Saturday, September 8, 2012

Fatal Van Accident in Gojal: From the Wedding Dance to the Dance of Death

By  Ghulam Amin Beg

It was early morning of Chorshamba, Wednesday, the 22nd August 2012.

Clear sky, seemingly a good day!

 It was a wedding day!

The small hamlet of Kamaris in Gulmit, the tehsil headquarter of Gojal in upper Hunza with 33 households, around 330 people, almost all having close kinship and communal relationships with each other, were in joy. It was like celebratory and pleasurable day.

Preparations for wedding of one of the educated young gentleman continued for three days during Eid vacations. As a tradition, preparation started with bet-rasidh, ribbon cutting, shapik-pacak, preparing traditional wheat-bread for two days and the final day, ghust-pacak, preparing the traditional meat sufra. Women, children, young and old, all seemed excited and in a celebrative mode, as the final day reached, when the Shoni, the bride-groom, will go as far as Khyber village, around 30 kilometers north of Gulmit towards Sost, and bringing back a bidghanz, the bride, back to the village.

As the custom is, over two dozen tuiche’ or wedding procession or party was selected a day earlier. Utmost care was taken to include at least one person from each sub-clan and close relatives, preferably the notables, respected and young and educated, who were in the village on those dates due to preceding Eid vacations. This is considered as an honour by both sides; by those nominated, and by the wedding family.

Nearby, in neighboring village of Ghulkin, young scouts for some time now have formed their own musical band; the Hunza trio-band having drum, damal and surnay players. The bride-groom and his friends decided to contact the young musical band, and they happily agreed to play music for the wedding procession as well as accompany them to Khyber to play for the wedding dance, tamosho at both villages, first time that the group was entertaining audiences outside their village.
With shoni nivizen soz, bridal departure music, happy tears and excitement and prayers, the villagers in Kamaris seen off the bride-groom and wedding procession starting travel early morning taking two vehicles from Kamaris to Gulmit, then boating over the Attaabad Lake tail-end between Gulmit and Hussaini harbour, and then again mounting three vehicles to reach the bride’s village around 9:30 in the morning. The bride-groom and procession was received by the family of bride and elders of Imamabad Khyber, after the rasmi-nikah, wedding ceremony in the village jamotkhona and exchange of wedding-ring. Happy moments were captured through snap shots and video clips on mobiles, group photos with family and friends and formal video streams by videographer.

While the family of the bride was preparing traditional food to be served around early noon, the traditional wedding dance started outside in a nearby open space. As a tradition, the guests coming from outside the village, as part of the wedding procession with the bride-groom were invited to dance in groups started from the most elderly to the young in order of age and rank, as is the custom in Gojal, followed by the host village taking their turn.

As the wedding dances from both sides completed, food was served and the bridal procession restarted their journey towards south, taking the same transportation mode on return back to its final destination in the afternoon, expected to be greeted with prayers, drums, children noise and dances, at Kamaris again in late evening.

However, unaware of their fate and the looming death scenes, when the vehicles crossed Passu village and was only 10 minutes away from the Hussaini port harbor, passing through the Sholimol rocky ridge, something happened!

Nobody was aware, nobody will know, what and why it happened?
One of the unfortunate vans driving by an experienced driver went off track rolling down the rock.

Killing two on the spot, as we know it now, they were our very dears; late Aqil Khan and late Bakhtullah Baig. Besides, we were cousins; we lived together in Karachi for over 10 years under one small roof. Aqil bhai cared for us, supported us all, like a single family.
The first news of their casualty was confirmed within 15-20 minutes of the accident by Majeed ullah Baig, my cousin over the mobile phone to my wife and me from the site of accident, with crying voice. He was himself fortunate to be riding the second van, following the unfortunate first van.

