Operation Heartbeat The earthquake that struck last year left Kashmir looking like Hiroshima after the bomb. Then a team of U.S. doctors came to help. By Derek Burnett From Reader's Digest March 2006 An 11-year-old girl whimpers softly as her father carries her into the blue insulated medical tent where Marc O'Regan has been working nonstop to treat the injured. More than six weeks have passed since the devastating earthquake in Pakistan, and the lesion the child sustained behind her left ear -- most likely caused by a falling beam -- has yet to be treated. The girl lays her head on her father's lap as O'Regan carefully cuts away some of her hair. He then cleanses the festering wound and dresses it. As he works, he keeps up a steady patter of encouragement: "I know it hurts," he says. "We're going to make it better." He administers an injection of powerful antibiotics, then hands over a packet of pills. Through a pair of soldiers who translate using rudimentary English, he tells his patient to come back to see him tomorrow. He wonders if she will. A physician's assistant from California, O'Regan is taking a month from his practice to volunteer with a medical-relief team called Operation Heartbeat in the demolished earthquake zone that spans Pakistani Kashmir, a region that has been at the center of a dispute between India and Pakistan for decades. Al Qaeda sympathizers reside in the area, and its mountains are a possible hiding place for Osama bin Laden. The quake struck on October 8, 2005, and to a world already fatigued by a year of disasters, its magnitude and severity were overwhelming: more than 80,000 people killed in a 12,000-square-mile region containing some of the steepest, most difficult terrain in the world. Nearly four million of the quake survivors, many of them seriously injured, had been left homeless, with winter coming soon. From the air, the place looked like Hiroshima after the bomb: Buildings were flattened like insects, debris was everywhere, including farm equipment and carcasses of animals that were the lifeblood of the region. Before the quake, Kashmir was spectacularly beautiful, its mountain peaks stretching dramatically toward the sky. An emerald river rushed along glacier-smoothed stones at the valley floor; steep red-dirt bluffs a hundred feet high created the first band of narrow roadway.
Then it was up, up, up, past terraced hillsides, where shaggy goats munched roadside flowers. Higher still, women carried water in metal jugs on their heads. There, amid homes and little villages, pine trees and hazy sunlight made the air cooler. In the distance stood the majestic Himalayas. In the aftermath of the earthquake, which measured 7.6 on the Richter scale, Pakistan and the United Nations issued a plea for help, and volunteers began to arrive. On the day O'Regan saw the girl with the head wound, he was performing a two-day drop-in mission for Operation Heartbeat, flying by helicopter from base camp into a remote valley called Gehl to care for the injured in three villages still inaccessible by road. A lanky, athletic bachelor in his 50s, O'Regan is a former Navy SEAL who once served with Jesse Ventura. He joined the military as a young man "wanting to jump out of planes and blow things up without hurting anybody," and left, ultimately to pursue a career in health care. In the following years, he began to shape his life by serving others. "I know I'm not going to change the world," he says. "But this work feeds my soul." Now here he is, sleeping and working in an eight-by-ten insulated royal blue tent donated by the Chinese government. Men wrapped in blanket- like shawls, women in colorful head scarves, and children hugging themselves against the cold squat silently outside his tent, waiting to be treated for everything from minor cuts and bruises to life-threatening infections. After all this time, the injuries are still severe. Today, a 60-year-old man is carried in with a crushed foot wrapped in filthy gauze, swollen to almost four times its normal size. O'Regan grimaces at the odor: gangrene. The patient has no illusions about his condition. "Please don't take my leg," he begs. O'Regan's near-constant smile fades as he turns to the interpreter. "Tell him first we save his life; then we worry about his leg," he says. He unwraps the dressing, and one glance tells him there is nothing he can do. So O'Regan accompanies the man by helicopter to the city of Muzaffarabad, carries him half a mile through rubble-strewn streets, and leaves him with better-equipped doctors at a Red Cross field hospital. It is the last time he will see him. Most cases are not so dramatic -- after such a horrific cataclysm, some patients just need attention.
