Naqsha Bibi

Naqsha Bibi (born 1965) is a Pakistani woman of Azad Kashmir, near the Pakistan-Indian border. She was found beneath the ruins of her house near Muzaffarabad on 10 December 2005, 63 days after the Kashmir earthquake which occurred on 8 October 2005. Initially great attention was given to her apparent survival beneath the ruins for more than two months.<ref name="FamilyScoffs"/> Later news reports claimed she had not been trapped in the ruins for the whole 63 days since the earthquake. It is believed that she was buried in the ruins of her kitchen, and rescued two days later. It is thought that she had returned to the ruins of her house within a few day, and was subsisting there with occasional food from neighbours. At the time of her hospitalisation in late 2005 she weighed less than 35 kg (77 lbs),<ref name="QuakeSurvivorAmazes"/> less than half the average weight of a woman of her build, and her muscles were frozen in the foetal position.
Naqsha Bibi - the true story

Being one of the doctors in charge of treating Naqsha Bibi right after she was retrieved from the ruins of her house, I do not believe the claim made in the entry above. Her story is somewhat different:
I met Naqsha Bibi at dusk on 12th December 2005.
I was in Pakistan for 12 days, 2 months after the earthquake, as part of a Danish NGO (Doctors for Earthquake Victims), including 8 doctors, divided into two groups of four. One of our subgroup's experiences made headlines in 58 countries: The finding of Naqsha Bibi that had been trapped under her collapsed house for 63 days (and not 2 days as Associated Press incorrectly reported).
Naqsha was brought into the PIMA Field Hospital in Musaffarabad one hour before our group arrived after transferring ourselves from another field hospital (in Gharia Habibula).
On arrival of our group the car door was opened by a BBC journalist (http://news.bbc.co.uk/2/hi/south_asia/4525710.stm) that asked me (being the only one with European appearance): "Are you the German doctor that found this lady?". I had no clue of what was happening and responded: "No, I am not German, and which lady are we talking about?" Very quickly we were taken to the crowd that had formed around Naqshas stretcher in the emergency tent, and briefed on the situation: Naqsha was expected to be dead after her house collapsed on 8th October. Her father, that had broken one or two legs was transferred to Islamabad for treatment immediately after the quake. He was now (December) soon to be discharged, so his cousin, Faiz Din, went back to the ruins of their house to get some materials for building a shelter for him at the remains of the village 5-6 km north of Musaffarabad (7-8 km south of the epicentre). When Faiz Din removed some rubble and a corrugated metal plate he found Naqsha on Saturday 10th December. He and the villagers with him thought she was dying, so the women washed her, cut her nails, and dressed her in clean clothes. They tried to feed her, but she wasn’t able eat anything.
Two days later, on Monday 12th December, she still refused to die, Coincidentally a German doctor, Holger Brockmeier drove by in an ambulance on a research trip for Caritas. The villagers they told him, through an interpreter, that she was an injured person. Although Holger couldn't see any immediate injuries, he found that she needed immediate medical attention and brought her to the PIMA Field Hospital in Musaffarabad.
When our group arrived one hour later we didn't know any of the local doctors, and couldn't identify anyone that seemed to be in charge of the situation, which was quickly escalating to grotesque heights. Naqsha was very unstable with BP: 85/50, P:170, completely dehydrated and apparently paralysed by anxiety. Flashes were going off, film cameras were running and curious people from near and far were gathering to get a glimpse.
Since no one else were apparently in charge, I decided that I would be, and managed to get Naqsha isolated in a separate tent (which worked as our make-shift ICU) get some i.v. lines in and act as a “door man” holding back the world press while Mariam (a Danish-Pakistani doctor, at intern level training) examined Naqsha. After evaluating her findings (I couldn't examine her himself, since I had the wrong gender…it's cultural thing even when lives are at stake, don't even try to understand….) our team made a plan for treating her.
We held several press conferences and gave several interviews over the following 72 hours. I gave one on Tuesday 13th to French TF1 which went world wide, and may have been the cause of the confusion about what had happened to Naqsha. When I was asked about what I thought had happened, I suggested 3 theories:
1. She could be a previously healthy person that had been trapped for 63 days as claimed by the people bringing her to PIMA.
2. She could be a mentally ill person before the quake, and had voluntarily hidden in the ruins since the quake.
3. She could be a previously healthy person suffering from Posttraumatic Stress Syndrome since the quake, and not been able to support herself nor eat sufficiently.
Associated Press apparently decided to go with the 2. explanation, and supported it by misquoting one of the junior doctors, (Hafeezur Rahman)working at PIMA. Hefeeezur unsuccessfully tried to make them correct this.
However, after researching the story and going to the place where she was found together with two Danish journalists we learned that Naqsha, up to the quake had been a normally functioning 40-year old woman, unmarried, and hence living with her father, and taking care of the household. The neighbours confirmed that she had been trapped under the roof for 63 days, while they thought she had been killed by the quake. One can only speculate about why the Pakistani journalists working for Associated Press decided to fabricate another story. Perhaps the pain experienced by relatives of earthquake victims, that had given up the search for their love ones 1-2 weeks after the quake was too strong when experiencing that someone had been able to survive for 63 days? I can only hope that Naqsha’s survival brought more hope than despair to Pakistan.
When I weighed Naqsha on Wednesday 14th December (by holding her in my arms while standing on a weight scale) she weighed 25kg. With a height of 155cm (measured in bed) this equalled a Body Mass Index
of 10,4 kg/m2.
Initially We decided to treat Naqsha with antibiotics, vitamins, and iv-glucose, while feeding her as much as possible. Initially this ment spoon-feeding her milk with lots of sugar. After about 12 hours she was able to eat mashed bananas and scrambled eggs (well fried to avoid infection).
Surprisingly, the few biochemical tests we could perform on Tuesday morning turned out normal. On hinesight, perpaps this was not so surprising. Had she been biochemically deranged for such an extended period, she would probably not have survived. Luckily Naqsha had been trapped in her kitchen a few days after the Ramadan had begun, meaning that she was initially surrounded by lots of supplies.

