‘I felt as if I was on a boat at sea’

first_imgPhysician Renee Salas was in a small, two-bed clinic just below the Mount Everest Base Camp on Saturday when a massive, 7.8 magnitude earthquake struck Nepal, crumbling buildings nearby and sending an avalanche through the camp.Salas, an instructor in emergency medicine at Harvard Medical School, is in the final weeks of a two-year Wilderness Medicine Fellowship at Harvard-affiliated Massachusetts General Hospital. Since last month, she has worked with the Himalayan Rescue Association in Pheriche, a small village in the Khumbu Valley, a six- to eight-hour hike from the base camp, and nearly 14,000 feet above sea level. The Gazette reached Salas by email today, and she shared her account of the unfolding disaster and the efforts to treat the wounded who streamed in during the days that followed. She described the challenges the medical and rescue teams faced, and the needs Nepal has now.GAZETTE: Where were you and what were you doing when the quake struck?SALAS: It was just after noon, and my colleagues and I were in the living space of the Himalayan Rescue Association (HRA) clinic in Pheriche … As the realization set in of the events that were occurring, we ran outside to see nearly all of the buildings of the small village of Pheriche crumbling, at least partly. About a third were completely destroyed.In the midst of screams and dust clouds, we quickly circled the village after the earthquake vibrations had settled to see if there were any injured. Amazingly, the only injury was one small head laceration. If this disaster had occurred at night, I fear the injury rate would have been much higher. The village came together, as everyone comforted one another and assisted those who had completely lost their houses. Some even began rebuilding their stone walls after the initial waves of aftershocks.GAZETTE: What did you experience or think at the time?SALAS: Due to the severity of the damage and the strength of the earthquake we had experienced, we were very concerned that the gravity of the event as a whole was severe. This was my first experience with an earthquake, and the severity of the earth’s movement was astounding. I felt as if I was on a boat at sea. [Our] immediate thoughts and concerns were for the status of the families of the Nepali workers here and to our HRA colleagues in Everest Base Camp and Manang.Unfortunately, we had few means to gain credible information. We had been without Internet contact for the few preceding days and this remained inoperable. We attempted to reach Everest Base Camp with the radio system we had in place but were also unsuccessful. Through conversations my Nepali friends had with family and the HRA headquarters in Kathmandu, we learned that it had affected the city but had no understanding of the severity. We then began to assess the damage to the clinic, which had thankfully affected only a portion of the living quarters and left the patient treatment area unaffected.The numerous aftershocks we experienced caused the villagers to remain outside for a good portion of the day. Unfortunately, it was snowing with moderate winds, which made this situation more difficult.GAZETTE: What have you been doing since?SALAS: This is exactly the type of situation that my emergency medicine and wilderness medicine training prepared me [for]. The first patients from Everest Base Camp were two climbing Sherpas who arrived about nine hours after the earthquake, as they had immediately descended via foot and by horse.We saw and treated them — one moderately injured who was admitted overnight and one minor who was treated and released. We began to understand the gravity of what had occurred at EBC [Everett Base Camp] as they recounted their experiences. We initially remained awake, believing that more would be arriving late that evening, but soon retreated to the sunroom (a building across from the clinic) to sleep, given the continued aftershocks.We were awakened the next morning a little before 6 a.m. to the sounds of helicopter traffic heading up the valley. We received word that they would be evacuating the critically ill and wounded from EBC to our facility and quickly began preparing for the possibility of significant patient volume.Our clinic has two inpatient beds, one consult room bed, and another extra bed in our research room. Our physician staff includes myself, Andrew Nyberg from the U.S., and Katie Williams from the U.K. Meg Walmsley from Australia, one of the Everest E.R. physicians, descended via helicopter that morning to assist with the large patient influx. Gobi Bashyal, our clinic manager, leapt into action and began making the necessary