Category Archives: Nepal

Kirsty Smith

By Kirsty Smith

Jul 31st 2015

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We need to build back a better Nepal with disabled people

Categories: Adult, CBM, Disaster, Inclusive, Nepal, People with disabilities, Poverty
Kirsty Smith, Chief Exectuve of CBM UK in Nepal

Kirsty Smith, Chief Executive of CBM UK in Nepal

Nepal is not Haiti. The scale of the earthquake is of course very different. Around 8,800 people were killed in the first quake of 25 April, and a further hundred in the second quake in May. In Haiti the numbers reached 200,000 including many senior civil servants which effectively meant that large parts of the government became dysfunctional or non-existent. This is not at all the case in Nepal where the government is clearly structured and very active in the earthquake response, working alongside agencies such as CBM to distribute emergency relief as well as post-emergency non-food items such as tarpaulins, sanitary kits and corrugated iron sheeting. However, people with disabilities are disproportionately affected at times of crisis and my time spent in Nepal demonstrates clearly how the often sporadic and uneven response often fails to reach those who need it most.

I am wandering through the rubble strewn streets of Bhaktapur with social worker Pramita. We pass a line of people waiting for government relief who have been standing in the sun for several hours. At the front of the queue, the crowd at the kiosk window is 3 people thick and I try to imagine how someone with reduced mobility or a wheelchair user would be able to get to the front.  “What happens if someone can’t come to collect relief supplies themselves?” I ask, thinking of others in more remote rural areas who may live several hours walk from anywhere accessible by road. “They ask a relative or neighbour to come for them, “ Pramita replies. “What happens if the relative or neighbour was killed or injured themselves, or is unable to spare so much time?” I ask. She sighs. “Then they might miss out,” she admits.

I learn more about the reality of this when I visit CBM partner, the National Federation of the Disabled Nepal (NFDN), an umbrella organisation representing a network of disability-specific bodies. The National President, Shudarson Subedi, describes story after story from these member organisations describing people with disabilities who were often just not aware of relief opportunities available, or unable to reach the distribution points which were many hours down steep hillsides.

NFDN has responded to this in a range of ways, including a project to introduce radio and SMS alerts to ensure those with hearing or sight impairment are aware of all rehabilitation opportunities. However, their most powerful approach has been in finding a stronger voice in the country’s rehabilitation efforts, working closely with the government to ensure that the “building back better” efforts are inclusive not only of people with disabilities but are inclusive of all those with specific and needs. In addition, they are helping to increase the extent to which people with disabilities are active participants in the decision making about reconstruction of health, education and livelihood systems and structures.

Patients evacuated from CBM partner Hospital and rehabilitation Centre for Disabled Children (HRDC) on 12 May.

Patients evacuated from CBM partner Hospital and rehabilitation Centre for Disabled Children (HRDC) on 12 May.

The next day I visit new CBM partner, the Spinal Injury Rehabilitation Centre in Kavre, which normally caters to around 40 patients with spinal cord injuries but is currently housing 110. To cope with this dramatic increase in numbers, CBM is supporting the hospital with emergency wheelchairs and anti-pressure sore cushions for earthquake affected patients. SIRC Director, Esha Thapa, explains that they might normally expect a patient to spend 3-6 months with them undergoing surgery and then extensive therapy and rehabilitation. However, with only 10 occupational therapists in the whole country, the rehabilitation phase is likely to take longer for so many new patients. SIRC would also expect to carry out around 50 home modifications in a year, but 90% of the patients who have been admitted with earthquake injuries have lost their homes.

We visit the stepdown facilities – huge tents erected in the hospital grounds – which allow those who have received surgery and rehabilitation at the hospital but who are not quite ready to leave the hospital. They can spend two weeks staying in the tents, being observed as they learn new ways of coping with daily tasks. The burden of this sudden physical trauma and the aftercare is a heavy burden not only on the injured person but also on their family or friends who stay with them at the hospital as primary carer. Esha describes one patient brought in by her neighbour who was forced to discharge herself far too early because the neighbour’s husband wanted her at home.  Another left hospital before receiving any of her physical therapy treatment plan because she was frightened of missing out on the relief materials being distributed in her village.

But some are there for the longer term. One young boy was carried by his neighbours from the ruins of his collapsed house in which his parents were killed. But with no family and no home to return him to, they were unwilling to take him back once his treatment had been completed. Another man, having seen the photographs of his own destroyed house and the devastation of most of his village, had no desire at all to go home.