Naqsha gradually got better during Tuesday 13th December, and by Wednesday we thought it safe to transfer her to a real ICU in Islamabad. She was now able to hold a banana while eating it, but still appeared neurologically injured.
However, the doctors in charge of running the PIMA Hospital enjoyed the attention of the press too much to be willing to let go of her.
My colleague from our Danish team, Imran Parvaiz and I made a multi stage plan to get Naqsha transferred to Islamabad:
1. First we would try to charm the doctors in charge of PIMA by telling them that at the moment this was a miracle history in the press, and that PIMA had managed to make Naqsha transferable.
We had a very long discussion with them at dinner Wednesday night. Especially one elderly gastroenterologist with US-Pakistani background claimed that the "ICU" at our tent provided as good a service as any ICU he knew of. I boldly asked him if the conditions in the US was so bad in ICUs that they were run in tents with dirt on the floor, no ICU trained nurses, no monitoring equipment except for a pulse-oxymeter, no heating except for charcoal and occasional electrical heating when power was not down, no ventilators, a very limited supply of antibiotics and 150 daily curious visitors, although we had positioned a guard at the tent door? My colleque from the US pretended not to understand the question….

2. We would try to motivate them by pointing out that they would look like fools if she died in their hands after surviving 63 days in the ruins.
Neither worked….
3. We would contact the press to make them ask questions about why she wasn't transferred.
I called a couple of Danish journalists in the area. They called back the next morning and said that we could also try contacting WHO in Musaffarabad to make them talk to The Ministry of Health, which could demand that she was transferred. Imran Parvaiz and I spent a couple of hours trying to find the right people to talk to.
4. Eventually we managed to get through to the general in charge of the health situation. He was some how related to Imran Parvaiz. Imran had the shortest telephone conversation ever, ending with the general promising to take care of the situation. One hour later we were told that Naqsha would be transferred to Islamabad. When we asked the doctors in charge of PIMA why, we were told that they thought we had been so insisting at dinner last night…..Well apparently there can be some upsides to a country run by a military junta.
5. Our ultimate stage never came to use, but consisted in offering to take the night between Thursday and Friday “on call” in the emergency room, dope the guard's tea, “kidnap” Naqsha using one of the ambulances, and drive her to either the MASH in Musaffarabad and leave her to the Americans or drive her to Islamabad ourselves.
Imran and I visited Naqsha at the hospital in Islamabad (Pakistan Institute of Medical Sciences) before leaving the country. She seemed to be in good hands, and recovered slowly.
I have since learned that Naqsha did suffer some degree of brain damage after the earthquake and now lives at an Edhi home for the homeless, run by Edhi Foundation.
In November 2009 some journalists took her back to visit her father. This visit can be seen on Youtube.com: http://www.youtube.com/watch?v=YndzKR4T_Xc. Unfortunately the video is not in English.
Martin Agge Nørgaard
Associate Professor, DMSci
Cardiothoracic Surgeon
Denmark
22nd December 2009

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