On June 3, Volcano Fuego in Guatemala erupted in what was the most destructive eruption in its history. Within hours, Kenneth Lim, MD, PhD, attending physician in the MGH Division of Nephrology – who had arrived in Guatemala the previous day to provide medical aid in underserved regions – was reassigned to join rescue workers with Misión Hispana. Lim was one of the first U.S. doctors to respond to provide medical care to those injured.

The eruption claimed hundreds of lives and more than 3,000 people were evacuated from the region. Lim and his colleagues worked in collaboration with the Guatemalan government disaster response team, which included members of the military, EMS, police, fire and rescue. On Lim’s second day – while he was serving in the hot zone – the volcano erupted again, forcing the volunteers to scramble for cover.

“One of the most frustrating moments was when rescue operations around the hot zone had to be halted by the government due to the unstable region,” says Lim. “We also could not distinguish between red lava and black lava at night, which presented extremely dangerous conditions for rescue workers. Knowing that we were only feet from people who were severely injured and dying and being unable to do anything to reach them was absolutely heart-wrenching.”

Lim treated a spectrum of general medical conditions and injuries, including burns, acute respiratory disorders from the hot ash, and lacerations. “One of my most memorable moments was when I asked the government for IV fluids and was handed three bags of peritoneal dialysis fluid because resources were scarce and it was the only type of fluid available,” says Lim. “As a nephrologist, I found this to be a very interesting scenario since peritoneal dialysis can be lifesaving for acute kidney injury management in disaster situations.”

Lim says a major concern there was the movement of tectonic plates, which could have caused a tsunami striking from the west, while the volcano was erupting from the east. With the help of a former Navy SEAL on his team, they were able to track these events.

“Many emergency medicine doctors and trauma surgeons often serve in this kind of disaster response,” says Lim, who has deployed to regions around the world to help during humanitarian crises. “I hope to encourage doctors from other disciplines of internal medicine – such as nephrology – to also respond to these disasters, as the scope of general and specialty practice we can offer provides essential lifesaving care when disaster strikes.”

Read more articles from the 07/13/18 Hotline issue.