16-22 January 2015 #741

On shaky ground

Looking around Kathmandu, it's clear we haven't learnt our lesson from the 1934 earthquake
Dhanvantari by Buddha Basnyat, MD

We are often reminded of the January 5, 1934 earthquake that shook Kathmandu violently killing thousands and injuring many more. Take a look around the city and it is quite clear we have not learnt our lesson.

The 2010 Haiti earthquake that killed almost 160,000 people and destroyed 250,000 houses should have been a wakeup call for Nepal. Experts agree if a similar powerful earthquake strikes here, the damage will be even worse.

The draft Disaster Risk Management Act that facilitates the coordination of earthquake response and preparedness hasn’t been ratified by the parliament even after five years of tabling it.

Nepal as a nation does not seem to believe in Murphy’s Law which states that anything that can go wrong will go wrong, which in this case is the high probability of an earthquake. Rather than taking concrete action to avoid the catastrophe, we believe that a little help from astrology and the usual ‘Ke Garne’ attitude will be sufficient.

With only few hospitals having adopted retrofit measures, many will be destroyed in the earthquake creating a huge gap in the medical services. It is thus important for hospitals to retrofit as it is to set up triage teams to determine appropriate type and level of care for admitted patients.

Another important concern is whether the hospitals (those who survive the quake) will have the necessary amenities and resources for a large number of complex surgical and medical needs. Rhabdomyolysi, a condition where the breakdown of muscles due to crush injuries releases myoglobin into the bloodstream, damaging kidney, was one of the most common injuries after the 2010 Haiti earthquake. Depending on how promptly fluid therapy is started, dialysis may be necessary to treat a patient with rhabdomyolysis. Although dialysis is now commonly performed in Nepal, the system may be greatly overwhelmed due to vast number of patients that may require the treatment due to crush injuries.

Another common aftermath of earthquake is crush injury that could lead to gangrene of the limbs, which may require amputation to save the person’s life. In addition to proper wound care and fracture repair, the patients will also need sufficient amount of crucial medical supplies. Another common health issue after a disaster is mental health issue and post-traumatic stress that can lead to depression and suicidal thoughts.

It is vital to increase awareness about earthquake preparedness to avoid deaths of people and damage of property. For instance, during an earthquake take cover under a safe sturdy place and protect your head and neck. Do not try to run outside during an earthquake as the likelihood of being injured by falling debris will be very high.

If you are outside, move away from buildings, steep slopes and utility wires.

It is difficult to question our commitment to safety as we continue to build tall buildings in an earthquake prone region. They say ‘live and learn’ but unfortunately in our case we may not live to learn. 

Read also:

Preparing to be prepared, Kunda Dixit

Unnatural disaster, Editorial

Thinking the unthinkable

70 years later, Naresh Newar