TRISULI, Nepal (AP) — The powerful earthquakes that shook Nepal in April and May took more than 8,700 lives, but they also injured more than 22,000 people who are now struggling to recover from broken bones, lost limbs and other injuries, uncertain if they will ever be able to return to the lives they once knew.
For those who reached hospitals for immediate treatment, the government provided free surgery and initial medical care. But many are now discharged and on their own. Only a handful of big hospitals in Nepal have physical therapy facilities or experts who are able to teach rehabilitation exercises vital for the fullest possible recovery.
"They don't do proper follow-up, which means basically the injury can bring like really long term impairments. And if they don't get proper treatment and proper physical treatment then they will not be able to get back to their daily activities," said Aurelie Viard, of Handicap international, a non-profit organization that has provided physical therapy, equipment and treatment.
Viard acknowledged that the top priority for many is getting food and shelter. But for those who can benefit from physical therapy, "our work is to convince them that if they don't do proper treatment now, they won't be able to do it later," he said.
Survival, not rehabilitation, is uppermost in the mind of Sedar Tamang, who lost his left leg after it was crushed by a boulder.
The 22-year-old father of three, who lives in a tent camp after his village was demolished by the April 25 quake, used to cut firewood and work in the corn fields. Now he doesn't know how he'll support his family.
"I come from the mountains but I can't climb and barely move in the plain areas. I have no idea what I am going to do and how I am going to feed my family," Tamang said outside his blue and orange tent where he now lives with his mother, wife and children.
Nepal's government has said it would help build houses destroyed in the earthquake but has not said anything about long-term treatment for the injured.
On Thursday, representatives from 53 nations and agencies are attending an international donor meeting in Kathmandu. Finance Minister Ram Sharan Mahat said Nepal needs about $6.7 billion for reconstruction but it is not seeking all that money from donor nations.
At the Trishuli District Hospital, in a hard-hit area about 80 kilometers (50 miles) northwest of Kathmandu where staff are working out of tents because of damage to the hospital buildings, many people with orthopedic injuries are still coming in for treatment.
"Most of them would require physical therapy to recover fast and properly but we don't have the expertise or facilities to provide such care for these patients," said Dr. Rajendra Lama. "We can hardly cope and provide primary treatment for the people."
Most patients are poor and uneducated and have no concept of physical therapy or other long-term treatment, he said.
One of Lama's patients, 45-year-old Pemba Tamang, had his right foot amputated after it was injured in the quake. He says he has no family members to take care of him and worries what will happen when he is released.
Kanchi Maya, in the next bed, has multiple fractures in her right foot and a dislocated back.
"I can't do anything. I am not able to farm. I have lost my house and my farm," she said. "I have trouble just standing up and moving, how will I able to pick up a shovel or harvest the crops?"
For many, even a full recovery is no guarantee of a livelihood.
In another tent camp, 13-year-old Bir Bahadur Tamang has a metal brace supporting his left shin while it heals. His village was mostly destroyed. He and his family helped guide foreign trekkers in the Langtang Valley, but widespread damage to the area suggests that trekkers and tourists will stay away for some time.
"Doctors have said it will take seven months before I can stand up," he said. "I have no house, village to go back to or a school where I can study."