Banepa: Eight hours after Bim Bahadur Gurung started walking along a mountain path, carrying his severely injured daughter on his back and hoping to find a hospital, a second earthquake struck already-devastated Nepal.
As the rocks tumbled and the earth shook, Gurung never thought of stopping, desperate to see 10-year-old Maya receive a prosthetic replacement for her leg, crushed when their house collapsed in the first quake.
"I could see landslides, but what could we do? I had to get her to a hospital, otherwise her life would be over," the father-of-four told AFP.
Gurung finally reached the hospital on the outskirts of Kathmandu where he had been told Maya could be fitted with an artificial limb. Her leg was healing well after doctors amputated below the knee following the disaster.
Maya is among thousands of Nepalese who face a daunting future after suffering loss of limbs, spinal and other permanent injuries in the twin quakes that claimed more than 8,700 lives.
Although they survived the disaster and received medical help, they face enormous challenges in the Himalayan nation with its unforgiving terrain, limited infrastructure and scant rehabilitation services.
Since the first quake on April 25, tents donated by UNICEF and other agencies have taken over hospital grounds, housing dozens of children and their families awaiting operations including on destroyed limbs.
"What we are seeing is the tip of the iceberg, we have a huge, huge challenge in front of us," Bibek Banskota, director of the non-profit HRDC hospital, where Maya was brought and treated, said.
"Once the dust settles, we are going to see many more cases. Even under normal circumstances, it takes months, maybe years, for a poor villager's kid with a broken leg to make it to our hospital," the orthopaedic surgeon told AFP.
HRDC is one of only a few hospitals in Nepal to make and fit artificial limbs and provide physiotherapy for disabled children.
Handicap International estimates 18,000 people sustained injuries in the quakes, many of them fractures. And experts warn delays in identifying and treating them could lead to permanent disability.
Long-term care of disabled survivors is also a major challenge, with a lack of physiotherapy services in Nepal to help them cope.
No Nepalese institutions currently offer degrees in occupational therapy or orthotics and prosthetics, resulting in a shortage of trained professionals, Handicap International's Blin said.
"The skills are just not there: we have 60 people in the entire country who are trained in these fields, all trained in India."