phone calls to the surrounding areas and country officials to obtain the necessary manpower and helicopters, while Thaneshwar Bhandari, our assistant manager, began assisting us with preparations.We quickly mobilized the sunroom into a patient facility, and the owner of the Panorama Lodge next door, whose lodge was one of only two that had been unaffected by the quake, graciously donated his dining room. We received approximately 10 critically ill patients first and placed them in the clinic and sunroom — many on makeshift beds placed on the floor. There was a mix of Nepalis and international patients from around the world. Approximately 20 to 30 more suffered major injuries and were unable to ambulate. In total, we saw and evacuated an estimated 73 patients, including many “walking wounded.”We utilized disaster training and placed large white stickers on patients with their names, injuries, vital signs, and medication administration times. Our resources here included intravenous fluids, medications, and an ultrasound. However, we are a remote post without access to blood products or the ability to perform sub-specialty procedures that many patients required. Luckily the weather cleared, and we were able to arrange further evacuation down to Lukla to the hospital there, which had increased resources. Numerous helicopters, including an MI-17 which could hold 16 to 18 patients, made numerous trips, as all patients were evacuated over a five-hour time period.The local and international community here in the region came together in a way unlike anything I have experienced. Locals from the village and neighboring town of Dingboche assisted with patient transportation, arranging supplies, and giving patients and volunteers tea and food. International trekkers with non-medical backgrounds who were in the region assisted selflessly with patient transport and donated first aid supplies and materials. We had numerous international physicians, nurses, and EMTs who spontaneously arrived and quickly set to work seeing patients, checking vital signs, and administrating medications. When the last patient was evacuated, the nearly 100 to 200 people who had assisted all cheered and hugged one another for the amazing team effort … and then people dispersed back to their villages, while many international trekkers continued their descent to lower villages.We have remained open and continue to see locals and trekkers until our job here is done. This will likely be until Everest Base Camp is cleared and then we will convene with our Everest E.R. friends and colleagues and determine the next best course of action. We have shared stories with those descending from Everest Base Camp about their experiences on that fateful day and tried to assist individuals as they try to learn about friends and loved ones. It has still been a very surreal situation that hasn’t truly hit home yet. There have been continued aftershocks that have served as jarring reminders that the danger is still ongoing. Helicopter traffic has been constant between EBC and Pheriche, as climbers from Camps I/II and EBC are being evacuated as well as the bodies of the deceased.GAZETTE: What do you think is important for the Harvard community to know now about the situation there?SALAS: Until we had access to Internet yesterday evening, we have been in a vacuum with limited knowledge of the gravity of the situation within the remainder of this amazing country that has become our home for the past two months.This is a country full of loving people, and the innately welcoming culture has created a collaborative and selfless post-disaster environment here in the Khumbu Valley. However, this a country with very limited resources. We had spent the first week of March in Kathmandu for orientation before our acclimatization trek here, so I know parts of the city well.The situation in Kathmandu sounds grave, as medical facilities have been quickly overwhelmed, and they have struggled to take care of patients in buildings in the continued wake of aftershocks. The situation in the more remote outlying villages is also unknown. As food and water resources dwindle and the lack of sanitation grows, the risk of epidemics is high, which will turn an already dire situation into a nightmare.The country will require basic needs such as food/water and medical and infrastructure personnel and supplies. Any assistance, depending on your resources and abilities, would be greatly appreciated, including prayers. Similar to the Haiti earthquake aftermath, which I participated in, this will be a marathon and not a sprint, as further pitfalls lie ahead as we attempt to rebuild this country.last_img read more

