in Kathmandu, we spent Monday morning urgently trying to find a helicopter, and later that afternoon we did an aerial assessment of affected areas outside the city. The devastation was clear.
We flew over districts to the east, north and west of Kathmandu. Around 45 of 65 villages were either partially or completely destroyed. People were staying in makeshift shelters, so it was clear that there would be a huge need for shelters, hygiene materials and cooking equipment.
Kathmandu itself has experienced a relatively low level destruction - the vast majority of buildings and houses are still standing. But many people are sleeping outside in tents and makeshift shelters because they are afraid to be inside due to the aftershocks. This is worrying because the seasonal rains have begun and will only get heavier in the coming days and weeks.
The enormous pressure on hospitals in and around Kathmandu from patients in need of life-saving or limb-saving surgery has passed, and people now need more minor or follow-up surgeries as well as treatment for regular illnesses.
We don’t yet have a full overview of the needs in the country because the hardest-hit areas are in the remote mountainous region outside of Kathmandu. It’s been difficult to get information and the extent of the damage and loss of lives in these areas is only starting to become clear.
The biggest challenge right now is transport. There are many small villages spread out over a large area of very tough terrain. Even before the earthquake, these areas were difficult to access.
So now with roads cut off because of avalanches and the risk of more landslides, the only way to get there is by helicopter and they are in short supply - especially cargo helicopters able to transport tonnes of relief supplies.
In the days since the earthquake struck there has been a huge influx of aid agencies and government relief teams from around the world. The most important thing now is that the assistance reaches those outside Kathmandu who are in the most affected areas.
Our priority is to reach people who have not yet received assistance in places where no one else is going. It is a huge challenge logistically to get the necessary supplies in through the airport which is still congested, and to secure the helicopter transport we need to provide medical assistance and deliver shelter and relief materials.
On Thursday we started running a mobile clinic by helicopter, visiting remote villages in the mountains north of Kathmandu. Typically in the weeks following a natural disaster such as an earthquake, water and sanitation become critical issues and people can develop diarrhoeal diseases and respiratory infections because they are living outside.
We need to increase the number of mobile clinics as quickly as possible and keep a close eye on communicable diseases such as measles and tetanus.
Our teams also plan to distribute tonnes of shelters, hygiene materials and cooking equipment. With the monsoon season approaching, we’re worried that the window of opportunity to reach people in these areas is rapidly closing."
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