With the detection of three new COVID-19 cases in Kailali district on April 4, one of them the country’s first case of community transmission, western Nepal could be the epicenter for two disasters: a coronavirus hot spot, and a ticking time bomb for a mega-earthquake.
This is not scare-mongering. Public health experts say western Nepal’s rudimentary healthcare system will be overwhelmed by a possible COVID-19 outbreak because at least 120,000 Nepali workers have returned from India without screening before both countries went into lockdown.
The government is extending rapid diagnostic testing to hospitals in Nepalganj, Dhangadi, Surkhet and Dadeldhura and there may be a surge in positive cases in the days ahead.
However, there is another Damocle’s Sword that has been hanging over the region even before novel coronavirus – the likelihood of a catastrophic mega-earthquake. As Nepal marks the fifth anniversary of its 2015 earthquake, seismologists have warned that an even bigger megaquake is not a question of ‘if’ but ‘when’.
The region between Pokhara and Nepal’s western border with India has not had a major earthquake since 1505 when an estimated 8.9M temblor killed one third of Kathmandu Valley’s population including the king, devastated north India, and created the debris fan from a cataclysmic flood on which Pokhara city is situated today.
Speaking with Nepali Times, seismologist Roger Bilham warned five years ago that the 2015 was not the Big One. He said the seismic gap in western Nepal had accumulated tremendous tectonic energy that had not been released for 500 years, and an earthquake was long overdue.
“There’s a plenty of stress stored for an earthquake above 8 magnitude in western Nepal, and it could kill at least 100,000 people in Nepal alone,” says Surya Narayan Shrestha of the National Society for Earthquake Technology (NSET). “But despite being the most at risk, western Nepal is less prepared and has relatively low awareness about earthquake safety, and this doubles its vulnerability.”
In two weeks, Nepal will mark the fifth anniversary of the 25 April 2015 earthquake yet neither the government nor the people seem to have learnt the lesson. Western Nepal, in particular, is ill-equipped to handle another major earthquake.
An 8.5M quake in western Nepal would be felt even more strongly in Kathmandu Valley than the 7.8M disaster five years ago. Still, disaster preparedness experts say attention should now turn from the 14 districts in Central Nepal affected in 2015 to western Nepal.
Before the COVID-19 lockdown, NSET with financial support UKAid, DfID and implementing partner Crown Agents had begun to retrofit 2,200 classrooms in 200 schools in four western districts Bardia, Surkhet, Jumla and Achham to be completed in four years. Prior to 2015, NSET had similarly retrofitted 300 schools inside Kathmandu Valley which survived the earthquake and served as emergency shelters. However, nearly 8,000 schools were completely destroyed in 2015, and colossal loss of lives was averted only because the earthquake struck on a Saturday.
“We selected the schools in western based on vulnerability, potential for replication, availability of masons and enthusiasm of the school management committee,” adds Shrestha. “Next step is to scale this up and this means more investment, technical support and massive mobilization of human resources.”
Hospitals in western Nepal at the moment are all on red alert for a possible outbreak of COVID-19 in the region and healthcare workers are keenly aware of shortages of live-saving medical equipment such as test kits, ventilators, ICU beds, oxygen and personal protective gear. In an event of a major earthquake, this situation will be even worse because the hospital buildings themselves may be damaged.
Three components within a healthcare facility determine if a hospital will be functional during an earthquake: seismic resistance of the building, state of power supply and medical equipment, and an emergency preparedness system with health workers trained for mass casualties.
Dadeldhura hospital has been identified as a disaster management hub in Far West Nepal with satellite facilities in other district hospitals.
“For the kind of earthquake projected here, none of us is prepared, western Nepal the least of all. We might have big hospitals in city centres but can the buildings withstand the quake is the real question,” says Bikash Gauchan of Bayalpata hospital in Achham.
Few weeks before the earthquake struck in 2015, Bayalpata hospital had undergone reconstruction to turn the institution into an eco-friendly, earthquake resistant facility. A disaster management protocol was also drawn up for triage in its emergency, as well as in and out patient buildings.
Gauchan says hospitals in the Far West have to be prepared for multiple disasters: “We can’t overhaul our system every time a disaster strikes, be it the coronavirus or an earthquake. We need a standard operating protocol based on concrete national guidelines.”
Back in 2003, Nepal government in collaboration with WHO had conduced earthquake vulnerability assessment of 15 major hospitals across the country that recommended they all be retrofitted. More than 15 years later, except from minor strengthening of health clinics, nothing has been done.
Hope now rests on the newly formed National Risk Reduction and Disaster Management Authority (DMA) which will replace the National Reconstruction Authority set up after 2015. Experts hope the focus will now shift to strengthening infrastructure of public buildings, transmission lines, telecommunication, sewage and water supply.
Says Surya Narayan Shrestha at NSET: “We spent the last fives years mostly in the reconstruction of residential building and heritage sites in Central Nepal. Our priority now is on reinforcing infrastructure and ensuring essential services are better equipped to survive the next big one.”
By Sonia Awale in Nepali Times - April 7, 2020