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One woman walks into the tent, slides into a chair and begins sobbing. Her home has been destroyed, and she is terrified of being alone in the world. O'Regan soothes and calms her. "It will be all right," he says. Operation heartbeat's earthquake response is seat-of-the-pants, conceived and spearheaded by a soft-spoken Pakistani American physician named Farzad Najam, who is based at the George Washington University Medical Center in Washington, D.C. Najam's heart sank when he first heard news of the quake. "I knew we had to do something," he says. So he rounded up as many volunteers as he could and jumped on a plane to Kashmir, where a group of 20 doctors and nurses quickly set up a primitive triage center on the soccer field of a college in the small town of Garhi Dupatta. It was like walking into hell. The other end of the field was being used as a helipad, and U.S. Army Chinooks were dropping in every 15 minutes. The injuries initially were horrifying -- sheared-off limbs, crushed skulls, compound fractures, internal bleeding. The doctors worked frantically, with limited medications and only the most basic tools. At first, they didn't even have a tent. They laid their patients out on a plastic tarp and treated them in the open air. Holding everything together was a logistician named Todd Shea. Shea was not a disaster-relief expert and had never been in charge of anything before. But he'd done some volunteer work, most recently in the aftermath of Hurricane Katrina -- where he met O'Regan, who had also stepped up to help. After the quake, O'Regan contacted Shea to see if he could put him to use. "There was no question that Marc would be perfect for this work," says Shea. Along with O'Regan, a steady stream of physicians from Canada, England, Pakistan and the United States came -- mostly for one- or two-week stints -- to Operation Heartbeat's camp in Garhi Dupatta. Many of the Americans were of Pakistani descent, had grown up in the United States but never visited the country of their heritage. Shea was deeply respectful of the medical teams. "These doctors are heroes," he said. "I'm only here so they can do their jobs." Still, he relished his role as organizer, supporter and scrounger. One of his first steps was to befriend members of the Pakistani army, which provided transportation and supplies to the remote valleys.
One nearly leveled village was Chikar, located about 18 miles from Garhi Dupatta and still unreachable because of damaged roadways. Abdul Majeed, a local, was standing in the bazaar of this hilltop village when he heard a blast that sounded like tons of dynamite. A mountain about a mile away cracked open, plunging two villages into a tributary of the Jehlum River. The mountain buried hundreds of people in a 400-foot-high natural dam that created two new lakes, one nearly a half-mile long. The sky turned black as dust rose, blocking the sun. The terrified people of Chikar were certain a day of judgment had come. In the darkness, graves burst open; homes built of stacked stone collapsed, their thick concrete-slab roofs pancaking and crushing inhabitants. Majeed's home was made of mud, not stone. Like many poor people, he had added layers to his house each spring, and over the years the walls and roof had grown to a thickness of nearly two feet. When the rumbling stopped, he ran from the bazaar to check on his family, but neither his wife nor two little grandchildren had survived when the thick earthen ceiling came crashing down. In Chikar, Operation Heartbeat set up a second field hospital consisting of a few small tents. During its first seven weeks, a handful of exhausted volunteer doctors saw 30,000 patients. They worked without x-rays, labs and sophisticated surgical equipment. Because of language and cultural barriers, they often had to guess at what might be ailing a patient, handing over drugs in the hope that the instructions for taking them would be interpreted correctly -- and then followed. In nearby Gehl, Marc O'Regan is one day summoned to the hut of a woman who has just given birth. The baby is healthy, but the mother is in pain and bleeding heavily. O'Regan takes a deep breath and nods reassuringly toward the woman's husband, aware that females in this deeply religious region are not typically treated by male physicians. He carefully places his hands beneath the blanket and, palpating the woman's abdominal area, confirms that her uterus has failed to contract, prolonging post-partum bleeding. O'Regan massages her abdomen to stimulate uterine contractions, and soon the bleeding stops.
He has probably just saved her life. Later, reflecting on the incident, he will recall something a grateful Pakistani said to him a few days before: "Humanity is the religion now." It is not lost on O'Regan that the work of international volunteers is helping change attitudes. A young Kashmiri man working at the camp in Garhi Dupatta suddenly stopped O'Regan one day, placed his hands on the volunteer's shoulders and said, "I never met Americans before. I didn't know who you were." He looked O'Regan in the eye, and then made this simple pronouncement: "I like Americans." There is virtually no one in the region who didn't lose a loved one. Cemeteries abound with fresh graves, and piles of debris are everywhere. Yet life is returning with surprising speed, in part because of the Kashmiris' deeply held faith in God's will. Volunteer groups and the Pakistani government are providing people with tents and other provisions to help the hardy natives weather the harsh winter. And amid the rubble, cricket matches are springing up. Kids play and giggle, standing on the broken roofs of collapsed buildings where their relatives died. The sound of banging hammers now echoes in villages throughout Kashmir. Encouraged by a government outreach program, citizens, including Abdul Majeed, are rebuilding using wood, brick and corrugated iron sheets, which will be much more quakeproof than the fragile stone-and-concrete buildings that crushed so many people. Operation heartbeat will not be leaving anytime soon. There are plans to convert the Garhi Dupatta camp into a state-of-the-art medical center staffed by Pakistani doctors. "We're going to be here for as long as it takes to get this place back on its feet," says Todd Shea. Marc O'Regan returned to the United States late last December. Before he left Pakistan, the young girl with the infected head injury paid him a follow-up visit. He was happy to see that she was responding to the antibiotics. During a final stop in the Gehl Valley, O'Regan opened his tent to find a woman in the doorway holding a ten-day-old baby. It was the same woman the physician's assistant had helped with the postpartum bleeding. O'Regan's face lit up. "Oh, good!" he exclaimed. "I was hoping I'd see you." Pausing amid the chaos around him, he took the baby girl in his arms and, grinning like a proud uncle, gazed down at this vulnerable but promising new life

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