Physical rehabilitation in Nepal
In Nepal access to physical rehabilitation services for people who were injured or sustained disabilities during the armed conflict or by other means is limited. The provision of artificial limbs can restore their capacity and help them resume their lives independently, to work and reintegrate into family and community activities. The experiences of retired Major Gunja Karki, whose arm was amputated after being injured by an explosive device, testify to this reality.
On 27 October 2003, the armed conflict in Nepal was at its height. The newly promoted Captain Gunja Karki of the Nepal Army went on a regular patrol in a joint unit with the Nepal Police of 64 men in Nuwakot district, about 30 km north-west of Kathmandu. The unit set off at 12 noon and at about 2 p.m. it discovered an explosive device planted in the ground that was connected to wires. Some members of the unit managed to remove the wires carefully. Then Captain Karki who was commanding the unit approached the device to diffuse it. Suddenly it went off with a huge explosion. "I don’t remember anything." he exclaimed. "The last thing I recall was going on that patrol."
Gravely injured in an explosion
Later on he was informed that there was another explosive device nearby that exploded, severely injuring him. A military helicopter was requested urgently by radio while two members of the unit performed first aid on him. Fortunately, the helicopter was available at short notice and arrived to evacuate him shortly after 3.10 p.m. to Kathmandu Military Hospital at Chauni. At the hospital, doctors promptly attended to his injuries and took him into surgery.
"I regained consciousness after 22 hours only to learn that my right arm had been amputated," Captain Karki recounts. "I realized a little while later that I could not see and at that moment I was very fearful, wondering whether I would be blind forever," he remembers. The wounded army officer had also suffered injuries to his face and eardrums. He spent the next three-and-a -half months in hospital. Fortunately, he regained his eyesight and hearing, and his face healed well.
Return to work
Captain Karki returned to the army after recovering, and was posted to Kathmandu Chauni Deport – centre for logistics and storage of army equipments. "With just one arm I reported to my new unit and served the rest of my tenure with the army for six years," recalls the captain. In March 2004, the army covered the cost for him to be fitted with an artificial arm in an orthopaedic centre in Kathmandu. His performance at work earned him a promotion to the rank of Major. In 2009, he retired after 33 years in the army.
The retired major's life however took a difficult turn when he left the army. Although he considered returning to his rural village in Ramechhap, he decided not to because he would not be able to earn a living through typical farming activities such as ploughing, planting and herding cattle without two fully functional arms.
"I would have been helpless and dependent on someone else, therefore I decided not to go back," he said. With his pension from the army he decided to build a house in Imadol, Lalitpur district of Kathmandu valley. "At least here, I am in Kathmandu. I can easily go to places and receive free treatment and maintenance of my artificial arm," he remarks.
Difficulties with his prosthetic arm
The artificial arm that Karki received became problematic. "It was very heavy and caused me pain around my shoulder joint. The strap that went around my chest up to the side of my waist was also uncomfortable and painful," he recollects. The colour of the artificial arm also started fading and the fingernails were falling out. "From a distance, people could easily spot the difference in colour of my two hands, which gave me an unpleasant feeling. I wished to get a new arm with fewer problems and tried to find someone who could help," he said.
One day Karki met his former superior, Colonel Nain Raj Dahal with whom he had worked for many years in same unit. Colonel Dahal was now the Deputy Director of the Nepal Army's Human Rights Directorate. Karki asked his former colleague if he could assist him in getting a new artificial limb. Colonel Dahal promised to do what he could to help since he was in contact with the ICRC, which he knew was supporting physical rehabilitation services. He contacted the ICRC to find out if Karki could be assisted. The ICRC contacted the retired major and referred him to the Green Pastures Hospital at Pokhara, where he was fitted with a semi-functional artificial arm and received occupational and physiotherapy to learn how to use it.
ICRC comes through with a new and improved arm
"I am very happy with this new arm. It is much lighter compared to the previous one, its colour resembles my skin tone, and it looks durable. I am feeling very comfortable now," he reports. Then he remembers going to a party recently and holding his plate in the artificial hand and eating with the other one to the surprise of all his friends who in the past had to assist him. Retired Major Karki, now 54, is married with a grown-up son and daughter and lives with his family. His son joined the Nepal Army and his daughter works for the army in a clerical job.