Remote districts are still inaccessible five days after second Nepal earthquake

BMJ 2015; 350 doi: (Published 18 May 2015) Cite this as: BMJ 2015;350:h2691
  1. Anne Gulland
  1. 1London

Health officials have been unable to reach health facilities in Nepal’s Dolakha district, five days after it was hit by a second major earthquake.

The 12 May earthquake, measuring magnitude 7.3, came just over two weeks after a 7.8 magnitude shock had devastated many towns and villages in the country on 25 April.

Rahul Pradhan, a surveillance medical officer for the World Health Organization, said that health services in Dolakha, one of the districts worst affected by the second earthquake, had already been fragile before the second shock. Of 57 health facilities in the province, including hospitals and primary care centres, 27 were completely damaged in the first earthquake, 18 were partially damaged, and 12 had no damage. The district’s five private hospitals were also partially damaged, he said.

“However, after the second major earthquake on May 12 we have not been able to contact 10 to 12 [primary care centres] and we do not know the exact status, but we think that only around two health facilities now have no damage. Even the private hospitals are almost completely damaged,” he said.

Pradhan, speaking to The BMJ on 17 May, returned from Dolakha to the capital, Kathmandu, on 15 May and said that health officials had not been able to visit any of the remote areas because of landslides and appalling road conditions, with some areas only accessible on foot.

“Before 12 May the situation was getting towards normal and we were doing our normal post-earthquake work. But after the second major earthquake on 12 May we have not been able to visit any of the remote primary care centres,” he said.

He added that his main concern was for patients with major trauma but that, as remote areas were impassable, it was difficult to say what kind of health problems they had.

“We have not been able to contact our health staff, but there’s no service. We are going to have to focus very hard on getting essential medicines and tents to restart health services and be careful about the outbreak of diseases. But it will be very hard to put that plan into action,” he said, adding that helicopters would be needed to deliver essential supplies.

He said that no major infectious disease outbreaks had occurred in Dolakha before the second earthquake. WHO and other agencies have reported outbreaks of diarrhoea, particularly in some temporary camps. Pradhan added that the June-July monsoon season would exacerbate access problems.

A situation report published by WHO on 15 May said that 8461 people had died in the earthquakes and that 16 808 were injured. The shocks have affected 4.2 million people and displaced 2.8 million.

Foreign medical teams were quick to come to Nepal’s aid, and 72 teams were deployed in the 14 districts most affected by the shocks. However, the United Nations Office for the Coordination of Humanitarian Affairs has warned that, as of 15 May, just $66m (£42m; €58m) of the $423m in relief money needed had been received. Similarly, just 15% of the $42m needed for health has been received and only 7% of the $63m needed for water, sanitation, and hygiene.

“If we don’t act quickly, the implications will be severe,” said Jamie McGoldrick, humanitarian coordinator in Nepal. “We can only expect misery, a crippling loss of dignity and the real potential for more deaths, especially in the rural and remote areas.”


Cite this as: BMJ 2015;350:h2691

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