A brief report of the medical relief work done by Dr Daya and his team in Uttarkashi. Join us on fb to know more: https://www.facebook.com/DoctorsForSevaDFS
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Uttarkhand relief updates 1st spetember 2013 1
1. A brief report on the Relief work
done by Doctors For Seva in August
2013
Dr. Dayaprasad G Kulkarni
drdaya@doctorsforseva.org
+919632306256
2. Acknowledgements
• Sewa International
• UDAPSS
• Youth For Seva
• Shivananda Ashram,Gangori
• Gayatri Parivar, Haridwar
• Seva Bharati, Chennai
• Care Vectors
• Ekam Foundation
• Hindu Seva Partisthana
• Cisco Systems, Bangalore
• IndianAssociation of Paediatrics, BangaloreChapter
• IndianArmy
• Government of Uttarakhand
• All the People of Uttarkhand
• Himanshu Thakkar
3. Introduction
• Dimensions of Disaster
• Events in brief
• State of Hydroelectric projects
• Warning signs and role of climate change
• The Team
• Details of Medical camps with images
• List of medicines and Equipment
4. Dimensions of UKD disaster
• Spread across Mandakini, Alaknanda, Bhagirathi, Pinder,
Yamuna, Goriganga basins
• Affected districts include Uttarkashi, Rudraprayag, Chamoli,
Pithoragarh, Tehri Garhwal.
• Thousands dead, missing, total upto 10-40K
• Large number of Houses, hotels, buildings washed away
• Roads washed away at 800 places
• Bridges washed away at 147 places
• Over 400 villages cut off
• Agricultural land washed away
• Tourism, hydropower project, roads, communications,
pilgrim sites affected, to take years to get back to normalcy
5. Events in brief
• Heavy snowfall in early June.
• Heavy Rainfall starts on 15th, continues till 18th.
• First signs of floods in Mandakini seen in Rudraprayag dist
on 16th June morning
• First wave of flash flood hits Kedarnath around 7 pm on
16th. Second wave at around 7 am on 17th June.
• Vishnuprayag gates closed at 11 pm on 16th, river bypasses
the dam during the night.
• Gates of Sringar closed at night on 16th June, opened during
early hours on 17th.
• Srinagar town faces worst floods in early hours on 17th.
• Bhagirathi peak flood of 6900 cumecs on 16th, Alaknanda
peak flood of 11000 cumecs on 17th June. Haridwar-
Rishikesh peak flood level on 18th June.
6. Disaster Vulnerabilities of UKD
• Young, fragile, Himalayan Mountain
• Landslide prone
• Flashflood prone
• Seismic zone IV and V
• Geological fault lines
• Forests and biodiversity based livelihoods
• Changing Climate adding to the risks
7. Status of Hydro projects in Uttarakhand
Basin Existing Hydro
projects
Under
construction
projects
Proposed
hydropower projects
Total Hydro projects
No of
projects
Capacity,
MW
No of
Projects
Capacit
y, MW
No of
Projects
Capacity,
MW
No of
Projects
Capacity,
MW
Alaknanda 32 456.97 16 1291.1 74 5199.25 122 6947.32
Bhagirathi 13 1851.5 13 1084.75 22 801.9 48 3737.75
Ganga Sub
basin
4 173.8 2 1.75 - - 6 175.55
Ramganga 12 210.8 - - 20 408.5 32 619.35
Sharda 28 427.75 8 0.375 48 12022.28 84 12450.405
Yamuna 9 478.195 2 0.14 33 2780.85 44 3259.185
TOTAL 98 3598.665 41 2378.12 197 21212.78 336 27189.56
8. Status of Hydro projects in Uttarakhand-2
Basin Large Hydro projects
(above 25 MW)
Small Hydro
projects (1-25
MW)
Mini-micro hydro
projects (<1 MW)
Total Hydro projects
No of
projects
Capacity,
MW
No of
Projects
Capacit
y, MW
No of
Projects
Capacity,
MW
No of
Projects
Capacity,
MW
Alaknanda 35 6419 61 524.65 26 3.67 122 6947.32
Bhagirathi 10 3469 28 266.7 10 2.05 48 3737.75
Ganga Sub
basin
1 144 3 31.2 2 0.35 6 175.55
Ramganga 7 512 14 105.3 11 2.05 32 619.35
Sharda 29 12335.6 20 109.65 35 5.155 84 12450.405
Yamuna 22 3144.75 14 113.3 8 1.135 44 3259.185
