It was just another Saturday morning in Kathmandu city. Suddenly, the earth moved. “Earthquake!” I sounded the alarm as I gathered my family and clambered out of the house. Disoriented and panicked, my family and I ran out to a field adjacent to our community of about a hundred houses. I watched in disbelief as the houses lurched back and forth for about half a minute. By the time the earth stopped shaking, hundreds of people had gathered in the field in small groups. Many compound walls had collapsed and dust from collapsed structures rose from the ground. I regained some composure after learning that all of my family and neighbours had also escaped the quake physically unharmed. I turned on my cellphone’s FM radio to take account of millions of other countrymen. My heart filled with dread as news of the devastation started pouring in from around the country. Nepal had just been shaken by an earthquake that measured at 7.8 on the Richter scale at the epicenter located 80 kilometers away from the capital city of Kathmandu.

The Kathmandu valley comprises three historically significant Nepalese towns: Kathmandu, Lalitpur, and Bhaktapur. These three towns were home to the Malla and then the Shah kings. These kings had built elaborate palaces with temples, courtyards, and waterspouts. Also known as durbars, these palaces dated back to over four centuries. These traditional durbars are mostly made up of wood, bricks, and stones cemented together with a mixture of lime and mud; not unlike many houses in old locales of Kathmandu still inhabited by many people. These durbars and old houses crumbled under the strain of the earthquake in a matter of seconds, killing and injuring thousands of people. My heart skipped a beat when I learned that parts of the Swayambhunath Stupa had also collapsed, trapping some people inside the rubble. Apart from damages to centuries old national heritage sites, many urban and suburban buildings also collapsed. Property developers often overlook national building safety codes to cut development costs. Due to these unsafe practices, these weak buildings also succumbed to the quake, blanketing their inhabitants under the debris. Most sadly, the Government of Nepal commercialized the Dharhara, a nine-storied tower made out of mud and bricks over a century ago, by charging people a fee to climb to a circular balcony for a panoramic view of the capital. Saturday’s earthquake completely destroyed the tower, killing almost two hundred people who had paid to climb the tower.

A faltering emergency healthcare system

The hospitals in Kathmandu were soon overtasked with caring for injured patients and overcrowded with dead bodies. Some of the private hospitals even closed shop after the government instructed them to treat patients for free. The public and private hospitals that remained open moved most of their services outdoors as ominous cracks developed in the hospital buildings. Makeshift camps surrounded the hospitals with relatives holding up saline bottles to sustain the injured. While the injured were being treated in the open space, confused and scared family members ran amok to find medicines, food, and drinking water for them. Some even had to go without food and water because they weren’t lucky to have family members tending to them. Hospitals ran out of medicines and other medicinal supplies very rapidly. As the incident occurred over the weekend, these hospitals were understaffed and only had their emergency services open. As hundreds of injured started pouring in, these hospitals could barely manage to treat them due to the scarcity of medicinal supplies and open space. They even discharged many patients prematurely. The hospital management, with help from social workers and local people, had to borrow medicinal supplies from private pharmaceutical shops. As grid electricity was cut off soon after the earthquake to prevent fires and accidents from fallen transmission and distribution lines, the hospitals were forced to operate on back-up diesel generators or battery packs to power electrical equipment and lights.

The government mobilized the Nepalese Army and Police in rescue and relief missions. However, it was soon evident that they were neither adequately trained nor well equipped to carry out these missions on such a large scale and at so many different locations. The excavators they used for removing the rubble soon ran out of diesel fuel. In the panic and confusion of tending to separate and scattered incidents, the government could not supply additional fuel on time. Soon, these relief personnel started clawing through the debris using bare hands to dig out the victims. As rescue efforts dragged into the cold night, it started to drizzle after midnight, hampering the urgent rescue missions and outdoor healthcare services.

Soon the earth shook over and over again with more earthquakes. These aftershocks, which were slightly smaller and lasted for just a few seconds, frightened millions of affected people into thinking that the worst was not over yet. Moreover, rumors that a bigger and more devastating earthquake was going to follow soon after spread like wildfire throughout the country. In the absence of an official emergency communication system to disseminate correct information to the citizens, such rumors were fueled through online articles and word of mouth. As terror took siege of the valley, most affected people chose to spend the night in makeshift tents even though their homes had suffered only minor damages. It was evident within a very short time that Nepal was not prepared to deal with a natural calamity of this scale. The situation worsened after most people, still well equipped with resources to continue with their day-to-day lives, started demanding temporary shelter in addition to other relief materials. However, the government maintained that relief supplies such as water, medicine, food, and waterproof tents were in short supply and made available only for people who had lost their houses and family to the quake. No relief came for millions of scared people spending the night outside in the cold and rain.

