Tag Archives: nepal

Many lessons learnt a year since the Nepal Earthquake

As I walked through the tiny entrance of a narrow but towering structure housing one-room homes in Madhyapur Thimi, a municipality in Bhaktapur District, I was hit by the vision of what it would have been like trying to escape through the a narrow and creaky wooden stairway when the Nepal Earthquake 2015 struck around noon on a balmy Saturday.

I brushed aside my anxiety and began groping in the dark for support though it was around noon; the bright sun outside offered a strange contrast to darkness in the building. Over the next week or so the question kept troubling me as the people we met talked about those who were left behind.

I was getting back after interviewing one of the survivors who are rebuilding their lives through the CBM and partners’ emergency response. For some of these partners, this was their first foray into emergency response, but they have great experience working on disability and development, so the projects extend smoothly into building community level capacity. I had been traveling to document what has changed as we approached the first anniversary of the Nepal Earthquake that killed over 8,000 people and injured more than 21,000.

Image of a temple partly destroyed by Nepal Earthquake o2015

A year since the Nepal Earthquake of 2015, the culturally important monuments still bear the marks of destruction.

An earthquake quake that ended the quiet

Sipping tea in the idyllic setting of the campus of the Hospital and Rehabilitation Center for Disabled Children, Dr. Bikash Man Singh underlined quite literally with his finger on a neat table top that the focus in now on preparedness and to map most at risk  sections of the community, especially people with disabilities, and build capacity of the health staff and community workers.

“The earthquake has taught us a difficult but a much-needed lesson of planning and working together, not just when a disaster happens, but all through… as one cannot see it just as a project… it’s an approach,” he said.

CBM has been working in the region specifically with medical and health institutions that play a critical role in the chain of events that follow when disasters strike.

Nepal has a vocal disability sector and a national level network of disability organisations that give advocacy teeth when it comes to national level policies. The earthquake has driven home the need for disability rights organisations to embrace the approach of disability-inclusive disaster risk reduction (DRR).

“We were all left shocked by the earthquake and deeply concerned about the impact it had on people with disabilities. The questions kept coming, on how will they reach the camps, medical centres, relief distribution… including issues like the accessibility of communication and response infrastructure being created,” said Manish Prasai, Administrative Manager, National Federation of the Disabled, Nepal.

Manish Prasai, Administrative Manager, National Federation of the Disabled, Nepal.  Manish has been a bold voice in Nepal’s disability sector.

Manish Prasai, Administrative Manager, National Federation of the Disabled, Nepal.

Manish has been a bold voice in Nepal’s disability sector and with CBM’s support, he has started steering the network to influence the national policy conversations on rebuilding and long-term planning around resilience.

“I don’t think people have forgotten the earthquake and its lessons… even the children who are barely at the age when they can speak talk about the disaster,” said Punyashori Suwal, an emergency response coordinator for the CBM support project with HRDC.

On the way back to Kathmandu city, we watched long queues of vehicles lined up for fuel that is still scarce with its distribution being regulated.

Punyashori talked about the experience of chaos that followed the earthquake with relief response not being well coordinated in the first few weeks. “We have learnt to appreciate the importance of coordination the hard way,” she said.

Stepping out of the longest two minutes

Everyone remembers where he or she was when the ground started shaking for close to two minutes. It felt like an eternity that changed things forever. When these stories are recounted one can see how their personal and collective memory has been impacted and reshaped by the disaster.

Even today wooden beams are seen holding the walls of buildings and historical structures in Madhyapur Thimi, one of the ancient, cultural and historical places along the trade route from Bhaktapur to Kathmandu.

This reminded me of the lingering impact it continues to have on survivors who have been receiving mental health support and psychosocial counselling from a CBM-supported project with partner KOSHISH, a respected and pioneering group working on mental health issues in Nepal.

“It is important to not let go of the realisation about the importance of trauma management and psychosocial care in disaster and the post-emergency response,” said Leela Khanal, Program development officer with CBM’s emergency response project. I was witness to how psychosocial trauma can leave not just individuals – like Hari, who is recovering now – but whole families isolated in society.

Santoshi, a survivor of the Nepal Earthquake 2015, with her family on a consultation  visit to Anandaban's  The Leprosy Mission  Hospital

Santoshi, a survivor of the Nepal Earthquake 2015, has recovered fully with the CBM supported project and is now looking at an independent future.

