Nepali Times
Emergency Room


Between the body-bag statistics of the Defence Ministry's daily briefings and reports of ambushes by the Maoists of security forces are thousands of stories of bereaved families, internally displaced refugees, the wounded and maimed.

The statistics are numbing: nearly 3,000 people killed in the past six years of the Maoist war, about 1,050 of them in the past two-and-half months of the emergency. But the wounded seem to fall between the cracks-left to recover on their own in the hospitals throughout Nepal. In fact no one is keeping an updated count of the wounded. Ordinary Nepalis caught in the crossfire, recovering not just from the physical trauma but also the mental agony of brutal torture, are beginning to fill up the hospitals.

At the Tribhuvan University Teaching Hospital (TUTH) in Kathmandu, the injured are in the orthopaedic ward and new patients arrive everyday in the emergency room.

"This has added tremendous pressure to our already over-stretched orthopaedics ward and the Emergency Room," Dr Mahendra Kumar Nepal, Executive Director of TUTH told us. "The patients require multiple surgery and long rehabilitation. They are all likely to stay for longer periods, and this means we cannot admit other patients."

There have been reports of villagers who have also been caught in the crossfire in attacks by security forces on Maoists, but we could not find any of these at TUTH. A handful of civilian casualties from military action have been airlifted and are being treated at army hospitals, defence sources say. At any time during the emergency there have been an average of about 15 patients being treated at TUTH, and those present there this week were mainly casualties of attacks by Maoists after the emergency was declared. They are teachers, social workers or political activists and they come from all parliamentary parties: Nepali Congress, UML, ML.

- A 63-year-old social worker and political activist from Bardiya has both legs in heavy bandage. Both his shinbones are shattered-beaten to fragments by the Maoists who attacked him. He also has a gaping khukuri wound on his left leg.
- A 43-year-old farmer and political activist from Tanahu has multiple fractures on his femur and fractures in his right shinbone. He was beaten with rods by attackers, and hacked with a khukuri so that he has
lost all his calf muscles in his right leg.
- Then there is the 32-year-old schoolteacher admitted to TUTH three months ago with multiple fractures in both hands and feet. Maoist attackers beat him till all the bones were shattered. Then they bored a half-inch wide hole into his thigh.

Aside from the wounds, it is the brutality with which the attacks were carried out that is shocking. The patients' eyes show the pain, and such is the fear instilled in them that few wanted to be named. Some didn't even want us to print the name of their village for fear that their relatives back home would be harmed.

Human rights activists say what is visible in the hospital wards is just the tip of the iceberg in the casualties of the Maoist war. These are the lucky few who managed to make it to hospital, there are many others trying best to recover in their home villages, or dying quietly. Sushil Pyakurel of the National Human Rights Commission, says his organisation is trying to tally the numbers of wounded, and admits that most of the information is about victims of Maoist attacks. "We are trying to find out the situation among those wounded in security force action," he says. The NHRC had written to the government for information but has not been able to put together the number of wounded.

Because of the nature of the injuries, many of the patients we interviewed will probably never walk, and if they do, will need crutches for life. Shanta Bahadur Bhandari, is a teacher at Chapakot in Syangja, and is one of the few who doesn't mind being named. He was the luckiest among three teachers abducted by the Maoists in early November. "I was taken away at around 9PM from my house and beaten with the non-cutting side of an axe," recalls Bhandari from his hospital bed. Then they drilled a hole into his thigh. Doctors have stuck steel pins into what remains of his feet below the knees to align the bones and give them a chance to heal. The other teachers who were abducted, Netra Bhandari and Gupt Bahadur BK, were beaten mercilessly and died of their injuries. Today, Shanta Bahadur, his brother and family live in Kathmandu-part of the growing population of people who have fled the conflict.

According to Informal Sector Service Centre (INSEC) statistics, eight teachers and 29 political workers have been killed by Maoists since November, and it appears to be part of a strategy to intimidate villagers and stop them from giving information about their whereabouts to the security forces. The attacks have been deliberately brutal, to drive the point home. According to INSEC's tally, 1045 people have been killed between 23 November and 11 February, 816 by the Maoists.

Government numbers from 26 November to 4 February put the Maoist death toll at 463, and wounded at 115. The police and army have lost 76 (police 40), and, says the Defence Ministry, 93 soldiers have been wounded.

Amber Bahadur Chauwan, 63, of Gola VDC in Bardiya district is a regional member of the Marxist-Leninist party. He was an active social worker who participated in development activities underway in the buffer zone around the Royal Bardiya National Park. Chauwan told us Maoists tried to lure him to their party and after he refused, threatened him. He left, and returned only after the emergency was imposed. "We were just completing a bridge," he recalls. "I had asked the attackers to spare an old man. But they beat me up instead." A group of about 50 Maoists dragged him out of his house on 6 Feburary, attacked him with steel rods and khukuris. Doctors are waiting for the flesh wounds to heal before they deal with the bone fractures.

A social worker at TUTH told us he has never seen worse cases. "Earlier patients did not have as many wounds, maybe they were trying to kill or just hurt them," he told us. "After the emergency, I have seen patients with bones beaten to pieces."

So far, the government is paying the hospital bills of all Maoist victims. Another inmate is Chatra Raj Bhandari, a farmer and a Nepali Congress worker from Tanahun. He was attacked on 23 November, the day the Maoists broke the ceasefire with the attacks in Dang and Syangja. "I had no prior warning," Bhandari recalls. "They just came, took me out of the house and started beating me up in the courtyard." Like the others, doctors say Bhandari will be in hospital for at least six more weeks. Then there will be another half-a-year of physiotherapy to allow him to walk properly again.

Tuesday, 12 February was like any other day at TUTH. There were 18 patients from the conflict, and the hospital was waiting for another three wounded to arrive later that evening. The orthopaedics ward is now looking more and more like a field hospital in a war, more so with a newly-build helipad to handle major disasters-and also so that the most seriously wounded can be flown directly in without going to the airport and being ferried in an ambulance.

Hospital director, Dr Nepal, shakes his head. "We are facing an emergency here, we need medicines and equipment. And we are running out of space in the wards."

(11 JAN 2013 - 17 JAN 2013)