There was hue and cry, which I could overhear over the phone. He told me there were many who were very seriously injured without naming anybody and disconnected in grief. Later we found over 13 critically injured with multiple wounds, out of the 16 passengers boarding the vehicle, almost all known to us and were members of our extended family. 
It was like a hell fire! The videographer standing on another vehicle was making video, when he captured the scene of a van rolling down the hill and the dust rising in the air, which I watched on YouTube later!

The last wedding dance had turned into a dance of death!
As the news unfolded, we were told over the phone in Gilgit that the wounded are being transferred through vans and boats to Gulmit from Hussaini, where the government has constructed a 10-bed hospital. We were hopeful; at least others would be treated to safe recovery, as we were not aware of the severity of the accident. We were in Gilgit, and it was kind of ‘no traffic’ day, as government had disallowed public and private vehicles on the road due to security situation in the town. We had to leave to Hunza taking with us sister Gulnar and other family members. Thanks to Dr Sher Aziz, who favored us to ride the Rescue 1122 ambulances that were going to transfer seriously injured from Hunza to Gilgit. While we were preparing to leave, subsequently came the bad news that Nambardar Nasiruddin and two young chaps, Shahidin and Irfan Karim from Ghulkin have also succumbed to death while reaching the hospital and at the hospital, where there was no emergency doctor posted by government. Dr Khadijah, the Aga Khan Health Centre’s, Child and maternity service contract doctor, who is posted on a project in Hunza, but transferred to Gulmit health centre, volunteered to support the community at the government hospital, despite the fact that there was no proper support system to help her and the wounded, she and the government hospital paramedic team trying their level best to save lives, we were told. There was no emergency support system at the hospital in terms of availability of life saving drugs, bandages, availability of filled oxygen cylinder etc. Despite the fact that there was a fully equipped operating room, however, due to unavailability of technical staff positions, the equipments and the magnificent building remained useless to save precious lives.

It was but natural that hundreds of desperate people, youth, volunteers and relatives rushed to the hospital and created a situation at the hospital where it was becoming difficult for the doctor and staff to perform their duties with whatever limited resources and tools in their hands.
After almost two hours or so of struggle for life and life saving efforts at the hospital, the doctor and team who were already feeling helpless and under immense pressure, as such level of injuries were beyond their means and the crowding of people inside the wards created more problems than solutions, she has to refer the cases to Hunza, as if some specialist doctors will attend to them or some miracle may happen to save some lives, despite the fears of loss of travel time between road, boat and again road transfer at Ataabad spillway, which takes almost two hours. All other injured, except for Razi, including Nasir Iqbal, Dad Ali, Shaukat Aziz, Mujahid, Wasi, Deedar, Iman Hussain, Khadim and Akram to Aliabad in central Hunza.

Dozens rushed to the hospital beds of the wounded, and transferred them in whatever vehicle was available. The government ambulance was out of fuel, the government run speed boat was out of fuel and they refused to drive, unless the people give money for fuel or fill their fuel tanks. It was only when desperate youth insisted and threatened them of dire consequences, they started moving, we were told by youth when we reached Aliabad hospital in Hunza from Gilgit around 10:30 p.m.  On the way between Gilgit and Hunza, we saw ambulances coming one by one, and found that the doctors in Aliabad further referred more critically wounded to Gilgit; first ambulance brought Wasi, the van driver, than Mujahid and Iman Hussain in another ambulance. We have to shift from the fully equipped Rescue 1122 ambulance which Dr Sher Aziz sent to transfer the wounded to Gilgit.

We took a sigh of relief to see Khadim and Akram at the Aga Khan Health Centre in Aliabad, and Surgeon Dr Amir Ahmed, who volunteered to travel from Gilgit to visit the wounded in Aliabad, examined them, and confirmed they were out of danger. Thanks God.
We moved to the government hospital in Aliabad Hunza. On the way, Uncle Sarfraz broke the bad news to Riaz bhai that two of his elder brothers are among the dead. This was like a quake. As we reached the hospital we found three dead bodies and a big crowed of people outside the hospital; bodies of Subedar Dad Ali, Ala Nambardar Nasir Iqbal and Kamadia Shaukat Aziz were wrapped in white sheets and placed in a hospital room. Everybody was speechless!

