Relief materials are the greatest need in Bhuj

With this flight, MSF will have transported 80 tonnes of essential relief supplies to the region. Four more staff members, primarily logisticians, are also travelling to increase MSF field strength in essential areas. MSF teams are concentrating efforts in the northern region of Bhuj and are primarily distributing tents, blankets, plastic sheeting, water containers and rope to the local population. There is less need for immediate medical care to the communities as this is being provided by local services which MSF is assisiting by supplying materials where needed. Although most of the hospitals were destroyed in the earthquake, surviving medical personnel have established Out-Patient Departments (OPDs) to handle most injuries. More severe injuries are being airlifted to hospitals that have not been affected by the recent earthquake. Although there are some gaps, medical needs through Bhuj seem to be well covered at this stage. Indian military hospital The Indian military hospital is functioning well and they have all their activities and patients accommodated in tents. There are also enough medical staff thee, with additional staff sent from all over India. Currently they have five surgeons. During the first three days after the earthquake they treated 10,000 wounded patients. At this time, there are approximately 40 wounded patients to be treated. Severely wounded patients and patients with renal failure have been transported by air to Bombay or Achmedabad. Currently the hospital has no patients with kidney failure. Government hospital This hospital was totally destroyed in the earthquake. The surviving medical staff have started a minimal OPD near the hospital. However the accommodation is very poor with shelter provided by sheeting material, not tents. There is sufficient medical staff to run the OPD and they have enough medical materials. The pressing need in the area is for the distribution of relief items to the area population. MSF staff are travelling with mobile clinics and relief trucks outside Bhuj to the small villages north/east of Bhuj. There are 60 villages there that are up to 90% destroyed. There is no apparent risk of cholera as it is a very dry area with no real endemic cholera. But as the hygienic situation is quite bad MSF is prepared for other outbreaks, such as shigella. The earthquake has destroyed the infrastructure for Bhuj and there is a need for water and sanitation (watsan) programmes in Bhuj as well as neighbouring Bhachao and Anjar. In addition, shelter supplies, blankets and other basic relief items are still needed. In the surrounding countryside, there may be a greater need for medical assistance but the issue seems more one of chronic supply problems than a medical emergency. Northern Bhuj In the area north of Bhuj, MSF staff visited a Catholic mission in Kutch Ficas Trust, had a meeting with the Father. They had an optometry hospital before the earthquake but now it is not functioning. MSF has resupplied the facility with dressing kits and a basic kit and the hospital staff is starting an OPD. Three villages in the area seems to be severely damaged. MSF visited one village that was 60% destroyed and have supplied tents, plastic sheeting and blankets. Mobile clinics will visit this place on a regular basis. South-east of Bhuj MSF has visited Anjar and Ghandhiham. Both places have an In-Patients Department (IPD) and surgical facilities that are running well with no medical or surgical items needed. Mental health Currently MSF is collaborating with Catholic Relief Services (CRS), who have a psychologist from Bombay who will be coming regularly and will be on the ground for the long term. A short workshop on trauma counseling will be held tomorrow Friday. The first impression is that people are busy organising daily life out of their homes. They display very little grief, tears or laments. They find much support in groups (kitchen activities etc.) and the hope of finding loved ones alive. However concerns are that, once this hope fades, grief will surface. Initially children and elderly are a priority.