Abstract
ProblemSeven months after the April 2015 Nepal earthquake, and as relief efforts were scaling down, health authorities faced ongoing challenges in health-service provision and disease surveillance reporting.ApproachIn January 2016, the World Health Organization recruited and trained 12 Nepalese medical doctors to provide technical assistance to the health authorities in the most affected districts by the earthquake. These emergency support officers monitored the recovery of health services and reconstruction of health facilities, monitored stocks of essential medicines, facilitated disease surveillance reporting to the health ministry and assisted in outbreak investigations.Local settingIn December 2015 the people most affected by the earthquake were still living in temporary shelters, provision of health services was limited and only five out of 14 earthquake-affected districts were reporting surveillance data to the health ministry.Relevant changesFrom mid-2016, health facilities were gradually able to provide the same level of services as in unaffected areas, including paediatric and adolescent services, follow-up of tuberculosis patients, management of respiratory infections and first aid. The number of districts reporting surveillance data to the health ministry increased to 13 out of 14. The proportion of health facilities reporting medicine stock-outs decreased over 2016. Verifying rumours of disease outbreaks with field-level evidence, and early detection and containment of outbreaks, allowed district health authorities to focus on recovery and reconstruction.Lessons learntLocal medical doctors with suitable experience and training can augment the disaster recovery efforts of health authorities and alleviate their burden of work in managing public health challenges during the recovery phase.
Highlights
Major disasters can have a severe health impact on populations and health systems, especially in underprepared low- and middle-income countries.[1]
The huge efforts undertaken for the immediate response can often be sustained only for a few weeks
Whereas the immediate response to the Nepal earthquake of 2015 has already been well described,[4,5,6,7] there is a lack of published information about health-sector recovery
Summary
Major disasters can have a severe health impact on populations and health systems, especially in underprepared low- and middle-income countries.[1]. From day 3 after the disaster, 14 WHO surveillance medical officers from the polio eradication and immunization preventable diseases programme of the WHO Nepal office were deployed in the 14 most-affected districts to assist the district health authorities in coordinating the health sector emergency response. Out of 14 earthquake-affected districts, only five were regularly reporting disease surveillance data to the health a Nepal Country Office, World Health Organization, United Nations House, Pulchowk, Lalitpur, Kathmandu, Post Box Number 108, Nepal.
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