Following earthquakes, building a more resilient Nepal

The UK's International Search and Rescue team go to work in Chautara, Sindhupalchok District, north east of Kathmandu, Nepal.

May 13, 2015 —  Like others before him, Harvard T.H. Chan School of Public Health student Kai Hsiao, MPH ’15, predicted that a major earthquake in Nepal was inevitable, and that the health care needs in the aftermath of such a disaster would be overwhelming. In a class paper he handed in just weeks before earthquakes struck the country on April 25 and May 12, he described the country’s health care system as unprepared for the triple burden it would face following an earthquake: acute injuries, the threat of epidemic-prone diseases such as typhoid and cholera, and the needs of a large population of people with chronic diseases whose care would be disrupted.

Kai Hsiao

Hsiao, an emergency medicine resident originally from New Zealand, spent three months working in a hospital in eastern Nepal  before enrolling as a student at Harvard Chan School in 2014. The vulnerabilities he saw in the country’s health infrastructure, as well as its lax building standards, raised his concerns. He noted that emergency medicine is still new in Nepal, with only a handful of physicians trained in the specialty.

He conducted research into Nepal’s earthquake vulnerabilities for a course he took earlier this year as part of his concentration in Humanitarian Studies. Hsiao learned about the current disaster while participating in a three-day humanitarian response simulation exercise as part of the program. A fellow student working for an aid agency was called to leave the simulation exercise to deploy to Nepal for the real thing.

Hsiao presented his findings at a panel discussion at the School on May 7 co-organized by Students for Nepal. He was joined by Jennifer Leaning, Francois-Xavier Bagnoud Professor of the Practice of Health and Human Rights and director, FXB Center for Health and Human Rights. View webcast

In Hsiao’s predicted scenario, which placed the epicenter of the quake in Kathmandu, deaths and injuries would have been far higher due to the city’s haphazard development and poorly designed buildings. Having predicted that the city’s hospitals were vulnerable, he was encouraged to see that they remained functional.

Hsiao stressed the importance of building long-term preparedness and resilience into the humanitarian response to the disaster. “Rather than simply reacting to the immediate needs, how do we leave the place stronger than it was before?”

During the webcast, Leaning said, “Nepal began from behind in terms of preparedness. We have to help them catch up.” She noted that Nepal had received just $18.5 million out of the $415 million in aid requested by the United Nations Office for the Coordination of Humanitarian Affairs. The U.N. raised the appeal to $423 million following the May 12 earthquake.

A team from the Harvard Humanitarian Initiative has been on the ground in Nepal since early May and has been working with several major nongovernmental organizations to assist in crisis mapping, assessments, and information management.

Nepal relief efforts at Harvard Chan School

After Nepal earthquake, caring for the injured (Harvard Chan School News)

Amy Roeder

Photos: Jessica Lea/DFID, Craig LaPlante