TOTAL 104 26024.35 140 1150.8 92 14.41 336 27189.56
9. A Run of River Project claimed to be
eco-friendly but having its own impact
One of the many
abandonedtunnels
10. A typical Hydro project means
• A large dam
• Tunnel that can be up to 30 km long, Tunnel can be wide enough to
have three trains running side by side, Tunnel is typically blasted
through the hills, notwithstanding the contrary claims
• Roads
• Township
• Mining for sand, boulders
• Deforestation
• Creation of several lakh cubic m of muck
• Big change in micro climate
• Drying up of rivers, Destruction of biodiversity
• large number of unskilled and Skilled labour mostly coming from
outside
• Each of these componentshave social, environmental, livelihood,
cultural, religious, aesthetic and other impacts. They also have impact
on disaster potential, erosion potential, flash flood potential of the
area.
13. Warnings ignored
• Need for proper EIA for all major interventions
• Needs for CIA
• WII study
• Conservation of rivers/ RRZ/ River bed construction/
Mining of sand, boulders
• CAG report on Hydro
• CAG report on Disaster Preparedness
• Climate change studies
• Changing weather patterns
• Glaciers study
• 4X4 study
• Recent disasters
• DMMC reports: 2012 disasters
14. Role of Climate Change
• Himalayas facing higher temperature increase than global average;
irregular rainfall with more high intensity rainfall events, retreating
glaciers increasing the possibilities of landslides and moraine flow
into the rivers; increased frequency of flashfloods and landslides;
• Himalayan region is named as one of the 4 most vulnerable regions of
India from CC perspective
• UKD is experiencing climate extremes for some years.
• This year: very early, very heavy, very widespread monsoon; 1356%
rainfall across state in June 13-19 week; Role of Glaciers; Snow fall
followed by rainfall; Cloud burst, flash floods
• Scientists are telling us that every weather extreme has CC impact.
Secretary, Union Ministry of Earth Sciences accepted the CC impact in
this event, but what are the implications? None so far? Vulnerable
sections not even identified.
• NAPCC, National Mission on Sustainable Himalayan Ecosystem, UKD
state APCC: Do we see any sign of these? Do we see any impact of
these on environmental governance in UKD?
• GOI is certifying every hydro project applying for CDM credits as
sustainable development everywhere, including Uttarakhand!
15. Our team comprised of Dr. Dayaprasad G Kulkarni,2 Local Pharmacists – Bheem and
Brijesh, VolunteersAjit Negi and Lokender, Umed and Deepak at base, Winnie Chang,
coordinatorVarun. Thisteam walked for days covering 75 kms and about 25 villages,
carrying rationsand medicines, treating over 500 patients, distributingkits to ASHA
workers, health assistantsand PHC staff between 5th and 22nd of July 2013.
The second team comprising of Dr Atul Kanikarand Dr. Neeraja has started work from
29th July 2013.
16. Names of villages with approx. population wheremedical camps were and
will be conducted
20. Some images showing the nature of destruction and landslides
One of the many
waterfallscreated on a
NationalHighway.
21. The first base camp
in Sanglai;School
converted to clinic;
Villagepradhanwith
his family (Our
Host); Anuja, 11 std
student carrying
loadsof fodder on
her back
Camps catering to villages of Bhukhi, Kujjan,Tihar, Gunga, Garam Pani, Sanglai
22. The amazinglyhardworking, happy, content,generous people of the
hills. We have a lot to learn from them and have an opportunityto
define “Development”according to what they think it is and not
impose what we think is best for them.
