On April 25, 2015, a 7.8-magnitude earthquake struck Nepal, killing almost 9,000 people and causing an avalanche on Mount Everest that killed at least 19 people. Renee N. Salas, MD, MS, a fellow in wilderness medicine in the Massachusetts General Hospital department of emergency medicine in Boston, was stationed at a medical clinic for climbers near the Everest Base Camp when the earthquake hit. As one of a handful of physicians in the area, she was on the frontlines of treating the injured in the aftermath of the quake.

Dr. Salas

Dr. Salas recently sat down with ACEP Now Medical Editor-in-Chief Kevin Klauer, DO, EJD, FACEP, to talk about the challenges she faced caring for those wounded in the quake using the limited resources available at the small clinic where she was working.

Dr. Kevin Klauer: Tell me about yourself.

Dr. Renee Salas: I went to medical school at the Cleveland Clinic Lerner College of Medicine, trained at the University of Cincinnati, and then came to Massachusetts General Hospital [MGH], where I’m completing a two-year wilderness medicine fellowship.

KK: You were in Nepal for three months?

RS: Yes, I was. I got in country on March 1.

KK: Was this part of your wilderness training experience, or was this a really long vacation?

RS: Luckily, the best part is when your job feels like it could be a vacation. All of the fellows at MGH spend three months working for the Himalayan Rescue Association. It’s an organization based in Nepal, with one clinic in Manang and one in Pheriche. Pheriche is approximately a two-day hike away from Everest Base Camp, and I was stationed there when the first earthquake happened.

Everest Base Camp, shadowed by Pumori, the mountain where the avalanche originated, taken a week before the earthquake.
Photos courtesy of R. Salas

KK: So the clinics weren’t established for relief efforts. What was the clinics’ purpose?

RS: The Himalayan Rescue Association started in 1973. Its foremost purpose is to see the trekkers because there were a lot of life-threatening altitude illnesses, like high-altitude cerebral edema and pulmonary edema, but there wasn’t any medical care up in these regions.

KK: You go up there planning on seeing the local people, and then what happens?

Villagers run toward the helicopter in a remote village outside of Gorkha, Nepal.