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A brief report on the Relief work
done by Doctors For Seva in August
2013
Dr. Dayaprasad G Kulkarni
drdaya@doctorsforseva.org
+919632306256
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
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
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
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.
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
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
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
A Run of River Project claimed to be
eco-friendly but having its own impact
One of the many
abandonedtunnels
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.
The numerousprojects back to back along the Bhagirathi
Uttarkhand relief updates 1st spetember 2013 1
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
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!
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.
Names of villages with approx. population wheremedical camps were and
will be conducted
Uttarkhand relief updates 1st spetember 2013 1
Uttarkhand relief updates 1st spetember 2013 1
Uttarkhand relief updates 1st spetember 2013 1
Some images showing the nature of destruction and landslides
One of the many
waterfallscreated on a
NationalHighway.
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
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.
Camps in the villages of Huri, Gangnani amd Bhangeli. Independenceday
with the children in Bhangeli
Some of the treacherouspaths and the variousmodes of transport
that we had to take during our 15 days, 75 kilometerjourney
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.
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
TraditionalWool work, Advisors and guides, abandonedvehicles and landslides
Medicines and kits distributed to the ASHA, Health Assistant and nurses
at variousvillages and health centers
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
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
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?
List of Medicines
Perinorm inj -200
Voveraninj-200
Ambroxal Pd - 600
AsthalinPd -600
Eye ointment- 2000
Famotidine-2500
Omeprazole-1000
Ranitidinetabs-1000
Becosule caps-4000
M2Tone Tabs -3000
multivitamindrops2000
Scabin lotion-600
Cinerazinetabs - 1000
Albendazole-1500
Ciplox Tz -2000
Norflox Metronidazolesuspension-2000
Norflox Tz-1000
Amoxy syp pd-300
Cetrizine-2000
Cephalexinoral suspnsn-200
Pentid-3000
Roxid 150 tabs-3000
Cephadroxil500&250mg-1500/1500
Oflox-oz-3000
cetrizine syp-3000
nasal drops-200
amlodipine-1500
Betnesol-3000
anticoldsyp-3000
dicyclinedrops-2000
norflox syp-2000
Colimax-2000
domostaldrops 2000.
cyclopam inj -120
paracetamolinj-600
Dry cough syp-300
mikacin125 inj-100
mikacin250 inj- 100
Dexomethasone inj-120
Etophyllineinj-150
Cefixime-3000
Salbutamol-5000
Ofloxacin-3000
cefalexin250 mg- 3000
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
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
Abdominal
Gynecological
InstrumentSet
Knife Handle No.3
Knife Handle No.4
Knife Handel No.7
Forceps Holder,8"
Forceps Holder,10"
Forceps Holder,12"
Mayo Disc. Scrs, 6 3/4"Str
Mayo Disc. Scrs, 6 3/4", Cvd
Metzenbaum scrs, 7"Cvd
Halstead MosquitoFcps, Straight,5"
Halstead MosquitoFcps, Curved,5"
Forceps, Kelly, 5 1/2", Cvd
Forceps, Rochester-Pean, 6 1/4", Cvd
Forceps,Rochester-Pean, 10 1/4", Cvd
Forceps, Rochester-Ochsner,10", 1x2th
Forceps, Mixter,9"
Forceps, Foerster SPonge, 9 1/2"
Forceps, Allis Tissue, 6", 4x5th
Forceps, Allis Tissue, 10"
Forceps, Babcock Tissue, 6 1/4"
Forceps, Babcock Tissue, 8"
Forceps, Backhaus Towel, 5 1/4"