23. Camps in the villages of Huri, Gangnani amd Bhangeli. Independenceday
with the children in Bhangeli
24. Some of the treacherouspaths and the variousmodes of transport
that we had to take during our 15 days, 75 kilometerjourney
25. Register of patients maintained
where possible
Seeing patientsin Vagori village at the Harshil helipada few kilometers
from the Indo-ChinaBorder with the soldiersfrom Gharwal rifles keeping
a close eye on the proceedings. We were also lucky to have the famous
Harshil apples and Rajma. Sadly, the orchards are overflowing with ripe
apples and other fruits but no tourists to buy them and no roads to send
them to the markets. This also means a loss of an entire years earnings.
26. The people of the hills are extremely hard working, speciallythe women folk.
They are also happy and kind people untouchedby the nuances of
urbanisation.Here are some of our hosts at variouspointsin our journey who
Graciously shared their homes, food and knowledge with us
28. Medicines and kits distributed to the ASHA, Health Assistant and nurses
at variousvillages and health centers
29. Outcome
• Over 1000 patients reached out to
• Medicines distributed to all patients
• Kits with basic drugs distributed to AHSA, Health Assistant, Nurse in
every village
• Training was provided to volunteers and health workers about
emergency care and first aid
• Safe Delivery kits distributed
• Established a personal network with over 25 villages for future
interventions
• Networked with other organisations working in the area
• Worked closely with the state
• All local volunteers engaged who could in turn support their
families with the honorarium
30. Next Steps
• Team of doctors to visit at regular intervals for
follow – up. (1 Pediatrician and Gynaecologist
already on a 10 day visit from 29th August)
• Engage with local volunteers to train and equip
local health centers to cater to their needs
• Connect with partner organisations to implement
long term, sustainable and multi-dimentional
interventions
• Reach out to Rudraprayag and Chamoli Districts
31. Questions to Ponder
• On vulnerabilities of different regions.
• On Environmental Governance and vulnerabilities
• Developmental impacts and the disaster potential of a given area
• Role of disaster preparedness, warning, forecasting, information
dissemination, mitigation and management in decision making
processes
• Do we even have credible disaster management mechanism in place?
• How does our environment impact assessments, environment
appraisal committees and environment ministry consider these
issues?
• Do we have credible cumulative impact assessmentmechanism?
• What space rivers need to flow and what we need to ensure that the
beauty (the river) does not become beast (disaster)?
• What sort of accountability and participatory norms do we have?
• Do our environmental governance institutes have capacity learn from
such events?
• What is our track record in this regard?
33. List of medicines sent to the Bhatwari camp
at the request of the government for the 4
day camp – 2 sets
• Tabcalcium1500,
• Digene 1000,
• B complex 1500,
• SypAlbendazole20,
• M Vit drops20,
• azithromycin10,
• Alprazolam100,
• Vit D3 sachet 1000,
• inj neurobion 50amp,
• Multi vitaminsyp10
• Doxycycline500
• Salbutamol1000
• Paracetamol 2000
• Cetrizine 1000
• Eye and ear drops100
34. List of instruments and kits
Delivery basic set
Forceps,Sponge Holding,200mm
Needle holder,Mayo,160mm
Scissors,Mayo,Curved,150mm
Scissors,Epiotomy,Braun-sadler,145mm
