The Critical Need for Safe Shelter and Temporary Health Care Facilities

An AmeriCares team arrived in Kathmandu, Nepal, just 48 hours after the April 25 earthquake. AmeriCares teams have been holding mobile health clinics for survivors and traveling to rural areas with stocks of medicine and supplies, to treat survivors and assess needs at hospitals and clinics.

The word for the day is “tents”: small tents, big tents, really big tents, medical tents, home tents and tarps (for a little variety). The monsoons are coming, and everyone is trying to get tents to protect people, clinic spaces and medical supplies. Tents are coming from the U.S. and India. The initial suppliers are tapped out with backlogs up to 4 months. The monsoons will be ending by then. So we are searching for new sources of quality tents big enough to be a clinic and see patients. We have initial shipments underway, but more are needed.

Meantime, I keep thinking about the broken buildings I saw in Nepal. In most places outside of Kathmandu, the buildings, home and clinic are made from field stone. They are built with stacked stone, 18 to 24 inches thick with no mortar. The roof beams embedded in the piled rock also are not mortared or connected. In regular times, these heavy thick walls would be more than strong enough to support the roof and protect people. But with an earthquake and no stabilizing connections between the parts, the roof beams shake loose, dislodge the stone walls and those thick walls of large stone fall and kill people. If you are inside, it would be hard to survive. I think this is the explanation for why there are relatively few injured compared to the number of deaths in Nepal; there are only twice as many injured as killed when the ratio is usually much higher in other earthquake experiences.

There are also many, many damaged buildings/clinics/homes likely to finish their crumbling once the rains start. If we don’t find a way to repair them or distribute enough tents to all the hundreds of thousands quickly, without safe homes, people will return to damaged buildings and face great risk.

Just weeks after the devastation of the earthquake, the Nepalese are already cleaning up. They probably feel considerable urgency as the monsoon season approaches.  Their surviving families, livestock and livelihoods are at stake, so they are reconstructing their homes with what they have: field stones piled into thick walls as before. But the aftershocks continue. Today there was another 4.4 that sent people scurrying back into the streets. The rain is coming, now only days or weeks away.