Forceps, ThumbDressing,5 1/2"
Forceps, Tissue,5 1/2", 1x2th
Forceps, Russian Tissue, 8"
Forceps, Adson Tissue, 1x2th, 43/4"
Retractor,Balfour
Retractor Richardson,1"x 3/4"
Retractor Richardson,1 1/2"x11/2"
Retractor,Army setof 2
Retractor,Ribbon, 3/4"x13"
Retractor,Ribbon, 1 1/4"x13"
Retractor,Ribbon, 2"x13"
Retractor,Deaver, 1"x9"
Retractor,Deaver, 1"X13"
Retractor,Deaver, 2"x12"
Retractor,Goelet
Forceps, Lahey Gall-Duct, 71/2"
Scissors, Metzenbaum,9"Str,TC Insert
Scissors, metzenbaum, 9", Cvd, TC Insert
Needle Holder,Mayo Hegar,7",TC Insert
Needle Holder,Mayo Hegar,8",TC Insert
Needle Holder,Mayo Hegar,101/2",TC
Tube,Yankeur Suction,113/4"
Tube,PooleSuction,Straight
Forceps,Schnidt,7 1/2"
Forceps, Tissue,8"
Knife Handle No.4L
Mayo Diseecting Scrs, 9",Cvd, TC Insert
Tissue Fcps, 12", 1x2th
Tissue Forceps, 2x3T, 5 1/2"
Rochester-Ochsner Fcps 8", Str
Foerster Sponge Fcps, 9", Str,Serr
Heaney NeedleHolder, 8", Cvd, TC
balfour retractor orpozzy retractor or O"Sullivan-O"Connor
Retractor
Allis Tissue Fcps, 7 1/2", 5x6 th
Graves Vaginal Speculum, Medium
Tenaculum Fcps
Vulsellum Forceps
Jacobs Vulsellum Forecpes, Str
Heaney Hysterectomy Fcps, 8 1/4",
Heaney Hysterectomy Fcps, Cvd, single th
Nebulizer 1
Thermometer 2
Mucus sucker 2
Pediatricstethoscope 1
Torch with extrabatteries 2
Measuringtape 1
Baby weighingscale 1
Prescriptionpads 10
O.P.D. Register 1
Other equipment for pediatric use
Medications/drugs(Injectables/parenterals)forpediatric use
Candid-Vgel 50
Lignoxgel 5
Tenovate 20
Candidpessary 20
Clintas-CLpessary 10
Betadine ointment 5
Caladryl lotion 5
Betnovate-C 10
Candidskin cream 10
Zocon dustingpowder 20
Silodermcream 20
Candidmouth paint 20
Annovate cream 10
Fusidincream 10
T-bact ointment 10
Medications/drugsfor local application
Drug Bottles
(Suspensions)
Tablets
Crocin/Metacin/Febrex125,
250mg
100 each 500mg- 300
tablets
Combiflam 100 100
Febrexplus/Wikoryl/Sinarest 100 500
Cyclopam 20 50
Colicaiddrops 50
O2H 200
Bendex 100 100
Taxim-O 50mg, 100mg D.T. 100 each
Oflox100mg, 200mg D.T. 100 each
Visyneral-Zdrops 100
Azithral 100mg, 200mg 100 each
Azithral 250mg, 500mg 100 each
Oflox/Ciploxeye drops 100
Sofracort eye drops 50
Clavam BiD 50
Roxid/Roxeptin50mg, 100mg D.T. 50 each
Easum powder (50 packets)
Monocef 250mg, 500mg 50 each
Clavam 300mg 50
Amitax 100mg, 250mg 50 each
Oflox(100ml) 20
Isolyte-P(500ml) 50
R.L. 20
D.N.S. 20
Budesal respules(0.5mg) 100
Waterfor injection(10ml) 100
Dexona 5
Effcorlin 5
Avil 5
Febrinil (Paracetamol) 20 ampoules/2 multi-dose vials
Calmpose 4
Gardenal (phenobarbitone) 4
Epsonil 4
Jonec25mg pediatricsuppository 10
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)
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
Thank you to everyone who have
been supporting us in these efforts
Contact drdaya@doctorsforseva.org; +919632306256

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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.
  • 11. The numerousprojects back to back along the Bhagirathi
  • 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
  • 27. TraditionalWool work, Advisors and guides, abandonedvehicles and landslides
  • 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?
  • 32. List of Medicines Perinorm inj -200 Voveraninj-200 Ambroxal Pd - 600 AsthalinPd -600 Eye ointment- 2000 Famotidine-2500 Omeprazole-1000 Ranitidinetabs-1000 Becosule caps-4000 M2Tone Tabs -3000 multivitamindrops2000 Scabin lotion-600 Cinerazinetabs - 1000 Albendazole-1500 Ciplox Tz -2000 Norflox Metronidazolesuspension-2000 Norflox Tz-1000 Amoxy syp pd-300 Cetrizine-2000 Cephalexinoral suspnsn-200 Pentid-3000 Roxid 150 tabs-3000 Cephadroxil500&250mg-1500/1500 Oflox-oz-3000 cetrizine syp-3000 nasal drops-200 amlodipine-1500 Betnesol-3000 anticoldsyp-3000 dicyclinedrops-2000 norflox syp-2000 Colimax-2000 domostaldrops 2000. cyclopam inj -120 paracetamolinj-600 Dry cough syp-300 mikacin125 inj-100 mikacin250 inj- 100 Dexomethasone inj-120 Etophyllineinj-150 Cefixime-3000 Salbutamol-5000 Ofloxacin-3000 cefalexin250 mg- 3000
