Immediate medical response and injury rehabilitation in Nepal earthquake: A quick review

Soon after the earthquake, hospitals were crowded with the injured people who needed surgical/medical services. Giving priority to the people with major trauma, others were relocated to the transition homes that had nursing care to prevent the infection of wounds. Large chunk of people had extremity injuries involving arms and legs.  It was estimated that nearly 1500 people with injuries needed long term rehabilitation care including around 60 recorded amputees and 200 spinal cord inured persons. Those with the need of long term rehabilitation were admitted in step down care facility and injury rehabilitation centers. People mainly in remote part of country were not able to reach to hospital because of blocked road and lack of transportation and often made a delayed presentation to health care facilities or mobile medical camps with infected wounds. The tireless works by Ministry of Health and Population (MoHP) together with the health cluster partners were able to meet the health needs of the affected people.

Major achievements

  • Foreign Medical Team (FMT) arrived on very next day of earthquake and deployed in EQ affected districts in coordination with Ministry of health and District Health Office. They treated around 28,372 OPD and 1499 IPD earthquake inured people with 440 major surgical intervention by the end of May 2015.
  • Hospital based syndromic surveillance system was established from at least 38 hospitals including event based reporting and partner reporting; and intensive case identification and treatment of communicable diseases like diarrhea, cholera, Hepatitis A, Influenza etc was done. Mass immunization for vaccine preventable diseases in affected communities were also organized.
  • Thousands of injured people were assisted to be discharged and referred to step down care facility and other hospitals for decongesting the health facilities
  • Multiple transition homes with nursing care were established for long term care and rehabilitation of injured persons.
  • Hospitals in Kathmandu performed hundreds of reconstructive surgeries with the provision of prosthetics and orthotics support who had the need.
  •  National and district level heath workers were trained in post-traumatic rehabilitation and injury management
  • Health post and community health workers were trained in early identification of impairments, risk factors for complications, and referral for medical and rehabilitation care
  • Physiotherapy service was also included in outreach mobile clinic
  • Spinal cord injury working group, reconstructive surgery and rehabilitation working group and prosthetic and orthotic working groups were formed
  • Establishments of early recovery working group to coordinate the partners who supported Ministry of Health and Population in the reconstruction of damage health facilities

Challenges

  • Despite the provision of free health care services to earthquake victims, some were reluctant to visit to hospital for follow-up care.  They were supposed to hold an Earthquake Injured Victim Card for claiming for free service. But, they complained of not having an easy access to the victim card because of the poor distribution mechanism and lack of coordination among health facilities.  Apart from that, due to lost to follow-up care, an increase in the number of cases with infected wounds in the community was reported.
  • Transportation of medicines and medical supplies to health facilities of remote area of districts became a challenge, particularly because of landslides in monsoon season.
  • Scarcity of Medical Commodities and Pharmaceuticals
  • Overwhelmed and exhausted human work force in government health facilities

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


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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