As we approach the anniversary of the April 2015 Nepal earthquake one can clearly see that the scars remain but so do the lessons learnt. What’s important is that there are more answers than questions.

Read more on CBM’s post emergency response in Nepal.


Six months after Nepal earthquake

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.

An aeroplane on the ground

First emergency assignment

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.

People with leg casts etc sitting eating

Outreach camp

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.

Meeting room with about 25 people

Cluster meeting Nepal earthquake 2015

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.

A man presenting to a group of adults

Koshish PFA session

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.

A young mother with baby

Ganga’s newborn baby

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.

A man holding a pocket radio to his ear

Communication is essential

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!

Read about CBM and partners’ response

Download six month report (PDF, ~ 1.1MB)


Nepal – We will rise again

Here is my first blog from Nepal, after a very moving day in Bhaktapur.

This ancient city lies nine miles east of Kathmandu. At its heart lie four connected courtyards containing some of Nepal’s most famous UNESCO World Heritage Sites, many of which were damaged or destroyed by the earthquake which shook Nepal on 25 April 2015.

Durbar Square, Bhaktapur

Durbar Square, Bhaktapur

In the main Durbar Square, around the base of one of the damaged temples, is an exhibition of photos of some of those who lost their lives, either because they were unlucky enough to live in old or poorly constructed homes or caught by the falling masonry in the web of narrow streets that characterise the area. Many of the photos show the faces of elderly men and women, or very young children, both groups disproportionately affected by natural disasters, but there are also faces of many other people, caught indiscriminately by either the first quake, or the one that followed two weeks later on May 12.

In one picture, a teenage girl in school uniform smiles shyly at the camera. Just a few yards away, a group of girls and boys of around her age are donning hard hats and picking up shovels before dividing into teams and heading off in different directions. Their matching t-shirts declare them to be members of the local community who are volunteering in street clearing initiatives.

This is one of the worst hit areas of the city and the lanes are still clogged with rubble, sometimes piled under the eaves of damaged houses, sometimes still filling the street so that you need to scramble over to get through. Despite other parts of Kathmandu being almost untouched, here there is not a road or side street which remains untouched.

Everything is covered with a thin film of dust, and the few shopkeepers who have ventured to open up again, busy themselves continuously with dusters and rags.

Psychosocial counselling and trauma care

A woman amongst rubble

Pramita Shrestha

I am with Pramita Shrestha, a social worker from KOSHISH, a CBM local partner that offers psychosocial counselling and trauma care in the Bhaktapur District. Pramita describes the additional support the psychologists and counsellors are providing, not only for those with mental health problems that they were already supporting, but also to an estimated 3,500 earthquake survivors who will need psychosocial support over the next few months.

This is one of the less visible after-effects of a disaster of this scale but one which touches on the lives of so many survivors. Schools have just reopened again and we are passed students with neat white shirts and royal blue skirts, matching ribbons bouncing above – but numbers are down as many children are too anxious to leave their parents, too scared to enter the school building or, with the many aftershocks still being experienced, too sleep-deprived to function well.

People have also started to return to work where they can, or to the social activities they used to enjoy and we see a few small groups of men on the verandas of undamaged houses playing cards or board games, while women sit in twos and threes knitting. But there are also those who sit in their doorways staring into space, and KOSHISH is reporting new cases every day of people of all ages struggling to come to terms with what has happened. Sadly for all those that come, as many remain unwilling to seek treatment for any kind of mental health condition which remains widely misunderstood and taboo in Nepal, as in many places.

Cleaning up, rising again

Man with wheelbarrow clearing rubble from street

Clearing rubble

We come across a single house collapsed among a row of otherwise intact buildings. Further along, two stories of a house with no side wall stand open to the air, as if a huge serrated knife has sliced vertically through the building.

As we approach, we see two figures rolling brick pieces down a corrugated iron sheet propped against the wall. On every street we come to, similar activity is beginning to take place. People on rooftops, shovelling debris. People pushing wheelbarrows of dust out of alleyways or carrying piles of bricks to the truck that cannot make its way down the blocked streets where life has started to go on once again.

Around the next corner, we come across a slogan daubed on a partially collapsed wall, “We will rise again”. Later someone walks past with this printed on a t-shirt.


Graffiti, Bhaktapur

The photos in Durbar Square are one of the ways that the city is mourning its loss and it will take decades before the country is close to full recovery. But this slogan has started to appear across the city and perfectly reflects the resilience of a nation that is already working hard to pick itself up and move forward.