  • 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
  • 35. Abdominal Gynecological InstrumentSet Knife Handle No.3 Knife Handle No.4 Knife Handel No.7 Forceps Holder,8" Forceps Holder,10" Forceps Holder,12" Mayo Disc. Scrs, 6 3/4"Str Mayo Disc. Scrs, 6 3/4", Cvd Metzenbaum scrs, 7"Cvd Halstead MosquitoFcps, Straight,5" Halstead MosquitoFcps, Curved,5" Forceps, Kelly, 5 1/2", Cvd Forceps, Rochester-Pean, 6 1/4", Cvd Forceps,Rochester-Pean, 10 1/4", Cvd Forceps, Rochester-Ochsner,10", 1x2th Forceps, Mixter,9" Forceps, Foerster SPonge, 9 1/2" Forceps, Allis Tissue, 6", 4x5th Forceps, Allis Tissue, 10" Forceps, Babcock Tissue, 6 1/4" Forceps, Babcock Tissue, 8" Forceps, Backhaus Towel, 5 1/4" Forceps, ThumbDressing,5 1/2" Forceps, Tissue,5 1/2", 1x2th Forceps, Russian Tissue, 8" Forceps, Adson Tissue, 1x2th, 43/4" Retractor,Balfour Retractor Richardson,1"x 3/4" Retractor Richardson,1 1/2"x11/2" Retractor,Army setof 2 Retractor,Ribbon, 3/4"x13" Retractor,Ribbon, 1 1/4"x13" Retractor,Ribbon, 2"x13" Retractor,Deaver, 1"x9" Retractor,Deaver, 1"X13" Retractor,Deaver, 2"x12" Retractor,Goelet Forceps, Lahey Gall-Duct, 71/2" Scissors, Metzenbaum,9"Str,TC Insert Scissors, metzenbaum, 9", Cvd, TC Insert Needle Holder,Mayo Hegar,7",TC Insert Needle Holder,Mayo Hegar,8",TC Insert Needle Holder,Mayo Hegar,101/2",TC Tube,Yankeur Suction,113/4" Tube,PooleSuction,Straight Forceps,Schnidt,7 1/2" Forceps, Tissue,8" Knife Handle No.4L Mayo Diseecting Scrs, 9",Cvd, TC Insert Tissue Fcps, 12", 1x2th Tissue Forceps, 2x3T, 5 1/2" Rochester-Ochsner Fcps 8", Str Foerster Sponge Fcps, 9", Str,Serr Heaney NeedleHolder, 8", Cvd, TC balfour retractor orpozzy retractor or O"Sullivan-O"Connor Retractor Allis Tissue Fcps, 7 1/2", 5x6 th Graves Vaginal Speculum, Medium Tenaculum Fcps Vulsellum Forceps Jacobs Vulsellum Forecpes, Str Heaney Hysterectomy Fcps, 8 1/4", Heaney Hysterectomy Fcps, Cvd, single th
  • 36. Nebulizer 1 Thermometer 2 Mucus sucker 2 Pediatricstethoscope 1 Torch with extrabatteries 2 Measuringtape 1 Baby weighingscale 1 Prescriptionpads 10 O.P.D. Register 1 Other equipment for pediatric use Medications/drugs(Injectables/parenterals)forpediatric use Candid-Vgel 50 Lignoxgel 5 Tenovate 20 Candidpessary 20 Clintas-CLpessary 10 Betadine ointment 5 Caladryl lotion 5 Betnovate-C 10 Candidskin cream 10 Zocon dustingpowder 20 Silodermcream 20 Candidmouth paint 20 Annovate cream 10 Fusidincream 10 T-bact ointment 10 Medications/drugsfor local application Drug Bottles (Suspensions) Tablets Crocin/Metacin/Febrex125, 250mg 100 each 500mg- 300 tablets Combiflam 100 100 Febrexplus/Wikoryl/Sinarest 100 500 Cyclopam 20 50 Colicaiddrops 50 O2H 200 Bendex 100 100 Taxim-O 50mg, 100mg D.T. 100 each Oflox100mg, 200mg D.T. 100 each Visyneral-Zdrops 100 Azithral 100mg, 200mg 100 each Azithral 250mg, 500mg 100 each Oflox/Ciploxeye drops 100 Sofracort eye drops 50 Clavam BiD 50 Roxid/Roxeptin50mg, 100mg D.T. 50 each Easum powder (50 packets) Monocef 250mg, 500mg 50 each Clavam 300mg 50 Amitax 100mg, 250mg 50 each Oflox(100ml) 20 Isolyte-P(500ml) 50 R.L. 20 D.N.S. 20 Budesal respules(0.5mg) 100 Waterfor injection(10ml) 100 Dexona 5 Effcorlin 5 Avil 5 Febrinil (Paracetamol) 20 ampoules/2 multi-dose vials Calmpose 4 Gardenal (phenobarbitone) 4 Epsonil 4 Jonec25mg pediatricsuppository 10
  • 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