Six months have passed. Looking back, it feels like just a short time ago that I was waiting to board a flight to Kathmandu – four days after a 7.8-magnitude earthquake rocked Nepal on 25th April. With its epicenter barely 100 kilometres from Kathmandu and first reports of the collapse of a nine-storey tower, I thought there’s nothing much left of the capital city. As I sat in the departure lounge, I could see the toll of dead and injured on the TV screen mounting every few minutes.
As such, it was pouring and lightning outside, very unusual for an April spring, tourist season in Nepal. My heart went out to those who had lost their shelter and their loved ones, and were stranded in the hills amid ongoing aftershocks and unfathomable destruction.
In the next few hours, as I embarked upon my first emergency assignment, I was going to travel to some of the most affected areas and witness first-hand the scale of the destruction.
On 1st May, I was part of a relief medical camp conducted by our partner HRDC (Hospital and Rehabilitation Centre for Disabled Children) in the yard of a partially-damaged house in Sipaghat in Sindhupalchowk district. Of the 133 clients, there were mostly people who had sustained severe head and spinal injuries, broken arms and ribs, and many had deep cuts all over their bodies. With minimum surgical equipment, the team sutured cuts and wounds, provided assistive devices such as cervical collars, splints and slings, and transported critical cases to Kathmandu for further treatment.
The next two weeks were very crucial. As CBM joined forces with a string of partners, including local DPOs (Disabled People’s Organisations), to conduct a Rapid Need Assessment (RNA) of the overall situation, I had to travel to seven of the 14 worst-affected districts. The RNA team held long discussions with CBM partners on how they could scale-up their capacities to meet the sudden rise in patient count and related demands. I was also part of several UN Cluster meetings where CBM not just represented but played a crucial role in creating an advocacy alliance that voiced for ‘inclusive humanitarian response’.
As life was slowly getting back to normal, a second major quake measuring 7.3 on the Richter scale jolted Nepal on 12th May. What I saw at HRDC hospital that day will remain unforgettable. Fortunately, the 20 tents provided by CBM were useful, to shift all 72 in-patients from the wards into safer, open spaces. While the children stayed in the tents for a month, the medical team at HRDC continued to reach out to some of the remotest villages in Sindhupalchowk, Kavre, Dhading, Makwanpur and Chitwan districts, and provided much-needed medical services to the people.
Over the next few months, I continued reporting about the efforts of CBM and its partners on the ground. As I travelled, I experienced and engaged in a range of activities conducted by CBM partners for people and communities impacted by the earthquake. Of all, the work of our partner ‘Koshish’ at providing psychological first aid (PFA) is of the utmost importance. I almost cried during a PFA session for schoolchildren in Bhaktapur district, as the little ones narrated their tales of trauma. Bhaktapur, with over 300 deaths and 12,000 injured, is one of the worst-hit districts. As schools reopened about two months after the earthquake, children were extremely happy to be sitting again in the classroom, but had a deep sense of fear and anxiety.
“Given the impact of disaster on the mental health of growing children, it’s important that we conduct psychological first aid sessions with schoolchildren…We have been doing such sessions in schools across Bhaktapur district after the Nepal earthquake,” explained Savitra Neupane, psychologist with Koshish. Furthrmore, with the support of CBM, Koshish went a step ahead to train teachers and social workers from other organisations on PFA and psychosocial counseling. “Sadly, there aren’t many organisations working to address the psychosocial needs of people affected by the earthquake… We’re happy to be working with CBM,” Savitra added.
Another memorable moment was meeting Ganga at the field hospital of our partner ‘The Leprosy Mission Nepal (TLMN)’ in Lalitpur district. “Ganga was heavily pregnant during the second quake on 12th May. As we were living in a tent, we were really worried about Ganga’s health. Yesterday morning we brought Ganga to Anandaban (TLMN) Hospital at around 7 am. We didn’t want to take any risks of post-partum complications. But even here everything was out in the tents… Ganga delivered a boy at 7.25 am. It was a smooth delivery and everything went well,” exclaimed Ganga’s caretaker Subhadra. Amid tents filled with injured patients, Ganga was beaming with joy. “Every now and then there’re people coming to our tent to see the newborn. I think they’re surprised to see a baby born in the tents…” said Ganga looking her baby.
Both TLMN and HRDC continued with their medical outreach camps in the affected districts. Sharing his experience, Dr Bibek Banskota, medical director at HRDC, says: “Initially, we saw a lot of clients with serious injuries at the outreach camps. But over a period of weeks to months, the flow of patients started changing into more chronic type of problems coming out of lack of proper sanitation, living in open shelters, and not having access to food and clean drinking water.”
In the meantime, CBM set up a dedicated emergency response team (ERT) in Nepal, and continued to roll out a full-fledged emergency response program with nine partners working mainly in central, and parts of eastern and western Nepal. In its first phase of eight months, the ERT was directed to work with a ‘twin-track approach’ – to empower persons with disabilities to access relief and participate in response initiatives, and to ensure mainstream relief is disability inclusive.
To me, the most strategic of interventions was what CBM borrowed from its experience of working in Haiti and Philippines – called the ADFP mapping system. ADFPs, or the Ageing and Disability Focal Points, were specialized hubs set up in three most affected districts in partnership with ‘National Federation of the Disabled Nepal (NFDN)’. These focal points were tasked with mapping all service providers in a particular area, and linking them with people or families that are in need of a particular service.
During a visit to Sindhupalchowk district in early July, I met Tul Bahadur (who has visual impairment) and his family at their temporary hut. Asked what support has he received from the ADFPs, a joyous Tul Bahadur explains: “I’m receiving their help since I got my disability identity card… After earthquake, they have provided me with a temporary shelter. In addition, I got 20 kg rice, two liters oil and two packets of salt. I’m happy that they provided me a radio. Now, I get all important information to cope with the post-quake situation. I even listen to music to heal my pain.”
Six months on, CBM has touched the lives of over 21,000 people from across all 14 affected districts in Nepal. Through outreach camps in remote, inaccessible villages, our partners have provided medical services to 14,800 people. Thanks to our partner Koshish, more than 2,700 people including schoolchildren have received psychosocial counseling through classroom sessions and psychiatric clinics. Through the focal points, more than 3000 people and 70 organisations have been ‘mapped’, and more than 900 referrals made. Besides, CBM has also held workshops with government officials, NGO and civil society members on accessibility and building inclusive structures. We’re also working with the Ministry of Health and Population in Nepal to provide injury management training to community health workers in 14 quake-hit districts. A campaign on accessible media information on relief and recovery work is underway; and CBM together with ‘HelpAge International’ is carrying out an operational research to analyse the impact of disasters on people with disabilities and older people, among other long-term initiatives.
However, this month as I visited Sindhupalchowk, on the way I could see children studying in an open, makeshift classroom right next to the highway – with just a tarpaulin sheet as a roof over their heads and shield from the noise of vehicles passing just inches away. I felt extremely sorry for the little ones. Indeed there’s so much to do. We have a long, long way to go… People continue to live in temporary shacks and struggle for basic needs and healthcare. October end marks the onset of winter in Nepal and temperature in the remote hills of Sindhupalchowk can drop to –5 degrees Celsius.
This week as I return to my hometown in the plains, the first time after the April 25 earthquake, my thoughts and prayers are with the hapless survivors battling winter chills up in the hills. While the rest of the country is celebrating the ten-day Dashain festival, the survivors must be missing their loved ones, must be remembering how things were during Dashain last year. But I know the tides will turn, and I look forward to being part of it, to doing more together!