In the aftermath of the Nepal’s blackest Saturday, many tales will be told; many selfies posted. Yet, whilst the tabloids work themselves into a breathless frenzy with tales of heroic mountaineers trapped high on Everest, there are other stories to tell.

One remarkable story is coming out of Pheriche, a small town near Ama Dablam which is a collection of a dozen lodges for trekkers, a few private buildings and, crucially, the Himalayan Rescue Association Aid Post.

After the earthquake, the four doctors at the clinic suddenly found themselves in the front line, as constant helicopter flights evacuated casualties from Everest Base Camp. 

Their situation quickly became, according to one of their blogs, “a mass casualty incident, or what the American College of Emergency Medicine would call a medical disaster, which they describe as a situation “when the destructive effects of natural or manmade forces overwhelm the ability of a given area or community to meet the demand for health care.”

In five hours, they managed to treat 73 injured climbers, porters and Sherpas from Everest Base Camp and evacualte them all to Lukla or Kathmandu. 

Katie Williams, 33, from the UK was one of the four doctors. After they’d processed the casualties – and then the dead – she wrote a cathartic blog to process her intense experience, and then got in touch with us.

Read on for her real view from the Pheriche front line.

Where were you when the earthquake hit?

Prior to the earthquake, we’d actually been trekking; I had told mum we were heading for Everest Base Camp. Had we taken the usual trekking route, we would have been arrived in camp the morning of the earthquake, and quite likely been hit. As it happened, we chose a different route and got caught in a snowstorm the previous afternoon. After camping at 5,400m and waking to two foot of snow, we left at 6am and made the 10km hike back to Pheriche. We arrived 30 minutes before the earthquake struck.

It sounds like you had a very crazy 72 hours at Pheriche medical clinic. Were you taking all the casualties from EBC or were other clinics involved?

We prepared the clinic for any casualties that might arrive, and on Saturday evening, we had two turn up on horseback from EBC, one of whom stayed overnight. The next morning, we woke early hearing the first helicopter of the day flying overhead at 05:45. The surprise came when the helicopter landed with two critically injured climbers needing to be stretchered across to the clinic (the only one in the immediate vicinity).

Without radio contact with EBC, we hadn't known what to expect and perhaps thought they would be evacuated direct to Lukla airport (there is a hospital in Lukla) and then Kathmandu. The pilot said that EBC was destroyed and as the weather wasn't great, he would be bringing over 50 critically injured climbers to Pheriche. We didn't have much time to think, as once the first two critically injured arrived, more and more followed suit. We had hundreds of trekkers and locals helping: volunteering their services including any who were medically / first-aid trained. In total, we received, re-triaged and re-evacuated over 70 injured climbers.

What were the typical injuries?

Typical of major trauma. The avalanche swept giant rocks and boulders into EBC, and some people were thrown over a 100 metres. We saw climbers who had sustained broken pelvis', broken limbs, dislocated hips, depressed skull fractures, head injuries, broken ribs (some with pneumothorax) and indeterminable internal injuries.

Where did the injured go after Pheriche?

Initially to Lukla, where there’s a small hospital. We then heard that some were transferred to Kathmandu. We have seen reports and photos to correlate this but, otherwise, have had very little contact with Kathmandu.

Do you know how the hospitals in KTM are coping?

Initially, we heard that patients had left the hospitals in the aftermath of the earthquake. We since heard that the hospitals appear to be coping well with the influx of casualties, however many surgeons are needed.

What will the difference in treatment be, between, say, an injured European climber and a local porter?

That’s difficult to comment on as we don’t know where the injured Everest climbers (Western or Nepali) were sent. Usually when we evacuate a trekker (with e.g. altitude illness) we advise them to attend the CIWEC clinic or Nepal International Clinic in Kathmandu. The way hospital medicine usually works in Nepal is that if a sick local goes into a government hospital, a family member or friend needs to go across the road and buy the medicines from the nearby pharmacy. There are private hospitals , where medicines are provided in house, but the costs are higher. So, if an injured Sherpa or porter has been sent to Kathmandu, it is quite possible their families are still in the local villages, some of which have been damaged.

We've been hearing reports that many remote villages, such as those in Langtang, have suffered severe damage – do you know any more?

I’ve heard through a couple of sources that, sadly, Langtang has been completely buried by an avalanche spanning 2-3km across that came down from Langtang Lirung and Langtang II. The avalanche also buried several smaller neighbouring settlements. There were only a handful of survivors.

How's the local area now? Could you describe the situation? What are the priorities?

Pheriche is quiet now, as locals have left many of the lodges that have been damaged, climbers are largely departing EBC and trekkers are gradually thinning out. We anticipate that once EBC has fully closed, we will have a meeting to discuss what happens next to the clinic. There are other villages in the region that have been damaged, notably Namche, Khumjung, Thame and also Machermo and Gokyo.

What are your plans now?

We’ll discuss as a group our movements from here. Though there is much need for aid in Kathmandu, but the Nepali government has apparently discouraged individuals from turning up to help if they are not part of an aid group. We have been advised by the Foreign Office to stay in a place of safety. At the moment we have food, water and solar power; we don’t need to drain vital resources back in Kathmandu. Our job here is largely done and I personally am keen to get home to family as this has been a stressful and emotional time for all.

If mountaineers wanted to help, what would you recommend?

Whilst help may be needed in the smaller villages of the Khumbu immediately, I imagine all involved up at Everest Base Camp will best help by getting themselves home. I cannot even begin to imagine the psychological impact of experiencing both an earthquake and avalanche. Some of the climbers coming back through the village have appeared a little shell shocked; others, perhaps, putting on a braver front.

For those climbers back at home and those returning to the UK, my thoughts would be to initially contribute to the Disasters Emergency Committee. However, in the long run, raising funds for Doug Scott’s charity Community Action Nepal would also be most beneficial. CAN has projects in the remote villages that have been badly affected by the earthquake and, in addition, works together with the International Porter Protection Group whose aid post at Gokyo was damaged in the earthquake.

Katie Williams qualified as a doctor in 2007. She completed the Diploma in Mountain Medicine and this is her second consecutive season working in the Everest region as a rescue doctor. Read her blog. 

Reuben Tabner, 34, is a freelance action and sports photographer with many years experience in the outdoor industry. He's also been a volunteer for two seasons now and looking to broaden his horizons as a photographer once back in the UK. See more photos on Katie's blog. 

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