Nepal: Latest MSF Updates

Emergency Aid for Nepal

A 7.8-magnitude earthquake shook the Kathmandu Valley before noon on April 25. Although the extent of the damages is still unknown, initial reports say houses and buildings collapsed in Kathmandu and surrounding areas.

Tremors were also strongly felt in northern India, in the states of Bihar and Uttar Pradesh.

This page will be updated regularly with new information on our emergency response as the situation develops. Follow @MSF_USA on Twitter for updates.

Please note that we are not recruiting for the current emergency response in Nepal. MSF does not recruit for specific locations or emergencies. Anyone interested in working in the field with MSF can apply online but must be open to working in the country to which they are assigned. Assignment is based on the needs of the field and the skills of the field worker.

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Update: May 15, 2015

Nepal has been hit by two earthquakes in less than three weeks, killing thousands, injuring tens of thousands, and leaving millions more with the burden of rebuilding their lives. Doctors Without Borders/Médecins Sans Frontières (MSF) teams, who were already on the ground soon after the first quake, continue working to reach and assist those affected. They are continuing to prioritize people in remote mountain villages who have borne the brunt of the destruction and remain isolated from help.

MSF teams mobilized shortly after the first 7.8-magnitude earthquake hit on April 25 and began providing medical services and shelter and food materials by helicopter to people in isolated villages. These teams were able to respond almost immediately following the second, 7.3-magnitude earthquake on May 12. In remote villages like Singati, Marbu, Yanglakot, and Lapilang, MSF evacuated patients in critical condition to hospitals in Kathmandu. The organization is now conducting assessments following the second earthquake in order to re-adjust its assistance according to the needs that have arisen from the two quakes.

 “In some areas, there has been up to 90 percent destruction,” said Dan Sermand, MSF country director in Nepal. “Hospitals and health centers have been damaged by the two quakes, leaving many people with no access even to the most basic health care. Up until yesterday, there were still landslides ongoing in some mountainous areas that we assessed. In some areas, whole villages have now been brought down, compounding an already dire situation as many people had already lost their homes in the first earthquake.”

Health Care

In many districts, hospitals and health centers were flattened, and those still standing have numerous cracks making them susceptible to collapse. Bhaktapur Hospital received a mass influx of wounded people after the second earthquake, prompting MSF to donate dressing kits and medicine.

In Dhading, Gorkha, Rasuwa, Sindhupalchowk, and Nuwakot districts, MSF is providing medical and psychological services to those in need, some of whom had not received any medical assistance since the first quake hit.

In Dolakha district, the epicenter of the second earthquake, MSF tended to people in critical condition on site and evacuated those with severe injuries, including fractured skulls, to hospitals in Kathmandu for further medical attention.

In Arughat, in Gorkha district, MSF’s 20-bed inflatable hospital has been operational since May 8 and now sees patients affected by the two earthquakes as well as people from nearby communities. It has surgical capacity; maternity, emergency, and general wards; and a mental health program. MSF is also working with the Nepali Ministry of Health to offer outpatient services, and supporting drug supply, medical training, and the referral system for the hospital. An average of 100 patients are treated per day in the outpatient department, mainly suffering from respiratory tract infections, diarrhea, and wounds sustained from the earthquake. In the emergency room, MSF is treating an average of 15 patients per day, mainly suffering from fractures and wounds. The first baby was born in the maternity ward on May 12.

“Most of the health facilities in Gorkha district have collapsed and the Arughat hospital is helping provide the much-needed secondary health care in the area,” said Dr. Managama Guyguy, medical coordinator in Nepal. “There are people who tell us they have walked for five days to the Arughat Hospital. This goes to show just how severely the earthquakes have destroyed the health care system.”

MSF is also providing mental health services and psychosocial sessions in villages in Nuwakot, Gorkha, Rusuwa, and Sindhupalchowk districts. In the Arughat Hospital MSF is providing psychological care to patients and local staff who were traumatized by the earthquake.

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Shelter and Food

Shelter was already a major need before the second earthquake, and the situation is now even worse. “My house was cracked in the first earthquake; the second earthquake finished it,” says Rajkumar Pakhrin, an MSF administration assistant from Mirge village in Dolakha District. “I’m broken, I have lost my property and my cattle are no more, but I’m happy that my family was not in the house when this happened. They were in a displacement camp for fear of the house collapsing. And they were right.”

MSF teams have distributed over 2,300 shelter and hygiene kits in 20 of the most-affected villages across Rasuwa, Sindupalchok, and Gorkha districts. Teams have also begun distributing reconstruction material such as iron sheets and nails in some villages of Dhading, Sindhupalchowk, and Rasuwa districts.

Food, mainly rice and high-energy biscuits, has been distributed in Rasuwa, Sindupalchok, and Dhading districts.