KOSHISH was there in the days immediately following the earthquake, providing psychological first aid as vital as the bandages being so much more visibly applied, and it will continue to support for the long term the efforts of the Bhaktapur community to “rise again”.

Read more about mental health and emergencies


Inclusive humanitarian response – change is coming!

I arrived in Nepal on May 12th, some hours after the massive aftershock that caused more casualties and a number of additional damages to properties and infrastructure.

I could see in the faces of people how their lives were shaken again, and how they didn’t see where and how to ensure the safety of themselves and their families. My first night in Kathmandu was broken by a number of aftershocks that woke me up and made me run outside in search of safety.

Though earthquakes are not new to me, every time it makes me realise how frightening they are, bringing a feeling of helplessness.

Three weeks later, life has become quasi-normal in Kathmandu, with its traffic jams, crowds in the street, shops and restaurants all open. If you don’t travel to affected areas you won’t see that two major earthquakes hit the city only few weeks back. Though people are still talking a lot about them and every day small aftershocks remind all of us that it has happened.

Working with partners – ensuring inclusion

It’s been three weeks of working with partners to provide support to the most affected people, to raise awareness about persons with disabilities and older people and to make sure that all of them are included and have equal access to relief, despite the challenges posed by isolated and remote villages and the upcoming rainy season.

A woman (using a crutch) receiving medicine in a tent

Receiving medicines at a relief camp organized by CBM partner HRDC (Hospital and Rehabilitation Centre for Disabled Children)

Our partners are doing a great job to save lives and contribute to the effort made to assist people in need through trauma care and rehabilitation, organising medical outreach camps, providing psychosocial support – trying to help people to regain independence and normality in their lives. However, we still hear stories from persons with disabilities and older people not being able to access distribution points and being left behind – unintentionally – by relief stakeholders. It is a hard job to reach out to the most at-risk, as often they are not informed, cannot reach the front of the queue and their voices are not heard.

What would you do?

What would you do to find food if you are an 80 year-old man living more than a three-hour walk far from the main road and next city? You will walk downhill, hoping to access a relief package, and then find out that you have to carry a 30 kg bag back uphill …and that you can’t do it. You will seek support, but all other people are also too busy trying to survive to help you.

What would you do if you are a blind person trying to find out where distributions are happening and how to access them, only to discover that you have to compete to be front of the queue as there are not enough supplies for all? Obviously you’ll be at a disadvantage, and most likely you’ll lose out.

What would you do if you are a deaf person, having been transferred by helicopter to Kathmandu for trauma care and have no clue of what is happening to you as no one can communicate with you?

These are only few stories, but many more like this are reported every day…

It is great that donors and organisations are moving towards inclusive policies and frameworks, but exclusion happens on the field. What would you do if you were that relief worker and have limited aid to distribute? Field workers must be supported to turn inclusive policies into inclusive humanitarian action.

Advocating for inclusion

CBM works with our partner the National Federation of Disabled in Nepal (NFDN), supporting them to identify persons with disability and older people and assess their needs to then mobilise humanitarian stakeholders to respond to them. It is very encouraging as many of these organisations are willing to make the extra effort, but lack knowledge or information to ensure inclusion.

People in a workshop (including a wheelchair user)

Bhojraj Ghimire, CIL Kathmandu (checked shirt) takes part in the workshop on disability inclusion organised by CBM and the International Federation of Red Cross and Red Crescent Societies (IFRC) in Kathmandu

Early last week I gave a two-hour orientation on disability inclusion to Red Cross staff, and the head of the delegation said:

“The Red Cross movement was created to help the most difficult to reach and the ones who couldn’t care for themselves, and yet in our response we reach only the easy one. We need to make the extra effort to access all those who are living in remote areas, who are facing barriers to access relief and whose rights we should protect.”

Well, this kind of statement and willingness to walk the extra mile is very encouraging, as it will support the relief worker to develop the mechanisms to help the older man to carry home his 30 Kg of goods, the blind person to find the distribution point and be in front of the queue or the deaf person to access a sign language interpreter to understand what is happening to him and get news from his family.

I will travel back to Europe soon but I’m confident that our partners will continue to raise their voices and to make them heard by all. Change is coming!

Read more about the Nepal 2015 earthquakes