Registed Nurses' Association of Ontario

Embracing nursing in a disaster zone

My tent in the mountainous Muzaffarabad region of Pakistan held 20 female patients. Each had family members that sat with them, and if they had young children, the kids slept beside them or under their bed.

It was 2005, and I was working in a field hospital with the International Federation of Red Cross (IFRC) Emergency Response Unit. A 7.6-magnitude earthquake had struck the area on Oct. 8, killing tens of thousands of people and displacing millions.

When I arrived, I was told I had two nursing assistants to help me. One was a high school student and the other a taxi driver. They worked out well with a little coaching and I was grateful for their assistance. Maybe after that experience they considered careers in health care.

There were some really ugly injuries in our camp. One little boy had an open fracture of his tibia. His family lived up in the mountains and it took seven days for them to get him down to the hospital. He was walking and hopping on his injured leg when he arrived.

One little boy had an open fracture of his tibia. His family lived up in the mountains and it took seven days for them to get him down to the hospital.

There was a man who had been buried under the rubble. One of his buttock cheeks was ripped from the top and was hanging down. He was literally holding his cheek on with a curtain that was wrapped around him and tied at the front. And I will never forget the man limping on homemade crutches with his knee cap turned in the wrong direction.

The patients never complained, even the children, and they never asked for anything even though they suffered terribly. One woman in my tent had her leg in traction (the weights were plastic water jugs hung from cords). She had surgery that morning, so the wound was fresh and the pain was intense and fiery. For most of the day she had been receiving Paracetamol and Ibuprofen for pain.

When I started my shift at 11 p.m., I did her assessment. She was not moving, not eating or drinking. She just lay there staring at the ceiling of the tent. Her vital signs were elevated and she had a sheen of sweat on her face. She spoke a little English and I asked her about her pain. She only moved her eyes towards me and the tears rolled down, wetting the small pillow under her head.

With my portable radio I called the doctor who was asleep in his tent. He ordered morphine. I went to the pharmacy tent and found the pharmacist sick as a dog and puking in a bucket by the entrance to the tent. She said she’d been puking for four hours and hoped her replacement would arrive soon. “The morphine’s on the shelf," she told me. "Might as well get two vials, just keep them in your pocket." She puked again as I left her tent.

I gave the patient 10 mg of morphine and then continued caring for the rest of the women (and sometimes their kids) in the tent. I got back to the women in traction about twenty minutes later and thought she was finally asleep. I touched her arm, she opened her eyes and beckoned me to come closer. I leaned in and she hugged me hard and close and whispered: “Thank you…you help me.” Then she slept.

I leaned in and she hugged me hard and close and whispered: “Thank you…you help me.”

I went home to Sarnia, Ont. a few days later and everyone was glad to see me. I hugged everyone, all my family and friends. After everyone but my daughters had left, I was sitting on a chair reading a book. One of my daughters noticed I was scratching my head and asked why.

“Oh crap,” I responded, as usual. "Will you look to see if I have lice?"

I looked back on my time in Pakistan and wondered where I had picked up the lice. Then I remembered the woman who hugged me. I smiled and slept. Lice was a small price to pay for the warm hug that I received from a grateful patient.

Bonnie Kearns, RN, BScN, has been with the Red Cross for 35 years. She has been deployed to disasters all over the world, including Ground Zero in New York and Jalalabad, Afghanistan.

You can read about Bonnie's work in the aftermath of Hurricane Katrina in the September/October 2005 edition of Registered Nurse Journal