84 open spaces in Valley for emergency accommodation
KATHMANDU, DEC 26 -
In a joint study conducted by the Ministry of Home Affairs (MoHA) and the International Organisation for Migration (IOM), 84 open spaces have been identified in Kathmandu that could be used for humanitarian support in the event of a crisis.
In those 84 spaces, the report says, 792,698 Internal Displaced Persons (IDPs) can be accommodated, but in a very crowded condition, which is likely to increase other humanitarian problems like water crisis, sanitation, and food.
The project has categorised large, medium and small areas in Kathmandu that have the potential to be used as accommodation centres or for other purposes for the IDPs. According to the report, an estimated population of 3.5 million are currently living within the confines of the Valley. Considering the high number of sub-standard constructions, a major earthquake measuring 9 on the Richter scale would destroy about 60 percent of these buildings.
The report recommends that schools be used as reception centres where IDPs may assemble for registration, following which their placement procedure
could begin. For this, the government has to identify retrofitted schools in the
Valley as soon as possible, the report suggests, adding that 3,150,000 square meters worth of open area would be required to provide 900,000 people with covered shelters.
The report offers a list of potential sites by identifying them at three different levels—large, medium and small. Large camps have been defined as those that could accommodate 30,000 to 90,000 people. The study identified two large blocks of land (875,043 square meters) at Tribhuvan University in Kirtipur and the National Agricultural Research Centre in Lalitpur (305,470 square meters) that could function as camps falling under the “large” category.
According to the report, these areas could hold up to 118,051 people together and be suitable for long-term accommodation, with the provision of some of the site services within the camps.
Medium-sized camps have been defined as those that could accommodate 20,000 to 45,000 people in a covered area (3.5 square meters per person). The report suggests six medium camps with the capability of holding up to 286,908 people. The planning for this is based on only providing covered living accommodation, with other camp facilities outside the site.
The Ratnapark/Tundikhel area (155,400 square meters), the airport and Golf Club site (253,327 square meters), the southern end of the runway of the International Airport (146,575 square meters), the Oxygenation Park on the banks of Bagmati River opposite Tribhuvan University (146,604 square meters), Gokarna Golf Club (178,212 square meters) and Birendra Sainik School in Bhaktapur (134,564 square meters) have been proposed as potential medium camps.
The small camps, the report defines, are 75 places that could accommodate accommodate approximately 387,739 people—3.5 square meters per person. Among the possibilities are Satdobato, Balkumari, Jawalakhel, Pulchowk, Pulchowk Engineering College, Lagankhel, Tribhuvan University, Bagbazaar, Naxal, greater Pashupati, Sinamangal, Lainchaur, Teku, Chabahil, Balaju, Sallaghari-Tinkune-Bhaktapur, among various other schools and colleges.
“The density of the camps may pose significant challenges to water, sanitation, and hygiene (WASH), food distribution and security,” the report reads. “Water emerged as the most critical of the planning factors. In the event of an earthquake, it is expected that 95 percent of water pipes could be destroyed and pumping capacity reduced by half. Using Sphere Standards of 15 litres per person per day, 13.5 million litres per day would be required for the IDPs. Additional water would be required for the rest of the population, which would be equivalent to 52.5 million litres per day (based on a population of 3.5 million).”
Stating that a UNICEF project has already constructed five deep tube-wells in Lalitpur district in preparation for a potential disaster, the study recommends that additional such tube-wells be built after receiving appropriate technical advice on whether or not the wells can survive an earthquake.
Going according to the WASH requirements in the event of a crisis, the report suggests one latrine be maintained for every 10 households or 50 individuals.
Similarly, the report recommends the maintenance of one hand pump and bathing space each for every 20 households or 100 individuals and a garbage pit for every 40 households or 200 individuals.
Hospitals aren’t prepared
KATHMANDU, DEC 26 -
Also testament to our lack of preparedness was the fact that the Ministry of Health and Population (MoHP) wasn’t sure how many casualties there were, and aware of the total loss that health institutions in the country had to bear with. It took around a month for the ministry to find the data, and even then I don’t feel that it was accurate. Had there been a communication centre for all of the hospitals to report to then it would’ve been easier for the government to gather information.
The National Society for Earthquake Technology (NSET) conducted two studies—Structural Assessment of Hospitals and Health Institutions of Kathmandu Valley and Non-Structural Vulnerability Assessment of Hospitals in Nepal in 2001 and 2003 respectively.
The results show about 80 percent of the hospitals assessed fell under the “unacceptable performance” category of new constructions and the remaining 20 percent were at high risk of life-threatening collapse.
According to the NSET, the city’s health sector cannot cope with 100,000 or more people, likely to be injured in a big earthquake. While the numbers of hospitals have increased significantly of late, they are yet to meet the standard. At some places, we can find buildings originally built for residential purposes being used for medical facilities, a very risky trend, according to experts.
The government is still not sure as to what proportion of human resource on health (HRH)—including doctors and nurses to administrative staffs—the country has at present. They have, however, started collecting data to ensure that a majority of the HRH can be deployed during the time of crisis.
