Emergency health response to Nepal earthquake: A quick review

 The 7.8 magnitude earthquake on 25 April and the strong aftershock on 12 May that struck central and eastern regions of Nepal caused 8,856 deaths and thousands of injuries. According to the Ministry of Home Affairs (MoHA), over 500,000 houses were destroyed and 269,000 damaged forcing thousands of people to leave their homes and to stay in temporary settlements among 14 affected districts: Bhaktapur, Dhading, Dolakha, Gorkha, Kathmandu, Kavre, Lalitpur, Makwanpur, Nuwakot, Okhaldhunga, Ramechhap, Rasuwa, Sindhuli and Sindhupalchok.

Source: Post Disaster Need Assessment (PDNA) report

The public health consequences of the earthquake was significant, with a total 1003 health facilities- mostly village health post often serving the population in hard to reach areas- were damaged and rendered non-functional. The total monetary value of damages and losses due to the earthquakes was estimated to be NPR 7.5 billion. A total of 18 health workers, including 10 Female Community Health Volunteers (FCHVs) lost their lives and other 75 health workers were injured. More than 1500 people with injuries needed long term rehabilitation care, about 60 lost their limbs and 200 sustained spinal injury.

Overall, during the post disaster period, there was increase in the incidence of

  • Injury related health conditions
  • Water and foodborne diseases- mainly diarrhea, cholera, typhoid, Hepatitis A
  • Diseases associated with crowding- Influenza like illness (ILI), Severe acute respiratory infection (SARI), tuberculosis, exacerbation of chronic obstructive pulmonary disease (COPD),
  • Vector-borne diseases- dengue, malaria, scrub typhus
  • Vaccine preventable disease- measles, chicken pox
  • Psychological problems
  • Others health conditions- Malnutrition, Sexually transmitted infection, skin infection, scabies, diabetic complications, uncontrolled hypertension, hypothermia

Emergency Health Response

The Health Cluster was activated in affected districts and started medical response in coordination with 227 partners. The Health Cluster had the following sub-clusters that conducted 3035 health activities in all affected districts and provided emergency health services to address immediate needs of affected populations residing in areas with insufficient access to health care

The Water, Sanitation and Hygiene (WASH) cluster was also formed immediately in coordination with Department of Water Supply & Sewerage (DWSS) and established basic hygiene standards and provided clean water to underserved populations in areas affected. Nutrition cluster coordinated the nutritional related activities including the nutritional assessment and distribution of supplementary nutrition to the affected population and help to minimize the malnutrition.

Health Operation Center (HEOC) was established and functioned 24/7 to ensure effective coordination and avoid duplication and confusion of the health response activities.

As part of the recovery efforts, the Government of Nepal (GoN) and the Ministry Of Health and Population (MHP) conducted the Post Disaster Need Assessment (PDNA) to estimate the total damages and develop a comprehensive strategy for recovery and reconstruction in 14 priority districts.  GoN also developed a Standard Guidelines for Post Disaster Reconstruction to guide the partners in reconstruction support.

Major achievements 

  •  Almost 99% of the destroyed and damaged health facilities resumed services across all affected districts within one hundred days of the response through rehabilitation of damaged health facilities
  • Surgical, medical and emergency obstetric care was made accessible to  earthquake affected persons particularly with trauma, wounds and burns; pregnant women, mothers, new-born and children remained a priority
  • Rehabilitation care was provided to the people with orthopedic and spinal injuries with the provision of step-down facilities and injury rehabilitation unit
  • Hospital based syndromic emergency surveillance systems was initiated that was effective in controlling cholera, H1N1 and typhoid outbreak in earthquake affected districts
  • Intensive Water, Sanitation and Hygiene (WASH) support was provided to the underserved populations and effort was made to maintaining the SPHERE standard on hygiene
  •  TB screening and chest camp was conducted for nearly all displaced population staying in temporary settlements in earthquake affected district
  •  Psychosocial support (primarily psychosocial first aid) was provided to the vulnerable people

Challenges

  • Weak inter-clusters and inter-partners coordination mechanism in central and ground level
  • Over exhausted human resource in government health facilities
  • Pre-existing health system barriers including natural calamities
  • The partners and agencies could not uniformly cover the all affected districts and remained concentrated in selected districts
  • Insufficient information sharing and reporting on logistical and other supports as well as on beneficiary list from the partners and agencies

References

https://www.humanitarianresponse.info/en/operations/nepal
https://www.humanitarianresponse.info/en/operations/nepal/health
https://www.humanitarianresponse.info/en/operations/nepal/foreign-medical-team-wg
https://www.humanitarianresponse.info/en/operations/nepal/injury-and-rehab
https://www.humanitarianresponse.info/en/operations/nepal/tuberculosis
https://www.humanitarianresponse.info/en/operations/nepal/nutrition
https://www.humanitarianresponse.info/en/operations/nepal/water-sanitation-hygiene
https://www.humanitarianresponse.info/en/operations/nepal/mental-health


My education includes training in medicine, public health, clinical research, biostatistics and health response in complex emergency. I have more than seven years of experiences in health research (Survey, Case control studies, Randomised Controlled Trials (RCT), Health Policy and Systems Research). My areas of expertise also include the project management particularly in health sector. I have also experience and interest to work in health emergency in large population in disaster setting.

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