Governor Wolf Announces $5 Million in Traffic Safety Improvements

first_imgGovernor Wolf Announces $5 Million in Traffic Safety Improvements SHARE Email Facebook Twitter October 04, 2019center_img Press Release Harrisburg, PA – Governor Tom Wolf announced today that 24 municipalities will receive over $5 million to support traffic signal upgrades, increasing safety and mobility across Pennsylvania’s communities through the Pennsylvania Department of Transportation’s (PennDOT’s) “Green Light-Go” program.“The safety improvements supported by the Green Light-Go program not only help municipalities relieve congestion and traffic flow, they help Pennsylvanians move safely and efficiently,” said Governor Wolf. “I’m proud to help our communities improve mobility for Pennsylvanians.”Green Light-Go grants are provided as reimbursement to municipalities for updates to improve the efficiency and operation of existing traffic signals. Grant funding through the Green Light-Go program may be utilized for a range of operational improvements including, but not limited t: light-emitting diode (LED) technology installation, traffic signal retiming, developing special event plans and monitoring traffic signals, as well as upgrading traffic signals to the latest technologies.Following is a list of approved projects:Allegheny CountyBethel Park – $44,000 for installation of pedestrian countdown signals, push buttons, and pavement markings at the intersection of Fort Couch Road and Oxford DriveCoraopolis Borough – $160,000 to modernize the traffic signal at State Avenue and Montour StreetSpringdale Borough – $430,000 to replace two traffic signals at the Pittsburgh Street/James Street and Pittsburgh Street/School Street intersectionsBerks CountyWyomissing Borough – $173,995 for LED replacement, pedestrian signal upgrades, and controller upgrades at 29 intersectionsCentre CountyFerguson Township – $80,000 for modernizing loop detectors with dilemma zone radar detection at two intersections along Blue Course Drive and Science Park RoadChester CountyEast Whiteland Township – $195,760 for use of automated traffic signal performance measures with upgraded detection at five intersections along PA 29 Morehall RoadSchuylkill Township – $64,455 for upgrading vehicle detection at two intersections along Valley Forge RoadColumbia CountyTown of Bloomsburg – $172,624 for retiming traffic signals at nine intersections, upgrading controllers, and providing connectivity to the regional Traffic Management CenterCumberland CountyEast Pennsboro Township – $160,000 for LED installation and controller replacement at 18 intersectionsSilver Spring Township – $219,436 for replacement of the traffic signal at Carlisle Pike and Commerce DriveDauphin CountySwatara Township – $210,406 for modernization of the traffic signal at SR 441 & Chambers Hill Road including additional left turn phasesLancaster CountyLancaster City – $691,760 for development of updated signal timing for the City’s 90 downtown traffic signals, including vehicle detection installation at eight key intersections for traffic signal performance measuresLititz Borough – $132,400 for upgrading outdated controllers at nine traffic signals and improving phasing and timing at the PA 501/PA 772 intersectionsWest Lampeter Township – $269,889 for upgrading vehicle detection at six intersections, signal retiming, signal head upgrades, and left turn phase evaluationLebanon County:Union Township – $187,572 for traffic signal retiming, vehicle detection upgrades, and controller replacement to provide monitoring and communications technology at three intersections along Fisher AvenueMercer CountyHempfield Township – $44,292 for upgrading pedestrian signals and developing optimized traffic signal timingsMontgomery CountyCheltenham Township – $537,138 for modernization of the traffic signals at the Washington Lane/Shoppers Lane and Greenwood Avenue/Longfellow Road/Rices Mill Road intersectionsLower Providence Township – $342,025 for use of automated traffic signal performance measures with fiber optic communication, controller upgrades, and detection upgrades at three intersections along Egypt RoadMontgomery Township – $400,206 for modernization of four traffic signals at Bethlehem Pike/Montgomery Mall entrances, Bethlehem Pike/North Wales Road, and Horsham Road/Pheasant Run.Upper Moreland Township – $160,000 for upgrading traffic signals at Davisville Road and Easton Road to improve safety at the at-grade SEPTA rail crossingSusquehanna CountyChoconut Township – $7,193.20 to upgrade vehicle detection at the intersection of SR 267 and Stanley LakeUnion CountyKelly Township – $263,094 for traffic signal retiming, controller upgrades, and communication at seven intersections along US Route 15York CountyFairview Township – $30,990 to upgrade three traffic signal controllersManchester Township – $269,889 for upgrading vehicle detection at three intersections, controller replacements, and signal head upgradesA list of recipients, project descriptions, and the amount of state investment is also available at www.penndot.gov on the “Traffic Signals, Management” page under “Travel In PA”.Follow PennDOT on Twitter at www.twitter.com/PennDOTNews or on Facebook at www.facebook.com/PennsylvaniaDepartmentofTransportation.last_img read more

Kingston’s mayor visits Miramar

first_imgBi-lateral relations, trade  and opportunities in culture between the city of Kingston, Jamaica and the City of Miramar  will be some of the topics up for discussion when the Mayor of Kingston, Delroy Williams and the Mayor of Miramar Wayne Messam will address residents in a Town Hall meeting scheduled to be held in South Florida next week.The meeting is also seen as an opportunity lay the foundation for the establishment of a sister cities agreement.A sister city, county, or state relationship is a broad-based, long-term partnership between two communities in two countries.The relationship is officially recognized after the highest elected or appointed official from both communities sign off on an agreement.The upcoming meeting is of particular significance as  Kingston celebrates a significant anniversary“It is fitting to have Mayor Williams visit Miramar as Jamaica and the Diaspora celebrate the 145th  year of Kingston as Jamaica’s capital,” said Messam.Kingston, Jamaica’s smallest parish, is located on  the southeastern end of the island.Founded in 1692, it sits on  the 7th largest natural harbor in the world that is protected by the Palisadoes, a sand spit that connects the city to the infamous town of Port Royal and the Norman Manley International Airport.Kingston is the heartbeat of Jamaica, rich in history and seeped in culture, the multicultural city came into existence as a refuse for survivors of the 1692 earthquake that destroyed two thirds of Port Royal.Spanish Town was then Jamaica’s capital and although the Governor of the island sought to have the capital moved to Kingston, a Bill to that effect was not approved by Britain.However years later, in 1865 Governor Sir John Peter Grant was assigned the task of re-organizing the island and this included relocating the capital to Kingston.The City of Miramar in Florida, came into being fairly recently.It was established in 1955 to serve as a “bedroom community”  for Miami and Fort Lauderdale .Based on the diversity of both cities, the Town Hall meeting is being touted as an opportunity for Williams and Messam to address residents of Miramar, members of the Diaspora and  the Caribbean Trade community.The event will be open to all residents.last_img read more