CBM has been working with local partners in Nepal for 30 years and the CBM country office and emergency response unit were able to respond within hours of the earthquake starting. CBM will be there not just for the weeks and months that follow the earthquake but, continuing to work through local partners and influence the government, for the years that will be needed to ensure that the post-emergency response and the rebuilding of the country’s structures and systems are inclusive.

More about CBM’s emergency response in Nepal

News: Nepal will rise again…but it will take decades

Kirsty Smith

By Kirsty Smith

Jun 18th 2015

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We will Rise Again – Nepal Earthquake

Categories: Earthquake, Emergency Appeal, Mental health, Nepal

On 4th June I travelled to Nepal to join CBM’s team of local staff and emergency response specialists, who have been working since the devastating earthquake on April 25th to ensure that people with disabilities and injuries receive the help they need. Here is my first blog from Nepal, after a very moving day in Bhaktapur.

Picking through the rubbleThis ancient city lies nine miles east of Kathmandu.  At its heart lie four connected courtyards containing some of Nepal’s most famous UNESCO World Heritage Sites, many of which were damaged or destroyed by the earthquake that shook Nepal on 25 April 2015. In the main Durbar Square, around the base of one of the damaged temples, is an exhibition of photos of some of those who lost their lives, either because they were unlucky enough to live in old or poorly constructed homes or caught by the falling masonry in the web of narrow streets that characterise the area. Many of the photos show the faces of elderly men and women, or very young children, both groups disproportionately affected by natural disasters, but there are also faces of many other people, caught indiscriminately by either the first quake, or the one that followed two weeks later on May 12.

In one picture, a teenage girl in school uniform smiles shyly at the camera. Just a few yards away, a group of girls and boys of around her age are donning hard hats and picking up shovels before dividing into teams and heading off in different directions. Their matching t-shirts declare them to be members of the local community who are volunteering in street clearing initiatives. This is one of the worst hit areas of the city and the lanes are still clogged with rubble, sometimes piled under the eaves of damaged houses, sometimes still filling the street so that you need to scramble over to get through. Despite other parts of Kathmandu being almost untouched, here there is not a road or side street which remains untouched. Everything is covered with a thin film of dust, and the few shopkeepers who have ventured to open up again, busy themselves continuously with dusters and rags.

I am with Pramita Shrestha, a social worker from KOSHISH, a CBM local partner that offers psychosocial counselling and trauma care in the Bhaktapur District. Pramita describes the additional support the psychologists and counsellors are providing, not only for those with mental health problems that they were already supporting, but also to an estimated 3,500 earthquake survivors who will need psychosocial support over the next few months. This is one of the less visible after-effects of a disaster of this scale but one which touches on the lives of so many survivors. Schools have just reopened again and we are passed by rows of neat white shirts and royal blue skirts, matching ribbons bouncing above – but numbers are down as many children are too anxious to leave their parents, too scared to enter the school building or, with the many aftershocks still being experienced, too sleep-deprived to function well. People have also started to return to work where they can, or to the social activities they used to enjoy and we see a few small groups of men on the verandas of undamaged houses playing cards or board games, while women sit in twos and threes knitting. But there are also those who sit in their doorways staring into space, and KOSHISH is reporting new cases every day of people of all ages struggling to come to terms with what has happened. Sadly for all those that come, as many remain unwilling to seek treatment for any kind of mental health condition which remains widely misunderstood and taboo in Nepal, as in many places.

Graffiti reads: we will rise again

We come across a single house collapsed among a row of otherwise intact buildings. Further along, two stories of a house withno side wall stand open to the air, as if a huge serrated knife has sliced vertically through the building. As we approach, we see two figures rolling brick pieces down a corrugated iron sheet propped against the wall. On every street we come to, similar activity is beginning to take place. People on rooftops, shovelling debris. People pushing wheelbarrows of dust out of alleyways or carrying piles of bricks to the truck that cannot make its way down the blocked streets where life has started to go on once again. Around the next corner, we come across a slogan daubed on a partially collapsed wall, “We will rise again”. Later someone walks past with this printed on a t-shirt.

The photos in Durbar Square are one of the ways that the city is mourning its loss and it will take decades before the country is close to full recovery. But this slogan has started to appear across the city and perfectly reflects the resilience of a nation that is already working hard to pick itself up and move forward. KOSHISH was there in the days immediately following the earthquake, providing psychological first aid as vital as the bandages being so much more visibly applied, and it will continue to support for the long term the efforts of the Bhaktapur community to “rise again”.