The USAID held a training regarding earthquake emergency responses at Tribhuvan University Teaching Hospital (TUTH) for the first time in 2004. It had developed a programme called the Programme for Enhancement of Emergency Response (PEER), which comprised of three aspects—Hospital Preparedness for Emergency (HOPE), Medical First Response (MFR) and Collapsed Structure Search and Rescue (CSSR). Until then, no other hospital besides Patan Hospital had any earthquake response strategies or conducted drills.
In fact, it was during these training sessions that we really understood how vulnerable we are considering we live on quake-prone land. Following that, we formed a committee at the TUTH that we hoped would help us come up with a better post-crisis response system.
We then started running similar training sessions for not just doctors, but also for the policy makers of various hospitals, so that plans could be made accordingly. We have also
provided the training to almost all regional and central level hospitals, as well as private hospitals in the country. And now, the private hospitals have begun setting up disaster management plans of their own and have also requested for drill sessions to be held. In a recent development, the Wold Health Organisation (WHO), in collaboration with the MoHP, has formed a health cluster and has sought out those hospitals to take the lead in earthquake preparedness. They have prioritised the TUTH, Birendra Military Hospital, Civil Hospital and Patan Hospital. The ministry plans to equip these institutions with emergency crisis responses by February 2012, the time when many INGOs working will retrofit the TUTH and create appropriate reserves of water, food and other necessary items in the premises. In the other two hospitals (Civil Hospital and Birendra Military Hospital) the organisations will just assist them for the aforementioned task.
So far, Shahid Gangalal National Heart Centre and Neuro Hospital in Bansbari have floated plans but haven’t proceeded ahead. KIST Medical College Hospital, Dhulikhel Hospital and Kathmandu Model Hospital, on the other hand, have been preparing disaster plans after undertaking the training. Despite visible progress made, if a disaster were to hit the country today then only TUTH and Patan Hospital would be prepared to handle the crisis.
The National Mass Casualty Management Strategy is being put together, which once finalised will compel all hospitals to have disaster plans. We have also been asking the government to set up a health emergency operation centre (HEOC) like National Emergency Operation Centre (NEOC), which is under the Ministry of Home Affairs. Now, if HEOC is formed, there would be a specific body under the MoHP to manage health personnel in the event of a quake.
Until we have a stable government or a strong commitment from the MoHP, checking the rampant and haphazard growth of substandard hospitals will be impossible. Standards set by the MoHP for private health institutions need to be strictly enforced if we are to hope for some improvement in quality and safety. The government has recently shown interest in disaster management. We hope it will swing to work.
Dr Vaidya is the coordinator of Hospital Preparedness for Emergency (HOPE) & professor and head of the Department of Surgery, TUTH
Vulnerable schools
School are used worldwide to temporarily accommodate the people displaced by natural disasters. But in Nepal, the poor state of school buildings has rendered them useless for this purpose, besides putting millions of school children at risk.The 6.8 Richter scale earthquake on September 18 this year proved that school buildings in the country are highly vulnerable, and school children are more prone to casualties. Half of the total 2,000 structures damaged or destroyed during the quake were school buildings in the eastern districts. It was a similar case during the 1988 earthquake that had its epicentre in Udayapur district, where 6,000 schools were destroyed. Thankfully, the quake hadn’t taken place during school hours. Still, the damage disrupted school attendance of thousands of children for several months.
According to a study carried out last year by the National Society for Earthquake Technology (NSET), a NGO working for earthquake awareness and preparedness, around 110,000 students could be killed if an earthquake with an intensity equal to that of the
1934 quake were to erupt during school hours. “Our study shows only 10 percent of the schools are earthquake resistant at present,” says Surya Prasad Acharya, chief of School Safety Department at the NSET.
After an earthquake, undamaged schools can play a crucial role in rehabilitating the displaced. As schools are spread throughout communities, they can be used as temporary shelters for the homeless or as medical clinics. But schools, including those in the Capital, are in severe need of retrofitting.
A survey carried out by the NSET in 2005 in one-third of the Kathmandu Valley’s public schools—643 in all—showed over 66 percent of the schools were likely to collapse in an earthquake with intensity IX on the modified Mercalli Scale. A quake of that scale, and during school hours, may kill more than 29,000 students and teachers (12 percent of the total public school occupants) and injure 43,000 (18 percent of the total public school occupants) in the Valley alone. Direct losses in terms of damaged buildings would amount to more than seven million dollars.
In the wake of increasing alarm, the Department of Education (DoE), in collaboration with the NSET, has started retrofitting in many public schools in the Valley. Maha Shram Sharma, director general at the DoE, says around 50 schools will be retrofitted in the fiscal year 2011/12.
“We are aware of the vulnerability of the public school buildings, which is why we aim to retrofit around 900 schools in the Valley within the next five years,” says Sharma. The cost to retrofit all the Valley schools is estimated to be around six million dollars at the rate of Rs 500 per square feet.
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