Lakers’ Kobe Bryant, Steve Nash to make long awaited return in preseason opener vs. Denver

first_img“He’s dealt really well with the rust and he’s moving very well,” Lakers trainer Gary Vitti said of Bryant. “But granted, he hasn’t played in a game. He’s scrimmaged, but that’s not the same. Part of the rehab process is actually playing. Your body is going to adapt to the loads that your body puts on during the game.”Both Bryant and Nash will start against Denver, but Scott declined to reveal to what degree they will play in limited minutes. Scott also added Bryant will likely play more than planned at small forward because of Young’s absence stemming from a torn ligament in his right thumb. Scott revealed Young could return in four to six weeks, though the Lakers will have a clearer answer after he has surgery today. Meanwhile, Lakers forwards Ryan Kelly (strained left hamstring) and Xavier Henry (back spasms) remain sidelined.“My concerns are no different than everybody else’s in terms of being able to come back from this,” Bryant said earlier this week. “If I can prove to myself I can do this thing, I can prove it to everybody else as well.”Yet, as much intrigue as Bryants’ comeback will become in an otherwise meaningless game, Scott said he remains more concerned about how the Lakers play on defense. Last season, the Lakers ranked 29th out of 30 NBA teams in points allowed (109.2), 24th in defensive field goal percentage (46.8) and 30th in fast-break points allowed (16.7).The general public, however, will likely narrow in on Bryant and Nash. “I’m curious to see Kobe, Steve and everybody really,” Scott said. “We’ve been going against each other for a week. So it’ll be fine to go against somebody else. I’m anxious to see how it all unfolds.” In portions of the Lakers’ practices open to the media in the last week, both Bryant and Nash appeared mobile and comfortable moving around the court. Both Bryant and Nash remained consistent with their mid-range jump shooting. Bryant also frequently challenged teammates, mostly to Nick Young and Jordan Clarkson, with trash talk. Both Bryant and Nash have sat out of the evening portion of the Lakers’ four two-a-day sessions as well as most of the tail end of running drills. What has Scott seen?“With Steve, his basketball timing. Everything seems to be there,” Scott said. “He’s shooting the ball pretty well. A lot of times when you have that much time off, that’s one of the things that takes the longest with the timing and to get that rust off. Both of the guys shot the ball better in the scrimmages than I thought they would. They moved gracefully. It didn’t look like they had any hiccups. I was extremely happy with both.”Still nothing replaces game experience. This will mark the first game Bryant has played since Dec. 17, 2013 in Memphis when he injured his left knee a mere six contests after missing the previous 19 while healing his left Achilles tendon. Nash has not played since April 8, 2014 against Houston, though he reported feeling fully health a month later. The duo last played in a game together in Sacramento on March 30, 2013. The legacy Kobe Bryant has built thus far traces back to when he won NBA championships in June. Steve Nash never collected that hardware. But his two NBA MVP awards and third-place standing on the league’s all-time assists list reflects the 40-year-old’s longevity, pinpoint passes and pick-and-roll perfection. Yet, the Lakers’ preseason opener against the Denver Nuggets on Monday in San Diego’s Valley View Casino Arena will provide an early glimpse into how both Bryant and Nash fare through the tail end of their career. Based on how Bryant and Nash played through one week of training camp, Lakers coach Byron Scott expects something far more cheerful than the combined 21 games Bryant and Nash played last season because of respective knee and back injuries. “To be where they are today in training camp, I’m ecstatic,” Scott said following Sunday’s practice at the Lakers’ facility in El Segundo. “They exceeded my expectations in training camp and came into much better condition than I thought they would. Both guys are a ways away, obviously. But right now for them to be where they are at this time, I’m extremely happy.”Both Bryant and Nash participated in Sunday’s practice, but in somewhat limited fashion. Bryant took part in the Lakers’ preliminary drills before sitting out of the team’s five-on-five full-court scrimmage. Scott reported Nash experienced “no issues whatsoever” after missing most of Saturday’s practice because of a rolled left ankle. Nash played in parts of the Lakers’ scrimmage on Sunday, but left the court before the media watched the tail end of practice. Neither Bryant nor Nash spoke to reporters on Sunday.center_img Newsroom GuidelinesNews TipsContact UsReport an Errorlast_img read more