The neighboring rural districts of Sindhupalchowk, Gorkha, Lamjung, Rasuwa, Dhading, Nuwakot, and Kavre suffered a worse fate. As rural houses were made of rocks, bricks, lime and mud, many of the scattered settlements were wiped off the map. Landslides resulting from the quake and the aftershocks blocked the rural dirt roads leading up to these scattered settlements. Compared to the Kathmandu valley, the rudimentary medicinal facilities in these rural areas are housed in a shack and lack even basic medicinal supplies. These horrendous conditions were bought to light only a month before the earthquake, when villagers in the district of Jajarkot fell sick and more than twenty-five people died of a mysterious illness. It took the government more than two weeks just to collect blood samples and determine that the villagers were suffering from swine flu. The Jajarkot incident illustrates the ineffectiveness of rural healthcare system in treating the earthquake victims. Therefore, aerial supply of relief material seemed the most viable option to deliver relief materials as well as to airlift the injured to hospitals in the district headquarters. However, due to a scarcity of air ambulances and other helicopters, many of the injured were left without any help for the first night. The survivors relied on each other to organize rescue efforts and gathered food and water they could find to survive through the cold and wet night. Some affected rural areas have not been provided healthcare services even four days after the earthquake.

Slow and inefficient relief

On Sunday morning, many countries including India, China, UK, and the USA announced relief packages. However, it was evident that all these separate relief efforts from the international community lacked coordination from the government, who did not have a viable system to manage the influx of foreign supplies and relief personnel. Although earthquake survivors in and around the valley started calling in for food, water, and tents, the government could not even deliver the relief materials that were stocked at the airport in Kathmandu. Twelve hours after the earthquake, the government had only counted fewer than a thousand dead. By Tuesday, three days after the earthquake, the government confirmed that more than 5000 were dead and around 9000 were injured. This number is steadily rising as the rescue and relief efforts continue and more dead bodies are recovered from the rubble. Many Nepalese volunteers with sufficient local knowledge have now flocked to help rescue and treat the injured, which has slightly improved the healthcare and relief situation.

Thousands of scared inhabitants are now fleeing the capital and other affected areas to less affected parts of the country. Transportation syndicates are overcharging travellers by up to ten times to take advantage of their urgency to evacuate. Most shops remain closed even on Wednesday, fours days after the disaster. In the absence of adequate supervision by the government, several businesses are exploiting this situation by selling urgent supplies such as food and drinking water for exorbitant prices. The government has been unable to restore basic services such as food markets and residential water supply, which would have helped an estimated eight million affected people to return to their day-to-day life and restore a semblance of normalcy to the capital. There is a scarcity of running water because water supply pipes have burst in many parts of the country. Even in normal circumstances the Nepalese depend heavily on liquefied petroleum gas (LPG) for cooking and heating due to a chronic shortage of electrical energy and daily scheduled power outages. During this crisis, people are running out of LPG to boil water for drinking or cooking food. Most petrol pumps have remained closed till Wednesday and there are long queues of automobiles at a few pumps that are open. Because Nepal lacks sufficient morgue facilities to store dead bodies, they have been put out in the open and only some of them have been covered with sheets. Although the government has announced mass cremations to avoid disease spreading, many bodies still remain under the ruins. The government has also been unable to collect household waste, which lies strewn over open fields and in the streets. Some communities have come together to organize waste collection and disposal in their locality by burning or burying the waste. However, such efforts have been organized in small scales and most public spaces and streets are still littered with waste. Now, that the initial shock of the earthquake is dissipating, the slow realization is setting in that widespread disease might spread from waste and human remains.

It is going to be a long and arduous task for Nepal to recover from this disaster. The next few days will be crucial for the government to restore a semblance of stability for the majority of affected people by reinstating basic services such as food, water and energy supply. Simultaneously, the government must efficiently manage the influx of foreign personnel and relief materials to provide healthcare and relief supplies to the injured and homeless. It must immediately announce and distribute relief packages for people who have lost their family members and homes. In the long run, it must ensure that building codes are implemented rigorously and open spaces are mandated inside urban areas. It must also establish well-equipped healthcare facilities in rural areas, which often suffer the most during such disasters. Finally, there remains the less urgent but important task of restoring the heritages so that Kathmandu valley and other affected areas do not lose centuries old historical sites. Most importantly, Nepal must learn the importance and necessity of an emergency preparedness system from this unfortunate experience. Although such programs exist on paper, the government must actively pursue disseminating emergency preparedness information to the public and conducting timely drills so that Nepalese people as well as the government are well prepared the next time such a natural disaster will inevitably strike again.

Abhishek Yadav is an engineer and energy consultant who frequently writes about various socio-economic and technical issues prevalent in Nepal.

Competing interests: None declared.