Water and Sanitation

MSF has installed water supplies and is building latrines in Chuchibati camp in Kathmandu. Bladder tanks have also been set up in some villages in Rasuwa district. The team also provided the communities of Gumpatang, Tembatang, and Nimlung of Sindhupalchowk district with pipes and tanks to restore their gravity water system.

Transport Challenges

Aircraft remain the only means of transport to reach mountainous areas where roads have been damaged or blocked. Since large helicopters cannot land in remote villages—where most of MSF’s work is concentrated—small helicopters are the only option. These have very limited flight capacity, which restricts the amount of cargo that can be transported.

“In a few weeks the monsoon-season starts and people can no longer live outside,” says MSF Emergency Coordinator Peter Paul de Groote. “By then the remote areas will be very difficult to reach. The window of opportunity is now. We are making every effort to get shelter to these villages before this window closes.”

This is an excerpt from MSF's 2015 International Activity Report:

Two earthquakes hit Nepal on 25 April and 12 May 2015, killing an estimated 8,500 people and injuring another 20,000.

After the first 7.8 magnitude earthquake struck, MSF teams quickly arrived in the country and focused on reaching the people living in remote mountainous areas. The earthquake’s epicenter was in Gorkha district, 50 miles west of Kathmandu.

MSF ran a system of helicopter clinics to provide healthcare and hospital referrals for emergency cases. Regular clinics were conducted in villages spread across Gorkha, Dhading, Nuwakot, Rasuwa, Sindhupalchowk and Dolakha districts. Their focus, in accordance with the needs expressed by the communities, was children under the age of five, pregnant women and mental healthcare.

In Arughat, Gorkha district, MSF set up a 20-bed inflatable hospital with an operating theater, and emergency, maternity and resuscitation rooms. This replaced the local healthcare center that had been destroyed by the earthquake until the Ministry of Health was able to open a semi-permanent structure at the end of June.

MSF also set up a temporary tented clinic in Chhapchet, Dhading district, an area that was severely affected. Staff provided basic healthcare and carried out minor surgical interventions, for example on patients whose wounds had become infected.

MSF teams were already operational by the time the second earthquake struck on 12 May, and were able to start providing healthcare in the hours that followed.

With many remote villages completely flattened, and the monsoon season fast approaching, shelter distribution and sanitation work were the priorities. MSF transported around 6,000 family-sized tents into the mountains by both land and air, as well as almost 13,000 iron sheets and 3,000 reconstruction kits for the building of more permanent dwellings. By the time the monsoon arrived, almost 10,000 households in Dhading, Nuwakot, Dolakha, Gorkha, and elsewhere in the Budhy Gandaki valley had some form of shelter.

Between April and July, MSF conducted over 2,500 health consultations and provided psychological support to more than 7,000 people, mostly via helicopter. Staff also treated 240 patients with emergency needs and carried out over 1,200 physiotherapy sessions in the Kathmandu orthopedic hospital. MSF distributed food, as well as shelter, cooking and hygiene items, to almost 15,000 households. Teams also set up a water supply network for 7,000 displaced people in Cheechipathi camp in Kathmandu, and sanitation systems in a number of other camps around the city.

Following this immediate emergency phase, MSF reduced its activities in July 2015, but continued working through two projects in Sangha and Charikot. In Sangha, MSF worked in the Spinal Injury Rehabilitation Center, a 50-bed facility situated east of Kathmandu. After the earthquake, a large number of patients needed surgery, particularly for injuries to their lower limbs. They were fitted with external fixation (a procedure to stabilize and join the ends of broken bones with a splint or cast), or put in traction. MSF provided extra capacity in general rehabilitation for post-operative patients with physiotherapy, dressings, medical follow-up and mental healthcare, and also constructed a new ward for general rehabilitation with capacity for 50 patients. All activities had been handed over to the Spinal Injury Rehabilitation Center by the end of the year.

Another MSF team worked with Ministry of Health staff in the emergency room, inpatient department and operating theater at the primary healthcare center in Charikot, a village in Dolakha district (the epicenter of the second earthquake), and also supported laboratory and X-ray services. All these activities had been handed over to a public–private partnership by the end of 2015.

Three Colleagues Lost in a Helicopter Crash

During a clinic on 2 June, three of our colleagues and their pilot lost their lives in a helicopter crash. Sandeep Mahat, Jessica Wilford and Sher Bahadur Karki (Raj), and their pilot, Subek Shrestha, were flying back to Kathmandu after delivering assistance to villages in Sindhupalchowk district when the accident occurred. It is with great sadness that we bid them farewell.

At the end of 2015, MSF had 58 staff in Nepal. MSF first worked in the country in 2002.

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