The funeral committee (Mayaat committee) of Aliabad community, the volunteers, boy Scouts and the local council President and members, the regional council secretary and members, all were seen actively taking care of the dead bodies and the families of the deceased at the hospital. Hundreds of students, professionals and business people from Gojal were seen standing and providing moral and healing support; many of them traveled with the wounded and actually took part in the initial rescue at Hussaini. Dr. Sher Hafiz and his government hospital team stood up all the night with the people opened his house for the close relatives and arranged food and resting place. While we are all up at the hospital with the three dead bodies, subsequently came another bad news from Gilgit that Mujahid who was just transferred to Gilgit, has also breathed his last as he reached the Aga Khan Health Centre in Gilgit and that his body will be brought back to Hunza same night.
The total number of causalities has now reached 9 in number.

The next morning we took the funeral procession of four dead bodies from Hunza to the spillway. The uniformed volunteers and scouts brought four boats and we reached Gulmit, only to find and thousands of men, women, young, old, children were waiting, crying and the procession went further up and up as the procession reached the final destination- Kamaris village, from where a day before, they started the wedding procession. We participated in all the funeral events and the dead were buried with solemn rituals and ceremonies.
The dance of death concluded.

I remained in the village for almost 10 days and returned back to my workplace in Gilgit.
Recently, Wasi bhai, the van driver, who was shifted to Islamabad, also unfortunately breathed his last and the body was taken back to the village for burial and services, taking the total number of causalities to 10.

In conclusion, before I say something about our miserable state of tangible health preparedness, I must say, our ‘intangible’ preparedness to provide psycho-socio support to the families is very powerful.
1.       In our social context, religion and culture plays a key role in providing healing support, guidance and prayers through rituals, funeral ceremonies and speeches and recitations from the Holy Quran, sharing the guidance from Hazir Imam, the poetry of Poet, philosopher Pir Nasir e Khusraw and others help the distressed persons and families overcome their losses through such personal and group responses. The support from the individual households, volunteers and the whole community who take care of everything from managing visitors to cooking food to voluntarily helping in completing the farming and non-farming work of the bereaved family was remarkable support that I witnessed.

2.       I also felt that death denial is a common human response by those who identify themselves ‘emotionally, spiritually and physically with someone they loved most’, and who are separated through tragic deaths like this. It takes time to accept the reality, that the loved one was no more with us physically, and that we can create new relationship of soul and mind by remembering the loved one through different paths, by following the path they choose to live or by propagating some of their ideas and thoughts and noble causes. Tragic deaths in a family system, especially death of bread earners and young people are seen like ‘emotional shock waves that run through the family like wildfire’. Our only consoling gesture would be to try our best to be of any support to the dependents with honor and dignity, in the hours of need, without hurting them or their sentiments indeed.

3.        Now, on the state of emergency preparedness in fatal accidents and emergencies. Many speakers including doctors who actually responded to the emergency, and community leaders and youth leaders talked of this in the post-accident days, so that we evaluate our state of preparedness to i) help reduce chances of such fatal accidents in the future and ii) save maximum lives if such emergencies happen again. It was a common agreement, that except for 2-3 persons, all other died because we were unable to provide proper first aid in the ‘golden hour’ and that there was no medical staff and facilities at the hospital where they were first brought or that if there was a heli rescue service operating from Gilgit, many lives could have been saved by reducing the lag time.

