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On April 25, 2015, a 7.8 magnitude earthquake struck Nepal. The loss of life and destruction were immediate and widespread. This was further exacerbated by a series of aftershocks and, in the subsequent months, monsoon rains and landslides. More than 8,700 people lost their lives and 17,000 sustained injuries. Many of the survivors will require long-term care for the trauma they endured.
Direct Relief conducts its emergency relief efforts in the following stages: immediate (emergency response), short-term (disaster recovery), and long-term (disaster mitigation and preparedness).
1. Immediate Response: Only Sending What Is Needed
Immediately after the April 25 earthquake, Direct Relief began communicating with partner hospitals and health facilities in Nepal to identify their most critical needs. Thousands of people had been injured and displaced, and still-functional hospitals and clinics were overwhelmed with patients. That meant that, while there was an increased need for health services, the capacity to provide such care diminishedsubstantially.
Direct Relief worked rapidly to mobilize emergency medicines and medical supplies for emergency medical teams and Nepalese-based organizations and health facilities responding to the disaster.
Also, through its preparedness program, Direct Relief had on hand many of the medical items required in disasters where trauma injuries, wound-related infections, dehydration, and conditions are prevalent. This program, which involves healthcare companies donating specific items to hold in inventory for disaster response purposes, enables wound care products, antibiotics, IV solutions, surgical supplies, orthopedic casting materials, and medications for diabetes and cardiovascular issues to be available for shipment immediately following a disaster.
Since the first earthquake struck Nepal, Direct Relief has delivered 144 tons of specifically requested medical material resources valued at $29 million. Direct Relief distributed these donated medicines and medical supplies to hospitals, emergency medical teams, medical outreach camps, and Nepalese NGOs caring for survivors.
In addition to donated medical resources, and based on requests from Nepal’s Ministry of Health and Population and the Emergency Operations Center, Direct Relief purchased medical supplies and equipment in India, which were delivered and distributed to specific district and referral hospitals. These items included critical care equipment such as ventilators and x-ray units, medical and surgical supplies such as orthopedic implants and hardware, and safe birth kits for use by midwives caring for pregnant women.
Facilities and organizations in Nepal that have received emergency shipments of medical material resources from Direct Relief include:
2. Short-Term Response: Anticipating Health Needs
A precise projection of health needs requires assessments that are not always possible while an emergency is still unfolding. However, the rapid provision of healthcare-related resources and support is critical to ensure that disaster survivors receive appropriate and adequate care and to prepare for the rehabilitation of the healthcare infrastructure.
Patients with severe injuries require effective care throughout the treatment and rehabilitation period. People suffering from chronic medical conditions must resume their medication and testing regimens. Those living in temporary shelters must contend with crowded and unsanitary conditions that can lead to outbreaks of life-threatening respiratory and water-borne diseases. And, in the case of Nepal, living conditions and access to medical care and resources have been significantly impacted by monsoon season rains.
To visualize the earthquakes’ impact, obtain updated information on local needs and conditions, and help identify critical issues requiring consideration in short- and long-term recovery efforts, Direct Relief used specialized Geographic Information System (GIS) software to develop a series of maps.
The mapping exercise – Open Data: Nepal Earthquake 2015 – uses a variety of data sources to understand better the changing needs and conditions in Nepal. Attributes include the location and intensity of aftershocks; where the greatest numbers of injuries occurred; the extent of damage to roads, airports, health facilities, and other infrastructure; physical locations of vulnerable populations; environmental concerns such as landslides and flooding; and the presence of health facilities and organizations.
The mapping tool provides valuable insight into earthquake-related needs and circumstances and enables Direct Relief to make more informed decisions regarding response efforts.
3. Long-term Response: Sustaining and Rebuilding the Health Infrastructure
A major emergency often requires substantial repairs to infrastructure repair, and this need is particularly acute within the health sector as disasters often severely damage health infrastructure and medical facilities throughout the health system. After the 2010 Haiti earthquake, Hurricane Sandy, 2012 Japan earthquake and tsunami, and the Ebola crisis – Direct Relief observed local groups doing great work to help survivors, but rarely did these groups even make it onto the radars of international donors. In each instance, as in Nepal, Direct Relief identified and provided such groups with cash grants to cover response-related expenses.
A deciding factor in the selection of grantees is whether they focus on the long-term treatment and care of people with disabilities. Direct Relief’s experience in post-disaster situations has reinforced the importance of supporting the institutions and services that provide specialized care for people who have suffered severe traumatic injuries.
To help strengthen and rebuild the health system in Nepal, Direct Relief has identified, vetted, and supported the following locally-run organizations:
Story of Survival: Ram
Ram was home with his wife, mother, and other relatives. His mother was working outside when she felt the earth move. As their home collapsed, she witnessed it bury her son and daughter-in-law. She raced to them and managed to move enough debris to spare the lives of Ram, his wife, and several others. Tragically, Ram’s grandmother was killed that day, and Ram suffered a spinal cord injury resulting in paralysis from the waist down.
Ram was hospitalized for several weeks before transferring to SIRC, where he has remained for roughly three months.
Ram has been making excellent progress at SIRC. He received awheelchair customized for earthquake-affected patients who live in rural areas. The three-wheeled chair allows its owner to travel longer distances with less fatigue in hilly and off-road conditions. Ram has been learning to use his wheelchair through daily training sessions in both indoor and outdoor courses.
Ram’s wife has been staying with him at the facility, learning about his condition and helping to care for him as he moves through the comprehensive rehabilitation program. They are both optimistic about the future, and grateful for the care and support that they are receiving at SIRC.
Story of Survival: Indira
Indira, who was pregnant and just a few weeks away from the delivery of her first child, was home with her family when the earthquake struck. Their poorly constructed house collapsed instantly, crumbling around them. Falling debris killed Indira’s mother-in-law, and Indira suffered a spinal cord injury. Other family members were fortunate enough to escape with only lacerations and broken bones.
Neighbors helped to free Indira from the rubble, and after waiting for many hours, she was finally transported to Tribhuvan University Teaching Hospital in Kathmandu. Despite the severity of her injury, she received some good news at the hospital. Indira suffered an incomplete spinal cord injury, meaning that some feeling or movement was still evident below the point of injury. With considerable rehabilitation, she would be able to walk again. She also learned her unborn child hadn’t experienced any trauma or significant health-related problems.
Indira stayed at the hospital for eight days to ensure that she was in stable condition. She then transferred to SIRC and was instructed to rest until the baby was born. After two weeks of being cared for at SIRC, Indira was brought to another Direct Relief partner, Dhulikhel Hospital, where she gave birth, via C-section, to a healthy baby boy.
Indira has returned to SIRC for rehabilitation treatment. Her mother and husband have taken turns staying at the facility and helping her care for the child. Her recovery may be gradual, but thanks to SIRC, Indira should be able to return to her daily life.
Individuals, foundations, and businesses entrusted Direct Relief with a total of $6,524,979 to help people affected by the earthquake in Nepal, and Direct Relief has restricted every penny for that exclusive purpose:
Of the total Nepal-designated cash contributions received to date, Direct Relief has spent $2,292,275 on earthquake response activities and support of local Nepalese groups to improve the health and lives of people affected by the earthquakes.
Direct Relief is committed to working with healthcare facilities and public health agencies in Nepal to provide intermediate and ongoing health care for earthquake-affected communities, and to rebuild and strengthen the country’s healthcare infrastructure.
On behalf of those who have benefitted from Direct Relief’s Nepal Earthquake Response efforts, thank you for your compassion and generosity.