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Caring for Earthquake Survivors and Rebuilding Health Facilities in Early Stages of Nepal Recovery

  • July 28, 2015

In Kathmandu, AmeriCares continues to distribute more shipments of critically needed medicines and supplies as the organization establishes a longer term presence and implements recovery programs.

The current team of international and local staff followed other medical and support staff led by the first AmeriCares India team that responded within 48 hours to the worst earthquake in Nepal in 80 years. In the immediate disaster response phase, AmeriCares mobilized medical teams and provided critical medicines and supplies to frontline health workers. Early recovery efforts focus on rebuilding health systems by working with local partners. Programs for health facility repair and mental health services are getting underway.

The 7.8-magnitude earthquake rocked the country, caused buildings to collapse, set off avalanches on Mount Everest and catapulted the entire region into chaos. It struck shortly before noon local time on April 25, centered about 50 miles from Kathmandu and could be felt as far away as New Delhi. More than 100 aftershocks have been recorded throughout the region, with more predicted – hampering rescue operations and terrifying survivors. The most powerful aftershock, a 7.3 magnitude quake more than two weeks after the initial disaster, has added to the death and injury toll. The monsoon season creates even greater urgency as survivors seek shelter amidst damaged and ruined buildings.

In the early days, our India medical team treated hundreds of patients through temporary medical camps in Kathmandu and nearby heavily damaged communities, while other team members distributed much needed medicines and supplies to partners on the ground and coordinated relief efforts with inter-agency groups and government authorities.

More air shipments of medical aid arriving in country after the first emergency airlift of 14 tons of medicines and supplies help to resupply hospitals, partners and mobile medical teams treating earthquake survivors. To date, more than $21.5 million in medicines and supplies have been shipped or hand carried to Nepal. Our team has established a temporary warehouse in Kathmandu, identifying needs and coordinating distribution with partners. In addition, AmeriCares is providing direct support to local partners, working to maintain health care access while planning to meet longer term needs in rebuilding and strengthening the health sector.

AmeriCares has been working with international medical teams on the ground in Nepal helping earthquake survivors. The teams included a special surgical group from India performing more complex surgeries on badly injured survivors. One of our partners, NYC Medics, has treated hundreds of survivors in hard-hit areas of Dhading District.

Massive Damage and Many Displaced Persons

Dr. Swati Jha of our India team treating a child survivor at Kirtipur Hospital Photo by Matthew McDermott.

More than 8,900 people are reported to have died in Nepal with thousands more injured. The U.N. estimates that the earthquake affected 8.1 million people — more than a fourth of Nepal’s population of 27.8 million — with over 2.8 million in need of humanitarian assistance. At least 880,000 homes have been destroyed or damaged, leaving many people homeless. Over 1,100 medical facilities have been severely or totally damaged in the most affected areas, making the need for mobile medical teams, medical tents and supplies even more acute. Shipments of medical tents and general use tarpaulins are underway as the monsoon rains have begun and further damage from aftershocks add to the dangers faced by survivors.

The scattered settlement of displaced persons in Nepal presents a particular challenge. The small, temporary settlements shift from place to place, complicating the task of planning and delivering adequate services. Lack of adequate water and sanitation in these small settlements increases the risks of disease, particularly in the monsoon season.

Communities outside of Kathmandu at the epicenter of the quake have been devastated and are difficult to access with the damage to roads and infrastructure. The India team was among the first to visit some of these communities to provide immediate medical care. Some of the more remote communities have been so completely leveled that they may have to be abandoned and the inhabitants relocated.

“With continued aftershocks and the monsoon season, we are very concerned about more injuries to survivors that could come with the collapse of already damaged buildings,” said Senior Vice President of Global Programs Dr. E. Anne Peterson.  “We are committed to providing health care access for immediate needs and restoring health services in the longer term.”

Read Dr. Peterson’s latest post:
When the rains come, what happens then? 

Survivors face aftershocks and monsoon season in makeshift shelters  Photo by Matthew McDermott

Building Back

With a commitment to helping Nepal build back better, we draw on our experience in early recovery and longer term rehabilitation programming to inform the next stage of our extended response strategy to restore health services for disaster survivors. Initially, we are evaluating rebuilding options for damaged facilities in conjunction with an engineering firm and training local counselors to provide mental health services at three hospitals in the Kathmandu area. AmeriCares is working with local partners to rehabilitate health facilities in Dhading District.

AmeriCares is supporting the efforts of partners and the government of Nepal to set up “Step-Down Care Facilities” in areas where hospitals were severely damaged. These facilities can provide follow-up rehabilitation services, nursing care and safe shelter for internally displaced persons (IDPs) who sustained earthquake-related injuries and disabilities.

Survivors’ Health Needs

Earthquakes survivors in Nepal are at risk for many health problems, says AmeriCares Medical Officer Dr. Julie Varughese. Early on, thousands of survivors needed medical treatment for cuts, lacerations, crush injuries and broken bones due to collapsing buildings and falling debris. In the following days and weeks, survivors suffer from wound infections and respiratory problems from inhaling dust. With disrupted water supplies and sanitation problems, survivors can become ill from drinking unclean water. The most vulnerable people – older people and young children, for example—are at risk for illness from exposure to changing weather conditions as well as overcrowding; tens of thousands of survivors are living in tents in Kathmandu as well as in any kind of makeshift shelter in outlying communities, either because their homes were destroyed or damaged or very real threats from continuing aftershocks.

Supplies of trauma and surgical supplies such as scalpels and sutures, IV fluids, antibiotics and other infection control medicine were critical in the early days, says Dr. Varughese, as were anesthetics for use during surgery. Subsequently, vaccinations against tetanus and measles are important as survivors often live in crowded conditions. Health workers also need to help survivors with stress from trauma and loss after this devastating disaster. Mental health services, therefore, need significant support.

Dr. E. Anne Peterson, AmeriCares SVP of Global Programs, walking through ruins of community of Lagnol. Photo by Matthew McDermott.

Nepal Prone to Quakes

Nepal is prone to earthquakes as it sits atop a thrust fault where the India and Eurasia tectonic plates meet: In 1932, the magnitude 8.0 Nepal-Bihar earthquake killed more than 10,000 people, the most deadly earthquake in Nepal’s history. A magnitude 6.9 quake killed close to 1,500 people in 1988.

Scientists believe that the 7.8 magnitude April 25 quake was felt by an estimated 105 million people in Bangladesh, India, Nepal, Pakistan and China’s region of Tibet, causing numerous landslides, especially in areas outside Kathmandu with steep slopes. Roads to the Gorkha district, the quake’s epicenter, were blocked by landslides. Many towns and villages have been completely destroyed, and continuing aftershocks are causing more destruction and death. 

A week before the quake, 50 earthquake and social scientists had met in Kathmandu to discuss the city’s vulnerability to a massive quake.  

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AmeriCares has been aiding survivors of natural disasters, political conflict and extreme poverty around the world for more than 30 years, saving lives and restoring health and hope.

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