a.       Road accidents are considered to be one of the ‘three big killers’ in the world. And young people are more at risk of road accidents as they mostly travel and drive. In order to reduce chances of accidents, there is a need to develop a comprehensive road safety framework by involving all stakeholders; government, private transporters, communities and frequent travelers including youth on board. The framework must look at road conditions, vehicle conditions and inspection, driving licensing test systems, driver’s mental state, frequent monitoring of compliances and spot check and community awareness about traveling risks, safety measures. This also should cover the boat service and making life jackets and rescue boat with equipped staff all the more important;

b.       First aid is considered to be the ‘real life saver’ in road accidents and fatal emergencies. It is important for each transporter, community volunteers and government officials especially the police, health and education departments and the public works departments to continuously train their volunteers and staff in basic application of first aid.

c.       State of the art ambulance, both vehicle and boat ambulance and paramedics both with ambulance and at the health centres is very important emergency service that need to be provided immediately.

d.      An evaluation of the basic emergency and health preparedness of the hospitals is very important. The government hospital in Aliabad Hunza at Gulmit and the Aga Khan Health centres at Aliabad, Chipurson, Sost and Gulmit and the dispensaries should be staffed and equipped with basic emergency support systems, life saving drugs, hospital supplies and medicines.

e.      There is no blood bank in the whole Hunza region. A fully functional blood bank is the need of the hour.

f.        The Gulmit hospital should be made fully functional with immediate deployment of doctors, nurses and key paramedic staff.

g.       There is no helicopter evacuation system for such emergencies. We should not see army and AKDN helicopter active only during non-emergency times or when there is a large-scale publicized disaster such as 2010 floods to supply relief goods or VIP movements. There should be a heli rescue service operational from Gilgit, so that it reaches the valleys in a short- time, and could rescue the wounded to Gilgit hospital within the ‘golden hour’.

h.      In the long-run, there is a real need to establish state of the art trauma centre on the KKH, as this is an international border, and with the Chinese improving the KKH, there will be more traffic flow, and more vulnerability to road accidents and loss of life.
The government, the elected representatives, the Pakistan Red Crescent Society, FOCUS and AKDN should join hands to develop a comprehensive plan on road safety and responding to such fatal emergencies in any region in GB in the future.

The pathetic state of health preparedness for fatal emergencies needs to be improved without loss of further time. We lost our 10 loved ones on 22nd August.  In the past we have seen such fatalities that happened in Chipurson, Misgar and central Hunza during last 10-15 years, in which over 30 people lost lives.
We can no longer sit idle. We all need to act, and act fast, as the frequency of such fatalities continuously increase, while our response plans and capacities remain rudimentary.


Ghulam Muhammad Syed said...

Indeed it was very shocking incident. Institutions responsible for well being of the people of GB should come forward with the workable strategy as to how emergencies can be addressed. How they can deliver, God forbid, if, happens large scale disaster.

Senge Hasnan Sering said...

‎Amin Beg sahab. Wearing seat belts is not part of our culture. Taxi jeeps and vans do not have enough seat belts for all the passengers. Lives can be saved during accidents if we promote use of seat belts. Secondly, health of the tire on the wheels is also an important factor in controlling accidents. Overloading can be controlled by giving incentives to the drivers and business owners....

Saturday at 5:34pm · Like

Rehman Alvi said...

Firt of all my sympathy and deep feelings for the grieved families this who lost their loved ones and the most valuable assets of the community.We all appreciate and proud of our social and community values in time of shock and desperation.I also agree with Amin Baig about the lack of unpreparedness and basic health facilities for the disconnected population of Gojal valley.After the Attaabad disaster I had meeting with WHO members regarding the medical needs of the communities in the disconnected region of Gojal valley.I suggested to develop an emergency centre for resuscitation of the acutely injured of medical conditions and air transfer facility to Gilgit town for tertiary care services but unfortunately Malik Riaz contractor promised to establish secondary care hospital in Gulmit and proven to be a drama and exposed his real intentions.Developing secondary care hospital may not be feasible but the real need is to develop an emergency care facilities with trained doctor and emergency care technicians to deal with the life theatning conditions and air ambulance facility to timely transfer of patients to near by tertiary hospital.The real issue is human resource at present not available to deal with the challenges, AKHSP should paly an important role to develop plan for human resource development in collaboration with AKUH. ,Karachi.During the crisis I was in contact with Dr.Haider Khan, Dr.Amir Ahmed and Dr.Sher Aziz and unfortunately there were avoidable deaths due to lack of primary trauma support system to control hemorrhage and to secure air ways.Once again my condolences to the grieved families and hope that this could be an wakeup call to the political leaders and social organizations of the region.

