Pilgrims walking the Char Dham Yatra trail were unprepared as a mudslide came rushing down the mountains. Thousands were caught in the natural disaster’s path. Because of training that was done the previous summer with BYU College of Nursing professor, Dr. Craig Nuttall, Indian nurses were able to use their new helicopter airlift program to take the injured to the nearby hospital, along with aid from military personnel.
Indian officials learned about the need to improve their hospital and helicopter systems in the regions during the COVID-19 era. Dr. Nuttall was tasked to evaluate the healthcare needs of the Himalayan region on a grant from the Scientific Exploration Society. During the trip, he saw how over 3 million pilgrims would struggle on difficult roads to trek 20 kilometers over mountain passes. He saw how these faithful people were not conditioned to higher altitude climbs and colder temperatures, nor were they ready for any injuries they received en route.
“For those who are traditional Hindu Pilgrims,” said Dr. Nuttall, “they trek the entire pilgrimage over a two-month period. There is very little healthcare access in that area and it is prone to natural disasters. Every day it drops below freezing, so there are huge risks of trauma and hypothermia.”
As a result of this trip, he compiled a list of all potential issues that he found and proposed changes that could address the vulnerabilities. The list included things like telecare (or meeting with a nurse online) and a revamped medical transport system. The Indian healthcare professionals took these recommendations seriously and found funding to address each need. Dr. Nuttall was then invited to train nurses from the All India Institute of Medical Sciences (AIIMS) Rishikesh to become flight nurses.
This training took part during the college’s Global and Population Health Nursing Clinical Practicum in India, enabling Dr. Nuttall to include several nursing students in the training. Graduate student, Kiley Bearden, was tasked with creating simulations for the Indian nurses. These three scenarios (chest pain, head injury, and altitude sickness) were chosen in tandem with the nursing director at the hospital and represented the most likely cases that they would encounter during helicopter rescues.
After explaining the protocols adapted from the US Department of Defense’s medical guidelines, the Indian nurses would practice with BYU undergraduate nursing students acting as the patients. Kiley threw in some curveballs to make the simulations even more realistic, such as a combative patient. “A lot of these nurses work in the ER or ICU, and if something big like that's happening, they have so many people coming to help,” said Kiley. “We tried to really emphasize the point that they’re in this tiny space with just the two of them, so they need to plan ahead and know exactly what they’re going to do to handle these critical situations in that space.”
Training people was a new experience for Kiley. “I've never really been on the other side of training,” said Kiley. “I've done lots of simulations in school and at work and it was eye opening for me to see how much work goes into creating these scenarios and having to anticipate what the nurses might want to do and have all the information prepared so that you're ready to provide good training. The Indian nurses were so smart with some of the questions they had. They're really prepared.”
Because of Kiley and Dr. Nuttall’s efforts, the newly trained helicopter Helicopter Emergency Medical Services (HEMS) is now the training center for four other locations around the country, and saved lives during this year’s hazardous pilgrimage. Dr. Nuttall is pleased that his counsel was implemented and allowed people to worship in safety. “Part of my desires for this entire project were to preserve religious freedom in a more round-about way by giving people who want to worship in these areas access to a safe environment by providing healthcare when they get sick or injured,” said Dr. Nuttall. “I feel spiritually tied to them. I love the Hindu people who are trying to worship. I want them to be able to worship and feel safe.”
The HEMS official inauguration date is October 29. Dr. Nuttall hopes to go back with a group of faculty and graduate students in March to continue training and evaluate the care they have provided so far. Read more here about Dr. Nuttall’s work in India.