Nepal Earthquake – A physiotherapy student’s perspective: Part I
Background:
The 7.8 magnitude earthquake in Nepal on 25th April, 2015, 11:56 am local time, left more than 8,000 dead, 19,000 injured and those who managed to escape unscratched are traumatized to say the least. Two hundred and eighty nine aftershocks of magnitude ≥4 ML followed (until May 29, 2015) with an aftershock of 7.2 magnitude on 12th May, 2015. Despite predicted high risk of seismic activity, Nepalese were not prepared for this event. So when the quake hit, it was a disaster in its true form. Houses built with sweat and hard earned money, educational and governmental institutions, as well as historical monuments turned into heaps of rubble. Humans and cattle alike were buried in the debris, with those alive crying out for help.
The downpour and landslides that accompanied made rescue efforts sluggish. Medical help was inaccessible. The hospitals that operated were under equipped for the overwhelming number of victims that followed. People spent the nights out in the open without tarps or tents drenched in the rain. Videos of people eating their dead cattle became public. Black-marketing flourished, there were concerns for spread of communicable diseases. The country was in a state of shock and mourning.
PSYCHOLOGICAL IMPACT:
Imagine how it feels to have lost everything you hold dear within a matter of seconds. Your home, the sanctuary where you make memories with your loved ones, is the reason you fear for your life. It is the reason you had to bury your child, or mother or father or sister or spouse. What do you do when the ground beneath you rumbles and shakes and the sky above you thunders with equal ferocity? Where are you “safe”?
I cried along watching the interview of a mother who had lost her son during the collapse of Dharahara, a nine storey tower, when she said “I know my son is dead. I have no hopes of finding him alive. But please help me find my son’s dead body so that I can cremate him. Help me find him.”
At Dhulikhel Hospital, where I volunteered as a student, I saw caregivers sobbing hiding their faces from their children, heard the victims, who sustained injuries saying “I asked them not to rescue me..... I asked them to let me die .. But they didn’t listen to me and now I’m here. What do I have to live for? I have nothing left. I wish I was dead.” Those who didn’t have to endure loss of a loved ones, feared losing their home, the only physical representation of what they had achieved all their life.
Those who survived are scarred and scared. Till date loud noises scare people and make them flee the scene. People in the hard hit districts are scared of the helicopters that have been assigned to rescue people and bring relief materials. The words “aayo aayo” (it has come, it has come) makes everyone’s heart jump, whatever may the “it” be referring to. When the major aftershock of May 12 hit, there were patients with fractured spine and limbs who ran out of the hospital building and jumped off the windows. We also witnessed a mother throwing her two month old child out the window so that the child survives. Even now after 5 weeks of the first earthquake, people still dread sleeping in houses, even if they are architecturally safe.
Potential consequences of the disaster: Instances of robberies and rapes have been reported. There is increasing risk of spread of communicable diseases and landslides with the monsoon approaching. Post-traumatic stress disorders is expected to be common among many. Nightmares of earthquake continue to haunt and wake up children and adults from their sleep.
Where do we go from here?
Victims who have had a successful treatment of their physical problems refuse to leave the hospital because they have don’t have a home to return to. Did we really treat their psychological and social problems? Where does biopsychosocial model stand in acute management of a disaster?
Preparedness is the key to coping-
When the second large aftershock on 12th May shook us, I realized most of us were psychologically prepared. A remarkable example was shown by Dhulikhel hospital which was ready to receive and treat new patients within 15 minutes of the scary tremor, and all the admitted patients were moved to open locations within an hour. This knowledge we now have regarding how to handle disasters needs to be passed on, to the current as well as the future generations.
Earthquakes cannot be prevented, but the extent of damage can. People need to be alert and put their knowledge about safety measures to use. With the possibilities of future seismic activities it would help us sleep better at night if there are steps taken to ensure safety. Buildings deemed unsafe should be demolished. Residential homes, health centers, schools and other infrastructures that pass safety recommendations should be established. Every VDC or municipality should have a depository with emergency relief materials based on the population, and workshops should be conducted routinely to remind people of the destruction we faced. We have a prospect for a better future.
“We have a chance to re-build Nepal brick by brick. We will rise again.”
This post is written by Anupa Pathak. Anupa is a third year undergraduate physiotherapy student at Kathmandu University School of Medical Sciences, Dhulikhel Nepal.
Contact Anupa: anupap104@gmail.com