6 Health Challenges Nepal Earthquake Survivors Now Face

Broken bones aren’t the only health concern faced by survivors. (Photo: Omar Havana/Getty Images)

On Saturday, a 7.8-magnitude earthquake rocked Nepal, leaving catastrophic disaster in its wake. Eight million men and women were affected, 1.4 million are in need of immediate aid, 8,000 are currently injured, and the death toll is 5,000 and rising. It’s the worst quake to strike the region in 80 years.

International and domestic aid is beginning to trickle into the impacted areas, including remote villages that have been unreachable since the natural disaster struck. But despite trained relief teams being dispatched, there are still a number of huge hurdles to cross, says Niki Clark, a spokesperson for the American Red Cross.

“One of the first concerns after an earthquake is access and helping the injured,” she tells Yahoo Health. “I met with two of the volunteers heading out tomorrow. They are bringing satellite systems to set up so that Red Cross workers will have communication, access to the Internet and be able to share information quickly from the ground. One of the challenges right now is connectivity and having these volunteers in Nepal and the systems installed will be incredibly helpful in guiding our response.”

Gerard Finnigan, Regional Health Advisor for Asia-Pacific at World Vision is currently in Kathmandu, Nepal, and says teams are working with the country’s government to understand the most pressing needs at hand. “For a country with around 27 million people to suddenly need to have the capacity to respond to a surge of 50,000 or 60,000 people needing urgent care, it’s simply overwhelming,” he tells Yahoo Health. “All organizations need to work in close collaboration with the local ministry of health and the health system to understand how we can best support them.”

As teams move swiftly to set up camp in the country, here are some of the challenges relief workers and healthcare facilities will be facing as they help the citizens of Nepal stuck in the center of a crisis.

Some survivors still need to be found.  

As Clark mentioned, there’s an ongoing effort to locate victims in need of immediate medical aid — and quickly. “Blunt head traumas and broken bones are very common after a disaster like an earthquake, so getting in medical equipment and health care workers is critical,” she explains. That said, there are some major issues preventing rescue workers from locating the wounded.

Hospitals are overloaded.

The United Nations reports damage to hospitals in Ramechhap, Nuwakot, and Sindhupalchowk, and it’s unknown if the main medical center in the Gorkha district is functional. Even in Kathmandu, where main hospitals are still standing, facilities are over-capacity. Many of the injured are being treated on the streets, and getting basic medical supplies and health care workers to every location is critical. “This is still very much the response part of the effort, and that’s what the focus is on,” says Clark. “The Nepal Red Cross has extensive experience in responding to natural disasters and plays a leading role in the government’s contingency plan, so this type of work is something they are highly skilled in.”

Vaccination initiatives are delayed.

After disasters, planned vaccination campaigns are often delayed or canceled — like for measles — because it’s no longer the top priority in a region. (Similar initiatives were suspended following the Ebola outbreak.) However, this leaves a given population exposed to outbreak. “We’ve seen firsthand the importance of getting these campaigns back on track as soon as possible to help prevent  even larger health disasters in the future,” Clark says. The UN says there’s a very small supply of the Measles/Rubella (MR) vaccine near Nepal, so getting more stock to the region will be a major priority.

The danger among the unvaccinated is huge, says Finnigan. “We know that the measles virus is deadly, and we cannot curatively treat it,” he explains. “If your child is infected with measles, I can’t do anything for them as a health professional. There is no drug to kill the virus; it is a lottery as to whether they survive or not. So what we know from 100 years of evidence in dealing with children who have contracted measles is that, if measles gets into a community, particularly a community that is highly vulnerable after a disaster, then it will kill children. Without any doubt. So one of the most critical things we can do to save children’s lives is to make sure together with their parent or caregiver that they are vaccinated.”

Lack of transportation is making intervention harder.

Disasters in areas like Nepal, with many small villages and rural communities, have their own set of obstacles, according to Clark. “Accessibility and transportation are challenging in Nepal in the best of times,” she explains. “Before the earthquake, many rural communities where the Nepal Red Cross worked were only accessible by foot. The main international airport in Kathmandu is a very basic facility, and planes often have to wait long hours in queue to land. With the destruction, this situation is even more dire and getting supplies and transporting them within [the] country is going to be a major challenge.”

People are remaining in the open.

According to the BBC, 90 percent of structures in areas like the district of Gorkha have been leveled. “Many people are sleeping in the open, both out of fear from aftershocks and because of lack of shelter, so there are health risks from being exposed to the elements, especially as the weather turns more inclement,” Clark says.

For instance, the UN reports that diarrhea is already becoming an issue in Kathmandu Valley, resulting directly from the outside conditions. “Diarrhea is the second-leading cause of death for all children under five,” Finnigan says. “The most important thing to do when helping a child with diarrhea is rehydrating them. But how do you do that when there is little to no safe water? What happens in a country like Nepal where the health system is now overwhelmed and a little child gets diarrhea? They have no safe water to drink and replace lost fluids, and if they become dangerously dehydrated, they may try to go to a hospital for IV fluids — but the hospitals are also overwhelmed.” All in all, Finnigan says the circumstances can be deadly — and “that’s the reality on the ground right now.”

Clean water and hygiene are major concerns.

When people can no longer easily get their hands on basic necessities, areas become hotbeds for epidemics to take hold. “Access to clean water and hygiene are issues after disasters, and so water-borne diseases like cholera are much more prone to occur following such an event,”says Clark. “When health infrastructures are damaged and destroyed, the spread of communicable diseases are also much more likely.”

The simplest practices and items can make all the difference after a disaster — if they’re possible to keep up or administer. “People are now homeless, without power, and without clean water or sanitation facilities,” Finnigan says. “Public health teams work to provide families with life-saving interventions like oral rehydration salts [and] material to disinfect the water supply, and one of the most critical interventions is getting soap to people so they can wash their hands. Soap is arguably one of the most important and life-saving interventions in preventing many illnesses.”

Witnessing the scene on the ground, Finnigan says the earthquake’s impact on the Nepali region is unprecedented. “Communities here were already dealing with malnutrition, scarce health resources, and limited access to health care because of the geographical challenges of living in a mountainous region,” he explains. “They are living in overcrowded areas and are at risk for diseases like diarrhea and respiratory infections. Plus, they’ve just experienced a tragedy and many have lost family and friends.

“The international community must do anything they can do help the Nepali people get through this.”