More about CBM’s emergency response in Nepal

Inclusive humanitarian response – change is coming!

Categories: CBM, Disability, Disability Inclusion, DRR, Earthquake, Emergency Appeal, Inclusive, Nepal, People with disabilities, Training, Uncategorized

I arrived in Nepal on May 12th, some hours after the massive aftershock that caused more casualties and a number of additional damages to properties and infrastructure.

I could see in the faces of people how their lives were shaken again, and how they didn’t see where and how to ensure the safety of themselves and their families. My first night in Kathmandu was broken by a number of aftershocks that woke me up and made me run outside in search of safety.

Though earthquakes are not new to me, every time it makes me realise how frightening they are, bringing a feeling of helplessness.

Three weeks later, life has become quasi-normal in Kathmandu, with its traffic jams, crowds in the street, shops and restaurants all open. If you don’t travel to affected areas you won’t see that two major earthquakes hit the city only few weeks back. Though people are still talking a lot about them and every day small aftershocks remind all of us that it has happened.

Working with partners – ensuring inclusion

It’s been three weeks of working with partners to provide support to the most affected people, to raise awareness about persons with disabilities and older people and to make sure that all of them are included and have equal access to relief, despite the challenges posed by isolated and remote villages and the upcoming rainy season.

Receiving medicines at a relief camp organized by CBM partner HRDC (Hospital and Rehabilitation Centre for Disabled Children)

Our partners are doing a great job to save lives and contribute to the effort made to assist people in need through trauma care and rehabilitation, organising medical outreach camps, providing psychosocial support – trying to help people to regain independence and normality in their lives. However, we still hear stories from persons with disabilities and older people not being able to access distribution points and being left behind – unintentionally – by relief stakeholders. It is a hard job to reach out to the most at-risk, as often they are not informed, cannot reach the front of the queue and their voices are not heard.

What would you do?

What would you do to find food if you are an 80 year-old man living more than a three-hour walk far from the main road and next city? You will walk downhill, hoping to access a relief package, and then find out that you have to carry a 30 kg bag back uphill …and that you can’t do it. You will seek support, but all other people are also too busy trying to survive to help you.

What would you do if you are a blind person trying to find out where distributions are happening and how to access them, only to discover that you have to compete to be front of the queue as there are not enough supplies for all? Obviously you’ll be at a disadvantage, and most likely you’ll lose out.

What would you do if you are a deaf person, having been transferred by helicopter to Kathmandu for trauma care and have no clue of what is happening to you as no one can communicate with you?

These are only few stories, but many more like this are reported every day…

It is great that donors and organisations are moving towards inclusive policies and frameworks, but exclusion happens on the field. What would you do if you were that relief worker and have limited aid to distribute? Field workers must be supported to turn inclusive policies into inclusive humanitarian action.

Advocating for inclusion

CBM works with our partner the National Federation of Disabled in Nepal (NFDN), supporting them to identify persons with disability and older people and assess their needs to then mobilise humanitarian stakeholders to respond to them. It is very encouraging as many of these organisations are willing to make the extra effort, but lack knowledge or information to ensure inclusion.

Bhojraj Ghimire, CIL Kathmandu (checked shirt) takes part in the workshop on disability inclusion organised by CBM and the International Federation of Red Cross and Red Crescent Societies (IFRC) in Kathmandu

Bhojraj Ghimire, CIL Kathmandu (checked shirt) takes part in the workshop on disability inclusion organised by CBM and the International Federation of Red Cross and Red Crescent Societies (IFRC) in Kathmandu

Early last week I gave a two-hour orientation on disability inclusion to Red Cross staff, and the head of the delegation said:

“The Red Cross movement was created to help the most difficult to reach and the ones who couldn’t care for themselves, and yet in our response we reach only the easy one. We need to make the extra effort to access all those who are living in remote areas, who are facing barriers to access relief and whose rights we should protect.”

Well, this kind of statement and willingness to walk the extra miles is very encouraging as it will support the relief worker to pay attention and develop the mechanisms to help the older man to carry home his 30 Kg of goods, the blind person to find the distribution point and be in front of the queue or the deaf person to access a sign language interpreter to understand what is happening to him and get news from his family.

I will travel back to Europe soon but I’m confident that our partners will continue to raise their voices and to make them heard by all. Change is coming!

More about CBM UK’s Emergency Nepal Appeal