Disaster Risk Management in Nepal: A Case Study from Selected Hospitals of Kathmandu Valley
Date
Authors
Upreti, Niva
Journal Title
Journal ISSN
Volume Title
Publisher
Department of Sociology
Abstract
Nepal is one of the most disaster-prone countries in the world. According to a study
conducted by UNDP/BCPR, Nepal stands at 11
th
and 30
th
respectively with regard to relative
vulnerability to earthquake and flood among 200 countries around the world. Kathmandu
Valley which, is located in the earthquake-prone area, has experience of several devastating
earthquakes in the past. Based on the historical records many experts believe that a major
earthquake similar to that of 1934 AD (IX MMI intensity) can occur anytime. Today,
earthquake risk in Kathmandu Valley is increasing due to rapid population growth and high
density, increasing unsafe construction practices, low level of awareness and unplanned
urbanization. According to the study carried out by the National Society for Earthquake
Technology Nepal (NSET) under the Kathmandu Valley Earthquake Risk Management
Project (KVERMP), an earthquake with similar level of shaking as that of 1934 AD
earthquake today would result into approximately 40, 000 deaths and 95, 000 injuries in the
Kathmandu Valley (Dixit et al., 1999). Hence, this study focuses on assessment of the status
of preparedness and earthquake response capacities of health related institutions, agencies
and hospitals system operating in Kathmandu Valley and draws conclusion for enhancing the
preparedness.
All together, 41 major hospitals from Kathmandu district (29 hospitals), Lalitpur district (7
hospitals), and Bhaktapur districts (5 hospitals) were surveyed as sample hospitals. The target
hospitals were the government, as well as private ones. Different health related institutions /
agencies located in the valley were inquired to identify their efforts in disaster risk
management. Primary data was collected from the hospitals with the help of structured
questionnaire. Personal interviews and Telephone interviews were also used as a method of
data collection.
A majority (71%) of the hospitals are located in the core urban area inside the Ring Road of
the valley. There are a very small number of hospitals with small capacities in Bhaktapur
District. Large part of the rural Village Development Committees (VDC) of the valley has no
hospitals except one hospital located at Sankhu, at Kathmandu District. Two of other
hospitals located at Jorpati, are very close to Kathmandu Metropolitan. Hence, large part of
VDCs in the valley are dependent on primary health care centres, health post and sub-health
post that usually suffer from insufficient health resources both in terms of human and medical
iv
Disaster Risk Management in Nepal: A Case Study from selected hospitals of Kathmandu Valley
supplies. The existing number of beds available in the valley is 4,900 and with the addition of
extra bed and mattress, the emergency state capacity increases to 5,400. This number of
available beds is extremely low as compare to number of victims due to an earthquake of
VIII or IX MMI intensity where nearly 1,00,000 to 1,50,000 injuries is expected. The number
of doctors available in the hospitals is difficult to calculate, as there is no systematic
association of doctors with the hospitals. However, it is calculated to be around 2,050 doctors
and 2, 500 nursing staffs. It is also found that VDCs are more vulnerable with unavailability
of doctors (with only one doctor is present in Primary Health Care Centre) during any major
disasters. Other major surgical facilites like operation theatre (132) , ICU (88), X-rays (86),
blood banks (11) and ambulances (60) in number seems to be extremely insuffecient for any
huge earthquake disaster. Similarly availability of other critical lifeline facilites in the
hospitals such as water supply, electricity, communication is likey to suffer during major
earthquake. However, all hospitals have backup generator and many (50 percent) with
suffecient alternative water supply system such as boring. Very few hospitals (24 percent)
have suffcient space outside the hospitals. Almost all hospital administrators consulted during
survey lack any formal classes, training, workshop etc. on disaster risk management. 32
hospitals (78 percent) lack disaster management plan and out of 9 hospitals (22 percent)
having disaster management plan, only 6 hospitals have conducted drill to test the plan.
In general, capacities for preparedness and response during disaster have started being
developed in health sector of Kathmandu Valley although much effort is required to improve
the present situation. The existing hospital capacity will be extremely insufficient for huge
earthquake of VIII or IX MMI intensity where the injuries is estimated to be around 1,00,000
to 1,50,000 in number. Efforts are being made by government, non-government, institutions /
agencies, international bodies, UN systems and hospitals to enhance preparedness and
capacities and of the health sector in the valley as well as throughout the country.