Background On 25^th April 2015 Nepal experienced earthquake of 7.8 Rector scale followed by another one of 6.8 Rector Scale next day with epicentre near Kathmandu. More than 9,000 people died, 25,000 injured, 200 missing, 500 000 houses collapsed. Big after-shock 17 days later on 12^th May, killed 300, injured 3000 people. Country’s central Hospital, Bir Hospital located in Kathmandu is a hub hospital for disaster management; though damaged itself, yet it treated all victims brought here.

Methods All victims brought in immediately and later were triaged, resuscitated, damage control surgery followed later by definite surgery were carried out as per necessity. Records were kept. Challenging logistics and supply were managed in best possible way under the circumstances with aid from abroad later in kinds, man power. As the hospital was damaged too, all in-patients were evacuated to nearby open field. Triage was carried out in open spaces available. Makeshift operation theatres were put up and surgery began as existing ones were damaged too. Side by side institutional rehabilitation was begun too with help from volunteers. Several volunteers from abroad technical and non-technical also helped us a lot.

Results Between 25 April till 17 June 2015, total of 2574 victims attended this hospital. Of them 132 were dead, 1434 were admitted, 1135 underwent Surgery, 568 of Major and 567 of Minor category, 24 died in hospital while on treatment. Of surgery, most (568) were orthopaedic cases, followed by Polytrauma and General Surgery 299, Neurosurgical 39, Chest trauma 24, Burn and Plastics 9, and ENT & Dental 7. Damage control surgery was performed on 40 victims. Of 190 Orthopaedic surgery, 101 were for Lower Limb, 69 for Upper limb, 20 for Spine and Pelvis. Mechanisms of injury included being buried in rubbles, trapped between heavy objects& collapsed building, falling objects and panic fleeing.

Conclusions This Natural catastrophe struck least developing country Nepal causing huge loss of life and economy. Rehabilitation and reconstruction is challenging. Since forewarning technology is still unavailable, Hospital preparedness in Emergency program with regular drill is essential for us to perform better in such situation.