Rehman Alvi said...

The tragedy of Gojal road traffic accident:
The community of Gojal valley were shocked to know about the tragic incident and we are very sorry for the great losses of precious lives.Mr.Amin Baig has conducted the detailed analysis of the disastrous situation to understand the strength ,weaknesses, threat and potentials of the community.We are all proud of the social support ,cohesiveness and sharing culture of Gojal valley.At the same time we have major challenges specially in the health care system,which gets exposed more during the major disaster situation.At present the government of Gilgit Baltistan failed to develop any strategic plan for the disconnected community and was unable to appoint a trained medical officer to provide basic care.

At the time of the Attaabad incident I had a chance to discuss with the WHO team in Sost about the health care needs of the disaster hit region and my suggestion was to develop a comprehensive emergency care to resuscitate and stabilize the acute medical conditions,including trauma before shifting to nearby secondary health facilities and this could be done effectively through air ambulance services. At the same time Malik Riaz of Beharia town adopted the Civil Hospital Gulmit and promised to continue secondary Heath care services on a long term basis. Riaz contractor proved to be a cheater and only wanted to grab the media's attention for his fake social services.

To my understanding the Government and AKHSP should develop a partnership program and focus on human resource development on a long term basis to overcome the future challenges . The GB government has the capacity to develop the infrastructure and provide the required equipment, at the same time AKHSP should concentrate on human resource development and long term maintenance of the facilities. Developing a major health facility will not be sustainable ,therefor the concentration should be focused on emergency care, referral and safe evacuation of acute medical condition to advanced health care facilities.

I was personally in contact with the medical team and according to my information many deaths were avoidable and could have been saved if proper resuscitation facilities were available including hemorrhage and air ways control in Civil hospital, Gulmit.

Dr.A.Rehman Alvi FRCS,FCPS
Associate Professor in Surgery
AKUH, Karachi.

Noor Muhammad said...

Great write-up Amin bhai, as always. Full of insights, emotions and practical suggestions.

You may like to read my random rants, penned one day after the Sholmol Tragedy.

Ali Meher said...

Indeed it was a tragic accident. Amin Baig ustad you have well elleborated about the situation and proposed strategies to over come such unforseen accidents. But the question arises here is that who should take step to ensure the in plce th
e systems.I would say whether our leaders have ensured the function of emergency hospital in Gulmit if not who should asked by them than our civil soicity and councils mandatery to ensure it. Apart from this whether the volunteers should not stop the passengers to sit on the roof. I think still passengers would sit on the roof of over loaded vehicles. Whether so far all transport has been checked up physically to ensure its feasibilty or not.At every stage we are reluctant. Basically our governance system is defective that is why the public has to suffer at every stage. Once again thank you for highlighting and important issue and suggestions for reducing measures as proactive step.

Zahir Shah said...

Dear Amin Uncle,
The fatal accident of 22nd Aug was a shock and remose for all of us hailing form GOjal and GB. I wish we learn from these unfortunate incidents soon to bring in practice the basic safety measures and necessary rescourses to minimize risks and casualities in times like this accident.

One running thought: If any follow-up is made to facilitate and improve skills of local people for emergency and disaster sitiuation, it shall be ensured that all the basic resources are made available in the locality like those you have mentioned were missing in the Hospital. Otherwise with just traings we will remain where we are... helpless and destitute.

And agreed with Noor bhai, beautiful write up.

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