Scissors,umbilical, 105mm
Speculum,vaginal,Auvard
Speculum,vaginal,Sims
Bowl,lotion, s/s,6 liters
InstrumentContainer,s/s,withcover,300x200x50mm
Kidneydish,24cm
Dressinginstrumentset
Forceps,dissecting,Straight,1/2 teeth,130 mm
Forceps,sinus,180mm
Forceps,Dissecting,Straight,Plain,115 mm
Forceps,Sponge holding,200mm
Scissors,Mayo,Straight,150mm
30. Scissors,dressing,Straight,165mm
Scissors,ligature,spencer,130mm
Bowls,lotion, s/s, 5 liter
Bowl lotion,s/s,0.2 liter
KidneyDish,24cm
Instrumentcontainer,s/swithcover,300x200x50mm
Minor surgertset
Dressing Scissors 6" sharp/blunt
Iris Scissors 4.5"straight
Mayo Scissors 5.5"straight
Stitch Scissors 5.5"
Gillies Dissecting Forceps 1:2 teeth 6"
Dissecting Forceps 5” block end
Halstead Mosquito Artery Forceps 5" straight
Mayo Hegar Needle Holder 6"with TC
Gillies Skin Hook
Kilner Retractor
McDonald Dissector
Volkmann Scoop,medium
No.3 scalpel handle suitable for blades #10 - #15
Probe
37. Name of the equipment Quantity Remarks
B. P. Apparatus 1
Stethoscope 2 One with pediatric chest piece
Thermometer 2
Weighing scale 2 1 adult and one baby weighing scale
Light source 3 2 torch and one electrical source
Surgical gloves no 6 and 61/2 200 each Surgical autoclave will be useful
Speculum 4 Cusco’s, 4 Simp’s Electrical/stove sterilizer necessary
Volsellum 2
Betadine liquid 4
Spirit 4
Sterillium 4
Hydrogen peroxide (H2O2) 2
Cotton and dressing pads (sterile
packs)
100
Disposable syringes 2 ml and 5 ml 200 each
Disposable syringes 10 ml 25
Simple rubber catheter 10
Infant feeding tube no 8 20
Urinary pregnancy test kits 100
Prescription pads 10 (100 pages
each)
Ante-natal check-up cards 200 If available
Disposable caps and masks 200
Electrical/heat sterilizer 1
Mucus sucker (rubber bulb) 2
Cord clamps 10
Foley’s catheter no.14 10
Surgical scissors 2 straight, 2 curved
Scalpel with blades 2 10 extra disposable blades
Suture material 1-0 Cat-gut, Vicryl,
linen
5 each
Sponge holding forceps 2
Surgical gowns, towels, sheets 4 each Disposable towels & sheets are available
Uro-sac (urine collecting bags) 5
Dynaplast, paper and cotton sticking 5 each
I. V. sets (JMS) 100
Pediadrip I.V. set 10
Veinflow/Intracath no. 18, 20, 22, 24 20 each
Venafix/easyfix 100 strips
Scalp vein set (Top) no. 22, 23 10 each
Proctoclysis/glycerin enema 20
Gynecology and Obstetrics
Inj. Tetanustoxoid (refrigeration needed) 10 multi-dose vials
I. V. Fluids(RL, DNS. D-5%, Isolyte-P) 2 boxes each
Hemaxoel (plasmaexpander) 2 bottles
Pitocin 100 ampoules
Prostodin 10 ampoules
Methergin 30
Trenexa 10
Ethasyl 10
Tramadol 10
Voveran 10
Paracetamol (Mol) 5
Lasix 5
Lignocaine 2% 1 vial
Sensurcaine 5% heavy 1 vial
Adrenaline 5
Effcorlin 5
Dexona 5
Rantac 10
Emeset 20
Perinorm 10
Kapilin (Vit. K) 50
Sterile water for injection (10ml) 100 vials (plastic)
Metrogyl (100ml) 20
Oflox (100 ml) 20
Taxim (0.5, 1 gm) 50
Amitax (250, 500mg) 30
Moxclav/clavam (0.3,0.75,1.2gm) 20
Monocef(0.5,1 gm) 20
Polybione 50
M.V.I. 20
Neurobione 20
Jonec 100mg suppository 20
Drugs and medications(Injectables)
38. Acknowledgements
• Sewa International
• UDAPSS
• Youth For Seva
• Shivananda Ashram,Gangori
• Gayatri Parivar, Haridwar
• Seva Bharati, Chennai
• Care Vectors
• Ekam Foundation
• Hindu Seva Partisthana
• Cisco Systems, Bangalore
• IndianAssociation of Paediatrics, BangaloreChapter
• IndianArmy
• Government of Uttarakhand
• All the People of Uttarkhand
• Himanshu Thakkar
39. Thank you to everyone who have
been supporting us in these efforts
Contact drdaya@doctorsforseva.org; +919632306256